Guide

What care homes cost in England, and who pays

Typical fees, the means test, the funding routes families miss, and the contract traps to avoid.

Care home fees are one of the biggest financial shocks families face, and the system that decides who pays is genuinely complicated. This guide gives you the shape of it. Figures change every year, so treat the numbers as a guide and check the current rates for your area.

What care homes actually cost

Fees vary widely by region and by home. As a rough guide, a residential place commonly runs into four figures a week, and a nursing place costs noticeably more. Homes in the South East cost more than those in much of the North. One thing that surprises people: self-funders are often charged more than the council pays for an identical room down the corridor, because councils negotiate lower rates.

The means test (financial assessment)

Whether your local council helps pay depends on a financial assessment of capital (savings, investments and, usually, property) against two thresholds:

Above the upper capital limit, you normally pay the full cost yourself.
Below the lower capital limit, the council pays most of the cost and you contribute from income.
In between, you pay a sliding contribution, losing a set amount of support for each band of savings.

Your home is usually counted as capital if you move into a care home permanently, but not if a partner, or certain other relatives, still lives there. There is also a 12-week property disregard when you first move in, and a deferred payment agreement can let you delay selling the house by letting the council take the fees as a charge against it.

Funding routes people miss

A lot of money goes unclaimed because families do not know these exist:

NHS Continuing Healthcare (CHC) can pay the entire package, including a care home, with no means test, if someone's needs are primarily about health rather than social care. It is hard to get and the assessment is demanding, but if needs are high or complex it is absolutely worth requesting.
NHS-funded Nursing Care (FNC) pays a flat weekly amount towards the nursing element in a nursing home, on top of any council or self-funding.
Attendance Allowance helps with care costs for people over State Pension age and is not means-tested. Personal Independence Payment does the same for working-age adults.

Before you sign the contract

A few contract points cost real money if you ignore them:

Get the fee in writing and a clear list of what it does and does not include. Chiropody, hairdressing, outings and escorts to appointments are commonly extra.
Ask how and when fees can rise, and by how much.
Check the notice period, and what happens to fees during a hospital stay or after a death.
If you are self-funding, ask what happens if your money runs out: will the council rate be enough to stay, or will your relative have to move?

Get free, independent advice

This is one area where it really pays to take advice before you spend. Age UK, Citizens Advice and an independent financial adviser who specialises in later-life care (look for SOLLA accreditation) can save you far more than they cost. Our companion guide on help with care costs goes through the NHS and council funding routes in more detail.

More guides

This guide is general information from InspectedCare, an independent site. It is not advice. For the official record of any service, see cqc.org.uk.