How to pay for your long-term care at home

If you’re having trouble with everyday tasks such as washing, cooking or getting dressed ask for a care needs assessment from your local council or Health and Social Care Trust in Northern Ireland (HSCNI).

Even if you’re paying for your own care, it’s still important to get a care needs assessment because:

• the assessment will officially recognise your needs
• the council, or HSCNI, will let you know about available services to meet your needs
• even if you’re not eligible for funding, you can still ask them to help arrange care services for you, but you’ll have to pay for it
• the assessment will be useful if your needs change later.

After the care needs assessment, you’ll also have a financial assessment to determine whether you need to pay for your own care, or whether your local council, or HSCNI, will contribute.

Find out more about the assessments and thresholds you need to meet to get help in our Beginner’s guide to paying for long-term care.

If you qualify for council, or HSCNI, funding for your care needs, the council must offer you a personal budget to help meet your care plan goals.

This budget gives you choices in how to use it, like through direct payments to buy your own support or having the council manage it for you.

You can’t use it for daily expenses like bills or food.

This budget aim to give you control over your care and support, letting you choose how and from whom you receive assistance.

You can get your budget through:

• direct payments into your bank account
• have the council, or HSCNI, manage it, or
• opt for an Individual Service Fund where an organization provides services according to your instructions.

You can even combine these options if you prefer.

Find out more in our guide Direct payments – arranging and paying for your care.

The services you’re offered will be based on a care needs assessment carried out by your local council, or HSCNI.

It’s called a ‘package of care’ and will be written into your personal care plan.

Services can include help with:

• getting out of bed in the morning, washing and dressing
• toileting and using continence aids
• preparing meals and drinks
• eating and drinking
• picking up prescriptions
• giving, or prompting to take, prescribed medication
• health-related tasks, as agreed with medical practitioners or community nursing nurses

• nursing care from a registered nurse
• shopping
• collecting pensions
• money, managing and paying bills
• getting out of the house and meeting friends
• supervision and companionship
• getting settled for the evening and going to bed.

When it comes to home care, you can either go through a home care agency, where they handle everything including hiring carers, or you can directly hire a private care professional. Fees are usually based on hourly rates, except for 24-hour live-in care, which is typically charged weekly.

Home care usually costs between £23 to £34 per hour, and live-in care costs about £1,100 per week, according to UK Home Care Association. But prices can vary depending on location and the level of care needed.

Check with the Care Quality Commision for approved providers

When your local council, or HSCNI, carries out a financial assessment to work out how much you’ll pay towards your care, they will assume that you’re already receiving certain disability benefits, even if you aren’t already claiming them. So, it’s important to check if you qualify and claim:

• Attendance Allowance, if you’re State Pension age or over, need help with personal care because of illness or disability.
• Personal Independence Payment, if you’re aged 16 or over but under State Pension age. If you live in Scotland, you need to apply for Adult Disability Payment.
• Disability Living Allowance, for a person aged under 16.

There are other benefits you might also be able to claim, depending on your circumstances. Find out more in our guide Benefits to help with your disability or care needs.

Selling your home and buying a smaller, cheaper one could free up money to pay for your care costs. It could also give you a chance to live somewhere that might better cater for your needs now and in future.

Downsizing can give you a more manageable and cost-effective living arrangement tailored to your requirements. For example, with a smaller house, managing daily tasks might become simpler, from cleaning to maintenance. It can also lower running costs, like reduced utility bills and maintenance expenses, which can ease financial strain.

But be aware:

• Downsizing or releasing equity may affect your financial assessment for home care and benefits eligibility.
• If you downsize your home or release equity from it, you might have to pay for your care costs, even if you weren’t paying for it before.
• Smaller properties, such as bungalows, may not always be cheaper, and modifications can be costly.
• Care costs might rise as you get older or if you fall ill. So, remember to factor that into your calculations.

It’s important to get professional advice if you’re thinking about downsizing or releasing equity, you can find an accredited adviser at the Society of Later Life Advisers (SOLLA)

You can consider other options besides downsizing to a smaller house, like:

• retirement property, also known as sheltered housing that has: 
  • help from a scheme manager (warden), or support staff
  • 24-hour emergency help through an alarm system
  • communal areas, such as gardens or lounges
  • social activities for residents.
• extra care housing suitable that has:
  • a minimum age for residents, usually 55 or 60.
  • help from scheme manager, warden, or other staff who can help
  • 24-hour emergency help using an alarm
  • communal areas, like gardens or lounges
  • social events for residents
  • you have your own place to live in, so you can be independent
  • shared communal areas where you can hang out with others.

Some extra-care housing is available to buy or rent yourself, while others are provided by the local council after they check your needs, but not every area has them available.

The Elderly Accommodation Counsel (EAC) charity can help you find a property to meet your needs

Sheltered and extra care housing are clusters of homes that share facilities, such as an on-site warden and social events.

They’re usually available to rent from local councils, housing associations and charities. If you want to buy, sheltered housing is also available from some private developers, but they can be expensive to buy.

Moving to a serviced apartment in a retirement village or into sheltered housing can bring advantages you might not have considered:

• your new home might be easier to maintain
• accessibility might be easier, so you can stay in your home for longer.

But be aware that there will often be annual charges to pay, such as service charges and ground rent if it’s a leasehold property. So, it’s important to factor these costs in your budget.

You can find out more about sheltered housing at Which?

If you have a lump sum, explore these options to help fund your long-term care.

If you release equity from your home or if you already have a lot of savings, an immediate needs annuity might be worth looking at.

It’s a type of insurance policy that provides a guaranteed regular income for life to pay for care costs.

The income from this type of annuity is tax free if it’s paid directly to the care provider. Find out how it works and whether it’s right for you in our guide What is an immediate needs annuity?.

You can use investment bonds to help pay for your care. But there’s no guarantee that the returns will cover the cost of your care, and your money is tied up for a long time.

Find out how investment bonds work and the pros and cons before deciding whether they’re suitable for you.

When your local council, or HSCNI, carries out a financial assessment to work out how much you’ll pay towards your care, money tied up in investment bonds will usually be excluded from their calculations, but it’s worth asking if that’s the case.  This is because they’re treated as life insurance policies and disregarded.

But if you already need care, you can’t just put your money into bonds to avoid paying. Your local council, or HSCNI, could see this as ‘deliberate deprivation of assets’ and take their value into account.

Find out more about deprivation of assets and the financial assessment in:

• England or Wales, at Age UK
• Scotland, at Care Information Scotland
• Northern Ireland, at Age NI

Consider seeking advice from a specialist care fees adviser, a financial adviser that specialises in long-term care funding. They’ll help you compare all your options before you decide what’s right for you.

Find out more in our guide Help funding care – how to get advice.