How Care is Funded
A plain English guide to the different ways specialist care can be paid for.
Funding is often the most confusing and stressful part of arranging specialist care. The system is not straightforward, and the language used by professionals can make it feel more complicated than it needs to be. This guide explains the main funding options in plain English. If you still have questions after reading this, call us on 01737 822221. We help families navigate funding every week, and we are happy to help you too.
"You do not have to understand the funding system perfectly. You just need to know that help is available, and we can guide you through it."
NHS Continuing Healthcare is funding arranged and paid for entirely by the NHS. It is available to people who have a "primary health need," meaning their care needs are mainly related to a health condition rather than social care. Many of our residents at King's Lodge qualify for CHC because their neurological conditions require ongoing specialist nursing care.
How it works: An assessment is carried out using a tool called the Decision Support Tool (DST). This assessment looks at 12 areas of need, called "care domains," and determines whether the overall need is primarily health-related. If the person qualifies, the NHS pays the full cost of their care, including accommodation.
Important to know: You have the right to request a CHC assessment. If you believe your loved one's needs are primarily health-related, ask the clinical commissioning group (now called the Integrated Care Board, or ICB) in your area to carry out an assessment. If the initial screening does not recommend a full assessment, you can appeal. Our team can advise you on this process.
At King's Lodge: Many of our residents are funded through CHC. We work directly with ICBs across the South East and are experienced in supporting the assessment process.
If a person does not qualify for NHS Continuing Healthcare, their local authority (council) may fund their care. This is sometimes called "social care funding." The local authority carries out a needs assessment and a financial assessment to determine what the person is eligible for.
Financial assessment: The council will look at the person's income, savings, and assets. If their capital (savings and property) is above a certain threshold, they may be asked to contribute to or fully fund their care. If capital is below the threshold, the council will fund the difference.
Top-ups: In some cases, the local authority's contribution may not cover the full cost of a specialist placement like King's Lodge. A family member may be asked to pay a "top-up" to cover the difference. This must be agreed before admission. We are transparent about costs and will discuss this openly with you.
At King's Lodge: We accept residents funded by local authorities across the South East and work with social workers and commissioners to agree placements.
Some families choose to fund care privately, either because they do not qualify for public funding or because they prefer the speed and flexibility of self-funding. Self-funders pay the full cost of care directly to King's Lodge.
Advantages: Self-funding means you are not dependent on the pace of NHS or local authority decision-making. Placements can often be arranged more quickly, and you have more control over the choice of home.
Financial planning: If you are considering self-funding, it is worth speaking to a specialist financial adviser who understands care costs. They can help you plan for the long term and explore options such as immediate needs annuities, which provide a guaranteed income to pay for care in exchange for a lump sum.
At King's Lodge: We welcome self-funded residents and are transparent about our fees from the outset. There are no hidden costs. We will provide a clear breakdown before you make any commitment.
In some cases, care is funded through a combination of sources. For example, the NHS may fund the health-related elements of a person's care while the local authority funds the social care elements. This is known as a "joint package" or "split funding."
How it works: The NHS and local authority agree on how to divide the cost based on the person's assessed needs. This arrangement requires cooperation between the two organisations, and it can sometimes take longer to put in place.
At King's Lodge: We are experienced in working with joint funding arrangements and can liaise with both the NHS and local authority on your behalf. We understand the process and will help ensure it moves as smoothly as possible.
If a person lives in a nursing home but does not qualify for full NHS Continuing Healthcare, they may still be eligible for Funded Nursing Care. This is a contribution from the NHS towards the cost of nursing care provided by a registered nurse.
How much: FNC is a flat-rate weekly payment made directly to the care home. It does not cover the full cost of the placement but contributes towards the nursing element. The current rate is set nationally and reviewed annually.
At King's Lodge: As a nursing home, all our residents who are not on full CHC receive the FNC contribution as standard. This reduces the amount that needs to be covered by other funding sources.
Need Help Understanding Your Options?
Funding is complicated. You do not have to navigate it alone. Call us and we will talk you through the options that apply to your situation. No obligation. No jargon. Just honest, practical guidance.