As life expectancy increases, more families in the UK are facing the reality of moving elderly relatives into care homes. With care home fees rising and the complexities of funding long-term care becoming more evident, one crucial question surfaces: Are next of kin responsible for care home fees? Many families worry about the financial strain, particularly in situations where assets might not be sufficient to cover care costs.
This article aims to provide a comprehensive guide to understanding who is responsible for care home fees in the UK, what happens when fees go unpaid, and how families can protect themselves from financial hardship.
What Are Care Home Fees?
Care home fees are the charges associated with living in a residential or nursing home where a person receives round-the-clock care. These fees cover various services such as accommodation, meals, assistance with daily tasks, and medical support for those with complex health needs. Understanding what these fees include can help families plan their finances more effectively.
How Much Are Care Home Fees in the UK?
Care home fees in the UK can vary greatly depending on several factors. The average cost of residential care is approximately £600 to £800 per week, while nursing care, which involves more complex medical support, can range from £800 to £1,200 per week.
These costs can be significantly higher in certain regions, particularly in London and the South East. The cost of care also depends on the level of care required—residential care homes are typically less expensive than nursing homes, which provide specialised healthcare services.
To give an example, a person requiring dementia care in a nursing home in central London might face fees as high as £1,500 per week, while in less urban areas like the Midlands, costs may be closer to £700 per week for residential care.
Additionally, the fees might be higher for homes with more luxury accommodations or additional services like therapy sessions and specialised activities for residents.
Legal Responsibilities of Next of Kin for Care Home Fees
One of the most common misconceptions surrounding care home fees is the belief that family members, such as children or spouses, are automatically responsible for covering these costs. This can cause significant stress for families who may already be dealing with the emotional toll of seeing a loved one move into care.
Are Next of Kin Responsible for Care Home Fees in the UK?
In the UK, the law is clear—next of kin are not automatically responsible for paying care home fees. The person receiving care is considered the primary individual responsible for paying these fees, typically through their savings, income (such as pensions), and, in some cases, the sale of their property.
If the individual’s financial resources are insufficient, local authorities may step in to cover the costs, but this is based on a financial assessment known as a means test.
The only situation where next of kin may be asked to contribute is when a third-party top-up payment is required. This happens if the individual receiving care chooses a more expensive care home than what the local authority is willing to fund.
In these cases, family members or other third parties may voluntarily agree to pay the difference. However, there is no legal obligation to do so.
Can I Refuse to Pay Care Home Fees?
The question of whether you can refuse to pay care home fees is a valid concern, especially when family members feel pressured to contribute.
If the individual receiving care is financially assessed by the local authority and it’s determined that they cannot afford the full cost, the local authority will typically fund a portion of the fees, subject to the person’s assets being below the £23,250 threshold in England.
Family members may be asked to contribute via third-party top-ups if the chosen care home exceeds the local authority’s standard funding level. If you, as a family member, do not agree to a third-party top-up, the local authority will likely offer alternative, more affordable care homes within their funding range.
Therefore, you do have the right to refuse payment for these additional costs, and it’s important to ensure that any agreement to pay third-party top-ups is made voluntarily.
However, if you have signed a contract agreeing to cover these top-up fees or any other care home costs, refusing to pay could lead to legal action, including being pursued for debt collection. It’s important to clarify the financial expectations early on and to understand your rights before making any commitments.
How to Avoid Care Home Fees?
Avoiding care home fees entirely is unlikely, but there are legitimate ways to reduce the financial burden and protect assets from being used to cover these costs. Planning ahead is crucial, as last-minute attempts to transfer assets could be seen as “deliberate deprivation of assets” by local authorities, leading to penalties.
- Trusts: One of the most common methods for reducing care home fees is placing assets, such as property, into a trust. This must be done well in advance of requiring care to avoid it being considered as an attempt to avoid fees.
- Gifting: Some families choose to gift assets to children or other relatives as a way to lower the value of the estate. However, if this is done too close to the time when care is needed, the local authority may still count the assets as part of the means test.
- NHS Continuing Healthcare (CHC): If the individual’s primary need for care is health-related, rather than just personal care, they may be eligible for NHS Continuing Healthcare, which covers the full cost of care. This can be a complex process to qualify for, but it’s worth exploring if the individual has significant medical needs.
- Deferred Payment Scheme: The Deferred Payment Scheme allows people to use the value of their home as security to delay paying care home fees until after their death. This means you don’t have to sell the home immediately to fund care, but the fees will eventually need to be repaid from the estate.
Reclaiming Care Home Fees After Death
Reclaiming care home fees after a loved one’s death is possible in certain circumstances, particularly if it’s believed that the individual was wrongly charged or overpaid for care.
This process usually involves claiming refunds for care fees paid when a person was eligible for NHS Continuing Healthcare (CHC), but this funding was not provided. Here’s a detailed guide on how to go about reclaiming care home fees after death, including eligibility, the claim process, and what to expect.
What is NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare is a package of care arranged and funded by the NHS for people who have significant ongoing healthcare needs. It covers the full cost of care, including care home fees, nursing care, and other healthcare services.
If a person’s primary need for care is health-related, rather than just personal care or social care, they may qualify for CHC. This can be a crucial benefit for those in long-term care, as it removes the financial burden of paying for care home fees.
Why Might Care Home Fees be Reclaimed?
Care home fees can be reclaimed after death if it’s determined that the person who was receiving care should have been eligible for NHS Continuing Healthcare but was not assessed properly or was wrongly denied this funding.
If CHC funding is awarded retrospectively, the care home fees that were paid during the period of eligibility can be reclaimed. This is particularly relevant in cases where families were unaware of CHC or were not informed about the individual’s potential eligibility at the time of entering care.
Eligibility for Reclaiming Care Home Fees
To be eligible for a refund of care home fees, it must be demonstrated that the individual had significant health needs and should have been receiving NHS Continuing Healthcare during the period they were in care. If CHC was not awarded or was incorrectly assessed, the family may be entitled to reclaim fees paid during this time.
Common reasons for reclaiming care home fees include:
- Failure to assess for CHC: The care home or local authority may not have carried out an assessment for CHC, even though the individual had ongoing medical needs.
- Incorrect assessment: The individual may have been assessed for CHC but was wrongly denied the funding due to an error in the assessment process.
- Failure to review CHC eligibility: CHC eligibility should be reviewed periodically, and if this was not done, the individual may have missed out on receiving the funding they were entitled to.
How to Reclaim Care Home Fees After Death?
Reclaiming care home fees can be a complex process, but it generally follows these steps:
1. Request a Retrospective Assessment
The first step in reclaiming care home fees is to request a retrospective assessment of the individual’s eligibility for NHS Continuing Healthcare. You can do this by contacting the local NHS Clinical Commissioning Group (CCG) or the relevant health authority.
You will need to provide detailed medical records, care home records, and any other documents that support the claim that the individual should have been eligible for CHC.
2. Gather Evidence
The success of your claim depends heavily on the evidence you provide. Key documents to collect include:
- Medical records: To show the individual’s healthcare needs during the time they were in care.
- Care home records: These records detail the type of care provided and can highlight whether the person’s primary needs were health-related.
- Financial records: Proof of the care home fees paid during the relevant period.
- Assessment records: If a CHC assessment was conducted, obtaining these records will show how the decision was made.
3. Submit a Claim
Once you’ve gathered the necessary documents, you can submit a formal claim to the relevant NHS authority. This claim should outline why you believe the individual was eligible for NHS Continuing Healthcare and provide evidence to support your case.
Keep in mind that claims are typically subject to a time limit—currently, retrospective claims can usually only be made for care provided after 1 April 2012.
4. Review and Decision
The NHS will review the claim and assess whether the individual should have been eligible for CHC. This review may take several months, as it involves going through medical and care records, and sometimes a panel of healthcare professionals will reassess the individual’s needs during the time they were in care. If the review concludes that CHC should have been awarded, you will be notified of the decision.
5. Reimbursement of Care Fees
If the claim is successful, the NHS will reimburse the care home fees that were paid during the period when CHC should have covered the costs.
This refund can include the cost of both residential care and nursing care, depending on what was required at the time. The amount refunded will depend on the fees paid and the length of time the individual was eligible for CHC.
Challenges and Pitfalls in Reclaiming Care Home Fees
While reclaiming care home fees after death is possible, it can be a challenging process. Some of the difficulties families face include:
- Complexity of the CHC assessment process: Understanding whether a person’s healthcare needs met the criteria for CHC can be difficult, as the eligibility criteria are highly specific.
- Length of the process: Retrospective claims can take a long time to resolve, sometimes over a year, as the NHS needs to review detailed evidence from the period when care was provided.
- Disputes: It’s not uncommon for families to disagree with the outcome of a retrospective assessment, particularly if CHC was previously denied. In these cases, families can appeal the decision, but this adds further time and complexity to the process.
How Long Do You Have to Reclaim Care Home Fees?
There are time limits for making retrospective claims for care home fees. The current deadline for claims is for care received after 1 April 2012. Any claims made for periods before this date are no longer considered by the NHS, though exceptions may apply in rare cases.
Therefore, if you believe your loved one was wrongly denied CHC, it’s important to act quickly and submit your claim within the allowable time frame.
Seeking Professional Help
Due to the complexity of reclaiming care home fees after death, many families choose to seek professional help from solicitors or specialist advisors who understand the NHS Continuing Healthcare process.
These professionals can help gather evidence, navigate the claims process, and provide guidance on appeals if the initial claim is rejected. While this comes at a cost, it can significantly improve your chances of successfully reclaiming care fees.
Outstanding Care Home Fees After Death
When an individual passes away, any outstanding care home fees become the responsibility of their estate. This means the fees will be deducted from the value of the deceased’s property, savings, or other assets before they are distributed to beneficiaries.
If the estate does not have enough assets to cover the outstanding fees, the local authority may write off the remaining debt, although this is rare and assessed on a case-by-case basis.
Outstanding Care Home Fees After Death and the Role of the Local Authority
In some cases, the local authority will pursue the deceased’s estate to recover unpaid care fees. If the individual was part of a Deferred Payment Agreement, where the value of their home was used to delay payment, the local authority may arrange for the home to be sold to recover the outstanding debt.
In situations where the estate cannot fully cover the outstanding fees, and there are no significant assets, the local authority may consider the debt uncollectable. However, they will usually seek legal avenues to recover as much of the debt as possible.
What Happens When the Estate Can’t Cover Care Home Fees?
If a person dies with more outstanding care home fees than their estate can cover, it creates a complex situation for both the care provider and the local authority.
The process often involves assessing the estate to determine how much can be recovered. If there are insufficient funds, the debt may be written off, although this is not guaranteed. For instance, the local authority might seek to recover fees through the sale of any property owned by the deceased.
In cases where there are no assets or property, the outstanding care home fees may simply be left unpaid. However, if there is any possibility that the estate could be used to cover the fees, the local authority will likely pursue this option.
Conclusion
Dealing with care home fees can be a confusing and stressful process for families, particularly when next of kin feel unsure about their legal responsibilities.
In the UK, the law is clear that next of kin are not responsible for care home fees unless they have agreed to contribute via third-party top-ups. Planning for care costs, understanding legal protections, and seeking expert advice are key steps to ensuring that you and your loved ones are financially secure.
It’s important to approach care home funding with a clear understanding of the rules, so you can avoid unnecessary financial burdens and make informed decisions about long-term care.
FAQs About Next of Kin Responsible for Care Home Fees
Can family members refuse to pay care home fees?
Yes, family members are not legally obliged to pay care home fees unless they have voluntarily agreed to cover third-party top-ups. Refusing to pay such fees will not affect the care provided, but may limit the choice of care homes.
Is there any way to avoid paying care home fees legally?
There are legal strategies to reduce or avoid care home fees, such as setting up a trust, applying for NHS Continuing Healthcare, or using the Deferred Payment Scheme. However, these methods require careful planning and professional advice.
How much do care homes charge per week in the UK?
Care home fees vary depending on the type of care required and location. Residential care costs around £600 to £800 per week, while nursing care fees can range from £800 to £1,200 per week. Some care homes in London and the South East charge higher fees.
What are third-party top-ups, and when are they required?
Third-party top-ups are payments made by family members or others to cover the difference between the local authority’s standard funding and the actual cost of the care home. They are voluntary and are only required if a more expensive care home is chosen.
Can care home fees be claimed back after a resident’s death?
In some cases, care home fees can be reclaimed if it’s proven that the individual was eligible for NHS Continuing Healthcare but was wrongly denied this funding. This requires a retrospective claim, which must be submitted within a specified time frame.
Who is responsible for outstanding care home fees after death?
Outstanding care home fees are usually covered by the deceased’s estate. If the estate cannot cover the full amount, the local authority may seek to recover the fees through legal channels or via the sale of any property.
Are next of kin legally liable for care home costs in the UK?
No, next of kin are not legally responsible for care home costs unless they have signed a contract agreeing to pay, such as for third-party top-ups. The primary responsibility lies with the individual receiving care.
