Funding for care at home in England comes from three places, and they are assessed by different people against different criteria. Families routinely go down one route without ever finding out they qualified for another.
Route one: your local council
Start here regardless of savings, because the needs assessment and the money assessment are two separate things.
Anyone who appears to need care and support is entitled to a care needs assessment from their local council. It is free, it is not means tested, and you can request one yourself. It establishes what help someone needs — which is useful information even if the council ends up paying nothing.
If the assessment finds eligible needs, a separate financial assessment decides who pays. This looks at income and capital, and there are thresholds above which you meet the full cost yourself. The figures change, so check the current ones with your council or on GOV.UK rather than relying on a number you read somewhere.
Two things worth knowing. The value of the home someone still lives in is not counted for care delivered at home. And if the council will not fund the care, it must still give advice about arranging it.
Route two: NHS Continuing Healthcare
NHS Continuing Healthcare — usually shortened to CHC — is a package fully funded by the NHS for adults whose main need is a health need rather than a social care need. It is not means tested at all. If someone qualifies, the NHS meets the full cost, including care delivered at home.
The distinction between a health need and a social care need is where the difficulty lies, and it is assessed rather than diagnosed. The process normally starts with a Checklist screening, and anyone involved in someone's care can ask for one. If the Checklist is passed, a fuller multidisciplinary assessment follows.
CHC is significantly underclaimed, particularly for people with complex or clinical needs at home — tracheostomy care, PEG feeding, unstable conditions requiring frequent clinical intervention. If that describes the person you are arranging care for, ask about a Checklist explicitly. It is worth pursuing, and decisions can be appealed.
NHS-funded nursing care is a separate, smaller contribution and applies in nursing homes rather than at home.
Route three: paying privately
Many people fund their own care, either because they are above the thresholds or because they would rather arrange it themselves than wait.
Self-funding buys flexibility. You choose the provider, the carer and the times, without a council panel deciding how many minutes a task warrants. It also means you should be looking hard at rates, notice periods and what happens when needs increase.
Ask any provider for a full written schedule of charges: the hourly rate, weekend and bank holiday rates, live-in weekly rates, what happens if a visit overruns, and what notice is needed to change or stop.
The money most people miss
Attendance Allowance is the big one. It is for people over State Pension age who need help with personal care, it is not means tested, it does not depend on National Insurance contributions, and it is not affected by savings. Enormous numbers of eligible people never claim it. There are two rates depending on whether help is needed during the day, at night, or both.
For people under State Pension age, Personal Independence Payment does a similar job.
Carer's Allowance may be available to someone providing substantial unpaid care, though it interacts with other benefits and with the cared-for person's own entitlements, so it is worth advice before claiming.
A Council Tax reduction may apply — including a disregard where someone has a severe mental impairment, which is frequently missed.
Disabled Facilities Grants from the council can pay towards adaptations: ramps, stairlifts, level-access showers.
A sensible order to do this in
1. Request a council care needs assessment, whatever the savings position.
2. Ask whether an NHS Continuing Healthcare Checklist is appropriate, especially where needs are clinical.
3. Claim Attendance Allowance or PIP — it is not means tested and it is not conditional on the above.
4. Get written rates from two or three providers and compare the total weekly cost, not the headline hourly rate.
Where to get independent advice
Age UK and Citizens Advice both give free, independent guidance on care funding, and neither is selling anything. For CHC specifically, the NHS website sets out the process, and there are advocacy services that specialise in appeals.
We will tell you what we think you are entitled to, but we are a care provider, not an independent adviser — take the funding advice from somebody with nothing to sell.
