Navigating your way around the different ways care is funded, whether at home or in a residential/rehabilitation setting, can be difficult. Sophie O’Connell, Head of Court of Protection at Brain Injury Group member firm, Wolferstans, provides an overview of different funding types.
Brain Injury Group provides help and support to those affected by a brain injury, if you would like advice on a specific funding matter, please email [email protected]
Do I have to pay for Intermediate Care?
Intermediate Care, which is also known as ‘reablement’ or ‘rehabilitation’, is likely to be the first type of care service you come across if you have been in hospital. These are services provided to help you return home after a hospital stay or sometimes to stay in your own home instead of going into hospital. The Local Authority will provide a programme of care and support for a specified period of time with the aim of enabling you to maintain or regain the skills to live independently in your own home. This is free for up to six weeks regardless of your income and capital. However, you must have an eligible assessed need.
What is a Local Authority’s Needs Assessment?
An eligible assessed need means that you must have a need arising from a physical or mental impairment or illness and be unable to achieve two of the following outcomes (without support, pain, danger, anxiety or it taking longer), and this will have a significant impact on your well-being: managing and maintaining nutrition; maintaining personal hygiene; managing toilet needs; being appropriately clothed; being able to make use of your home safely; developing and maintaining family and other relationships; accessing work, education, volunteering and training; making use of the local community; and carrying out caring responsibilities for a child.
Funding your care needs
The Local Authority has a duty to assess the needs of anyone who appears to be in need of care and also to assess their carer’s needs. However, it only has a duty to meet your needs if you are ordinarily resident in the authority’s area (generally you will be if you chose to live there) and if your capital is below the financial limit. This is currently £23,250, so if the value of your capital (savings, investments, some property) is above this, the Local Authority will not have to fund your care but can provide advice and arrange care in some circumstances. However, some of your assets are not taken into account and these are known as disregards. Examples of disregards are: compensation including interim payments (only if it is in a Personal Injury Trust, in the 52 week disregard period or managed by a Deputy under the Court of Protection); your main residence if the care is provided there; or if you are in residential care your main residence may not be taken into account but this will depend on who still lives in the property and whether or not your stay in residential care is going to be temporary.
If the Local Authority does fund your care, it will take your income such as welfare benefits, pensions etc into account and you will have to pay a contribution from your income. Your contribution depends on whether you are in residential care or at home and other factors such as your disability related expenditure (for example extra heating, dietary needs, special bedding/clothing care not arranged by the Local Authority).
If you no longer require rehabilitation but you have eligible needs, the Local Authority will need to meet these. If you are returning home but the adaptations are not yet complete, the Local Authority will have to fund suitable care until your home is ready, unless your capital assets (not including your home as you are returning there or any compensation in trust or the disregard period) are over £23,250.
NHS Continuing Healthcare Funding
The team assessing your needs on discharge from hospital or when the Local Authority is assessing your care needs should always consider if your care needs are such that the provision of care should be funded by the NHS. Continuing Healthcare (CHC) funding is care arranged and funded by the NHS when your need for care is related to your health. It is not means tested unlike the social care provided by Local Authorities. To determine if you are eligible for CHC the assessor will apply the checklist and if this indicates a health need, a full assessment of your needs known as the Decision Support Tool, will be carried out. If you are not eligible for CHC funding you may still be entitled to NHS Funded Nursing Care. This is paid to the care home towards costs of care provided by a registered nurse for those assessed as eligible.
After Care Services, S117 Mental Health Act 1983
If you have been detained in hospital under section 3 of the Mental Health Act 1983, the Clinical Commissioning Group (CCG) and Local Authority are required to provide any services needed to meet a need relating to your mental condition and reduce the risk of it getting worse. These services could include: support with employment, accommodation, provision of domiciliary services and the use of day centre and residential facilities. Care provided under S117 is not means tested.
Produced by Sophie O’Connell, Head of Court Protection at Wolferstans Solicitors
Wolferstans has an experienced and growing Court of Protection Team which operates within the frame work of the Deputy Standards working with clients and their wider support network to assist them to manage their property and financial affairs and respond to their needs.
Samantha Buckthought is the Senior Private Client Partner at Wolferstans and acts as a deputy and a Panel Deputy meaning she is recognised for her skill and expertise in this area. She also has a background in litigation. The team is also experienced in making applications to the Court of Protection, providing social and healthcare funding advice, and creating and managing Compensation Protection/Personal Injury Trusts.
What is the Brain Injury Group?
The Brain Injury Group exists to support individuals and families affected by brain injury and the health and social care professionals working in this specialist field. Our mission is to provide anyone affected by brain injury with access to advice on legal, financial and welfare benefit issues delivered by proven experts in the field who have been chosen not only for their skills and knowledge, but also for their passion and dedication to helping people.
How can Brain Injury Group help you?
If you’ve been affected by brain injury and need free legal or welfare advice on funding care or any other matter, there are several ways to get in touch:
- Call us on 0800 612 9660 or 01737 852203
- Email us at [email protected]
- Complete this short enquiry form and we’ll get back to you