Paying for your care and support
Which care services do you pay for?
Most NHS care is free but many people have to pay for some things. All people registered with a Welsh GP, who get their prescriptions from a Welsh pharmacist, are entitled to free prescriptions.
You may be entitled to benefits like Attendance Allowance or Disability Living Allowance to help meet the cost of care at home (see Financial help and advice).
In most circumstances people are expected to contribute towards the cost of their care. Free services include information, advice and assessments of what help people and their carers need.
Who qualifies for financial help?
The rules for deciding who qualifies for financial help include ‘allowances’ (capital threshold and ‘personal expenses’). These allowances are reviewed annually with changes taking effect from April each year. The value of your home is not taken into account for non-residential care, however second homes or other property will be taken into account.
If the Adult Care department are paying some or all of the costs of care you can still have a say in which care providers or service you have.
Adult Care will encourage you to source and arrange your own care services. You can choose to receive ‘Direct Payments’, which means that you are given money to buy your own care. This allows you to tailor your care package to suit you.
What is the assessed contribution?
Residential and nursing home accommodation is not provided free of charge. If you move to a care home you will have to pay a weekly charge from the date you move into the home. The ‘assessed contribution’ is based on your ability to pay following a financial assessment. If you have financial resources above the limit set by the government then you will be charged in full and will be treated as a self-funded service user.
What is a Third Party contribution?
A Third Party contribution is a payment made to a residential or nursing home on your behalf, normally by a friend or relative. Where we are contributing to the cost of your care we only pay up to a certain amount, but many care homes charge more than this. You can choose a more expensive care home if a friend, family member or a charity pays the difference. This is called a ‘Third Party contribution’ and it is normally paid directly to us, so that we can pay the home in turn. As the service user, you are not allowed to pay a Third party contribution. The level of third party contribution will often increase (generally annually) when the rate charged by a Care Home increases in turn. There can be no guarantee given that any such increase will be shared evenly between the council and a third party. Therefore anyone considering becoming responsible for Third party payments should consider this commitment very carefully.
Why can’t I make Third Party contributions?
The guidance issued by the Government states that residents within care homes cannot make Third Party contributions out of their own resources and local authorities do not have the power to collect any additional charges from the residents own resources to make Third Party payments. However there are certain exceptions to the rule – see below.
When can I make Third Party contributions?
If you have property to sell, you can enter into a deferred payment agreement with the local authority. In this case the Council will consider providing temporary funding which may be in excess of the Council price, because the Council will later recoup the funding by means of a charge on the property. You should be aware that this is not standard practice and we do not automatically agree to allow a third party payment on a deferred payment. This is something you would need to request when applying for a deferred payment.
What is our responsibility in this arrangement?
We need to be sure the Third Party is able to pay the contributions for as long as may be needed. However, we have no powers to carry out a financial assessment of a Third Party. Because of this, we ask the Third Party to read this leaflet carefully and sign the enclosed document, as a record that they have read and understood the information contained in this leaflet. Particularly, you should note that the Council reserves the right to recover from the third party any outstanding contributions that become due. If the care home stops providing satisfactory care or is otherwise in breach of the terms and conditions of our contract with them, we also reserve the right to move you to alternative accommodation. If your needs change significantly you will be re-assessed by a social worker to see whether your current accommodation continues to meet your needs.
What happens if the Third Party stops paying?
We will negotiate on your behalf with the Care Home to see whether they will accept the set local authority price for the accommodation, which may be lower than the price you are being charged. If the Care Home is not prepared to re-negotiate the price then you may need to move to a less expensive room in the same home, or to an alternative home at the local authority price. Before this happens, the social worker will carry out a full community care assessment, (including an assessment of your emotional and psychological needs) in order to ascertain the impact on you of the move. If the community care assessment identifies exceptional circumstances the social worker will refer you for special consideration of additional funding. If however, the community care assessment identifies no exceptional circumstances then we will explore a number of options to find alternative accommodation at local authority prices.