Funded nursing care, and why it only applies in a nursing home

To qualify, your relative needs to live in a nursing home, to have been assessed as needing care from a registered nurse, and not to be eligible for NHS Continuing Healthcare. The payment covers the nurses' time on hands-on nursing and also their time planning, supervising and checking the care that other staff give. It is part of the wider picture of help with care costs, which the funding care guide sets out route by route.

The rate is set nationally and reviewed each April. Nobody applies for it in the way you would apply for a benefit. It follows from an NHS assessment, and the home receives it from the local integrated care board, which is the NHS body that plans and pays for health services in the area.

Wherever your relative lives, nursing by a registered nurse is an NHS service, and the law keeps it with the NHS rather than the council. At home, the NHS provides it through the district nursing team, who visit people who are housebound to care for wounds and leg ulcers, help with continence, and look after them through a spell of illness. The GP or the hospital makes the referral, and the visits cost nothing. The same is true in a residential care home, which does not employ nurses and calls in the district nurses instead. Only a nursing home employs its own nurses and charges for them in its fees, so only a nursing home receives the NHS payment.

What is not free, at home or in any home, is the everyday care: help with washing, dressing, meals and company. That is where the money goes if your relative stays at home. The council may pay towards it after a care needs assessment and a means test, with savings over £23,250 meaning your relative pays in full, and council funding explains how that works. If you are weighing a nursing home against care at home, with the district nurses doing the nursing, you can search for carers near you and compare their rates. Live-in care on PrimeCarers starts at £1,050 a week with our fee included, and whether live-in care is cheaper than a care home puts the two side by side.

1. 1

   Continuing Healthcare is considered

   First

   Before a decision on funded nursing care, the NHS should consider whether your relative is eligible for Continuing Healthcare. Usually this starts with a short screening checklist, and sometimes goes on to a full assessment.
2. 2

   Their nursing needs are looked at

   If Continuing Healthcare is not awarded

   If the full assessment was done, it will usually settle the question of nursing too. If your relative was screened out at the checklist, they should have a separate assessment of their day-to-day nursing needs.
3. 3

   The NHS pays the home

   Weekly

   If they need care from a registered nurse and a nursing home is the right place for them, the integrated care board pays £267.68 a week to the home.
4. 4

   It is reviewed

   Within 3 months, then yearly

   The first review should happen within three months of the decision, and then at least once a year. Each review should consider Continuing Healthcare again if your relative's needs have changed.

The two decisions are linked, so this page does not repeat the Continuing Healthcare rules. NHS Continuing Healthcare covers the checklist, the twelve areas of need, and how to challenge a decision. If your relative's needs grow while they are in a nursing home, you can ask for the Continuing Healthcare checklist again at any time rather than waiting for the yearly review.

If you disagree with a decision that your relative does not need nursing care, ask the integrated care board to review it. Beacon, the free Continuing Healthcare advice service, and Age UK's advice line can help you with the request.

For a sense of scale, the nursing home figure we use across this site is about £1,410 a week. Whether a home's quote is before or after the NHS payment changes what your relative pays by £267.68 a week, which is why the first question above matters. Where the council is helping and the family pays extra for a more expensive home, that extra is a separate agreement, which care home top-up fees explains.

Choosing the home comes first, and choosing a care home covers the visits and questions that decide it. If you are not yet sure your relative needs nursing rather than residential care, the difference between a nursing home and a care home explains how the two are registered and staffed. The Local Government and Social Care Ombudsman has published guidance on funded nursing care in care home contracts, written after complaints about how homes charged around the payment, and it is worth reading if the bill does not add up.