The funding of residential homes continues to be an area both of difficulty and of controversy. For many it is a greater concern than the impact of Inheritance Tax (IHT). Those who have been prudent, or fortunate, enough to have built up some capital (including the value tied up in the house) will find themselves paying the fees of the residential home whilst others are funded by the local authority. Guidelines as to the application of the means test are set out in Charging for Residential Accommodation Guidelines which may be found on the Department of Health website. Early advice and planning may help to ensure that the impact of the means assessment is not greater than it need be.
For residents needing personal care, the question of funding presents greater complexities. Under s 49 Heath and Social Care Act 2001, the NHS became responsible for providing nursing care (free): Local authorities were relieved of the burden of nursing care obligation but continued to have responsibility for social care (means tested). The National Framework for NHS Continuing Heathcare and NHS funded Nursing Care came into effect in October 2007. Under the provisions of the framework the person is assessed for eligibility for NHS continuing healthcare: if the person qualifies, then the costs of providing an appropriate package of care are funded by the NHS. Otherwise, there is an assessment as to whether there is a need for care from a registered nurse and whether those needs are best met in a care home. In those circumstances, the person would receive a payment for NHS funded nursing care. Whereas previously there were 3 bands of NHS funded nursing care, a single rate has now been introduced. The outcome of the assessment process can have a very substantial financial impact both for the person concerned and for the NHS. It is hardly surprising that decisions lead to dispute and challenge. It is often worth taking matters further because of the substantial sums involved – especially where the requirement is likely to exist over a long period of time.
Further information, including the 2007 Framework, is available from the Dept Of Health| Contact us on 01752 205202 |
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