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How the care system works across the UK


The way the system works is different, depending on which part of the UK a person lives in.

Unlike the NHS, services are not free. Some people aged 65 and over will get help towards their costs, but others can pay the full cost.


Image caption The government is introducing a cap on care costs in England from 2016

Social care is provided by councils and is pretty tightly rationed. Local authorities only have to provide help to those with very high needs.

But even then people with assets of more than £23,250 still have to pay for the full cost of that care regardless of whether it is in a care home, nursing home or in their own home.

Outside of their own home, that figure may include the value of their property.

But from April 2020 (the government has delayed the original 2016 date) the system is changing. From that point onwards the cost of their care will be capped at £72,000, from the age of 65 onwards.

However, that sum only includes the care element. Some £230 a week of the costs charged by the care home will not count, as these are being classed as living costs that people would have to pay in the community to cover things such as accommodation, food and bills.


Image caption The cost of care at home in Wales is capped at £55 per week

In Wales, important changes are taking place in social care. From April 2016, everyone will have the right to have their need for help assessed.

Home visits will have to be long enough to meet the specific needs of that person. The government in Wales says the new system will focus on people’s wellbeing and the prevention of problems.

It is up to local authorities to determine whether an individual is eligible for help. Most have set the bar at only providing help to those with substantial or critical needs.

If care at home is needed, the cost is capped at £55 a week. This figure will increase to £60 a week in April 2015. If an individual has savings or assets of more than £24,000, not including their home, they will be expected to pay for home care up to that limit. Those with less may be entitled to help.

In a care home or nursing home people with assets of more than £24,000 – and that may include the value of any property they own – will have to pay for the full cost of their care. Those with less than that may be entitled to some help towards the costs.

Northern Ireland

Walking stick
Image caption Health and care is integrated in Northern Ireland, unlike the rest of the UK

Social care is much more integrated in Northern Ireland. There are five health and social care trusts, which assess the help people need.

For people over the age of 75 most care in the home is provided free.

Those who are under the age of 75 may have to pay towards their care. Any charges are at the discretion of the local trust.

If someone needs to be looked after in a care home or nursing home, those with assets of over £23,250 – and that may include the value of the individual’s property – pay for the full cost of their care.

Those with less may be entitled to some help.


Beans on toast
Image caption Personal care, such as helping to prepare meals, is free in Scotland

In Scotland, anyone who is over 65 is entitled to free personal care if they are assessed as needing help.

It is up to local authorities to set their criteria for who is eligible. Most have set it at substantial or critical level.

Personal care includes support to wash, dress and prepare meals. It does not, however, cover the cost of supplying the meals or for tasks such as help with shopping.

Anyone who needs care which requires a qualified nurse will also have that provided free by the NHS.

If an individual is in a care or nursing home they will get £169 towards personal care and £77 towards their nursing care. The individual will then be liable for the rest.

However, they may be entitled to some help if their assets – and that could include their house – fall below £26,000. They will be assessed to see how much they can contribute. Those with assets of between £16,000 and £26,000 may get some help.

Those with less than £16,000 will be funded by the council, but may still have to contribute from their income.

From April 2015, the care and NHS budgets will be merged. Ministers believe this will encourage greater integration between the two sectors.


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