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Elderly Care

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How to Avoid Paying Care Home Fees

The amount of money that has and continues to be spent unnecessarily on care home fees is staggering, especially when you consider the major impact this has on those in care and their families. The cost of care in the UK is considerable with an average cost of over £700 a week and the financial burden of meeting this is severe. It is an all too familiar story where families are forced to sell their homes to cover nursing home costs when they shouldn’t be paying in the first place.

Whether you are eligible for free nursing care home fees is dependent upon government assessment. If the assessments conducted are inaccurate, you may be paying too much and you may be able to claim for a care home fee refund.

There are two types of assessment - an NHS continuing healthcare assessment and a means tested social care funding assessment.

  • An NHS continuing healthcare assessment checks whether your state of health means you should receive free care.
  • A social care funding assessment looks at your assets and assesses how much you should be paying towards your fees if you do qualify to pay.

It is important that both are conducted correctly if you are to avoid nursing home fees. If they are not conducted correctly you or your loved one may be being overcharged.

NHS Continuing Care Assessment

Before going into care, an NHS Continuing Care assessment needs to take place to determine if you or a loved one needs to pay care home fees. It is estimated that billions of pounds are being wrongly spent on care home fees with a Continuing Care Assessment being carried out inaccurately or in some cases not at all.

The NHS system for deciding care home funding has been notoriously difficult and under publicised, meaning that people are simply unaware that they may not have to pay.

Primary Health Needs = Avoid Nursing Home Fees

You or your relatives do not have to pay care home fees if you have primary health needs. An NHS Continuing Healthcare Assessment determines whether or not you have primary health needs.

Many people are unaware that if you are in a situation where the main care being provided to you or a loved one is nursing care, the NHS should cover the full costs of your care home fees.

An NHS Continuing Healthcare Assessment looks at whether your care needs are related to 'primary health needs'. If the needs that you have are health-related rather than age-related you should be able to avoid nursing home fees, with the costs of your long-term care being covered by the NHS. 'Primary health needs' are physical and mental health needs which have occurred as the result of an accident or an illness. If you are eligible for free nursing home care NHS Continuing Healthcare Funding covers the whole cost of your care home, regardless of your financial situation.

Many elderly people are sacrificing their life savings and their assets to pay fees for care homes that they could avoid paying. This is all because they have not received an NHS Continuing Healthcare Assessment, they did not know they could receive this assessment or they have received an inaccurate assessment.

There are 3 circumstances when an NHS Continuing Care Assessment needs to be carried out:

  • You or a loved one is going into a care home for the first time
  • You or a loved one never received an assessment before entering a care home
  • You or a loved one’s health has deteriorated since entering a care home

So the first thing to do to avoid paying care home fees unnecessarily is:

Make sure you have undergone an accurate NHS Continuing Care Assessment

If this has not happened when it should have, then you need to ask a solicitor to investigate and arrange a assessment as well as get a retrospective from when you or a loved one entered care.

When May Someone Become Eligible For Free Nursing Home Care?

  1. In Care Already
  2. When an individual enters care they should be assessed to see if they qualify for NHS continuing healthcare funding. If this assessment did not take place you may be paying for care home fees when you would be eligible for free nursing home care. In this case 1st Claims can help you to get a proper assessment. You should always check that you do not qualify for free care via a full NHS assessment, in case speculative advice you have been given does not apply to your situation.

    Alternatively if you experienced an NHS continuing healthcare assessment that you think was inaccurate you can contest this with our help. 1st Claims can offer you help getting a reassessment if you or a loved one is currently in care and you think they should qualify to avoid care fees due to their primary health needs.

  3. Deteriorating Health In Care
  4. Sadly, people usually do not remain in the same state of health for the duration of their stay in care. If health deteriorates whilst an individual is in care they may become eligible to have their care home fees paid by the government. A reassessment of an individual's circumstances is necessary in this situation and 1st Claims can help you with this.

  5. Moving Into Care From Hospital
  6. The NHS covers hospital care but when an individual moves from hospital to a care home they will need to have their health needs assessed properly to establish whether or not they are eligible for free care fees. 1st Claims can help you make sure that assessments of needs are conducted correctly if you wish for us to do so.

Furthermore, if you are not eligible for free nursing home care, you will be eligible to pay a certain amount towards your care fees depending upon your financial situation. 1st Claims can also give you advice regarding means testing and things that will or will not be taken into account in a means assessment. If you or a loved one was previously in care prior to entering hospital we can help you make sure an accurate reassessment takes place.

Why Didn’t I Receive an NHS Continuing Care Assessment?

You may have found that you or a loved one were eligible for help with care home fees but circumstances meant that the an NHS Continuing Care Assessment did not take place. These are some of the more common reasons:

  • Those who are discharged from hospital straight into a care home.
  • Those who received NHS Nursing Care (which pays for the nursing, but not accommodation) who were not assessed.
  • Those with more money who assumed no help would be available. NHS Continuing Healthcare Funding is not means-tested so if you primary care needs, you get it.
  • Those who receive care in their own homes are still covered by the NHS Continuing Healthcare Funding. It is not simply for those in care or nursing homes.
  • Those who were refused funding when entering care but their health has deteriorated.

What can I do to avoid nursing fees?

Make sure you have full access to your parents’ medical records

It is essential that you have as much information and evidence on the exact state of your parents’ health before they enter a home and when they are in a care home. Access to their medical records can be arranged with help from your solicitor. With full access to their medical records you can track any changes in their healthcare needs that may affect their eligibility for funding. If their condition deteriorates whilst in a nursing home then they can become eligible for funding when previously they were not.

Speak to a solicitor with experience in care home fees

You can discuss your situation in detail with an expert solicitor that knows the process inside and out and let them fight your case for you.

If they find that you are not eligible for payment under an NHS Continuing Care Assessment then there is still a way to avoid paying care home fees through a means-tested assessment.

Social Care Funding Assessment

If you were not eligible following an NHS Continuing Health assessment, you may qualify to receive financial help from the government to fund your long-term care. This is a means-based assessment that may help you avoid nursing home fees. The scenarios are as follows:

  • Assets over £23, 250 = pay all care home fees
  • Assets worth between £14,250 and £23,250 = pay a contribution towards care home fees
  • Assets less than £14,250 are disregarded but you will have to make a contribution from your income

Important points to remember with a social care funding assessment:

  • assessment must only take into account your assets not the joint assets of a couple
  • assets must be disregarded in a financial assessment

1stClaims Can Help You

Eligibility for financial help with care home fees can often be incorrectly assessed. At 1stClaims we do not believe that anyone should be unfairly paying for their care in old age so we will do our best to help you if you think this has happened to you or someone you care about. Call us now on 0800 2888 693 or fill out a free online enquiry form.

Further reading on how to avoid paying care home fees unnecessarily and claiming back the money that is rightfully yours:

  1. Care home fees Homepage
  2. How to reclaim care home fees
  3. Recovering Care Home Fees Infographic



Let Us Help You?

Whatever your question or concern about care home fees, we can and will help you with a free, no obligation enquiry.

We can advise you:

  1. Whether you may be entitled to reclaim any paid care fees;
  2. Whether you are eligible for funding of your care home fees;
  3. How to make a claim; and
  4. How we can help you and how much it will cost (but the initial contact is completely free of charge).

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Why Choose 1stClaims?

  • We hand select only the best care home fee solicitors to help you.
  • Completely free, no obligation initial enquiries.
  • Expertise in helping other people to receive free care home fees.

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