Who pays for care at home depends on your relative’s care needs and their money. The council may pay towards care, the NHS pays for some people, and benefits can help with costs. In most cases the person is expected to pay towards the cost of their care.
This article is for England. Rules can differ in Scotland, Wales and Northern Ireland. It is general information, not legal or financial advice.
Will the council pay for care at home?
The council may pay towards care, but you cannot be sure until it has done two checks. The first is a needs assessment. The second is a financial assessment, also called a means test. It checks whether the council will pay towards care.
The council’s adult social services team can help with personal care and day-to-day activities. You can read more on the NHS page on social services and dementia.
What happens at the council’s needs assessment?
A care needs assessment is free, and anyone can ask for one. You do not need to wait for a crisis. The assessment may also show needs you had not thought of.
It should ideally be face to face. A relative or friend can come along, help explain things and take notes.
Our suggestions to help the assessor understand all your relative’s needs:
- Write down, in the weeks before, what your relative needs help with each day.
- Note problems with memory, such as missed meals or forgotten medicines.
- Note when they need reminding or prompting to do things.
- Note whether they need someone nearby to stay safe, including at night.
- Describe a bad day, not only a good one.
- Ask for a copy of the written outcome.
Will my relative have to pay anything?
Possibly. The council will ask about savings and income.
The council can explain how the financial assessment applies to your relative. Our rights and benefits guide covers the means test.
Which benefits should I check?
Attendance Allowance is worth checking. It is for people over State Pension age who need help at home. It does not depend on income or savings. Getting it can mean your relative gets other benefits, or more of some benefits.
- Lower rate: £76.70 a week, for frequent help or constant supervision in the day, or supervision at night.
- Higher rate: £114.60 a week, for help or supervision day and night, or for people likely to have under 12 months to live.
These are the rates in the Dementia UK guide. Check the current rates when you apply.
Under State Pension age, your relative may be able to claim Personal Independence Payment (PIP) instead.
Tips for the Attendance Allowance form:
- Answer based on bad days.
- Give detail, even when the need seems obvious.
- Use the food and drink section to show if your relative cannot plan, buy and prepare food and drink.
- Explain whether they need supervision to stay safe by day or night.
- Phone to apply. This can allow payments to be backdated by up to six weeks.
- Ask the Attendance Allowance helpline for a paper or alternative format of the form if you need one.
If it is refused, you can ask for a mandatory reconsideration, which is a request for the decision to be looked at again. You must ask within one month of the decision letter.
Other things to check:
- Carer’s Allowance: the main state benefit for carers who look after someone for 35 hours a week or more.
- Council Tax Reduction: a person getting Attendance Allowance may be entitled to it, even if they already pay less.
- Appointee: if your relative has lost mental capacity, you can apply for the right to claim their benefits.
The free benefits check on the entitledto website can show what else you may be owed.
When does the NHS pay for dementia care?
The NHS pays for some people through NHS continuing healthcare. Your local integrated care board (ICB) pays for it. A dementia diagnosis does not automatically mean your relative qualifies.
A team of healthcare professionals decides. To ask for an assessment, contact your local ICB and ask for the NHS continuing healthcare co-ordinator.
NHS-funded nursing care is similar, but it applies to people in a nursing home. It is not a way to pay for care at home.
What should I gather before I phone the council?
Having papers ready makes the call and the financial assessment easier. Gather:
- Bank and savings statements.
- Pension details and other income.
- Your notes on care needs, including bad days and night-time problems.
- Any benefit letters.
What to do next
- Phone the council’s adult social services and ask for a free care needs assessment.
- Take a relative or friend, and bring your notes.
- Apply for Attendance Allowance, or PIP if under State Pension age, and run the entitledto benefits check.
- Ask the council about independent financial advice. Councils have a duty to help people find it.
- If you think your relative may qualify for NHS continuing healthcare, ask your ICB for an assessment.
If you notice sudden changes in your relative’s health, speak to their GP or call NHS 111. In an emergency, call 999.