Choosing a care home
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Assistance and advice- Care homes
- Choosing a care home
Some offer full time nursing care (sometimes known as nursing homes), whilst others just provide personal care or support people with a specific disability or medical need, such as dementia. They can be run by local councils, private businesses or not-for-profit companies or voluntary organisations.
Choosing a care home is an important decision. You should always visit those that you are interested in; ideally, with a friend or relative. Your district nurse and/or hospital staff will also be willing to offer advice on the type of home you should look for.
On this page:
Key things to considerKey questions to ask
Paying for your care
Who pays for nursing care?
What will I be left with?
Deferred payments
Trusts
Giving money to children or grandchildren
Selling or renting your home
Care home inspections
- Facilities - what activities are provided for residents? Is there a garden?
- Upkeep - is the environment clean and well-tended?
- Atmosphere - Is the care home noisy or quiet? Do current residents seem content?
- Equipment - to suit your needs
- Staff - are they interested, welcoming and friendly?
- Location - is it easy for your loved ones to visit?
- Can you keep your current doctor?
- Can any specific dietary needs be met?
- Can your religious and/or cultural needs be met?
- Is there easy access to public transport?
- Are the bedrooms single or shared?
- Are there set times for getting up and/or going to bed?
- Is it possible to have a 'trial' stay, to see if the care home suits you before committing to a longer-term arrangement? According to Department of Health guidelines, this may be possible
Here's a quick overview of the costs you'll be expected to pay and the help available.
Each council sets the maximum amount they are willing to pay for care home placements depending on the type of care you need. If you are assessed by the council as needing to live in a care home you will then be financially assessed to work out how much you should contribute towards the cost.
If you go into a care home temporarily you may not have a financial assessment for the first eight weeks but instead the local authority may consider what it is reasonable for you to pay towards the cost. If you are going into a care home on a longer term or permanent basis you will have to undergo a financial assessment straightaway.
The financial assessment takes into account:
- Your income
- Your capital
Your income, including;
- Private or state pension
- Some benefits, e.g. pension credit, attendance allowance, and the care component of Disability Living Allowance
Your capital, including;
- Savings
- Investments
- Any property you own
However, if you have over £22,250 in capital, you'd be assessed as being able to meet the full cost of your care.
If you have between £13,500 and £22,250 in capital, this would be calculated as providing you with an income of £1 per week for every £250 of your savings between these two figures.
If you have less than £13,500 in capital, it won't be taken into account.
If your care home provides you with nursing care, the NHS would normally contribute £103.80 per week towards the fees.
Some people have the full amount of nursing home care paid by the NHS. This is called 'NHS continuing health care'. Hospital staff or your GP can arrange an assessment if you think you qualify.
No matter how much you have to pay towards care home fees, you must be left with £21.15 per week to spend as you like.
If you are entitled to the mobility component of Disability Living Allowance you'll carry on receiving it.
You'll also receive up to £5.25 per week of any savings credit if you're over 65.
If the council isn't paying towards your care, you can also claim Attendance Allowance - a non-means-tested non-taxable allowance worth £44.85 per week to those requiring day or night care, and £67 per week to those requiring both.
If you go into a care home temporarily your home won't be counted as capital.
If your capital apart from your home is below £22,250 your home will not usually be counted as capital until 12 weeks after you move permanently into the care home. Your home is not counted at all if any one of the following still lives there:
- Husband, wife, civil partner or de facto partner.
- Close relative who is 60 or over or incapacitated.
- Close relative under 16 who you are legally liable to support.
- Ex-husband, ex-wife, ex-civil partner or ex-partner if they are a lone parent.
Things to be aware of:
- If your local council is helping with fees, you are still free to choose your care home, providing:
- There are places available.
- The care home can meet your assessed needs.
- They can agree a contract with the care home to ensure you receive the support you need.
- The cost is not more than the local council normally pays for someone with your assessed needs.
- If you choose a care home that is more expensive than those provided for by the local council allowance, a top-up fee would usually be required which can only be paid by a third-party, a relative for example. You are not allowed to top-up yourself from your remaining capital and income.
- If your local council cannot find a place that meets your needs in your local area, they should be prepared to pay more than the usual amount to meet your needs.
- You can move into a care home in a different local council area, to be close to relatives. Your current local council will still cover the costs of the ongoing care up to the amount they would usually pay.
- Even if you are required to pay for your care home at the start, you may receive help from the local council if your funds start running low, as long as you're assessed as needing the type of care you've chosen.
If you are assessed as having to pay the full cost of your care home fees because your own home is counted as capital, your local council may, at their own discretion, agree to you making 'deferred payments'.
This means that you only pay the contribution due if your home wasn't counted as capital until you die (or sooner, if you choose to sell your house), then the council collects the money owed from the sale of the house - from you or whoever inherits it.
You can also set up a family trust to transfer the ownership of your home and/or other assets to someone else as long as it's not regarded as deliberate deprivation of assets to avoid paying for care.
Click here for more information on trusts.
Giving money to children or grandchildren
Before moving into a care home permanently you should plan your inheritance and, if you haven't done so already, make a Will.
You can also give money or assets to your children and/or grandchildren.
There's no limit, but they may have to pay tax on any interest or income they receive.
If you give an asset to someone within the seven years before you die, the person who receives the gift may have to pay Inheritance Tax.
Please note; it is against the law to transfer assets just to avoid paying care home fees.
The council can look into this and there is no time limit as to how far back they can go and, if you transferred assets within 6 months of needing care, they can recover the costs from the person who now owns your assets.
If you choose to sell your home, it might be worth considering a dedicated Care Fee payment plan rather than leaving money in a bank or building society. Visit the NHFA website for further advice.
You could also rent out your home to use the money towards fees whilst participating in a deferred payments agreement. Rental income is not taken into account in the financial assessment.
Care homes are regulated by the Commission for Social Care Inspection (CSCI) and inspected or reviewed periodically depending on how the care home was rated. This is to ensure that the care home meets the approved standards, taking into account things like:
- Health and safety
- Access to facilities
- Access to education and employment
- Quality of furnishings and fittings
- Personal care
When you move into a care home, you should be made aware of the complaints procedure as a matter of course.
If you have any problems that don't get resolved, you can complain to the care home or go directly to the CSCI.
You can also ask a friend, relative or the Citizens Advice Bureau to complain to the CSCI on your behalf.