Remaining at home

 

Support from the state

Unfortunately, help with the cost of services you might need at home is not standardised. Almost all local authorities now impose charges for such services, but there is no standard level of charging and no agreed system for assessing people’s means. Charges are highly variable.

They are heavily subsidised in some areas, whilst in other areas charges are so high that individuals could possibly purchase the same, or similar, services more economically privately.

Councils have discretion to make charges for a very wide range of services, including home care, day care, lunches, transport, incontinence laundry and alarms.

Most councils use some form of means test in order to assess an individual’s ability to make a contribution towards the cost of such services, however there is, as yet, no national standardised test. In some areas, even if you are receiving Income Support you may have to pay towards services such as home care.

However, you should be aware that Councils are subject to a test of ‘reasonableness’. An advice note to local authorities from the Social Services Inspectorate demonstrates this:
 

  • Charges must be waived or reduced for those unable to meet them
     
  • Users must be left with adequate disposable income
     
  • No account should be taken of the resources of carers or other family members
     
  • Service users have the right to appeal against their ability to pay
     
  • Services cannot be withdrawn for those unable or unwilling to pay, but debts may be pursued through civil procedures
     

Your Social Services department should give you the information you might need to make a complaint, or to appeal against a level of charges which you will have difficulty in meeting. To find out whether it would be possible to get some help towards the cost of support services , you should ask social services for an assessment of your need – see The Role of Social Services.

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Direct payments

This is money paid to you by Social Services, to enable you to pay directly for your own care - rather than accepting care arranged by Social Services. You can employ your own care worker(s) ­ or you may prefer to buy services from a voluntary or private agency.

Unless you live in Scotland, you cannot use Direct Payments to buy services from your local authority - but it may be possible to  combine Direct Payments with other services provided by your local authority.

If you think you might want to switch from an existing care service, to organising your own care with the help of a Direct Payment, you will need to talk to your social worker or care manager. If your need for services is being assessed for the first time, you should raise the question about managing your own services at the time of the assessment. You should not be left without help whilst you arrange your own services ­ so may need to asksocial services to provide temporary assistance.

All local authorities now have a duty to offer the option of Direct Payments - to disabled people; and anyone aged 65 or over, who has been assessed as needing community care services. The criteria local authorities adopt in making a decision regarding Direct Payments are:

  • You have been assessed as needing a service.
     
  • You (possibly with help) are able to manage your Direct Payment. The key point is that the local authority must be satisfied that you will have control over the services.
     
  • Your needs will be met by using Direct Payments.

Direct Payments also have to be offered to carers (except in Scotland, where this duty only extends to carers of disabled children).


Using direct payments

You should be able to use the payment as you wish, so long as this results in your needs being met.  The whole idea of Direct Payments is to give people more choice and control over their own lives. Nevertheless, the legislation states that you cannot use the money to pay:

  • Your spouse or partner, or a relative living in the same household.Users must be left with adequate disposable income
     
  • Anyone else living in the same household (other than a paid live-in carer).

    The guidance in Wales differs from that in England and Scotland. In certain circumstances in Wales, direct payments are given to individuals receiving support from someone in their household. Each case is looked at individually.
     
  • A close relative living elsewhere.
     
  • For a service provided by Social Services (except Scotland).
     
  • For a service which should be provided by the NHS.
     
  • For a service which should be provided by the housing department.
     
  • For permanent care in a care home, although you can use it to pay for short stays of under 4 weeks at a time. 

You may choose to use your Direct Payment for services such as Home Care. Look in the section on Staying in Your Home which will tell you about agency services and live-in services.  If you intend to employ your own help you will find the section Employing Your Own Staff useful. Direct payments can also be used for purchasing equipment and we suggest you look at Aids and Adaptations.


Arranging your own staff

In most areas there are likely to be organisations which will help you in setting up your own service. They will offer help in understanding your responsibilities as an employer and may be willing to take on the actual paying of your staff and deductions of tax and national insurance. They may be able to help you to find suitable staff and will suggest possible wording for contracts and appropriate terms and conditions.

Your local authority will be able to tell you about these types of services. If there is not a specific organisation to support you in this way, a local home care agency may be willing to help ­ and will also provide a back-up service if your own care staff is temporarily unavailable for any reason.


The choice is yours

Finally, you don't have to take a Direct Payment just because your local authority offers it to you. If you prefer, you can have your care arranged for you by your local authority. It's always your choice.

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Maximising your income

Welfare benefits

We have already looked at both subsidies from Social Services towards the cost of care to support you at home and direct payments. There are also entitlements to some benefits which may assist you either to pay for local authority-provided care, or to purchase your own care. Very many people, particularly the elderly, are not aware of additional income to which they may well be entitled.

 

Pension Credit

This is a new government benefit for people aged 60 and over, paid by the Pension Service. As with the Minimum Income Guarantee (MIG) scheme it replaced, Pension Credit is designed primarily to provide a basic minimum income for pensioners on very low incomes – but also includes possible top-up payments for some people who have income from private pensions and savings.

For all couples aged 60 and over, the Pension Credit guarantee is £189.35 per week and £124.05 per week for a single person. For people over 65 with savings or private pensions the possible topped-up amounts are £26.13 a week for a couple and £19.71 for single people. These top-ups are means tested, depending on assessments of current income from savings and investments.

How to find out more

You can find out everything about Pension Credit through The Pension Service website. Go to www.pensions.gov.uk/pensioncredit. It gives full details concerning payments qualification, income assessment examples and application procedure. Alternatively, you can call the free Pension Credit line on 0800 99 1234.

 

Council Tax Benefit

You can get help with Council Tax as follows:
 

  • If you are on a low income you may be able to get help to pay your council tax bills.
     
  • You can apply for a discount if you are the sole resident of your home or if the only other resident is someone who is a carer. There are some other more complex rules about who can be considered a carer for this purpose, including their level of earnings.
     
  • You can get a disability discount if you or anyone in your home is considered to be ‘substantially or permanently disabled’ and if there are specific facilities or space in order to cater for your (or their) needs.
     
  • ‘Granny flats’ occupied by elderly or disabled relatives are exempt from Council Tax.
     
  • Any dwelling occupied only by someone with severe mental impairment is exempt.
     

Council Tax Benefit can be claimed from the Housing Department of your local authority, who should provide you with the necessary forms. You will also find a Council Tax claim form (NHB1) in the Income Support claim pack referred to above.

 

Housing Benefit

There will be a test of your means, which establishes your ‘applicable amount‘ - your income and your ‘eligible rent’. ‘Eligible rent’ will be the rent you pay less deductions for any heating, water charges, or other service items. There is an exception at present for general counselling and support services, such as might be available from a warden in sheltered housing schemes, but the government has reviewed this 'Supporting People' money and there is currently an interim funding arrangement in place. Care Directions will keep you updated with further changes as they are introduced.

You cannot get housing benefit if you go permanently into a care home. You should certainly note, however, that Housing Benefit is still an important option if you are moving into sheltered or retirement housing. One grey area at present is the applicability of housing benefit to help pay for your accommodation in some assisted living schemes where, although you live in your own flat or bungalow, care and meals are provided. There are also some other exclusions – which will be explained to you by Social Services.

Housing Benefit can be claimed from the Housing Department of your local authority, who should provide you with a claim form.

 

Deprivation of Assets

Note: If you are found to be 'depriving' yourself of capital by, for example, giving away assets in order to obtain benefit or increase benefit, you will be treated as still having the capital in question.

 

Attendance Allowance

This is a key non means-tested benefit for older people who are infirm and need help with personal care. Your eligibility for the allowance is not dependent on your financial circumstances but on your ability to care for yourself and the extent to which you need assistance. It is a particularly important benefit because, once you receive it, you may well be entitled to other help, such as with the cost of Council Tax. The allowance is paid at two levels:

  • £44.85 per week is paid if you need care during the day or night
     
  • £67.00 per week if you need care during both day and night
     

You have to be 65 or over to be eligible (although those under 65 can claim Disability Living Allowance). You have to be resident in the UK (and not an immigrant subject to any limitation or condition). You will also have to be so severely physically or mentally disabled for at least the last six months, that you require either:

  • Frequent attention throughout the day in connection with your bodily functions, or continual supervision throughout the day to avoid substantial danger to yourself or others.
     
    OR
     
  • Prolonged or repeated attention at night in connection with your bodily functions, or another person to be awake at night for a prolonged period or at frequent intervals to watch over you.
     

If either one of these conditions apply to you, you will be able to claim the lower level of allowance. If both the above are applicable, you would be eligible for the higher rate of allowance. If you are terminally ill you should automatically qualify for the higher rate of Attendance Allowance, without having to wait for the six-months lead-in period.

The term ‘bodily functions’ is perhaps misleading and off putting. In this context it is taken to mean breathing, hearing, seeing, eating, drinking, walking, sitting, sleeping, getting in and out of bed, dressing, undressing, using the toilet and moving around.

Domestic tasks are not normally included. The Child Poverty Action Group’s excellent ‘Paying for Care Handbook’ includes at p.82 some further very useful definitions of terms. For a copy of this handbook, please telephone 020 7837 7979.

Attendance Allowance should be claimed from the local Disability Benefits Centre by telephoning 0800 882200. They will send you a pack with a claim form. It has to be said that the form is long and complex and you may well be advised to seek some help in completing it. Your GP will need to verify certain sections of the form and will generally be very useful to consult concerning your application. Remember to state clearly those aspects of caring for yourself with which you need help, not just those with which you already receive help. It is probably a good idea to think through a normal day and to identify those tasks you have difficulty with, or need support to accomplish.

If your initial application is rejected, do not be deterred. If you think the decision is wrong, or your situation has worsened, write to the Benefits Agency restating your case. The decision will be reviewed in most cases. Be persistent, Attendance Allowance can often make all the difference if you are determined to continue living relatively independently.

It should also be noted that Attendance Allowance is not affected if you have to move into a nursing or care home and can, indeed, be a crucial element of the funding you may need to live in the accommodation you prefer.

 

Disability Living Allowance

This applies only to disabled people making a claim, before the age of 65. Disability Living Allowance is in two parts ­ the mobility component and the care component. You may be able to get just one component, or both.

The mobility part of the award is for people who cannot walk, have great difficulty walking, or who need help to walk outdoors. It is paid at two rates: an upper of £46.75 per week and a lower of £17.75 per week. The higher rate is awarded if:

  • you are virtually unable to walk as a result of physical disability
     
  • you are unable to walk out of doors without help, because you are blind and deaf
     
  • you cannot go out without assistance because you are severely mentally impaired.

    The lower rate, £17.75, will be awarded if:

  • you are unable to walk out of doors except on familiar routes, without guidance and supervision from another person

You have to have satisfied the above criteria for at least 3 months, and be likely to continue to satisfy them for at least a further 6 months (unless you are terminally ill – see below)

The Personal Care element of the award has three payment levels: £17.75 (lower) £44.85 (middle) and £67.00 (higher). Your eligibility will depend on whether your need for assistance with bodily functions is both at night and during the day, or whether it is one or other of these.

The lower level grant is available to people who are unable to prepare a cooked meal for themselves, or those who need attention in relation to bodily functions at times during the day.

You cannot make a first claim for DLA once you reach the age of 65 (Attendance Allowance would then apply). If,however, you made the DLA claim before that age and are receiving the benefits, they will continue after the age of 65. This is particularly important with regard to Mobility Allowance, since that is not available unless you claim DLA.

You can claim Disability Living Allowance from the Benefits Agency on form SDA1. DLA is non-taxable and does not count as income for means-tested benefits. DLA application can also entitle a claimant to premiums of means-tested benefits.

 

Terminal Illness

If you are terminally ill, you automatically qualify for the higher rate of Attendance Allowance or Disability Living Allowance and do not have to satisfy any waiting time qualifications. Your doctor will have to support your claim by completing a form DS1500.

 

Winter Fuel Payments

Winter Fuel payment is £200 per household with residents over age 60. For households with residents aged over 65, an additional £200 will be paid alongside, towards council tax.

 

Benevolent Funds

Almost all trades or professional associations have welfare funds. If you (or your wife or husband in some cases) have worked in these fields you may be able to get either specific one-off grants or regular small payments. The Forces too have welfare funds and, even though you may only have served for a short time, you may well be eligible for some help. There are also some more general voluntary organisations which are able to offer financial help to older people in need – such as the Royal United Kingdom Beneficent Association (RUKBA) and the Universal Beneficent Society, which offers survival income for the elderly at home. They can both be contacted on the same telephone number: 020 7605 4200.

Counsel and Care for the Elderly offers good advice on possible sources of voluntary funding and may also be able to help you with planning how to pay for care. Their telephone number is 0845 300 7585 and their line is open on weekdays between 10.30am and 4pm.

The Association of Charity Officers will also help to direct you towards appropriate support funds. You should write to them at: FiveWays, 57-59 Hatfield Road, Potters Bar, Herts EN6 1HS. Helpline 01707 651777 or visit www.aco.uk.net

Charity Search will also identify possible sources of funding. Their telephone number is 0117 982 4060.

You might also find it helpful to read ‘A Guide to Grants for Individuals in Need’ by Sarah Harland – possibly in your local library, or from the Directory of Social Change on 0207 209 5151

 

Using your home to pay for care

If your choice is to stay in your own home you will not, of course, be in a position to sell your home outright to pay for the services you need. However your home may still be a very useful source of additional income:

Our section on Financial Planning makes suggestions for various options for releasing equity, or part of the capital value, from your home. Known as Equity Release Plans or Home Income Plans, these include Remortgage Annuities and Reversion Sales.

The Nursing Home Fees Agency (NHFA) is an extremely knowledgeable specialist in all forms of funding, both for care homes and, despite the name, for the support you may need in your own home. The NHFA has a nationwide team of specialist financial advisers who will visit and provide personal advice. This might include advice on welfare benefits or on specific fees’ plans to cover the costs of care. The service is particularly useful if you are unhappy with your local authority’s assessment of your needs. The NHFA adviser will be able to review the assessment and might be willing to intercede with the local authority on your behalf.

There are also more direct ways of ensuring that your home itself contributes to the care funding you may need. For example, using a Live-in care service scheme may provide you with the type of help you need at a cost which reflects your providing accommodation as part of the arrangement. A Homeshare arrangement can realise some free care, support and companionship in exchange for accommodation.

Do you, like many older people, live in a house which is now far larger than you really need? An option may be to turn the house into two self-contained flats. The rental income on one flat will provide, or contribute to, the funding for any assistance you need. If there is a Home Improvement Agency in your area they might well be able to help you identify reputable builders and be prepared to oversee the work for you in return for a small fee. A trusted friend or relative might also be asked to help and advise.

If you decide to establish a rentable property you must ensure that you get advice from a solicitor, to draw up a suitable shorthold tenancy agreement. You should also seek help and advice on advertising for and selecting tenants. A reputable estate agent with a lettings department would be able to assist with this.
 

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Long term care insurance

If you intend to pre-fund long term care, an insurance policy may be the best course of action to pursue. You will find detailed information about long term care insurance in our Financial Planning section.

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