The short answer
- The council's words are about assessmentA needs assessment decides what help is needed, and a separate means test decides who pays. Both are free to ask for.
- The money words decide who paysIn England in 2026/27, the council may start paying towards care once savings are below £23,250.
- Several NHS words mean the NHS paysContinuing healthcare, district nursing and section 117 aftercare are free. Reablement is free for its first six weeks.
- The legal words are about who decidesCapacity, best interests, a lasting power of attorney and a deputy all answer one question: who makes a decision when your relative cannot.
This page describes England. Scotland, Wales and Northern Ireland use some of the same words under different law. Every definition was checked against its source in September 2026.
Find a word
Where each word comes from, and who to ask about it
Most of these words belong to one of five places: the council's assessment, the money, the NHS, the law, or the running of care at home. Knowing which one a word belongs to tells you who to ask about it.
48 words in five groups, by where you are likely to hear them
The council and the assessment
Adult social care at the council where your relative lives
Paying for care
The council's financial assessment team, and the DWP for benefits
The NHS and the hospital
The ward, the GP, and the local NHS integrated care board
Decisions and the law
The GP or clinician, a solicitor, and the Office of the Public Guardian
Day to day at home
The carer, the pharmacy and whoever wrote the care plan
Each word links to its definition further down, and each definition links to the guide on this site that explains it properly. Where the exact meaning matters, the definition comes from the law itself, the NHS, or government guidance, and the source is named beside it.
The words for kinds of care at home, such as domiciliary care, live-in care and respite, are explained in what domiciliary care, home care and live-in care mean, so they are not repeated here. If you are at the very start, the home care guide sets out what care at home involves before any of this vocabulary arrives.
The assessment
Words from the council's assessment
These are the words you hear once you ring adult social care. They follow an order set by the Care Act 2014: an assessment, a decision on eligibility, then a plan.
Who uses these words: Adult social care at the council where your relative lives
- Needs assessmentcare needs assessment, Care Act assessment
The council's look at what somebody can no longer manage at home and what would help. The Care Act says the council must carry one out whatever the level of need and whatever the person's money, and it is free.
How to ask for a care needs assessment · Source: Care Act 2014, section 9
- Carer's assessment
A separate assessment of what caring is taking out of the family member who does it, and what would help them. It is free, and anyone over 18 who looks after somebody can ask for one.
What a carer's assessment covers · Source: NHS
- Eligible needs
Needs that meet three national conditions: they come from a physical or mental impairment or illness, they stop the person achieving two or more of ten set outcomes, such as eating properly or keeping clean, and that has a significant impact on their wellbeing. The council has a duty to meet eligible needs.
The three tests the council applies · Source: Eligibility Criteria Regulations 2015
- Independent advocate
Somebody the council must arrange to support a person through their assessment and planning where they would have substantial difficulty taking part and there is nobody suitable to help them.
The legal side of caring for a parent · Source: Care Act 2014, section 67
- Care and support plancare plan
The council's written plan of which needs will be met and how. By law it has to state the personal budget.
The care plan guide · Source: Care Act 2014, section 25
- Care package
Everyday shorthand for everything arranged together: the visits, their times, any equipment and who provides it. It is not a term the Care Act uses, so when you hear that a package is in place, ask which visits start on which day.
- Reablementintermediate care
Short-term help at home to get somebody doing things for themselves again after an illness or a hospital stay. The NHS says it usually lasts up to six weeks, and the regulations stop a council charging for the first six weeks.
Reablement and the free six weeks · Source: Preventing Needs Regulations 2014, regulation 4
- OToccupational therapist
A health professional who helps people who have difficulty with everyday activities because of illness, disability or ageing. At home, an OT is usually the person who assesses for equipment and adaptations.
The right equipment for an older person · Source: NHS Health Careers
The needs assessment comes first, and the rest follow from it. It is free, it does not depend on savings, and anyone can ask for one on behalf of a relative. If you are the one doing the caring, ask for a carer's assessment in the same call, because it is a separate right of your own. How to ask for a care needs assessment covers what to say and what happens on the day.
If the answer is that your relative's needs are not eligible, the council still has to explain its decision in writing. Ask for that record, because any challenge starts from it.
Paying for care
Words about who pays for care
Money comes after the assessment, never before it. These are the words for how the council works out what your relative pays, and the benefit that is paid whatever their savings.
Who uses these words: The council's financial assessment team, and the DWP for benefits
- Means testfinancial assessment
The council's look at income and savings, which decides how much a person pays towards care the council arranges. It is separate from the needs assessment and comes after it.
How council funding works · Source: NHS
- Upper and lower capital limits
In England in 2026/27, somebody with more than £23,250 in savings and other capital pays the full cost, and capital under £14,250 is ignored. Between the two, the council expects a contribution from it.
Council funding and the thresholds · Source: DHSC charging circular 2026/27
- Personal budget
The amount the council says it will cost to meet somebody's eligible needs, split into what the person must pay and what the council must pay.
Personal budgets and personal health budgets · Source: Care Act 2014, section 26
- Direct payment
A personal budget paid as money to the person, or somebody they choose, so they can arrange the care themselves instead of the council doing it. The NHS says most councils ask for evidence of how it was spent every three months.
How direct payments work · Source: NHS
- Attendance Allowance
A weekly benefit for people at or over State Pension age who need help because of a disability or health condition, at £76.70 or £114.60 in 2026/27. It is not means-tested, so savings and earnings do not affect it.
Who can claim Attendance Allowance · Source: gov.uk
- Top-upthird-party top-up
An extra payment, usually by a relative, when somebody chooses a care home that costs more than their personal budget. It needs a written agreement with the council.
How care home top-up fees work · Source: Choice of Accommodation Regulations 2014
- 12-week disregard
When somebody first moves permanently into a care home, the council ignores the value of their home in the means test for the first 12 weeks. For care at home, the home they live in is not counted at all.
A care home week against a home care week · Source: Charging and Assessment of Resources Regulations 2014
- Deferred payment agreement
An arrangement in which the council pays care home fees and the money is repaid later from the value of the home, when it is sold or from the person's estate. Interest and administration charges are added.
How deferred payment agreements work · Source: NHS
The means test for care at home is gentler than the one for a care home, because the value of the home your relative lives in is not counted. The 12-week disregard, top-ups and deferred payments apply mainly to care homes. Care at home or a care home sets the two side by side, and the different types of care funding lists every route in one place.
These are the council's rules. PrimeCarers does not give financial advice, so for decisions about savings, property or a deferred payment agreement, speak to a regulated financial adviser who specialises in care fees.
The NHS and hospital
Words from the NHS and the hospital ward
These words tend to arrive in a hurry, around a hospital discharge or a change in somebody's health. Several of them mean the NHS, not your relative, pays.
Who uses these words: The ward, the GP, and the local NHS integrated care board
- Discharge to assess
Short-term care, rehabilitation and reablement after a hospital stay, with the assessment of longer-term needs left until the person has recovered as far as they can.
Hospital discharge explained · Source: Hospital discharge guidance
- Pathways 0 to 3the discharge pathways
Pathway 0 is home with no new care needs. Pathway 1 is home with new support, pathway 2 is a short stay in a community bed to recover, and pathway 3 is a care home, which the guidance says should be used only in exceptional circumstances.
What to arrange before discharge day · Source: Hospital discharge guidance
- CHCNHS continuing healthcare
Free care arranged and funded solely by the NHS for somebody with long-term complex health needs. Eligibility depends on the needs, not on a diagnosis or on savings.
NHS continuing healthcare · Source: NHS
- Checklist
The short first screening for CHC. It decides only whether a full assessment follows, not whether the person is eligible.
NHS continuing healthcare · Source: NHS
- DSTDecision Support Tool
The form used at the full CHC assessment. A team of professionals records needs across 12 areas, including breathing, nutrition, mobility, cognition and behaviour, and recommends whether the person is eligible.
NHS continuing healthcare · Source: National Framework for CHC
- Fast track
A quicker route into CHC for somebody whose condition is deteriorating rapidly. A doctor or nurse completes the form, and the NHS says care should usually be in place within 48 hours.
How fast-track CHC works · Source: NHS
- FNCNHS-funded nursing care
An NHS payment towards registered nursing for somebody in a care home registered to provide nursing, where they are not eligible for CHC. It is paid straight to the home.
Funded nursing care · Source: NHS
- Section 117 aftercare
Aftercare from the NHS and the council for somebody who has been detained under certain sections of the Mental Health Act, such as section 3. It covers needs arising from their mental disorder and continues until both agree it is no longer needed.
Mental health support at home · Source: Mental Health Act 1983, section 117
- Personal health budget
The NHS version of a personal budget. People on CHC and people eligible for section 117 aftercare have a legal right to one.
Personal budgets and personal health budgets · Source: NHS England
- District nurse
An NHS nurse who visits people at home and in residential care homes, usually arranged through the GP surgery or the hospital. District nursing is free.
- SALTspeech and language therapist, SLT
A therapist who helps people who have difficulty with communication, eating, drinking or swallowing. Where swallowing is a problem, the SALT recommends how soft food and how thick drinks need to be.
Swallowing and speech · Source: NHS Health Careers
- IDDSI levels
The International Dysphagia Diet Standardisation Initiative, a scale from 0 to 7 that describes food textures and drink thicknesses. Drinks run from level 0 to 4 and foods from level 3 to 7.
Dysphagia diets explained · Source: IDDSI
The difference between health care and social care is where most of the money is decided. Care the NHS has to provide is free, and the Care Act stops a council meeting somebody's needs with a service the NHS is required to provide. So if your relative has complex health needs, ask the ward or the GP whether a CHC checklist has been considered before a care package is agreed. Funding care after a hospital stay explains who pays for what once somebody is home.
If discharge is close and nothing has been arranged, what to do when discharge is tomorrow and there is no care goes through the options in order.
Decisions and the law
Words for decisions and the law
These words come from the Mental Capacity Act 2005 and the Care Act 2014. They settle who decides when somebody cannot decide for themselves, and what protects them.
Who uses these words: The GP or clinician, a solicitor, and the Office of the Public Guardian
- Mental capacity
Being able to make a particular decision at the time it has to be made: to understand the information, keep it in mind, weigh it up and communicate a choice. The law assumes a person has capacity unless it is shown that they do not.
How mental capacity is assessed · Source: NHS
- Best interests
The rule for a decision made for somebody who lacks capacity to make it. The decision-maker must consider their past and present wishes, beliefs and values, and consult the people close to them.
What families are responsible for · Source: Mental Capacity Act 2005, section 4
- LPAlasting power of attorney
A legal document in which somebody appoints people they trust to make decisions for them. A health and welfare LPA can only be used once they cannot decide for themselves. A property and financial affairs LPA can be used once registered, with their permission.
How a lasting power of attorney works · Source: gov.uk
- Deputy
A person the Court of Protection authorises to make decisions for somebody who cannot make them and has no LPA. A deputy can be for property and financial affairs, or for personal welfare.
Deputyship: advice and fees · Source: gov.uk
- Court of Protection
The court that makes decisions on money and welfare for people who cannot make them. It decides questions of capacity, appoints deputies and rules on deprivation of liberty.
What the Court of Protection does · Source: gov.uk
- OPGOffice of the Public Guardian
The government office in England and Wales that registers lasting powers of attorney and supervises deputies.
Paying for care as an attorney · Source: gov.uk
- DoLSDeprivation of Liberty Safeguards
The process for authorising care that deprives somebody who lacks capacity of their liberty. It applies only in care homes and hospitals. At home, it takes an application to the Court of Protection. A Supreme Court judgment in June 2026 changed the test for what counts.
Deprivation of liberty at home · Source: SCIE
- Safeguarding
Protecting adults with care needs from abuse and neglect. Where a council has reasonable cause to suspect it, the Care Act says the council must make whatever enquiries it thinks necessary.
How to report a safeguarding concern · Source: Care Act 2014, section 42
- Advance decisionliving will
A decision, made while somebody has capacity, to refuse a named treatment if they later lose capacity. It is legally binding if it meets the rules, and a refusal of life-sustaining treatment must be written, signed and witnessed.
Advance decisions and advance statements · Source: Mental Capacity Act 2005, sections 24 to 26
- Advance statement
A written note of somebody's preferences, wishes, beliefs and values about their future care. It is not legally binding, but anyone deciding about their care must take it into account.
Advance decisions and advance statements · Source: NHS
- DNACPRdo not attempt cardiopulmonary resuscitation
A decision that CPR will not be attempted if the heart or breathing stops. It covers CPR only, and all other care and treatment carry on. The form is kept in the medical record and may be kept at home too.
Palliative care and hospice at home · Source: NHS
- ReSPECTRecommended Summary Plan for Emergency Care and Treatment
A form recording recommendations for somebody's care in a future emergency when they cannot say what they want, agreed in conversation with them, their family and clinicians. It is not legally binding.
Advance decisions and advance statements · Source: Resuscitation Council UK
A lasting power of attorney can only be made while your relative still has capacity to make it. Once that has gone, the route is an application to the Court of Protection for a deputy, which takes longer and costs more. Lasting power of attorney explains how to make one.
PrimeCarers does not give legal advice. For a will, a deputyship application, or a dispute about capacity or best interests, speak to a solicitor who works in this area, or to the Office of the Public Guardian about an LPA or a deputy.
Day to day at home
Words used in the day-to-day running of care
These are the words that come up once care has started: in the medicines folder, on a care plan, and in the checks behind the person who comes to the door.
Who uses these words: The carer, the pharmacy and whoever wrote the care plan
- MAR chartmedicines administration record
The record a care worker fills in each time they give or support somebody with a medicine, ideally printed by the pharmacy. NICE says it should list each medicine, its strength, when it is taken and how.
Can carers give medication? · Source: NICE NG67
- Delegated taskdelegated healthcare activity
A healthcare task, such as a tube feed or an injection, that a regulated professional such as a nurse hands to a named care worker after training them and checking they can do it for that person.
How delegated healthcare tasks work · Source: Skills for Care
- Double-updouble-handed care, two carers
Two care workers at every visit. It is usually arranged where a mobile hoist is used or moving the person is complicated.
Transfers, hoists and two carers · Source: NHS Health Research Authority
- Waking night
A carer who stays awake all night to help with turning, the toilet or somebody who wakes confused. Carers on PrimeCarers charge £150 to £160 a night for one, with our fee included.
- Sleep-insleeping night
A carer who sleeps in the house and gets up if needed. The other words for kinds of home care are on the page listed below.
- CQCCare Quality Commission
The independent regulator of health and adult social care in England. It registers, inspects and rates care services, including home care agencies that provide personal care.
How home care is regulated · Source: CQC
- Enhanced DBS and the Update Service
An enhanced DBS is the fullest criminal record check. A carer on the Update Service keeps the certificate current, and with their permission it can be checked online at no cost.
Do private carers need a DBS? · Source: gov.uk
- Introductory service
A service that introduces families to self-employed carers, who then work for the family. PrimeCarers is one: we are not an agency or a care provider and hold no CQC registration. We check each carer's identity, right to work and enhanced DBS (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 18 months, and interview them online. We do not check qualifications, training or references.
Some of these words are about what a carer may do. Giving medicines from the pharmacy's packs and recording them on a MAR chart is part of ordinary care. A healthcare task, such as a tube feed or an injection, is different: a carer may do it only if a nurse or another regulated professional has assessed your relative, trained the carer and signed them off for that person. PrimeCarers does not check qualifications or training, so ask each carer about their experience and check it with them. Can carers give medication? explains where the line sits.
When you have worked out what your relative needs, you can search for carers near you and compare their rates, reviews and availability. Visits on PrimeCarers cost £18 to £25 an hour with our fee included, against £28 to £35 through an agency.
Questions
Questions families ask about care words
The needs assessment looks at what your relative can no longer manage and what would help. It is free and does not depend on their money. The financial assessment, or means test, comes afterwards and works out how much they pay towards care the council arranges. The guidance says the money must not influence the needs assessment. The care needs assessment explains both.
NHS continuing healthcare (CHC) is a whole package of care paid for by the NHS, at home or in a care home, for somebody whose main need is a health need. NHS-funded nursing care (FNC) is a smaller payment towards the nursing part of the fees for somebody in a care home that provides nursing, who is not eligible for CHC. The NHS considers CHC first. NHS continuing healthcare covers how to ask.
Your relative chooses their attorneys by making a lasting power of attorney while they still have capacity to do so. A deputy is appointed by the Court of Protection when somebody has lost capacity and there is no LPA in place. Both must act in the person's best interests. The Office of the Public Guardian registers LPAs and supervises deputies. The Court of Protection explains the deputy route.
No. A DNACPR is a decision about CPR alone, which a doctor can make and must tell the person about. An advance decision is made by the person themselves, while they have capacity, and can refuse other named treatments too. A ReSPECT form records recommendations for an emergency and is not legally binding. Advance decisions and advance statements sets the three side by side.
Gov.uk says a direct payment lets somebody choose and buy the services they need themselves, instead of getting them from the council, including paying somebody to care for them. It has to be spent on what the care plan agreed, so ask the council before you commit. Direct payments and personal assistants and direct payments go through the rules.
It means your relative is going home, or to where they usually live, with new or extra care needs. Pathway 0 means home with no new needs, pathway 2 a short recovery stay in a community bed, and pathway 3 a care home. The guidance says longer-term needs are best assessed once somebody has recovered. Hospital discharge explained covers what happens next.