Care and support for older people

Social services must assess the needs of an older person who has care and support needs as a result of physical or mental illness or disability. From 1 April 2015 the assessment is carried out under the Care Act 2014.

Prior to 1 April 2015, services for older people were provided under a number of different statutes, including the Chronically Sick and Disabled Persons Act 1970, the National Health Service Act 1977 and the Health Services and Public Health Act 1968.

From 1 April 2015, an adult's care and support needs may be met under the Care Act 2014 by the provision of:[1]

• accommodation in a care home or other premises

• care and support at home

• counselling and social work

• goods and facilities

• information, advice and advocacy

Social services may charge for most care and support services. They carry out a financial assessment to assess the contribution, if any, that a person must make towards the cost of any services provided. However, some services cannot be charged for.

Older people may be able to claim benefits to assist with paying for care.

Find out more about benefits from Citizens Advice or Turn2Us.

Disability living allowance/Personal independence payment

Disability living allowance (DLA) or personal independence payment (PIP), is available for disabled people who make a claim before their 65th birthday. If awarded, payment can continue after the claimant's 65th birthday.

Attendance allowance

Attendance allowance is available for people aged 65 years and over who need help with care at home or who need supervision. It is payable at two rates: a lower rate for people who need help either during the day or during the night, and a higher rate for those who need help during both day and night. It is not necessary for the applicant to be receiving help with care to get attendance allowance, and the benefit does not have to be used to pay for care needs.

See Gov.uk: Attendance allowance for more information on attendance allowances.

Carer's allowance

Carer's allowance is available for people who are looking after someone receiving either attendance allowance or the higher or middle-care component of DLA. The carer must be unable to work because they are providing care and must spend at least 35 hours per week providing the care.

Winter fuel payment

People of state pension age who are normally resident in the UK can receive payments to help with winter fuel costs.[2]

Winter fuel payments are made automatically to people in receipt of state pension or specified welfare benefits, otherwise a claim must be made. The amount of the payment depends on a person's circumstances. A higher amount is usually paid to those aged 80 or over.

Find out more from Gov.uk about heating and housing benefits.

A payment is not made if the person of state pension age:

• is in prison

• has been in hospital for over a year

• has been living in a care home for more than 12 weeks and is in receipt of pension credit, income-based JSA or income-related ESA

Warm home discount scheme

Eligible people, including those in receipt of the Guarantee Credit element of Pension Credit, may also receive a discounted electricity bill if their electricity supplier has signed up to the government's Warm Home Discount Scheme. The discount also applies to people with pre-pay or pay-as-you-go meters.[3]

Cold weather payment

In addition, older people in receipt of pension credit automatically receive an enhanced weekly amount, known as a cold weather payment, for any period in which the temperature falls to zero degrees or lower for seven consecutive days between 1 November and 31 March the following year.

Older people who own their own home and want to remain there may need to consider raising capital from the home, for example to undertake adaptations, to pay for care services or to provide an income.

Equity release

An equity release scheme enables a person to obtain a lump sum and/or a regular income.

Schemes either involve borrowing money secured against the home, known as a home income plan (or lifetime mortgage), or selling part or all of the home, called a home reversion scheme. There are risks involved in these schemes – property values can decrease, resulting in negative equity, which could result in large debts upon the person's death. Older people should be advised to seek specialist independent advice from a solicitor or independent financial adviser before applying for a scheme.

Those applying for an equity release scheme will usually be expected to meet certain conditions before bring accepted. These vary between schemes.

Equity release: Home income plans

A home income plan (or lifetime mortgage) is entered into with a finance company such as an insurance company or building society. It involves raising an interest-only loan, up to a maximum of 75% of the value of the property. The loan is secured against the property by way of a mortgage. This then provides an annuity income paid each month for life. Applicants usually also have the option to take a lump sum at the start of the plan, which reduces the amount of income paid each month.

Home income plans are more suitable for people in older age brackets, for example those aged over 75, as they receive a higher income owing to their shorter life expectancy.

Changes in interest rates may affect and possibly reduce the level of income that is paid. The proportion of the value of the property that is borrowed becomes a charge on the property, repayable when the property is sold.

Some home income plans allow applicants to take out capital protection, which protects part of the loan if they die within a short time after taking out the plan. An applicant's income  from the scheme is reduced if they take out capital protection.

If the homeowner moves home, they may be able to transfer the plan to their new property. They may have to repay part of the loan if the value of the new property is less than the value of the old one.

Home income plans are regulated by the Financial Conduct Authority (FCA). The FCA sets out standards with which companies offering the schemes must comply. The Equity Release Council has a code of conduct, which aims to ensure that companies participating in the campaign provide information about the benefits, objectives, and limitations of their schemes.

Read more from the Equity Release Council about equity release.

Equity release: Home reversion schemes

A home reversion schemes involves selling all or part of the home to a company (known as a 'reversion company') for a percentage of its sale value, usually somewhere between 30 and 60%. The occupier then receives either a lump sum or a monthly income for life. The occupier is allowed to remain in the home for free or for a nominal rent, but upon their death the property will belong to the reversion company.

Most home reversion schemes only accept people over a minimum age, usually 70. There is also usually a minimum value that the property must be worth, and most schemes require that the property is in a reasonable state of repair. The homeowner will usually remain responsible for repairs.

If the homeowner wants to move, then the home reversion company will make a decision about what happens to the property. Usually it will be sold. If the homeowner has sold the whole of the property to the company, then if the company sells the property the homeowner will not get any of the proceeds. If they have sold part of the property, the proceeds will be divided between the company and the homeowner.

Home reversion schemes are regulated by the FCA. Some reversion companies are also members of the Equity Release Council and should abide by its code of conduct.

Information about home reversion (and equity release) is available from Age UK and the Money Advice Service.

Interest-only and roll-up loans

Interest-only loans are loans raised against the value of the home. The applicant receives a lump sum, and then makes interest payments. The capital does not have to be repaid until the home is sold or the applicant dies. A roll-up loan or roll-up mortgage is an interest-only loan where both the capital and interest repayments are deferred. This means that all the payments on the loan are not due until the property is sold. The applicant receives a lump sum and/or a monthly income.

Where an older person needs adaptations or extra facilities in order to remain in their home, they may qualify for a disabled facilities grant to pay for necessary work.

Where only minor repairs or adaptations are needed, the older person may benefit from the assistance of a specialist agency who can give advice on getting repairs and improvement work done.

For more information, see Which: Home Improvement Agencies.

Social services may be able to help a person apply for a grant, or pay for works not covered by a grant. In some situations social services can also provide help with adaptations, provided the adaptation is to assist with nursing at home or to aid daily living, and provided that the adaptations required do not cost more than £1,000.[4]

The Equality and Human Rights Commission has published an adaptations toolkit for local authorities on housing and disabled people.

Older people may receive care provided by family members, friends or neighbours instead of, or in addition to, the options outlined above. The type of services received by an older person has an impact upon the ability of such carers to provide care. Carers are entitled to an assessment of their ability to provide the care required.[5]

Respite care

This refers to a temporary period of care, which may relieve a carer of the responsibility of caring for the older person for a short period of time. It can take place within the older person's home, or involve the older person moving temporarily into a care home, or going on holiday.

A person entering a care home on a temporary basis may receive housing benefit on their previous home for up to:

• 52 weeks if the placement is temporary, for example for respite care, and the person intends to return to their original home

• 13 weeks if moving into a care home on a trial basis to see if it is suitable for their longer term needs, with the intention on the day of entry to return to their previous home if the trial proves unsuccessful[6]

These entitlements are not affected if at some point during their stay in the care home, the person decides to stay in residential accommodation permanently.[7]

Nightsitters

In some circumstances, it may be necessary for someone to remain with the older person at all times. Therefore the carer may need some respite overnight in order to get some sleep or have a break. The provision of a nightsitter can enable this to take place.

These services are accessed via social services following a Care Act 2014 assessment.

The Equality and Diversity Forum provides a searchable list of voluntary, statutory and umbrella organisations that may be relevant to advisers working with clients who are elderly and/or disabled.

The Directory of Deaf and Disabled People's Organisations provides information about organisations, mostly but not exclusively based in London, that support disabled people.

Elderly or disabled people and their advisers can search LASA to find sources of support and information available to them locally.

A person with a complaint about their care should initially complain to the care provider or social services.

Find out more from the Care Quality Commission about making a complaint about an adult social care service.

Human Rights Act protection

Where a registered care provider provides care and support to an adult in the course of providing personal care to that adult in their home, that provider is taken to be exercising a public function under the Human Rights Act 1998 where the care and support is arranged by a local authority, or paid for (directly or indirectly, in whole or in part) by that authority.[8]

This means that human rights protection is available to an adult who is receiving care at home even if they are self-funding (ie paying for the care themselves), as well as to adults in care homes, as long as the care and support was arranged by the local authority under a provision of the Care Act 2014.