Paying For Your Care
Once your care needs have been assessed and there is a care plan to say how your needs will be met (see the ‘Your Care and Support Journey’ Page) we will look at how your care is going to be paid for. You may have to pay the full costs of your care or make a contribution towards the costs of it. Some people will have their care fully funded by the Council, but most people are expected to make some contribution to the cost of their care. This is because although health care is offered for free at the time that it is accessed, social care is not. Social care is means tested.
We work out how much you need to pay towards the costs of your care by doing a financial assessment with you. When we do a financial assessment, we use the rules and guidance in the Care Act 2014 and in our local charging policy.
What is a financial assessment?
Doing a financial assessment with you is the way that we find out how much you can afford to contribute to the costs of your social care. The way we do the financial assessment depends on where you are cared for. The rules for how we do a financial assessment are different depending on whether you are cared for in a residential care home, or somewhere else in the community – for example in your own home, or in supported living. As part of a financial assessment, staff from the Finance Team will explain how the rules apply to your individual situation.
Depending on your level of assets, we might not do a full financial assessment with you. By ‘assets’ we mean things like the money you have in the bank, your income, and the value of any property you own. Before deciding whether to do a full financial assessment with you, we will ask you to tell us roughly what assets you have.
We might not do a full financial assessment with you if, for example, you have assets above what is called the ‘upper capital limit’. The upper capital limit is set by the government. At the moment, the upper capital limit is £23,250, but it could change in future. If you have more money than the upper capital limit – more than £23,250 – you will be asked to pay the full cost of your care. If we already know that you can afford to pay for the full cost of your care (because you have more than £23,250), you might not benefit from spending time on having a full financial assessment.
If you refuse a financial assessment we will treat you as if you can afford to pay for the full costs of your care.
If you have assets below the upper capital limit (less than £23,250), we will need to do a full financial assessment with you so that we have enough information to help decide what you can afford to contribute to the cost of your care. Most people will contribute something.
The Finance Team at Focus Independent Adult Social Work can tell you more about having a financial assessment. You can contact them by telephone (0300 330 2870) or by email (focus@nhs.net). The Finance Team at Focus acts on behalf of the Council.
What happens as part of a full financial assessment?
The Council works closely with Focus Independent Adult Social Work (‘Focus’). The Finance Team at Focus will do the assessment with you, on behalf of the Council. Someone from the team will contact you to agree a time to do the assessment, and talk to you about what is involved.
The team will work with you to complete the assessment in the way that works best for you. You can choose to have someone with you to support you when we do the assessment. The assessment is a detailed conversation about your finances, so if you have someone to support you, you will need to pick someone that you are happy to have hearing about your finances.
The team will ask you questions about your finances, and ask you to share evidence of your finances such as bank statements or benefits letters. You can choose not to answer questions or to share evidence, but if you don’t, the team won’t be able to complete the financial assessment with you. If the team can’t complete the assessment with you, we will assume that you can afford to pay for the full cost of your care. This applies whether you get care at home or in a care home.
The team will take into account what you tell them, and work out what you need to contribute to the costs of your care. The law says that whatever we ask you to pay, you should still be left with a minimum guaranteed amount every week to live on.
The team will also help you to think about whether there are benefits that you might be entitled to that you are not getting. The team will let you know if they think there is anything you could be missing out on, and what to do about it.
What will I be asked, as part of a full financial assessment?
The Finance team will ask about:
- The money you have coming in (your income). This includes any benefits you might get, such as a pension/disability benefits
- The money you have in the bank or in investments (your capital). This includes things like savings or shares
- The value of your assets, such as your home or other property that you might own
- Any trusts or settlements that you benefit from
- Any housing related costs you are liable for, such as mortgage payments, rents, or council tax
- Any debts you might have
- Any Disability Related Expenditure you may have
Although we will ask questions that will help us get a full picture of your financial situation, not everything you tell us is included in how we work out what you can afford to contribute to the costs of your care. For example, we might not take into account all of the disability benefits you get, or all of the debts you pay, as part of the assessment. You can find out more about how we use your financial information to work out what you should pay below.
How do you use financial information to work out what I should pay towards the costs of my care?
How we work out your contribution to the cost of your care is set out in the law (the Care Act 2014) and in our local Charging Policy.
Some rules about charging are quite complicated and can be confusing. For example, although we will ask you to tell us about all the income you receive (the money you have coming in), we might not take some of it in to account as part of the financial assessment. For instance, if you have a job and earn wages, we won’t take your wages into account as part of your financial assessment. If we don’t take all your income into account, that will generally mean that you will pay less towards the costs of your care. As part of a financial assessment, staff from the Finance Team will explain how the rules apply to your individual situation.
You might also have some expenses that we might not count as part of the financial assessment. For example, if you are a disabled adult living at home with your parents and you pay them a contribution to household expenses, we might not take everything you pay into account. This is because we will generally only take into account expenses that the law says you are responsible for, such as a mortgage, or rent that you have to pay because of a rent agreement. If we don’t take into account everything that you are paying out, that will generally mean you will pay more towards the costs of your care. As part of a financial assessment, staff from the Finance Team will explain how the rules apply to your individual situation.
In very basic terms, a financial assessment calculation means that we –
- Work out what money you have coming in (although like in the example above, we might not count some of it)
- Take off the money you pay out (although like in the example above, we might not take all of it into account)
- Work out what you have left
- Take off the minimum guaranteed amount the government says you need to live on
- Ask you to contribute what is left to the costs of your care.
What if my situation changes after the financial assessment?
You need to tell us about any changes so we can make sure we ask you to pay the right amount towards the costs of your care. If your situation changes and you don’t tell us about it straight away, once we know about it, we might need to recalculate what you pay. For example, if the amount you get in benefits goes up and you can afford to pay more towards the costs of your care, once we know that, we might recalculate what we ask you to pay and send you an invoice backdated to the date of your benefits increase.
If your situation changes, contact the Finance Team at Focus by telephone (0300 330 2870) or by email (focus@nhs.net).
What if someone else manages my money for me?
If you don’t manage your own finances, please let us know so we can involve the person who does. This might be someone that you have chosen to act as your attorney or who acts as your deputy for your property and finances. You can read more about attorneys by using this link and about deputies by using this link. If you have someone who acts as appointee for your benefits, we will also need to involve them. You can read more about appointees by using this link: https://www.gov.uk/become-appointee-for-someone-claiming-benefits
What if I am not happy with the result of my financial assessment?
If you are unhappy with the outcome of the assessment, speak to the Finance Team at Focus. You can contact them by telephone (0300 330 2870) or by email (focus@nhs.net). The Finance Team at Focus acts on behalf of the Council.
If you are still not happy after you’ve spoken to the Finance Team, please visit our Contact Us page for details on how you can make a complaint or appeal against a charging decision.
How do I pay for my care and support at home?
If you get care and support at home, there are two ways of paying for it. You can either pay by standing order, which means the money will automatically come out of your bank every 4 weeks, or you can receive an invoice. Your invoice will cover a 4-week period. You can pay it in a number of different ways, which will be listed on the back of your invoice. The invoice will be sent to you by North East Lincolnshire Council.
If you get a direct payment to organise your own care and support, you will still need to make a contribution to the costs of your care. This means that you will need to pay your contribution into your separate direct payment bank account (usually a direct payment card account) regularly. We will pay your direct payment into that same account, so that you can use the money in it to pay for your care. You can read more about direct payments on our direct payment page.
If you have questions about how to pay for your care, speak to the Finance Team at Focus. You can contact them by telephone (0300 330 2870) or by email (focus@nhs.net). The Finance Team at Focus acts on behalf of the Council.
You can read more about local care options, including care at home using this link: Care Options – LiveWell (nelincs.gov.uk).
How do I pay for my care and support in a care home or nursing home?
If you get care and support in a care/ nursing home and pay either the whole amount or a contribution, you will receive an initial invoice from the Council. You will need to make your payment direct to the care home. Details will be given to you as part of the financial assessment process and then staff at your care or nursing home will help you with making your ongoing payments.
If you have questions about how to pay for your care, speak to the Finance Team at Focus. You can contact them by telephone (0300 330 2870) or by email (focus@nhs.net). The Finance Team at Focus acts on behalf of the Council.
You can read more about local care homes and nursing homes using this link: Residential Care – Nursing and Care Homes – LiveWell (nelincs.gov.uk)
Useful links
https://www.focusadultsocialwork.co.uk/social-care-handbook/
Page last updated: 25 Oct 2023