Paying for care and support in Wales

What is the Social Services and Wellbeing (Wales) Act 2014?

Information on these pages refers to the Social Services and Wellbeing (Wales) Act 2014. The Act sets out the legal responsibilities of local authorities (councils) in Wales for adults who need care, as well as their carers.

The Act aims to make sure that every decision about a person’s care helps them to live independently for as long as possible. This takes into account the person’s strengths, capabilities and wellbeing and aims to build on these.

Who pays for care and support in Wales?

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 live at home

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 assets (such as any savings or shares you have).

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 get care and support in your own home

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 Social Services and Wellbeing (Wales) Act states that charges for care must be ‘reasonable’.

For more information see ‘Paying for care in Wales: support at home'.

If you live in a care home

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.

For more information see ‘Who pays for care home fees in Wales?’ .

If you need NHS funding

You may have all or part of your care funded by the NHS – see ‘Nursing care costs in Wales: when does the NHS pay?’.

Can I get help with making care and support decisions?

The Social Services and Wellbeing (Wales) Act 2014 aims to build on people’s strengths, abilities and wellbeing, and to help people to live independently for as long as possible.

In order to do this, the Act says that people must have access to good quality information and advice. This can help people with dementia, carers and families to take control and make informed choices about care and support needs now and in the future.

The information and advice that is available should include care and support-related aspects of:

• health
• housing
• benefits
• employment.

The information supplied must be available to everyone and you have the right to ask for clear written explanations if you need them.

You should also ask for extra information and advice if you need it. For more information see ‘Paying for care in Wales: useful resources’.

Can I get financial advice about paying for care and support?

Local authorities and local health boards don’t have to provide all the information and advice themselves, but if they can’t, then 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 the ability (known as ‘mental capacity’) to make decisions 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.

If you aren’t able to understand any information, you may have someone with Enduring or Lasting power of attorney, or a deputy, who can receive the information on your behalf. 

Can someone else make care and support decisions on my behalf?

If you lack the mental capacity to make decisions about your care and support now, or in the future, you will need someone else to make decisions on your behalf. Often a family member or friend will make these decisions.

What if I don't have anyone suitable to make decisions on my behalf?

Not everyone has someone suitable to support them in this way. If you have substantial difficulty and no one to help, your local authority must provide you with an ‘independent professional advocate’. This person will help you to have your voice heard. 

You may also be offered this service if you have mental capacity but are experiencing significant stress, such as a bereavement.

The Social Services and Wellbeing (Wales) Code of Practice on Advocacy says that local authorities should identify these people as early as possible in the process in case an advocate is required.

If you are not able to participate fully in decisions about your care and support and you have no one to help you, the local authority is responsible for providing or arranging for an independent professional advocate to support you.

Family members, friends or volunteers can be a good source of support. However, if this support is not available – or unable to help in this way, you will need formal or independent professional advocacy.

The role of the advocate is to independently represent the views of the person with dementia, which may in some circumstances vary from the views of their friends and family.