Cash for carers

This item has been revised.

Six million people in the UK devote their time to caring for a frail, sick or disabled relative or friend. Half of them also hold down a full time job. Many are over 50 and none of them is paid. Carers are estimated to save the country £57 billion a year – almost as much as the whole National Health Service.

Some carers can get some small help from the state. Carer’s Allowance is just £45.70 a week. To qualify you must give at least 35 hours care a week care to someone who gets attendance allowance or the highest or middle rate of disability living allowance. Your Carer's Allowance will be taken away if you do paid work and earn £82 a week or more.

Carer's Allowance cannot be paid on top of state retirement pension, you just get whichever is the higher. So there is usually little point in claiming it if you are already over pension age.

If you are under 60 and claim Carer's Allowance you will normally get your National Insurance contributions paid. People under 60 who care for someone but cannot claim Carer's Allowance may be helped to qualify for a state retirement pension. Any whole tax year when you spend at least 35 hours a week looking after someone can count as a year of ‘Home Responsibilities Protection’. But you must register each year with the Department for Work and Pensions. They may also have to to undergo a ‘work-focused interview’ to help you keep in touch with employment and, eventually, get a job if you can.

You might wonder why the Government is so difficult about a benefit that is so small. After all, £45.70 for 35 hours a week works out at just £1.31 an hour, about a quarter of the National Minimum Wage which, from October, will be £5.05 an hour. At that rate an individual giving 35 hours care a week – and most carers spend far more time caring than that – would be paid £176.75.

An estimated 300,000 carers who could claim the allowance do not do so. If you think you may be able to claim, find out more from your local JobCentre Plus office or download the claim form or claim online at www.dwp.gov.uk – put carer’s allowance in the search box. Claim now if you think you are entitled because Carer's Allowance will not normally be backdated more than three months.

New rules started on April 1 that should give carers more rights to information, training, and time off – or ‘respite’ – from caring. Contact your local social services department and say you want a ‘carer’s assessment’.

Care homes
Most people, probably four of out of every five, never need to go into a care home. But for a minority, however well they are looked after, there may come a time when they have to leave own home and go into a residential care home. With average fees now £500 a week if you need nursing care and £350 a week if you do not, the big fear that haunts people is ‘how will I pay for it?’ But there is a lot of help out there and it is important to make sure you do not pay a penny more than necessary. Some of the rules are different in the four nations of the UK.

Your home is safe
Your home is not counted at all as part of your wealth if your wife or husband still lives there – and that includes an unmarried partner. It is also not counted if a relative lives there who is aged 60 or more or is disabled. It can also be ignored if someone lives there who has cared for you for a number of years. Even if none of that applies and your home is left empty, then you cannot be forced to sell it. The local authority will make what is called a ‘deferred payment agreement’ with you. Under that the council will pay for your care, or most of it, and you agree that the bill will be paid after your death when your home is sold. No interest is charged on what you owe for your care while you are alive – and for 56 days after. You or your heirs are free to let out your home to help pay the cost of your fees. Your heirs settle up after your death, and may find that much of the value of your home has been preserved for them. Even if you do not do this, the value of your home is ignored completely for the first 12 weeks in the care home so you will probably find that most of your fees are paid for that period.

Nursing care
If you need nursing care then the NHS will pay some of the cost of it. In England it is paid in three bands - £40 a week if nursing care is ‘minimal’; £80 if you need care from a registered nurse daily or £129 if you require frequent attention from a registered nurse. It is always worth appealing to be moved up a band. And if you are in the top band you may be able to claim free care – see below. In Scotland you will get £65 towards your nursing costs and £145 towards your personal care – a total of £210 a week. In Wales you will get £105 towards your nursing costs (£100 in Northern Ireland).

Free care
Two groups of people are entitled to have their care home fees paid in full by the National Health Service. Anyone discharged from hospital who needs to go straight into a nursing home should see if they can get the full cost paid for by the NHS. The law is tricky and complicated but should now be a lot more evenly applied than it was in the past. Anyone who has been discharged from hospital straight into a care home, or who is paid the top band of nursing care, should argue strongly with their local NHS Trust that it should pick up the bill. Many people who have been denied free care may now be entitled to it. The matter has been through the courts and investigated by the Parliamentary Ombudsman and the Department for Health..

If you are discharged from hospital into a care home and your primary need is for health care rather than what is called ‘social care’ then the NHS should pick up the bill. However, the dividing line between ‘health care’ and ‘social care’ is a hard one to draw. Each of the 28 Strategic Health Authorities in England sets out its own criteria in agreement with the local social services departments.

Anyone discharged from a hospital straight into a care home who believes they have a need for health care rather than social care, should apply to their local Primary Care Trust and say that they have a need for ‘continuing NHS health care’ and the NHS should therefore pick up the bill. The application may well be refused. If that happens, ask for an independent review and if that fails make a formal complaint. Ultimately go to the Ombudsman on grounds of maladministration – 4000 people already have. The rules may become clearer when the Government imposes national guidelines, probably in March 2006. The best guide to the problem and how to challenge decisions is Age Concern’s Factsheet 20 (37s for Scotland) Continuing NHS health care. Call 0800 00 99 66. If you live in Wales ask for the extra pages for Wales.

Anyone admitted to hospital under s.3 of the Mental Health Act 1983 is entitled to free nursing home care when they are discharged under s.117 of the same Act.

Attendance Allowance
If you are in a care home and pay all your own fees you can claim attendance allowance. It is paid at two rates - £40.55 a week if you need care by day or by night and £60.60 if you need care by day and by night.

Means test
Most people get their care home fees paid by the local authority. The amount that is paid depends on your income and savings. If you have capital of more than £20,500 then you will not get any help with your fees – you will be expected to pay them out of your capital. The figure is £21,000 in Wales and £19,500 in Scotland. If your capital is just below these amounts then you will be expected to pay towards your fees. But if it is less than £12,500 (in Wales £14,750, Scotland £11,750) your capital is not counted at all and does not reduce the help you get. If your capital is between those two amounts you will be expected to use it to pay some of the fees. If you are married or have a partner they do not have to support you or pay your fees. It is your money that is counted. So it is a good idea to split any joint savings or a joint account before you go into a care home so that only your money is taken into account.

You will be expected to pay towards your fees out of your income. You will be allowed to keep £18.80 a week for your personal expenses (£19.10 in Wales) and you may also be allowed to keep up to £4.85 of any pension savings credit you claim.

Choice
Even if the local council pays some or all of the cost of your care, you still have some rights to choose the care home you want to live in. The home you choose must be able to provide the care you need and, of course, have a place available. It must also comply with the local council’s standards and charge no more than the local council normally pays. If it does charge more – or you want to pay more to have a room of your own or an en suite bathroom – then you have to get a relative or friend to pay the extra. You cannot pay it yourself out of your own capital or income.

More information
Age Concern has leaflets about paying for care on its website or call 0800 00 99 66. The Nursing Homes Fees Agency is an independent financial adviser which specialises in care issues or call 0800 99 88 33. Carers UK offers help and advice to carers or call 0808 808 7777 (10-12, 2-4 Wed and Thurs only)

July 2005

e-mail Paul Lewis on paul@paullewis.co.uk