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Who pays for care home fees – the resident, their family or the local authority?

The Fremantle Trust is a registered charity and not-for-profit organisation providing care and support services for older people and adults with learning disabilities. They run through the fee-paying options below and it’s well worth a read, whether this is something you will be going through now or in the future.

Considering a care home for yourself, a relative or a friend can be a daunting process; whether you are looking at residential care for older people or adults with learning disabilities. You may be feeling emotionally vulnerable and overwhelmed. Understanding who will pay the care fees and organising funding arrangements can add to the worry.

Many people feel like they are in the dark about care home fees, are anxious that they don’t have enough money, or are putting off thinking about it until a future need arises. Luckily, there is support available. The NHS provides helpful guidance on the ‘care homes’ page on their website, with useful telephone numbers – and there are some ways to cover the fees which you may not have considered…

Who pays for care home fees?

Care home fees are paid for by the following:

  • The resident: by self-funding, the person being cared for (or their family, or friend) pays for all the costs.
  • Local authority funding: the local authority can fund part of or all of the care. Family and friends can also voluntarily contribute to top-up fees.
  • The NHS: in some circumstances, the NHS will pay for the care.

What’s the most common funding source?

Almost half of all the people living in care homes in the UK pay for themselves, while the rest are paid for (either partly or fully) by the NHS or their local authority.

When will a resident pay for care home fees?

Self-funding the full cost for a care home is decided based on your personal savings and assets. The upper capital limits for care home funding include all your savings and assets. In England and Northern Ireland, the upper capital limit is £23,250 (for 2021-22). So, generally speaking, anyone who owns their own home, and has no spouse living with them, is eligible to pay for their own care home fees.

You will pay care home fees if:

✔ The local authority didn’t deem your needs eligible after the initial assessment

✔ You have a regular income that covers the fees

✔ You have assets and savings in excess of £23,250

When will a local authority pay for care home fees?

The first step is a free ‘needs assessment’, which your local authority carries out to determine what level of care you need. Contact social services at your local council and ask for a needs assessment.

If you meet the self-funding criteria, you might think that you are not eligible for financial support, but requesting a needs assessment is still worth doing. The social services team will log and record your care needs and provide you with information about the different types of care and support available.

If the result of the needs assessment finds that you are eligible, a financial assessment will be carried out. This is often called a ‘social means test’. This test will help establish how much of your care should be funded by the local authority and how much you need to pay.

If the council finds you to be eligible for financial help, then you will be offered a choice of care homes. And if you have your heart set on a more expensive care home, the difference via a ‘top-up fee’.

When will the NHS pay the fees for your care home?

In situations where the resident has very complex health needs, the NHS can pay all the care home fees. This is called NHS continuing healthcare. It is not means-tested because it is  wholly about health needs. The health needs can be a result of an accident or major illness or due to a disability.

NHS-funded nursing care can be offered after assessment, which helps to pay for nursing home fees if you are eligible. Again, this is not means-tested, but the health needs and criteria are very specific.

The Fremantle Trust puts the person at the heart of all they do, using their expertise, professionalism, kindness and compassion. Their services include care homes, extra care, residential and supported living schemes across Buckinghamshire, Bedfordshire, Berkshire, Hertfordshire and Milton Keynes.

If you would like further information, contact The Fremantle Trust today or phone 0333 005 8735 or 01296 393 000 to speak with a friendly advisor.


We have care homes located across the Buckinghamshire county. Learn more about care homes nearest to you:

Care home in Aylesbury
Care homes in Princes Risborough
Nursing home in Chalfont St Peter
Care homes in Amersham
Care homes in Slough
Care homes in Chesham
Care homes in Stoke
Care homes in Burnham
Care homes in High Wycombe
Care homes in Marlow