Who pays for home care? Funding explained in plain English

Care funding in England is confusing by design rather than by accident, and most families only learn how it works when they are in the middle of a crisis. This is the short version: the four ways home care gets paid for, who qualifies, and the order in which to do things. It is general guidance rather than financial advice, and the rules and figures change, so check gov.uk or speak to an adviser before making decisions.

1. Paying privately

If the person has savings above the council’s upper capital limit, they will be expected to pay for their own care. The limit has sat at the same level for many years and is published on gov.uk. For care at home, the value of the house the person lives in is not counted, which surprises many families. Paying privately gives you the widest choice of provider and the most control.

People who pay privately are still entitled to a free needs assessment from the council, and to Attendance Allowance if they qualify. Do not skip either because you assume you will not get anything.

2. Local authority funding

The process has two stages. First, a needs assessment, which anyone who appears to need care is entitled to, regardless of money. A social worker or assessor looks at what the person can and cannot do and whether they meet the national eligibility threshold. Second, a financial assessment, which looks at income and savings to decide how much the person contributes.

If the council agrees to fund care, you can usually take the money as a direct payment and choose your own provider, or let the council arrange care with one of its contracted providers. Direct payments involve more paperwork but give you the choice. In Berkshire, adult social care is run by each unitary authority, so Reading, Wokingham, Bracknell Forest and West Berkshire each have their own team.

3. Attendance Allowance

This is the benefit most often missed. It is for people over State Pension age who need help with personal care or supervision because of illness or disability. It is not means tested, so savings and income do not matter, and it is not taxed. There are two rates depending on whether help is needed during the day, at night, or both. You do not have to be receiving care already to claim it, and you can spend it however you like. If the person is under State Pension age, the equivalent is Personal Independence Payment.

The form is long. Age UK and Citizens Advice will help you fill it in for free, and it is worth the effort.

4. NHS Continuing Healthcare

If someone’s needs are primarily health needs rather than social care needs, the NHS may fund the whole package, including care at home, with no means test. The bar is high and the assessment is detailed, starting with a checklist and moving to a full assessment if the checklist is passed. If you think it may apply, ask the GP, district nurse or hospital discharge team for a checklist. Even if the full package is refused, the NHS may still contribute through funded nursing care or joint funding.

Two smaller things worth knowing

Reablement after hospital. If someone leaves hospital needing short term support to get back on their feet, the council may provide up to six weeks of reablement care free of charge. Ask the discharge team.

Carer’s Allowance and a carer’s assessment. If a family member provides substantial care, they may qualify for Carer’s Allowance and are entitled to their own assessment from the council, which can lead to respite and other support.

The order to do things in

Ask the council for a needs assessment. Apply for Attendance Allowance at the same time, because it takes weeks. If there is a hospital stay involved, ask about Continuing Healthcare and reablement before discharge. Then, with a clearer picture of what help you can expect, choose a provider. Many families arrange care privately while the assessments are going on, then adjust once the funding position is known.

Frequently asked questions

Will I have to sell the house?

Not for care at home. The home is disregarded in the financial assessment while the person lives in it. It can be taken into account for permanent residential care, though even then there are exceptions and deferred payment schemes.

Can I top up council funded care with my own money?

For home care, yes. Many families use council funding for the core visits and pay privately for extra hours or for companionship.

Does Apex accept direct payments?

Yes. We work with families paying privately, through direct payments, and through council or NHS contracts.

Where can I get independent advice?

Age UK, Citizens Advice, Independent Age and the Money Helper service all offer free guidance. For complex finances a Society of Later Life Advisers accredited financial adviser is worth the fee.

Confused about where to start? Ring us on 0118 391 3542. We cannot give financial advice, but we can explain how the pieces fit together and point you to the right people. Or arrange a free initial meeting.

Questions about care?

Our team can talk you through costs, funding and what might be available for your family. Call 0118 391 3542, it's free, and there's no pressure.