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The True Cost of Care

Everything You Need to Know

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Chapters

01: Home care – the basic costs
02: Care in a residential home – the basic costs
03: Financial support from the government
04: Self-funding care
05: Looking after your loved one's finances
06: How Elder can help

When 80s rock band The Knack sang ‘You Can’t Put a Price On Love’, it’s clear they were yet to come up against the UK care system.

Turns out, this is exactly what makes the search for the perfect care solution so difficult. After all, everyone wants to find somewhere safe, secure and comfortable for those they love, but there’s no easy way around the question of just how much it could set us back.

That’s why we’ve put together this guide covering all the information you need about the cost of long-term care, to help you make the decision that’s right for you. Whether you’re just starting to consider the options available to you or you’re much further down the road, this guide is the ideal place to get a better understanding of the costs involved.

We’ll walk you through the variety of care options and the basic costs of each of them. We’ll then take a look at the forms of support available to you - from government subsidies to equity release schemes - as well as break down the legalese you’re bound to encounter along the way.

01: Home care – the basic costs

We’ll be honest: there’s no simple answer to how much each type of care will cost you.

We know - it’s probably not what you wanted to hear. But while we’d love to tell you exactly how much you can expect to pay each year, it’s impossible to say without knowing your personal circumstances - how much care your relative needs, where you live and so on.

What we can do is take you through the basic costs of each of the five most popular care options. In this chapter, we’ll start with the three types of care that take place in the home: caring for someone yourself, domiciliary care and live-in care.

Caring for someone yourself

  • Ongoing practical, personal and emotional support

  • Ensures more control over scheduling

  • Suitable only for someone with low-level needs

How does caring for someone yourself work?

When you care for a loved one yourself, you take personal responsibility for their care duties.

There are two ways you might choose to do this. You can either visit them in their own home and provide care on an intermittent basis, or you can invite them to live with you and look after them as and when they need it.

By choosing to visit someone in their own home, you have the flexibility to offer as much care as required when it suits you. The care recipient, meanwhile, is able to stay put and maintain their existing support structure. In short, neither of you needs to significantly change the way you like to do things.

It’s no major surprise that many UK carers and care recipients prefer this option, but it’s not always on the cards. After all, your relative may require more attention than intermittent visits can provide, and distance may prove a stumbling block if you’re not based in the same area.

In these instances, you might prefer to care for them by moving them into your own home. This means you’re on hand to offer support - medical, physical or emotional - whenever they need it.

The cost of caring for someone yourself

If your loved one lives independently, your home or theirs may need to be adapted to accommodate their changing needs.

You may, for example, need to budget for all sorts of specialist equipment: handrails (£50-150 each), stairlifts (£900 and up) and easy-access shower facilities (£200 and up, depending on requirements, plus labour), to name a few. You may also need to improve overall accessibility to your property, with ramps from around £40.

On top of this, there are all those little expenses - bills, petrol, shopping and more - which can start to add up. Given that they depend so heavily on the extent of care involved, it’s hard to estimate exactly how much this will cost. That’s why we recommend getting into the habit of creating a plan.

Plans are a useful way to predict what you might spend in the next quarter- or half-year, and to see how your prediction stacks up at the end of that same period. You should always overestimate every expense, to make sure you’re always within your budget and won’t be caught off-guard by those added costs you didn’t see coming.

Domiciliary care

  • Professional care alongside an independent lifestyle

  • Limited control over scheduling

  • Suitable for someone with low- to mid-level needs

How does domiciliary care work?

In domiciliary care - also known as home care - your loved one receives home visits from a professional carer.

This means their way of life needn’t change significantly: they can continue to live independently - without having to depend on family support - while receiving intermittent visits from a healthcare professional.

If their needs are limited, a daily check-in may be enough. But if they have particular medical requirements, they’ll likely need a district nurse or healthcare assistant to visit more regularly - to administer medicine, change dressings, perform medical obs and so on. These caregivers can also help with personal care, including washing, dressing and feeding.

The cost of domiciliary care

If your family opts for domiciliary care, you may need to cover the costs of home modifications.

We’ve gone into this a little above, but there’s plenty of other equipment out there to help make your relative’s life easier, and a quick Google gives you a basic idea of how much it’ll all cost.

Professional care itself is generally charged at an hourly rate. During the day, this is likely to be between £10 and £30 per hour depending on where the care recipient is based. This price goes up for overnight care, and may be charged at a nightly rate rather than hourly - usually upwards of £100 a night. You may find you have to pay a little more at weekends and bank holidays, too.

Let’s say a home carer costs £17 an hour, and the care recipient needs them for two hours a day from Monday to Friday. By the end of the year, this will have cost you a total of around £8,900. That said, both your own peace of mind and your loved one’s continued independence may well make this a worthwhile investment.

Live-in care

  • Round-the-clock professional support and companionship

  • Continued independence in familiar surroundings

  • Ideal for someone with low to mid-level needs

How does live-in care work?

With live-in care, a professional caregiver moves into the care recipient’s home and provides round-the-clock support.

There’s no need to uproot, only to be able to accommodate a new tenant. The care recipient can stay close to friends, family and the structure of support they’ve built up, all without compromising their independence. You, meanwhile, have the flexibility to visit when you can, knowing there’s always someone around when you’re not there.

The caregiver is a qualified professional, with specialist training in low to mid-level needs. They have experience in administering medical requirements and supporting physical and behavioural issues, with the added bonus of offering constant companionship to those most important to you.

Live-in care is our specialty, and we spend a lot of time making sure our carers and care recipients are a good fit for one another. In short, we choose people who aren’t just top notch at what they do, but who will become a part of the family.

The cost of live-in care

As your loved one is able to stay put in their own home, you may - as with the previous care options we’ve looked at - need to cover certain expenses to modify the property.

You need to pay the caregivers themselves on a weekly basis, usually at a rate of between £750 and £1,200. Our specialists, for example, cost £795 a week, which works out at £3,080 each month. The average self-funder cost of a care home is £846 per week, so live-in care promises far more for your money, with dedicated, one-on-one support in familiar surroundings for less money.

Keep in mind that you don’t have to take into account the costs of a new tenant in the house: it’s their responsibility to pay for their food and any additional living expenses they incur.

02: Care in a residential home – the basic costs

You’ve started to get the gist of how much it would cost for your loved one to continue living in their own home. So let’s take a look at the costs of care in an assisted living facility or residential home, and see how it stacks up against what we’ve seen so far.

Assisted living

  • Ongoing low-level care in new surroundings

  • On-site access to a range of services and activities

  • Ideal for low to high-level needs

How does assisted living work?

In an assisted living facility, residents have their own private living space - usually a self-contained apartment or bungalow - within a residential care complex. Your loved one can live an independent life just as they did before, buying or renting a space which they can then call their own. If they have medical or physical issues, staff and nurses are on call 24 hours a day, and there’s emergency support in case of any accidents.

Otherwise, your loved one is free to enjoy their day-to-day. They have access to communal facilities, including hairdressers, shops and gyms, and can experience a self-contained community of friends on their doorstep.

The cost of assisted living

To live in an assisted living facility, your loved one generally has to rent the home they stay in.

The value of the home depends on a number of factors, including its size and the number of communal services on offer in the facility. You’ll find small homes in standard facilities at around the £500 a week mark, but for a larger property surrounded by more services, you may have to stump up anything between £1,000 and £2,000 a week. These costs may or may not include nursing care, so be sure to enquire with the facility itself.

Homes come with their own cooking facilities, so you still need to cover the cost of groceries and other amenities. There’s no reason monthly living expenses needs to change, but, as ever, it’s worth putting together a plan based on what you already know of your loved one’s spending habits. Some community services may also cost extra, but these are entirely optional.

Keep in mind that if your loved one moves into an assisted living facility, they can put Personal Independence Payments (PIP) or attendance allowance towards the cost. We’ll go into both of these in more depth in the ‘Financial support from the government’ chapter.

What our customers say

“Judith is absolutely lovely and you could see the fantastic relationship she has with my mum. My mum’s smile nearly lit up the whole house when Judith arrived.”

Alison, UK

Care homes

  • Provide continuous support in a shared residence

  • Fully equipped to cater for those with medical issues or limited mobility

  • Ideal for those with mid- to high-level needs

How do care homes work?

In a care home, your loved one is attended to around the clock by healthcare professionals in a communal residence.

Every resident has their own bedroom and ensuite, but shares all communal areas - lounges, gardens, dining rooms - with other residents. Fully trained staff are on hand to prepare meals, bathe residents, conduct moderate medical care and organise activities. Some homes also offer 24-hour nursing and rehabilitation for more serious issues.

While low-risk residents are allowed to leave the facility during the day, many residents require ongoing supervision for their own security.

The cost of care homes

The cost of care homes vary but on average, you can expect to pay in excess of £50,000 a year for a room.

If you need more specialist care - medical nursing for a specific condition such as advanced dementia, for example - this is likely to be closer to £60,000. The costs vary largely depending on your location, with the highest being in the south east of England.

These care home costs include almost every service the care home offers - meals, physical care, medical tests and so on - so there’s no need to worry about paying for living expenses or bills. There may also be some additional costs for medical requirements that aren’t covered by the home, as well as optional extras such as trips out, hairdressing and condition-led therapies.

03: Financial support from the government

Maybe you’ve already settled on the kind of care that fits your family best. Maybe you’re still trying to come to a decision. Either way, now’s the perfect time to start thinking about government funding initiatives you may be able to take advantage of.

There’s a number of ways the government can help your family with the costs of care, and these initiatives could - eventually - make your life a lot easier. Only problem is, you have to jump through a lot of hoops to get there.

While we’re sorry to say we can’t do the applications for you, we can take you through the steps involved and make the journey that little bit easier.

Different ways the government can help

  • Local authority funding

  • Direct payments

  • NHS continuing healthcare

  • NHS-funded nursing care

  • Benefits for care recipients

  • Benefits for caregivers

Local authority funding

In some cases, your loved one may be able to receive partial funding from their local council.

They need to speak directly to social services in their area and complete a care needs assessment to find out if they’re eligible. It’s worth highlighting that if you live in England or Northern Ireland and have assets of greater than £23,250, you’re automatically discounted. This figure differs for Wales (£24,000 for care at home, £30,000 for care in a home) and Scotland (£26,500).

The care needs assessment helps the local authority gain a better insight into the extent of care required, as well as a broader understanding of your loved one’s specific needs. The person in need of care can do it themselves over the phone or in person, or you can do it on their behalf. In either case, you’ll need to provide the care recipient’s:

  • Address

  • Date of birth

  • Contact details

  • GP’s address

At some point, they also need to complete a means test. This is essentially an appraisal of their financial circumstances, to establish what you need to contribute towards the total cost of care.

Your point of contact then comes back to you with their decision as to whether you’re eligible for funding, and, if so, a recommended care plan. Once agreed, it’s put into writing. The overall process can take a two or three months from start to finish.

How much can we expect to receive?

There’s a limited amount of money available for local councils to allocate, so those who receive full or majority funding are in short supply. This level of funding generally goes to those who live alone, have recently been discharged from hospital or can’t manage without care.

For those of lower priority, the council may agree to subsidise individual needs, such as rehabilitation or home adaptations. This is all laid out in a support plan, which outlines when, how often and from whom you’ll receive the required services. The financial value of this plan ultimately depends on your situation.

Direct payments

Direct payments - also known as a personal health budget - are government contributions the care recipient can use to independently arrange their care.

Like local authority funding, your loved one will receive ongoing financial support. But rather than having to construct a care plan with another party, they can use this money however they see fit. This gives your family more choice, control and flexibility over how you meet their care needs.

To find out whether you’re eligible for direct payments, you need to get in touch with your local council and complete the same funding assessment as above. Remember that your eligibility is once again affected by the value of assets.

How much can we expect to receive?

Those eligible for direct payments generally receive between £50 and £600 a month, depending on the extent of their needs.

NHS continuing healthcare

NHS continuing healthcare is a care plan which includes full financing for any services that take place outside the hospital.

To find out if your relative is eligible, they need to visit their GP, who will complete an initial checklist and refer the case directly. They are then invited to take part in a full assessment with a multidisciplinary team of healthcare professionals.

This group reflects on a whole range of needs - including behavioural, cognitive, physical and nutritional - and assesses which of them, if any, are priority concerns. They look into the complexity and severity of these requirements, and how predictable they are moving forward.

You’ll have a decision within a month about whether or not your loved one will receive these sources of funding for care. If they do, your family then works collaboratively with a professional to create a bespoke care and support package.

How much can we expect to receive?

If you receive NHS continuing healthcare, your loved one won’t have to pay a penny towards the cost of care outside the hospital.

They’re only considered eligible, however, if they are perceived as having severe needs in at least two of their priority areas. Keep in mind, too, that funding depends on need rather than diagnosis. In short, if the needs of your loved one change - even if their medical condition hasn’t - your funding may be at risk.

In some cases, the NHS may decide to work with your local authority to cover the costs of care. This is known as a ‘joint package’.

NHS-funded nursing care

The NHS may pay a weekly rate for a registered nurse to visit your relative in their care home. This is known as NHS-funded nursing care.

The assessment process is the same as for NHS continuing healthcare - ie via a GP and then a panel of experts - as you’ll only be offered this option if your loved one has failed to qualify for the former. It’s also exclusively for those who live in care homes, since the care will be provided by nurses employed by the residence.

If the care recipient is eligible, the NHS will arrange and fund nursing on their behalf. This covers a whole range of nursing services, including planning, supervising and monitoring healthcare tasks, as well as one-on-one care.

How much can we expect to receive?

With NHS-funded nursing care, you receive a contribution of £155.05 per week. This works out at around £8,000 a year.

Free Guide: The Elder Live-in Care Plan

The live-in care plan enables homeowners receiving care at home to unlock some of the value in their home to help pay for their care using a lifetime mortgage.

Benefits for care recipients

Personal Independence Payment (PIP)

Personal Independence Payment, also known as PIP, goes towards the costs of long-term health conditions and disability for those below the age of 65. It’s very similar to Disability Living Allowance, which is being phased out in favour of PIP.

PIP is made up of two components, and each of these is paid at a standard or an enhanced rate.

  • Standard weekly rate for daily living component £55.65
  • Standard weekly rate for mobility component £22.00
  • Enhanced weekly rate for daily living component £83.10
  • Enhanced weekly rate for mobility component £58.00

To claim PIP, you’ll need to get in touch with the Department for Work and Pensions (DWP). The assessment isn’t means tested, which means your loved one is evaluated based on the support they require rather than on their financial circumstances.

After a routine medical assessment, your relative will find out if they’re eligible to receive PIP, and what component they fall into.

Attendance allowance

Attendance allowance helps cover the costs of care for those aged 65 and over. Like PIP, it isn’t means tested.

Attendance allowance is specifically designed for those who need help with everyday activities, getting around and medical care. There are two rates available:

  • If you need help both day and night, you’ll receive the higher rate of £83.10 a week

  • If you need help throughout the day, you’ll receive the lower rate of £55.65 a week

To claim Attendance Allowance, you’ll need to fill in a claim form and fire it over to the DWP. They’ll then get back to you to discuss the care recipient further, and to confirm their eligibility.

Benefits for carers

If you look after someone for 35 hours or more a week, you may be entitled to carer’s allowance.

This is normally £62.70 a week, though whether you receive the full amount depends on your financial situation. Make sure you also check the eligibility criteria carefully, as the person in your care must be a recipient of certain benefits - PIP, attendance allowance and so on - themselves.

If you look after someone for at least 20 hours a week, you may instead be entitled to National Insurance credits.

You should also use an online benefits calculator to investigate other means-tested benefits. You may be in the running for:

  • Income support

  • Income-related employment and support allowance

  • Jobseeker’s allowance

  • Pension credit

  • Universal credit

04: Self-funding care

Once you’ve exhausted your options with the government, it’s time to turn your attention to the ways you can fund care for yourselves.

Savings and pension will go some way to help, and your loved one may have an insurance policy in place to ease the financial burden. They may even have assets they’ve been holding onto, and now’s that rainy day they’ve been waiting for to cash them in.

But these options often only go part of the way to pay off your chosen care solution. That’s why many people look to leverage value in their homes - by selling up, or by taking advantage of an equity release scheme.

What is equity release?

Equity release is the process of freeing up the money tied up in your home without having to move out.

Equity release schemes enable you to generate an additional income or access a cash sum, which you can then use to privately fund care without support from the government. The amount you make available depends on a number of factors, including the value of the property, the outstanding mortgage and the borrower’s age and wellbeing.

There are two key types: lifetime mortgages and home reversion.

Lifetime mortgages

A lifetime mortgage is a tax-free loan secured against your home. The borrower repays the loan, plus the interest it’s accumulated, at the end of the mortgage term - when they sell the property or pass away.

Anyone over the age of 55 can take out a lifetime mortgage on their property as long as it’s their main residence, and they can choose to receive a one-off payment or a regular income. All the while, you still own your home, and can continue to live there for as long as you like.

When the mortgage term ends, the loan is paid off, along with the rolled-up interest in full. Alternatively, you might choose to pay the interest off on an ad hoc basis, to reduce the impact of compound interest.

At Elder, we’ve teamed up with leading lifetime mortgage provider Key Retirement to make the process of paying for care as effortless as possible. So if you decide to use live-in care with us, be sure to ask us about Key Retirement.

The benefits of lifetime mortgages

  • Lifetime mortgages provide a guaranteed income or cash sum

  • They’re fixed rate, so you won’t be stung in an adverse housing market

  • The care recipient is able to stay in their own home

  • You stand to benefit from an increase in the value of the property

  • The equity released is free from tax

  • The disadvantages of lifetime mortgages

  • They may affect your loved one’s entitlement to benefits

  • They can be inflexible in changing living and health circumstances

  • There may be arrangement, valuation and legal fees to pay

Home reversion

Home reversion is the process of selling all or part of your home to a specialist provider, in exchange for a tax-free lump sum or regular payments. It is available to all over 65s in the UK.

The homeowner sells their property, or tranches of it, at a price usually between 20% and 60% of its actual market value. How much they receive depends heavily on their age and state of health.

They then effectively become a rent-free tenant of the provider, though this shouldn’t affect them on a day-to-day basis. It’s only upon the sale of the property that the reversion company gets its share of the proceeds.

The benefits of home reversion

  • The former homeowner secures a guaranteed income or lump sum

  • They’re able to stay in their own home for as long as they need to

  • Any capital you draw down is tax free

The disadvantages of home reversion

  • The provider owns the property, which may affect inheritance, benefits and more

  • The former homeowner may still be liable for maintenance and insurance expenses

  • They are inflexible if circumstances change, and can be poor value in the short term

05: Looking after your loved one's finances

If you’ve learned one thing from this guide, it’s probably this: paying for care is a minefield.

Hardly surprising, then, that those in need of care may well need someone to navigate this tricky path on their behalf. That’s why they may want to consider setting up a power of attorney over their financial affairs.

What is a power of attorney?

Power of attorney grants someone the right to make decisions about someone else’s money on their behalf.

There are two types: ordinary powers of attorney and lasting powers of attorney.

Ordinary powers of attorney

A donor temporarily confers financial authority upon someone they trust (an ‘attorney’). This means, for example, they give another person control over their finances while they’re sequestered in hospital, or if they’re physically unable to visit a bank. They can also define which assets - property, savings and so on - this attorney has a say over.

In short, it’s an option for those who require assistance from time to time, but are still mentally capable of making decisions.

Lasting powers of attorney

A donor gives someone they trust the right to manage their financial affairs on an indefinite basis.

Unlike an ordinary power of attorney, a lasting power of attorney (LPA) is still valid even if your loved one’s mental health declines. This means someone will step in when the donor is unable to sufficiently grasp the potential consequences of a decision they need to make. Those diagnosed with dementia often decide to pursue this option.

Just as in the case of ordinary powers of attorney, however, an LPA is valid only as far as the donor is willing to permit.

This may extend to:

  • Paying off a mortgage
  • Maintaining a property
  • Selling a home
  • Cashing out investments
  • Managing pensions and benefits

How much does live-in care cost?

Elder’s expert advisers have helped hundreds of families across the UK seeking live-in care to find a financial solution. We offer complimentary, impartial advice – from setting up power of attorney, to lifetime mortgages, to local authority funding – all just a phone call away.

How to set up powers of attorney

To set up a power of attorney - ordinary or lasting - you’ll first need to register with the Office of the Public Guardian. This usually costs between £65 and £115, though this fee may be waived if you’re on a low income or receiving certain benefits. For more information, AgeUK have produced a comprehensive guide on how powers of attorney work.

Before you register, we recommend seeking advice from a solicitor. There are multiple independent sources providing good advice on how to find one, including the Law Society and Solicitors for the Elderly. Costs will vary, but it will likely prove a sound investment that saves you time and effort in the long run.

06: How Elder can help

We’re Elder, the UK’s leading live-in care provider. Our mission is to bring a higher quality of life to those in need of care, and a renewed peace of mind for their families.

To get started, give us a ring on 0330 134 6372, or drop us an email at hello@elder.org and we’ll get back to you as soon as we can.

How Elder works

When you come to us, we’ll take our time to get to know your loved one.

We’ll find out what they like and what they don’t like, and get a feel for their personality. We’ll discover what they’re looking for in a carer, and answer any questions they might have along the way. And, once you’re both happy, we’ll introduce you to a carer we think might be perfect for you.

Our carers are some of the best in the UK, chosen by our in-house team of experts. That’s why only 10% of our applicants make the grade. But we go one step further, hand-picking someone from our list of top quality candidates who we think would fit right into your family.

You’ll have a chance to meet them and have a chat over a cup of tea, and, if we’ve got it right, we’ll get your care plan sorted in no time.

Paying for care with us

We know just how much there is to think about when it comes to paying for care. That’s why our payment process has been created with simplicity in mind.

With us, you’ll pay a fixed weekly rate of £795. There are no hidden fees or little surprises, and you’ll always pay on the same day each week, making it easy to budget for the week or month ahead.

We also have an expert team on hand to help you make more sense of your funding options. You’ll get your own dedicated advisor who can explain everything we’ve covered in this guide in even more detail, and recommend a funding plan to suit your own unique circumstances.

Get in touch on 0330 134 6372, or drop us an email at hello@elder.org and we’ll get back to you as soon as we can.

We're here to help, always.

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