Who provides social care?
How do people know if they are eligible for funded social care in England?
The first step for most people is to speak to their local authority. Local authorities are responsible for ensuring that anyone with ‘an appearance of needs’ (due to a physical/mental impairment or illness) receives an assessment under the Care Act 2014.
A formal diagnosis is not needed to be able to receive an assessment. Regardless of where you live in England, every local authority will use the same eligibility criteria to determine what level of need a person has and how their needs impact on their wellbeing. The local authority cannot fund anything that is the legal responsibility of the NHS.
How is the NHS involved in providing social care?
Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.
Some people will have a joint package of care where the NHS funds part of their support, alongside the local authority. For more information, take a look at the NHS guide to continuing healthcare.
Is local authority-funded social care free?
Not usually. While local authorities have discretion not to charge people, most people are expected to contribute towards the cost of their care and support. To establish how much a person can afford to pay, the local authority will carry out a financial assessment (known as a means test). The amount that a person is charged will depend on where they live, their income, living costs, and capital.
Capital is usually made up of a person’s savings or valuable assets, but the value of any property that a person owns must be disregarded if the person lives there as their main or only home.
Where a person’s resources are below the lower capital limit of £14,250, this money will not be taken into consideration during the financial assessment. People who have more than £23,250 in capital will be expected to arrange and pay the full cost of their care and are generally referred to as ‘self- funders’. Local authorities have discretion to arrange social care on behalf of a self-funder for a fee. For people with savings or assets between the lower and upper capital limits, they will be charged a proportion of that capital to pay towards the cost of their care and support.
Paying for care and support
Local authorities are not allowed to charge people more than it costs them to arrange the person’s care and support. There are certain types of care they cannot charge people for – such as home adaptations of up to £1,000 or after-care services when someone comes out of hospital. Local authorities must ensure that people are only asked to pay what they can afford. For more information please see the FCSS Care Act resource.
Who supports people with social care needs?
Family carers – provide support without payment to people with care and support needs. Family carers are usually a relative but may also be a friend. There are around 6.5 million family carers in the UK – that is 1 in 8 people and this number is rising. The economic value of the contribution made by family carers in the UK is £132 billion a year.
Charity – part of the Third Sector, a term used to describe organisations that are neither private sector nor public sector. Charities are not-for-profit organisations that can provide direct support and information. Charity providers are value driven, which means that an organisation will strive to achieve a certain goal, such as ‘improving public welfare’, rather than making a profit. They are not-for-profit, so surplus funds are reinvested directly back into the charity.
Shared lives – is a scheme that pairs someone who needs support with an approved carer. The carer will share their family and community life, while providing care and support to that individual. How the pair spend their time together can vary; visits can be on a daily basis, the person the carer is supporting could move in with them, or sometimes it is a combination of day visits and overnight stays.
Private providers – involves someone arranging their own care and support which they pay for themselves. Alternatively, they can take their own personal budget (the amount it costs the local authority to fund their care) and have it paid to them as a ‘direct payment’. The individual can then employ their own personal assistant/support worker using their direct payment. HomeCareDirect is national database for finding Personal Home Care Assistants. Registration is free.
Local authority managed service providers – will contract organisations to provide care services in the area.
Are all providers regulated in the same way?
All social care providers have to be regulated to ensure high quality standards of care and support are maintained for individuals.
In England, The Care Quality Commission (CQC) is an independent regulator for the quality and safety of care. This includes care provided by the NHS, local government, private care and charities.
Are all providers funded in the same way?
Local government, private and charity providers are funded in different ways.
Local government – receives funding through central government grants, council tax, financial contributions from people in receipt of local authority funded care and support, business rates and NHS contributions.
Private – the majority of a private organisation’s funding comes from individuals who are paying for care, or from local government organisations that contract them to provide care.
Charity – receives funding in a number of ways including via government grants and contracts, as well as individual donations and major gifts, bequests, foundation grants, and corporate grants.
If I wanted to find out more about social care options, where could I go?
- Contact your local authority and request a needs assessment under the Care Act 2014. Remember that family carers are also entitled to an assessment in their own right.
- The Social Care Institute for Excellence provides useful Care Act-related assessment and eligibility information.
- The NHS Social Care and Support Guide provides useful information, including getting access to and paying for social care.
- You can check what existing care services are available locally via the CQC Central website.