Care Funding FAQs

The questions on this page are about continuing care and related issues in general. If your question is more specific to Cheselden, our services and how we can help you, please visit our FAQs about Cheselden page.

If your question is not answered on these pages, you will probably find the answer elsewhere on our website, in one of our Factsheets or in the Glossary. If not, please call us on 0845 659 1588 and we will be pleased to help.

Q. Who decides if someone qualifies to receive NHS Continuing Healthcare?

A. The patient’s Primary Care Trust (PCT) is responsible for identifying when a patient might qualify for continuing care, and then arranging an assessment to decide if they are eligible. The assessment team should include at least one local authority representative as well as NHS staff. Visit our National Framework and Assessment Process pages to find out more.

Q. Am I eligible for continuing care?

A. You will qualify for full care funding if you are assessed as having a Primary Health Need that outweighs any other care needs you might have. To find out if you are eligible now, or have been wrongly turned down for continuing care in the past, please contact us so we can assess your case for free and with no obligation.

Q. Why wasn’t I told about continuing care before I started paying care fees?

A. Unfortunately, there is still confusion and inconsistency around continuing care and who is eligible for it. This has led to a ‘postcode lottery’ where people in some parts of the country are more likely to be assessed and/or quality for NHS funding than people in other areas. Cheselden believes this is unfair, which is why we are working to help eligible patients claim the refunds and/or ongoing funding they deserve.

Q. What happens if I am approved for continuing care?

A. If you are awarded NHS Continuing Healthcare as a result of a PCT assessment or a successful claim made by Cheselden on your behalf, your PCT will create a care package that meets and pays for all your healthcare needs. If you live in or are moving into a care home, your accommodation fees will also be covered. Please read our Factsheet 4 for more details.

Q. What happens if I only partly qualify for care fees?

A. If this happens, you will normally receive NHS-funded Nursing Care (which covers the costs of care provided by a registered nurse) if you live in a care home, or another type of NHS-funded care. Your local authority will means-test your ability to pay for any other care costs and your accommodation if you live in a care home. Please read our Factsheets 5, 6, and 7 for more information.

Q. What happens if I am not eligible for any NHS funding at all?

A. Your local authority will means-test your ability to pay for your own care and, if you live in a care home, your accommodation. You may need to fund some or all of your own care, although you may be able to reduce the amount you have to pay by claiming all the state benefits to which you are entitled. Please read our Factsheets 7 for more information.

Q. What are my options for funding some or all of my own care?

A. If you are a self-funder, you have a number of options to pay for nursing home fees whilst protecting your property and assets. It is important to plan carefully how you will pay for your care to avoid unnecessary financial pitfalls and disappointments. We can help you make the right choices about funding your care – please visit our Funding Your Own Care page to find out more.

If you are currently paying for some or all of your care but have (or have recently developed) a serious health condition, you might quality for NHS-funded Nursing Care or NHS Continuing Healthcare. Please contact us so we can assess your case.

Q. Why do care home charges vary between homes?

The average cost for a care home place is around £26,000 a year for a residential care home and £35,000 for a care home with nursing. However, charges vary significantly, depending on:

• The care home’s location. Care homes in wealthier or urban areas, such as south east England, will charge more than those in rural or deprived areas.
• Who runs the home. The NHS and local authorities have set weekly care home charges which vary by area. Voluntary organisations and private companies can set their own fee levels.
• The type of care home and care provided. Residential care homes which provide accommodation, social and personal care have the lowest charges. Care homes with nursing tend to be more expensive, although some of the costs are usually covered by NHS-funded Nursing Care. The most expensive homes are Elderly Mental Infirm (EMI) homes which provide specialist care and facilities for patients with conditions such as dementia and Alzheimer’s disease.
• Whether or not residents are self-funding. Some private homes charge self-funders more than they receive from the NHS or local authorities for people whose care is partly or fully state-funded. The extra charge aims to ‘top up’ shortfalls in covering the home’s costs for accommodating state-funded residents.

Please read our Factsheet 7 for more information about care homes.