Care & Later Life questions
24 direct answers, each with the short version first and a link to the full guide. For the whole topic, see Care & Later Life.
Will I have to sell my house to pay for care?
Not necessarily, and not immediately. Your home is disregarded from the means test if a qualifying person still lives there, and it never counts for care at home. Even where it is counted, a deferred payment agreement lets you delay paying until the property is eventually sold — the council cannot force a sale during your lifetime.
Can I give my house to my children to avoid care costs?
You can give it away, but it may not work. If avoiding care costs was a significant motivation, the council can treat you as still owning the property under the deprivation of assets rules — there is no time limit and no safe period. You would then pay for care as if you still had the money.
Has the £86,000 care cap started yet?
No. The £86,000 lifetime cap on personal care costs was legislated in the Health and Care Act 2022 but has been repeatedly postponed — first from October 2023, then October 2025 — and no firm start date is currently confirmed. Care costs you pay now will not count towards any future cap.
Can someone with dementia still make a lasting power of attorney?
Yes, provided they still have mental capacity when the LPA is made. A dementia diagnosis does not automatically mean capacity is lost — it is assessed at the time of signing, and a GP or solicitor can certify it. But capacity can decline, so act quickly: once it is lost, it is too late.
Can a care home increase fees after you move in?
Yes — most care home contracts allow annual fee increases, but only with reasonable notice (usually around 28 days) and in line with what the contract actually says. Unexplained or excessive increases can be challenged through the home’s complaints procedure, the Local Government and Social Care Ombudsman, or the CMA.
Can you pay a family member to provide your care?
Sometimes. Council direct payments generally cannot be used to pay a close family member who lives with you, though councils have discretion in exceptional circumstances. A relative who lives elsewhere can usually be employed as your personal assistant, and friends can be too — subject to the council agreeing it meets your assessed needs.
How do I get a care needs assessment?
Ask your local council’s adult social services — no referral is needed and it is free whatever your savings. If you appear to need care and support, the council must carry out an assessment under the Care Act 2014. The assessment itself usually takes one to two hours.
How much savings can I have before paying for care?
£23,250 is the upper capital limit in England — above it you pay the full cost. Between £14,250 and £23,250 you contribute a tariff income from your capital, and below £14,250 only your income is assessed. Your home is ignored entirely for care at home.
How do I challenge a refusal of NHS continuing healthcare?
Ask the Integrated Care Board for a local review first, then request an NHS England Independent Review Panel, and finally the Parliamentary and Health Service Ombudsman. Focus on whether the Decision Support Tool was properly scored and the National Framework correctly applied — CHC is significantly under-assessed.
What is CHC fast track?
A route to immediate, fully NHS-funded care for someone with a rapidly deteriorating condition that may be entering a terminal phase. A clinician completes the Fast Track tool and the Integrated Care Board must arrange care within 48 hours. There is no means test.
What is NHS-funded nursing care worth?
£235.88 a week, paid by the NHS directly to the nursing home towards the registered nursing element of care. It is not means-tested, but it is not full funding either — you or the council still pay the rest of the fee, and only nursing homes qualify.
What is a deferred payment agreement?
An arrangement letting you delay paying care home fees using the value of your home, secured by a legal charge like a mortgage. The council pays the fees and recovers them with interest when the property is eventually sold. Councils must offer one where you meet the criteria.
Can a care home ask my family for a top-up fee?
Only where the council has first identified at least one suitable home it will fund at its standard rate. Top-ups must be paid by a third party, agreed in writing, and arranged with the council — a care home charging the family directly may be acting unlawfully.
How much is a Disabled Facilities Grant?
Up to £30,000 per application in England and £36,000 in Wales. It is means-tested for adults but not for children, covers adaptations such as ramps, stairlifts and wet rooms, and the council must process the application within six months. Renters can apply with the landlord’s written consent.
What is a carer’s assessment?
A free council assessment of your own needs as an unpaid carer — the impact of caring on your health, work, relationships and wellbeing. You do not need the consent of the person you care for, and if you are eligible you may receive a carer’s personal budget.
How do I arrange respite care?
Start with a carer’s assessment, which should consider your need for a break, and ask the council about funding. Respite can be provided at home, at a day centre, through a short care home stay or a Shared Lives placement — and emergency arrangements should be planned in advance.
How do I make an advance decision to refuse treatment?
Set out clearly which treatments you refuse and in what circumstances. Where it covers life-sustaining treatment it must be in writing, signed and witnessed. Then make sure your GP, hospital and carers hold copies — an advance decision only works if the people treating you know it exists.
What happens if someone loses capacity without an LPA?
Someone must apply to the Court of Protection to be appointed deputy — usually a family member, and most often for property and financial affairs. Deputyship is slower, costlier and far more tightly supervised than a lasting power of attorney, with annual reports to the Office of the Public Guardian.
How is mental capacity assessed?
Decision by decision, and time by time. Capacity is presumed unless the two-stage test shows otherwise, and the assessor is whoever is making the decision — a doctor, social worker or carer. Complex or disputed cases may need a formal assessment by a psychiatrist or neuropsychologist.
Who decides what is in someone’s best interests?
The person making that particular decision — often a doctor, social worker, attorney or deputy — applying the Mental Capacity Act framework. They must consult family and carers, give real weight to the person’s past and present wishes, and choose the least restrictive option that works.
How do I report concerns about an adult at risk?
Contact the local council’s adult safeguarding team — anyone can raise a concern, including anonymously, and you do not have to be the victim. Where the council suspects abuse or neglect of an adult with care and support needs, it has a legal duty under section 42 of the Care Act 2014 to make enquiries.
How do I complain about a care home?
Start with the home’s own complaints procedure — every registered home must have one and must respond in writing. Then escalate: the Local Government and Social Care Ombudsman for council-arranged care, the Parliamentary and Health Service Ombudsman for NHS-funded care, and the CQC for regulatory concerns.
Can a hospital discharge someone before care is arranged?
It must ensure an appropriate package of support is in place before discharging you, and you can refuse to leave if you do not feel safe. Under the Discharge to Assess model many assessments now happen after discharge, at home or in a step-down bed, rather than on the ward.
What should I look for when choosing a care home?
Check the CQC rating first and read the full inspection report, aiming for Good or Outstanding. Then visit at least twice at different times of day, talk to residents and relatives, confirm the home can meet the specific needs involved, and understand the whole fee structure before signing.