An introduction to home care costings

Direct payments

If you currently get social services, your local trust must offer you the option of direct payments, except in special circumstances, which your trust will talk to you about. You are required to be able to give your consent to receive direct payments.

You must also be able to manage them daily, whether you are able to do this yourself or have a ‘suitable person’ doing it for you.

Direct payments are paid into a bank account by the trust to people who have been assessed as needing social care or home help and would rather organise and pay for their own services than receiving services from their local trust.

Direct payments do not affect any other benefits you receive.

Your local trust decides how much you get, determined by your needs assessment. You can use this money to pay for whatever health service or equipment you need, for example, employing a care worker.

In general, you are eligible for direct payments if:

• You have been assessed as needing help under health and personal social services legislation

• You are over 16 years old and have a disability, or if you are a care worker with parental responsibilities for a disabled child

• You are an older person

Your local trust should still be involved in your care and check in with you regularly to ensure you receive the care you need.

If your situation changes, whether it is a long-term or short-term change, contact your local trust as that could mean your payments needs readjustment. You cannot use direct payments for everyday costs, such as utility bills and food.

Click here to find out all you need to know about a needs assessment

NHS Continuing Healthcare

NHS Continuing Healthcare (NHS CHC) is a care package for people over 18 funded by the NHS that covers all costs of your support needs if you require substantial long-term care.

The scheme is not tied to specific diagnoses or conditions, instead it depends on the care you require. NHS CHC is not means-tested.

How do I qualify for NHS Continuing Healthcare?

To be entitled to NHS CHC, it must be proven that you have a primary health need, which means your care needs are mainly for healthcare. There are two stages in the assessment process to determine if you qualify.

The first stage to find out if you qualify is the completion of a Continuing Healthcare Checklist. A qualified healthcare professional, such as a nurse or social worker, evaluates your care needs using the checklist covering 11 areas of care, which will determine if you are eligible for a full assessment.

You can request an initial assessment at any time, so speak to your doctor or care worker if you believe you are eligible. However, the process should trigger automatically in particular situations, including if your physical or mental health deteriorates substantially or you are ready for discharge from hospital but need continued care.

If the results are positive and indicate that you could qualify for NHS CHC, you enter stage two in the process. Within a few days, you should be contacted to arrange a Full Assessment.

The Full Assessment is either organised by your local NHS Clinical Commissioning Group (CCG) or a third party commissioned to do the assessment on their behalf.

A multidisciplinary team (MDT) of healthcare professionals, made up of at least two professionals from different care disciplines, will conduct an assessment.

It examines all your care needs; what assistance you require, the complexity and intensity of your needs and how unpredictable your needs are, including any related risks.

The assessment includes reviews of care records and a face to face meeting, which should involve you or your representative.

The gathered evidence is used to complete what is called the Decision Support Tool (DST), which divides the information into 12 domains including cognition, communication, breathing as well as skin and tissue viability.

Each domain is given a level of need from ‘No Need’ to ‘High’, ‘Severe’ or ‘Priority’. The team then discusses whether you have a primary health need and sends their recommendation to the CCG who makes the final decision.

If you qualify, NHS Continuing Healthcare will cover the costs of care received, as agreed with the CCG. The agreed package is reviewed after three months, followed by at least once per year. If your needs change, your eligibility and funding plan could too, a decision you can challenge.

If you are ineligible for NHS Continuing Healthcare, you can appeal the decision. The letter with the decision should contain information on how to appeal.

What benefits can I claim when I need home care?

Always check if you are entitled to any benefits and if you are, make sure to claim them. Even if you have a substantial amount of savings, you could be entitled to benefits as some are not means-tested.

The figures below are for the 2022/23 tax year.

Attendance Allowance

To be entitled to claim Attendance Allowance, you must have reached State Pension Age (over 65 depending on date of birth) and:

• You have a physical and/or mental disability, including learning difficulties

• You require someone to care for you or have someone to supervise you because of your disability

• You have needed that care for at least six months, unless you are terminally ill.

All people in the UK are entitled to this benefit.

There are two rates available, determined by the level of support you require. However, it does not cover mobility needs. You may need to be assessed by a healthcare professional if it is unclear how your condition affects you.

• If you need frequent help or constant care either during the day or at night, you could receive £61.85 per week.

• If you need help both day and night, or if you suffer from a terminal illness, you could receive £92.40 per week.

If you suffer from a terminal illness and your remaining life expectancy is six months or less, there is no qualifying period and if you are eligible, you are entitled to the higher rate.

Attendance Allowance does not take into account your earnings or savings and you are not required to have someone helping you in order to claim.

If you receive Attendance Allowance, you could be eligible for other benefits, or a higher rate of benefits, including Pension Credit, Housing Benefit and Council Tax Reduction.

Personal Independence Payment (PIP)

People aged 16 to 64 (or have not reached State Pension Age) who require long-term care at home due to a disability or illness can claim Personal Independence Payment. The amount you receive is determined by how your condition affects you, not what it is.

To be eligible, you must have had trouble with everyday living (such as eating and communicating) and/or getting around for three months and you expect the difficulties to persist for at least nine more months.

PIP is a tax-free, non-means-tested benefit you can receive whether you are working or not.

Further, it is mandatory that you have lived in England, Scotland or Wales for at least two of the last three years and you need to be in one of these countries when you apply. If you live in another EU or EEA country or Switzerland, you can only get help with daily living needs.

If you are not a British citizen, you must generally live in or prove you intend to settle in the UK, Ireland, the Isle of Man or the Channel Islands and not be subject to immigration control unless you are sponsored.

How much you get is decided by an assessment, conducted by an independent health professional, and the rate is frequently reviewed to ensure you receive sufficient support.

There are two components to PIP – daily living and mobility - and you could get both, but it depends on how badly affected you are by your condition.

The two parts have different rates:

• The weekly daily living rate is either £61.85 or £92.40

• The weekly mobility rate is either £24.45 or £64.50

If you are terminally ill and not expected to live for more than six months, you will receive the higher daily living rate, but the mobility rate is determined by your needs.

For a detailed guide on PIP, click here.

Industrial Injuries Disablement (IIDB)

If you are disabled as a result of an accident in the workplace, or an illness caused by work, you could be entitled to a benefit of up to £188.60 per week. IIDB also covers more than 70 diseases, including asthma, deafness and asbestos-related diseases.

All people in the UK are entitled to this benefit, except if you are self-employed.

The incident must have taken place in the UK and the amount received depends on your circumstances. On a scale of 1 to 100 per cent, your disability level affects the amount you might receive, assessed by a medical advisor. In general, you need to be deemed 14 per cent disabled to be eligible.

The Government’s guidelines say if you are deemed 20 per cent disabled you could be entitled to £37.72 per week, up to £188.60 if you are assessed as 100 per cent disabled.

If you are eligible for IIDB, you could be entitled to Constant Attendance Allowance (CAA).

Constant Attendance Allowance (CAA)

If you are ill or disabled as a result of an injury and require constant care, you could be entitled to Constant Attendance Allowance. You must receive either Industrial Injuries Disablement Benefit (IIDB) or a War Disablement Pension to claim CAA.

Your entitlement to CAA will be automatically considered at the time of your IIDB medical assessment.

You are unable to get CAA if you already get Attendance Allowance and it may affect your claim to other means-tested benefits.

You can apply for CAA if:

• you claim IIDB and you have been deemed 100 per cent disabled (based on a medical assessment) and need constant, daily care.

• you claim a War Disablement Pension of 80 per cent or more and need personal care for the same reasons that you get the pension.

Depending on your disability and how much it affects you, there are four different allowance rates available in 2022/23:

• Part day - £37.75

• Full day - £75.50

• Intermediate - £113.25

• Exceptional - £151

Carer’s Allowance (CA)

If you care for someone at least 35 hours per week you could be entitled to £69.70 a week in Carer’s Allowance, paid weekly or every four weeks. If you are under pension age, you get National Insurance credits each week towards your pension as well.

To be eligible you must meet the following conditions:

• Spend at least 35 hours a week caring for someone (you do not need to live with them or be related)

• The person you care for receives a qualifying disability benefit

• Be at least 16 years old

• Not earn more than £132 per week after tax, national insurance and expenses

• Have been in England, Scotland, Wales or Northern Ireland for a minimum of two of the last three years

• Normally live in England, Scotland, Wales or Northern Ireland, or live overseas as a member of the armed forces, or living in or moving to another EEA country or Switzerland

• Not be in full-time education or studying 21 hours per week or more

• Not be subject to immigration control

You do not need to live with or be related to the person you care for, but they must already receive one of the following disability benefits:

• Personal Independence Payment (daily living component)

• Disability Living Allowance (middle or highest rate)

• Attendance Allowance

• Constant Attendance Allowance (at or above normal maximum rate with an Industrial Injuries Disablement Benefit or at the basic rate with a War Disablement Pension)

• Armed Forces Independence Payment

Carer’s Allowance is not means-tested but there is a cap on how much you can earn from work and is taxable if the carer’s other combined sources of income, such as personal pensions, is above the tax threshold.

If you live in Scotland and receive Carer’s Allowance, you will automatically receive Carer’s Allowance Supplement (CAS), which is a lump sum of £245.70 paid twice a year (2022/23). This is done to bring Carer’s Allowance to the level of Jobseeker’s Allowance.

Click the following link for a more detailed explanation of Carer's Allowance.

If you receive State Pension you won’t be paid Carer’s Allowance but if otherwise eligible, you could be awarded extra Pension Credit or Housing Benefit instead.

Pension Credit for the 2022/23 tax year

Pension Credit is a means-tested, two-part benefit for people with a lower income who have reached State Pension age.

The two parts are Guarantee Credit (up to £278.70 a week) and Savings Credit (up to £16.20 per week). You can get Pension Credit if you have savings and whether you are working or have retired.

You can apply up to four months before you wish to start claiming.

Pension Credit can be claimed by single pensioners and couples (living with a partner) who live in England, Scotland, Wales or Northern Ireland.

If in a couple, you can only start receiving Pension Credit if both of you have reached State Pension age or one of you is receiving Housing Benefit for those over State Pension age.

If you are single and receive Pension Credit but you start living with someone below the State Pension age, they must reach the State Pension age before you can get it again.

How much Pension Credit could you get?

Pension Credit takes your income into account, including:

• State pension and other pensions

• Earnings

• Most benefits, excluding Attendance Allowance, Christmas Bonus, Disability Living Allowance, Personal Independence Payment, Housing Benefit and Council Tax Reduction

• Savings and investments over £10,000

You can have up to £10,000 in savings and investments (excluding your home) before it has any effect on how much you get. Every £500 over the £10,000 savings and investment threshold adds an extra £1 to your weekly income.

For example:

You have £11,600 in savings (£1,600 above the threshold). There are three parts of ‘£500s’ above the limit, which adds £3 to your weekly income.

Guarantee Credit tops up your income. Guarantee Credit is for single pensioners with a weekly income of less than £182.60 and for couples with a joint weekly income below £278.70

• If you are single, Guarantee Credit will bring your weekly income to £182.60.

• For couples, Guarantee Credit will take the joint weekly income to £278.70.

Savings Credit provides an income boost to people with some retirement savings. Savings Credit can only be claimed by people who reached State Pension age before April 6th, 2016 (65 years for men, 63 for women – 2016 State Pension ages).

• Savings Credit can give single pensioners up to £14.48 extra per week and couples up to £16.20.

To qualify for Savings Credit in 2022/23, your weekly income needs to be at least £153.70 if you are single and a combined £244.12 if you are in a couple.

Every £1 over these thresholds adds 60p of Savings Credit up to the £14.48 and £16.20 maximum weekly amounts.

Disability premiums

A disability premium is extra cash added to other benefits, such as the Housing Benefit. There are three kinds of disability premiums and you can get more than at the same time.

The three types of disability premiums are:

• Disability premium

• Enhanced disability premium

• Severe disability premium

What is disability premium and how much can you get?

Claiming disability premium will get you £36.20 a week if you are single and £51.60 for couples.

To qualify for disability premium, you or your partner must be under State Pension age and either be registered blind or receiving any of below benefits:

• Personal Independence Payment (PIP)

• Armed Forces Independence Payment (AFIP)

• Disability Living Allowance (DLA)

• Attendance Allowance

• Constant Attendance Allowance

• Severe Disablement Allowance

• Incapacity Benefit

• War Pensioners Mobility Supplement

• Working Tax Credit (with disability element)

What is severe disability premium and how much can you get?

If you are eligible for severe disability premium you will get £69.40 if you are a single person and £138.80 if you are in a couple and both of you are eligible.

To be able to claim severe disability premium, you must receive the disability premium or an Employment and Support Allowance related to income as well as one of these benefits:

• Daily living component of Personal Independence Payment (PIP)

• Armed Forces Independence Payment (AFIP)

• Middle or highest rate of the Disability Living Allowance care component

• Attendance Allowance or Constance Allowance funded with Industrial Injuries Disablement Benefit or War Pension

In general, you won’t be eligible if you live with someone over the age of 18 except if they receive a qualifying benefit, are registered blind, pay your landlord separately or if they are a boarder or subtenant.

Additionally, you are unable to claim severe disability premium if someone caring for you receives Carer’s Allowance or Universal Credit (carers element).

If you are in a couple you can still get the lower rate if someone is caring for only one of you and they claim Carer’s Allowance or the carers’ element of Universal Credit, or if only one of you are eligible and the other partner is registered blind.

What is enhanced disability premium and how much can you get?

If you are eligible for the enhanced disability premium you will be entitled to £17.75 a week if you are single. You get £25.35 per week if you are in a couple and one of you must be eligible.

You can only receive enhanced disability premium if you are under Pension Credit age and you must receive the disability premium or income-related Employment and Support Allowance, as well as one of the benefits below:

• Higher rate of the PIP daily living component

• Armed Forces Independence Payment

• The highest rate of the care component of Disability Living Allowance

You are also eligible if you are in the Employment and Support Allowance support group.

Follow this link for more information: How to claim disability premiums.

Council Tax discounts and exemptions

If you are in receipt of the daily living or mobility component of Personal Independence Payment (PIP), you will be able to get money off your Council Tax bill.

The amount will depend on the rate of PIP you are getting.

Council Tax only applies to people living in England, Wales and Scotland. If you live in Northern Ireland, you might be able to pay reduced rates through the Rate Relief Scheme.

Article By: Viktor Berg

Last Updated: 7 Apr 2022

From homecare.co.uk