My NHS Continuing Care Funding has been withdrawn and I don’t have grounds to appeal, so what happens next?
NHS Continuing Care funding is subject to review, initially after a period of 3 months then every year. If the assessor concludes that the person no longer has a primary health need, the funding will be withdrawn. You can’t be asked to repay any care fees which were paid by the NHS funding (unless there is evidence of fraud in obtaining the funding initially) so you don’t have to worry about a large backdated care fee invoice. NHS Continuing Care funding is separate to means tested local authority funding and while they are both paid from the government, the criteria for the funding is different. So, if your NHS Continuing Care funding is withdrawn, you may still be eligible for funding from the local authority.
The next steps will depend on the circumstances of each individual. If the person has funds above £23,250 they will be expected to then meet their care fees going forwards. It is very common that care homes charged more to privately funded residents than what they would charge the local authority if they were paying. The care home should provide a new contract to be signed which sets out the care fees payable.
If the person has capital of less than £23,250, the local authority has a duty to make contribution towards the care fees. Upon the NHS Continuing Care funding being withdrawn, you should immediately request a financial assessment from the local authority. This normally means that you need to complete a detailed form setting out the full capital, income and expenditure of the person being cared for. Each local authority does have different procedures so you will need to check with the relevant local authority for their assessment process. The local authority may also carry out a care needs assessment to ensure the appropriate level of care can be provided in that setting.
Property is included in capital, so if the person owns a property the present market value of it will be deemed to be included in their capital. The value is less any mortgage or loan on the property and less 10% of the value where there would be expenses to sell it.
Property can be disregarded if you only need short term or respite care. It will also be disregarded if it is still occupied by your partner, or former partner (unless you are estranged). Estranged partners can count as exempt occupiers if they are also a single parent of a dependant of the person. Occupants who are relatives over the age of 60, children under 18, or relatives who are disabled also make the property exempt from consideration in the financial assessment.
If the property is deemed to be included in capital, but you don’t have the funds to meet the ongoing care fee costs, you can ask the local authority to allow you to make a deferred payment. If you have less than £23,250 in capital, other than the value held in property, you will be eligible and the local authority must offer you the chance to make a deferred payment. If agreed, the local authority would put a legal charge on the property, which is similar to a mortgage. The terms of deferred payments can be negotiated to include a sale of the property after a set time (e.g. if there are delays in selling the property), or to defer the payments until the person dies, at which point the funds will be deducted from their estate and repaid to the local authority.
Some people may consider giving away their property to relatives once their NHS Continuing Care funding is withdrawn so it does not count in their capital and therefore the local authority would have to pay the care fees. However, this may count as deliberate deprivation of assets and the local authority could have the right to still charge you the same level of fees as if you still owned the property.
If you need any advice regarding obtaining local authority funding for care fees, please contact the Court of Protection team.
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