Long-term care: what are the options?

11th January 2022

At a glance

  • The first step is to understand your or your loved one’s care requirements – and a care needs assessment by social services can help with this.
  • Care can then be either in the home (usually costing upwards of £10,000 a year) or in a care home (usually costing more than £30,000 a year); most people in England and Northern Ireland with savings or investments of more than £23,250 will have to fund this themselves.
  • Your St. James’s Place Partner can support you throughout the process – both with the practical and financial aspects.

When the need for long-term care arises, whether it’s for yourself or a close relative, most people have very little idea of where to start. This is because of the complexities of the current care system, a lack of clarity in how care is funded and a common misconception that the NHS will pay for all our needs.

Immediate questions are likely to spring to mind, such as the cost of care-home fees and in-home care, and how to work out the best option at such a difficult stage in life.

There are many moving parts in the care system. Because of this, it’s important to have an understanding of the different types of care available, how they match your or your loved one’s needs and how you are going to set about paying for them.

Identifying needs

If you feel you’re not managing in the way you used to – or the same is true for a loved one – before taking any other action, it’s crucial to work out what level of care is required. This may seem blindingly obvious, but it’s often an incredibly difficult and emotional conversation to have with the people around you.

It’s important to ask questions such as: Is there a need simply because you or your loved one is getting older and requires a bit more help? Or is it because there’s a medical problem – which could be physical or mental – that needs regular support? And how are things likely to develop in the months and years to come?

You can contact the social services department of your local authority and ask them to conduct a care needs assessment. This will enable them to identify what is required and either arrange care or point you in the right direction.

The different types of care for the elderly

Once you have answers to the questions above, it then becomes easier to understand the type of care you require. This generally falls into two main categories.

1. Care in your own home – sometimes called ‘domiciliary care’

A lot of people might think that needing care means moving to a care home – but that certainly isn’t always the case. Care in your own home can often solve many of the day-to-day challenges and could range from relatively straightforward things such as having meals delivered and help with the cleaning and gardening, to regular support with washing or medical matters, or even full-time live-in care.

It could also mean having adaptations made to your home, such as installing a stairlift or a walk-in shower with a seat, which would allow you to stay in your own place for as long as possible (support may be available from your local authority for minor adaptions).

2. Residential Care or Nursing Care

Again, this kind of care can vary enormously. At one end of the scale are residential homes that offer personal care such as help with washing, dressing and taking medication. They also usually organise social activities such as coffee mornings, visiting entertainment and outings (subject to COVID-19 restrictions, of course).

At the other end, Nursing Care homes offer all of the above, combined with more specialised nursing or dementia care from qualified nursing professionals. Many homes offer both kinds of support.

Some care homes are registered to provide both types of care.

When working out what’s best, it’s important to understand that no two experiences are likely to be the same – and the situation is unlikely to remain static over the years – so it’s important to work out what’s best for you or your loved one according to your own individual circumstances.

Paying for care

When your council conducts a care needs assessment, if they decide that some form of care is required, they will offer you a means test to work out if you’re entitled to financial support.

However, how much a local authority will pay for a care home or home support is very limited: in England and Northern Ireland, if the person needing care has savings or investments of more than £23,250, you are likely to have to meet the entire cost themselves. Also, if you move to residential care and own your own property, you are expected to use the equity in this property to fund the care – usually by selling the house or using an equity release scheme.

This means that most people are likely to have to fund some, or all, of their care themselves. The costs of this can vary a lot, depending on a wide range of factors such as geographical location, the level of support required, and whether the care is in-home or residential.

As a general guide, you could expect to pay in the order of £10,000 to £15,000 a year for basic care at home1 – this might cover, for example, someone coming in for two hours every day. But, of course, if more care is required, those fees can go up by a lot.

For a residential care home, the national average for a basic level of care is around £35,000 a year2, but this average varies from region to region throughout the UK. If more specialised nursing or dementia care is required on top of that, you could expect to add at least another £12,000 or so per year on top, maybe even more3.

For many, those figures can be a daunting prospect, so it’s important to seek expert financial advice. Your St. James’s Place Partner can help you work out the best way to structure your finances to meet the cost, while also helping to ensure you make the most of any tax relief or allowances available to you, making the next steps as smooth and painless as possible at this difficult time.

If you or a loved one needs care, your St. James’s Place Partner can help guide you through the process.

1,2,3 Laing Buisson Care of older people, UK market report 2018/19