Paying for care and support in England

Paying for care and support in England

Many people with dementia will need care and support from their carer, family, friends or professionals as their condition progresses. All care – including any you pay for – should help you to live well with dementia. The types of care put in place will be different for everyone, because everyone’s needs are different.

The Care Act 2014 sets out the legal responsibilities of English local authorities (councils) for adults who need care, as well as their carers. It aims to make sure that every decision about a person’s care takes into account and builds on their strengths, capabilities and wellbeing, to help them to live independently for as long as possible. 

Who pays for care?

There are national rules about who has to pay for care and support, although these can vary locally. It mainly depends on the type of care and support that you need, where you live and what is available.

If you are still living at home, you will usually pay for the costs of your own care and support. The local authority (council) may also contribute, but this depends on your income and your assets (such as savings or shares). You may be assessed by your local authority as having to pay for all your own care and support at home. This is sometimes called being a ‘self-funder’.

If you are receiving care and support in your own home, you are entitled to keep a basic level of income (money you receive regularly), however much your care costs. The Care Act states that charges for care must be ‘reasonable’.

If you are living in a care home, you might pay for all of your care and support costs which means you are a ‘self-funder’. Or, you may make a contribution, with the local authority and/or the NHS also contributing. Again, this depends on your income and assets, and on your needs. See ‘Care home fees’ for further details.

You may have all or part of your care funded by the NHS – see ‘Nursing care costs’ for more information.

Information and advice

People with dementia, carers and families can take control and make informed choices about care and support. The Care Act says that you have the right to ask for clear, written explanations, and the right to be provided with clear information from your local authority.

Even so, paying for care can be complicated, and it’s best to speak to an adviser in your area. Ask for extra information and advice if you need it.

Financial advice about paying for care in England

Local authorities do not have to provide all of the information and advice about paying for care in England themselves, although they are expected to signpost (tell you about) or refer you to independent and impartial sources of information and advice.

If you need independent financial advice so that you can make informed decisions, the local authority must help you to access it. You can ask for information and advice about understanding care charges, and ways to pay for them.

The local authority should know (or find out) whether you have decision making capacity before giving you advice. This means you are able to understand the information that is relevant to that decision, and to choose what to do next. You may have a deputy of the Court of Protection or a person with Enduring power of attorney or Lasting power of attorney who is acting on your behalf.

For more information, see Lasting power of attorney, or Deputyship.

Independent advocates

You may have difficulty being involved in, and making decisions about, your care and support. Not everyone has a family member or friend to support them, so if you have substantial difficulty and no one to help, a local authority must provide an independent advocate. This person will enable you to have your voice heard.