Funding care costs

Funding care costs can be crippling, but there is a solution that should be better publicised, says leading healthcare solicitor Lisa Morgan
Arranging care for a loved one can be an emotionally challenging experience - not least due to the financial burden it entails. Sadly, it is not unusual for a place in a care home to cost £10,000 a month. Families facing significant healthcare may be entitled to a funding option known as NHS Continuing Healthcare (CHC), regardless of their financial position. Unfortunately, often this vital resource goes untapped, either because families are unaware of it or because their application is wrongly rejected.
Families can claim CHC funding they are entitled to, even retrospectively after a loved one has passed away. Too often, families deplete their life savings, sell cherished homes and liquidate assets to cover the substantial costs of residential or care home fees.
The NHS must pay the full cost of care fees for those who have significant ongoing healthcare needs. If a patient's needs primarily fall under health, rather than social care, they are entitled to a free package of care paid for by the NHS. Funding is not related to an individual's wealth and can be provided in a nursing home or in an individual's own home.
If funding is not the responsibility of the NHS, it is the responsibility of the local authority. However, unlike the NHS, local authorities will assess the individual's ability to pay. Currently in England, if a person has assets worth more than £23,250 (£50,000 in Wales), they will have to meet the full cost of care.
Full NHS funding is not based on the diagnosis of an illness, or the fact an individual is being well cared for. It is based on the type and amount of care someone requires to meet their health needs. Retrospective claims for unassessed periods of care can also be made back to April 2012, if a person has been in care for some time or has since died. To date, over £400 million has been paid out by the NHS in redress for past periods of care.
A real-life example we dealt with concerned the children of a lady who had Alzheimer's disease. She entered a care home but they were not informed about the option of applying for CHC. To fund her care they had to sell their mother's beloved home and exhaust her savings, which had totalled more than £250,000.
In their mother's final year the children found out about CHC and contacted us for a thorough assessment and retrospective review. We secured funding approval for their mother, relieving them from the monthly burden of £2,500 in care fees. Having funded her care up to that point, and being aware that this support should have been accessible much earlier, the children launched a retrospective claim. After persistent appeals the family reclaimed £40,000.
It is disheartening that families are pushed to sell homes and assets for care costs. If health is the primary reason for care, the responsibility should lie with the NHS, not the family. The story above highlights a systemic issue:
individuals end up depleting their financial assets, leaving nothing to pass down to their descendants, even when they are entitled to funding.
It is more important than ever that the thin line between healthcare and social care is understood and assessed correctly, as the impact for the individual is the difference between free or means-tested care. It is extremely important for individuals to be aware of their legal rights regarding CHC, which can remove a hefty burden of healthcare costs.

◆ Lisa Morgan is a partner and head of nursing care at the law company Hugh James. For more details visit hughjames.com

Directory
Mulberry Live-In Care, mulberryliveincare.co.uk 01380 870270
Pillar Care, pillarcare.co.uk 020 7482 2188
Safehands Live-In Care, safehandsliveincare.co.uk 020 3417 0090
T&G Care, tgconsultants.co.uk 01793 701982

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