Paying for services at home



Oxford Dementia Centre

Institute of Public Care

Roosevelt Drive

Oxford OX3 7XR

Tel: 0845 120 4048












This fact sheet will cover what services the person you care for can and cannot be charged for.It explains what guidance local authorities must follow when charges are being assessed.


You may also find the following fact sheets helpful:


               What is dementia?

               Assessment and diagnosis

               Making your home dementia friendly

               Treatment and therapy for people with dementia

               Finding what help someone needs and who can provide it

               Looking at your needs as a carer - having a carerís assessment

               Making the decision about future plans for care

Services not charged for

NHS services and services delivered through your Primary Care Trust or GP are free at the point of delivery. This may include respite care in a hospital.If you are getting additional help from social services for a temporary period (6 weeks) as part of intermediate care then these services should not be charged for (outlined in the Delayed Discharge Act 2003).If the cared-for person has been receiving after care services under section 117 of the Mental Health Act 1983 then these services should not be charged for.


Finance - If services are offered how much will they cost?


Charges for community care services.


Your local authority can charge for services that they arrange to provide to the cared-for person in their own home.This may include laundry services, home care, meals on wheels and day centres.The Local Authority cannot make a profit on what they charge you.


Guidance is issued to Local Authority Social Services, under Fairer Charging Polices for Home Care and other non-residential Social Services.If they are unable to pay or refuse to pay, the service cannot be withdrawn if there has been an assessment of need.

How are the charges worked out?


Each person has an individual financial assessment (means test) to see what they should pay towards a service.There is government guidance on how and what local authorities can charge for services but each local authority sets its own charges.If the cared-for personís income is calculated at being below a certain amount then they should not be charged for the service.


ĒRegard should be had to the effect of any charge on a userís net income; net income should not be reduced below defined basic levels of Income Support or the Guarantee Credit of pension, plus 25%.Charging polices which reduce usersí net income below this defined basic level are not acceptable.Ē(Fairer Charging Polices for Home Care and other non-residential Social Services)


Certain disability benefits may be taken into account as part of the cared for personís income when calculating how much they will be charged for services. Where disability benefits are taken into account as income in assessing someoneís ability to pay, the personís disability expenditure should also be taken into account in an individual assessment.


The local authority should ensure comprehensive benefit advice has been given so that the person is receiving their maximum income entitlement.


Once the person you care for has had a single assessment they should be given clear information about what the charges for services will be, and how the local authority will calculate the amount.


If you disagree with the charges you should contact your local Age Concern, Citizens Advice Bureaux, Alzheimerís Society or Carers Centre who may be able to help you.


What cannot be taken into account:


The mobility component of Disability Living Allowance is excluded by law from being taken into account for charges.


Benefits that can be taken into consideration are:


1)†††††††† Disability Living Allowance (care component).

2)†††††††† Attendance Allowance (and constant AA).

3)†††††††† Exceptionally Severe Disablement Allowance.


However where these benefits form part of the cared for personís income, that income may not be reduced below basic levels of income support plus 25%.It must not result in the cared-for person being left without the means to pay any other necessary care or support or for other costs arising from their disability.




When assessing disability related expenditure, councils should include the following:


              Payment for any community alarm system

              Costs of any privately arranged care services required, including respite care

              Costs of any speciality items caused by disability eg specialist washing powders or laundry

              Additional costs for special dietary needs due to illness or disability

              Special clothing or footwear, for example where this needs to be specially made, or additional wear or tear to clothing caused by a disability

              Additional costs of bedding, for example because of incontinence

              Any heating costs or metered costs of water, above average levels for the area and housing type, required by age, medical condition or disability

              Reasonable costs of basic garden maintenance, cleaning or domestic help if necessitated by the individualís disability and not met by social services

              Purchase, maintenance and repair of disability-related equipment

              Personal assistance costs, including any household or other necessary costs arising for the cared-for person

              Other transport costs necessitated by illness or disability, including costs of transport to day centres, over and above the mobility component of DLA


Costs of infrequently purchased equipment can also be taken into account.


Charges to respite care


If the local authority arrange for someone to go into respite care the charge is usually based on a means test that has the same formula as if someone were going into a care home, except that the value of the personís home is ignored.If your local authority does not do this they will set a ďstandard chargeĒ that they think is reasonable for you to pay.Charges may vary from a proportion of the weekly cost to the whole cost.


If the person you care for is in residential care for over eight consecutive weeks then they will be assessed as a temporary resident.


What do I do if I am not happy with the assessment?


If you are not satisfied with anything about your carer's assessment, the care provided or the amount charged for the services, there are a number of ways in which you can complain.Each local authority has its own complaints procedure.


Advice centres like the Citizens Advice Bureau or a disability organisation can help you make a complaint or give you details of lawyers able to advise on community care law.



Under the Data Protection Act 1998, you can ask social services for a copy of the cared-for personís assessment and the care plan.If you are legally able to act on behalf of the person you are caring for, you can also ask for their file.You should receive this information within 40 days, but the local authority can charge for accessing a clientís file.


Carerís Assessment


If you are providing ďregular and substantialĒ care for a family member, friend or relative then you will have a right to an assessment of your own needs as a carer.


This should look at your ability to continue caring and take into account other commitments you may have eg other family commitments.Local authority Social Service can provide services, for instance breaks from caring.The local authority has a power to charge Ė but many authorities do not actually charge for services to carers.


It is often helpful to carers if this assessment can take place away from the person with care needs.You are entitled to an assessment of your needs even if the person you are caring for does not wish to have their needs assessed.See Fact sheet: ĎCarerís Assessmentí.


Then the local authority decides what to provide.They have to take into account the results of both your own carer's assessment and the community care assessment of the person you care for.The completed assessment should be the basis on which services are offered.The local authority social services department will then provide certain services.





This fact sheet can be made available in large print.


We are constantly looking to improve our information.It helps if you let us know whether the information in this fact sheet was/was not useful and if there are other fact sheets that you would have found helpful that we have not yet provided.


While the information contained in this fact sheet is believed to be correct, DISC does not accept liability for any error/s it may contain.