How can I fund live-in care?

1. Situation 1

   NHS Continuing Healthcare is agreed

   The NHS pays the whole live-in care package, whatever your relative has in savings, and a personal health budget is how you keep the choice of who moves in.

   What you pay

   £0 towards the care

2. Situation 2

   Savings below £14,250

   Savings are left out of the sum completely below this line. The council works out a weekly contribution from income alone, and it has to leave your relative at least £241.45 a week to live on.

   What you pay

   A share of income, often small

3. Situation 3

   Savings between £14,250 and £23,250

   The council adds an assumed income of £1 a week for every £250, or part of it, in this band, then runs the same sum. Ask for the money as a direct payment if you want to choose the carer yourself.

   What you pay

   A larger share of income

4. Situation 4

   Savings above £23,250

   Your relative pays the full cost. Attendance Allowance, worth up to £5,960 a year if it is granted, comes off that bill whatever their savings are.

   What you pay

   £1,050 to £1,400 a week

5. Situation 5

   Paying from the home rather than the bank

   Equity release or an immediate needs annuity can fund the same weekly cost without your relative spending down savings or selling the house now.

   What you pay

   The same weekly figure, from a different source

Most families land on more than one rung: Attendance Allowance in payment, a council contribution taken as a direct payment, and the family finding the difference. Attendance Allowance sits underneath every row here, because it is not means-tested.

The two assessments that decide the top of the ladder are free, and they can run at the same time. One is an NHS Continuing Healthcare checklist; the other is a council care needs assessment. Ask for the checklist first, because a council should not be charging your relative for care the NHS has a duty to fund. What does fully funded care mean? sets the two out side by side.

Nothing here depends on your relative moving anywhere. Live-in care happens in their own house, which is why the means test treats it so differently from a care home. If you are still weighing the two, is live-in care cheaper than a care home? does the comparison with figures.

Continuing Healthcare is decided on the shape of the needs rather than on the label attached to them. A stroke, advanced dementia or Parkinson's does not qualify anybody by itself. What counts is how much skilled judgement the care takes, how often, how several needs make each other harder, and how quickly things change.

Live-in care and Continuing Healthcare fit together well, because one person in the house all day is a credible answer to needs that are unpredictable. That case has to be written down. Ask for the care plan to record what happens on the bad nights and how quickly somebody has to respond, rather than a list of tasks. NHS Continuing Healthcare explains the twelve areas of need and how to challenge a refusal.

Most councils hold contracts with hourly home care agencies and with care homes, and very few for live-in care. That is why a live-in arrangement almost always arrives through a direct payment: the council hands over the money it has calculated, and your family buys the care. Direct payments covers the conditions the council checks, what the money will buy and the records you keep.

The figure the council hands over is called a personal budget, and it must be enough to meet the needs the council has agreed your relative has. The statutory guidance tells councils to set it against local market conditions and the cost of local quality provision, and says they should not have arbitrary ceilings that force people into care homes against their will. Those sentences are worth quoting back, in writing, if what is offered is a care home place.

The same guidance is clear about the other side. A council can take its own financial constraints into account, and may refuse a direct payment request that is, for example, twice as expensive as a care home or as the care it would commission itself. The argument is therefore won on the needs assessment rather than on preference. If the plan records night-time needs, a risk of falls and what happens when a visit is missed, a live-in arrangement starts to look like the answer. Ask for the plan in writing, and ask for a reassessment if a need you raised is missing.

Once a budget is agreed and you know the weekly number, you can search live-in carers near your relative and compare their rates, experience and reviews before committing to anybody. Knowing what a live-in week costs in their area is the strongest thing you can bring to a conversation about whether the budget is sufficient.

Read the sum from the bottom up and you can see where a family has room to argue. The Minimum Income Guarantee is a floor set nationally, and a council can leave somebody more than the minimum but never less. Disability-related expenditure is the line most often left at zero because nobody asked for it: if Attendance Allowance is being counted as income, the council must let your relative keep enough to meet disability needs it is not meeting itself, from extra laundry and heating to a community alarm, a special diet, gardening, cleaning that is not in the care plan, transport and equipment. Write the list before the assessment and keep the receipts.

The line that matters most for live-in care is the one that is missing. The value of the house is disregarded while your relative is living in it, however much it is worth. Care at home never triggers the twelve-week property disregard, the deferred payment agreements or the charge on the house that families associate with a care home move. For a parent who is asset-rich and income-poor, that one rule can make a live-in arrangement affordable when a care home place was not.

Two further points catch people out. A council has no power to assess a couple on their joint resources, so each person is worked out on their own income and their own share of any joint savings. And somebody above the upper capital limit who is paying in full still has a right to ask the council to arrange the care, though it can charge the full cost plus a fee. Local authority funding works through the eligibility test in more depth.

One part of the gap is specific to live-in care, and no funding route covers it. The weekly figure a carer quotes does not include their food, which goes on the household shop, or the spare room your relative has to provide. Under the terms families and carers agree through PrimeCarers, bank holidays are charged at one and a half times the carer's normal rate and Christmas Day at twice. The cost of live-in care breaks down what a live-in week includes, and live-in care rotas covers what happens when the regular carer is away.

If the gap is still there, the options are a different shape of care, family time around a part-time arrangement, or paying the difference from savings or the house. If the pressure is coming from a discharge date, funding care after a hospital stay covers the six weeks of free reablement that should come first.

Attendance Allowance is the one to claim first. It is not means-tested, it arrives as cash to spend on anything, and it carries on if council funding starts. It has one twist here: in a financial assessment for care at home it counts as income, so claiming it can raise the contribution your relative is assessed to pay. That is why the disability-related expenditure line matters, because a council that counts the benefit as income must let your relative keep enough of it for disability needs the council is not meeting. Claim it, then itemise the spending. Attendance Allowance covers who qualifies and how to fill the form in.

Carer's Allowance is paid to the family member doing the caring rather than to your relative, and it can affect other benefits in the household, so check the whole picture before claiming. It also interacts with the sum above: where your relative or their partner receives it, or has an underlying entitlement to it, an extra amount is added to the Minimum Income Guarantee, which lowers the assessed contribution. Carer's Allowance sets out the conditions, and can my mum pay me to care for her? covers being paid by your own relative to do the caring yourself.

Equity release comes in two forms. A lifetime mortgage is a loan against the home with no monthly repayments, where interest rolls up and the loan is repaid, usually by selling the home, once your relative no longer lives there. A home reversion plan sells part or all of the home to a provider now, in exchange for a lump sum or an income and the right to live there rent-free for life. Both are regulated by the Financial Conduct Authority and have to be arranged through a qualified adviser; the Society of Later Life Advisers lists advisers who specialise in later-life lending. Both are also largely irreversible, so take the advice before, not after.

Equity release suits live-in care better than it suits a care home move, for one structural reason. A lifetime mortgage becomes repayable once the borrower has died or moved permanently into residential care. While your relative is still living in the house with a carer, neither has happened, so the loan is not called in.

An immediate needs annuity works differently. Your relative pays an insurer a lump sum once, in exchange for a guaranteed weekly income for the rest of their life, priced on their health at the time. Where the payments go directly to a registered care provider, they are paid free of tax under HMRC's rules. It suits a family who wants certainty over a bill that will otherwise keep rising. Self-funding care covers the wider options.

1. 1

   Ask for the Continuing Healthcare checklist by name

   Today

   Ring the GP, the community nursing team or the hospital discharge team. Say: my mother may have a primary health need and I am asking for an NHS Continuing Healthcare checklist. Ask for the request and the outcome in writing. If things are deteriorating quickly, ask about the fast track instead.
2. 2

   Ask adult social care for a care needs assessment

   Today, on a separate call

   It is free, your relative is entitled to it whatever their savings, and it does not have to wait for the NHS answer. Ask for a carer’s assessment of your own at the same time.
3. 3

   Write down the week before anybody visits

   Before the assessment

   Two sides of paper: what happens at night, what happens on a bad day, what has gone wrong this month, and what you are doing yourself to hold it together. Answer for the worst day. The funding conversation is built on this.
4. 4

   List the disability spending

   Before the financial assessment

   Extra laundry, extra heating, a community alarm, a special diet, gardening, cleaning not in the care plan, transport, equipment. Every pound accepted here comes off the weekly contribution. Bring receipts.
5. 5

   Ask for a direct payment or a personal health budget

   Once anything is agreed

   Say you want to choose the carer rather than take whoever is arranged for you. This is the step that lets public money pay for one named person living in the house, and it is easier asked for at the care planning stage than afterwards.
6. 6

   Look at live-in carers while you wait

   Free to search

   Search by postcode to see who is available near your relative and what they charge. Every carer has an online interview, and an ID check, a right to work check and an enhanced DBS on the Update Service before they appear, and they are insured while they work.