Care homes in the UK are subject to the same system across the board when it comes to charging fees and paying the bills.
Care homes in England specifically work on the basis of two thresholds, one low and one high. Following an income assessment, it will be determined where the household income lies on this scale. Below the low threshold, your local council will be expected to pay for 100% of your care home bills. Above the high threshold, they will not contribute. Most incomes fall somewhere in the middle, so they qualify for some financial assistance and the cost will be shared between the council and the patient or their family.
In order to get more financial assistance from the council, some people may try to artificially lower their income by transferring assets temporarily to someone else. If the local council becomes aware that this is likely to have happened, they can alter the financial assessment to reflect this.
One thing that can have a major impact on this financial assessment is whether or not the patient’s home is counted as income. It will be unless a spouse, civil partner or dependent child lives there, or a family member who is elderly or disabled. In some cases, the same exemption is applied if the person’s carer permanently lives in the property, but it is up to the local authority if they choose to consider this.
If a council or local authority is paying for care, they will set a maximum budget. The patient and/or their family must agree on a suitable care home within that budget in order to accept the financial help. The only way a council can be expected to increase their budget is if the needs of the patient cannot be met by any available care home within the current budget.
Top-up fees are the extra amount that patients’ families can pay on top of the budget allocated by the council in order to put their loved one in a more expensive care home. The council can ask patients to pay these fees if they specifically chose a more expensive option, but only if a cheaper and suitable option was turned down.
In some cases, when patients and their families do not immediately have funding available to pay for care, a deferred payment agreement (DPA) can be set up which works like a loan from the local council. They cover the payments until the patient’s home can be sold in order to contribute to the costs, at which point the money should be repaid according to the terms set out in the DPA. The loan may be subject to interest and other fees.