This factsheet describes how the Care Act (2014) and its supporting regulations and guidance sets out a clear legal framework for how local authorities support an individual who has sufficient assets to pay for their care and support (self-funders).

What happens now? – community-based care and support

A local authority’s duty towards a self-funder only differs when it comes to arranging care and support which has been identified as part of the care and support planning process as they do not qualify for financial assistance to meet their eligible needs. The self-funder’s capital and savings should not influence the way in which the duties noted above are undertaken which should be underpinned with strengths-based and person-centred practice.

A self-funder has the right to request an assessment of needs for care and support under Section 9 of the Act and the local authority has the duty to undertake an appropriate and proportionate assessment if there is an appearance of need. It may be necessary to appoint an Independent Advocate if it is identified that the self-funder would have substantial difficulty participating in the assessment without additional support and there is not an Appropriate Individual that can maximise their involvement.

A referral for an assessment of needs for a self-funder can be made by a third-party and if the self-funder has the capacity to consent to the assessment, the local authority has the duty to undertake one. If there is reasonable belief that a self-funder lacks the capacity to make this decision, the Mental Capacity Act (2005) must be followed and the decision regarding the assessment of need must be taken as a Best Interest decision.

After the assessment of needs has been completed, the local authority will decide if the assessed needs are eligible needs following the guidelines of Section 13 of the Act and the accompanying Care and Support (Eligibility Criteria) Regulations 2015. 

If eligibility is determined a self-funder can ask the local authority to support them in developing a support plan and make necessary arrangements within the community to meet the identified eligible needs, for example arranging for an agency to provide support within a person’s own home.  This can have benefits for a self-funder as the local authority may be able to get cheaper rates than self-funders arranging care themselves. If a self-funder makes this request, the local authority must meet the eligible needs, but the self-funder will be charged the full amount of the cost of care as Section 14  gives the local authority the power to charge if an individual has savings and income which exceeds £23,500 (UCL).  If the self-funder decides to arrange care and support via the local authority, they may also be charged a fee for this service.

It may be necessary to appoint an Independent Advocate if it is identified that the self-funder would have substantial difficulty with the support planning without additional support and there is no Appropriate Individual that can maximise their involvement.

If a local authority has arranged care and support for a self-funder, the local authority must keep the care and support plan under review. This must be done no less than yearly but may be undertaken more frequently if the self-funder’s circumstances change.

A self-funder may prefer to arrange for care and support independently due to additional fees which the local authority may impose. 

If the self-funder’s savings and capital look set to fall below £23,500 a financial assessment will be undertaken to ascertain the amount of financial support that the individual may be entitled to once they are below the threshold. Self-funders may have people supporting them to meet their social care needs and if these individuals are not paid for the support that they provide, they will be seen as carers under the Act. More details about carers can be found in the Care Act factsheet 4: Legal duties for a carers assessment.

What happens after charging reform?

The local authority’s obligation to provide financial assistance to meet eligible needs will increase as the threshold for determining a self-funder will change from an UCL of £23,500 to £100,000. This means that there will be an increase in the number of individuals who will be eligible for financial support from the local authority towards the cost of their care and support.

The maximum amount that a self-funder will be expected to pay towards the cost of care and support will be £86,000 (under current proposals). 

The elements of care and support that are considered are those incurred to meet the outcomes specified in the Care and Support plan, for example support from a third-party to enable an individual to get washed and dressed.

When a self-funder approaches the cap, the local authority will have to notify the self-funder in advance and provide information for when they reach the cap and agree in advance how the self-funder would like their needs to be met once the cap is reached.

What happens now? – residential and nursing home care and support

When a self-funder’s eligible needs are to be met by the provision of specified accommodation (e.g. accommodation in a care home) the local authority should decide whether it is obliged to make the necessary arrangements itself. To determine this the following questions need to be considered:

• Does the person have the capacity to make arrangements for accommodation?
• Does the person have someone who is able to make the necessary arrangements on their behalf?

If the answer to both questions is ‘no’, the local authority must meet the eligible needs and make any arrangements for the care home, including on a cross-border basis. The self-funder will be charged the full amount of the cost of care and may be charged an arrangement fee for this service.

If the answer is yes to these questions, the local authority has discretion as to whether it will provide support beyond the provision of information and advice. It may be advantageous to the self-funder if the local authority arranges the placement on their behalf as the local authority may be able to negotiate better rates. The self-funder will be charged the full amount of the cost of care and may be charged an arrangement fee for this service.

When the local authority supports a self-funder to arrange specified accommodation, the equity of the person’s home is considered, alongside any savings and capital. If it is anticipated that it may not be appropriate to sell the home due to other occupancy, a self-funder may be offered a deferred payment account by the local authority. This means that the local authority agrees to meet any personal contribution towards the cost of the specified accommodation until the time that the house is sold. A local authority may charge for this service.

It is important that self-funders are aware that in the event their capital, savings and equity of their home falls below the UCL and they become eligible for financial assistance from the local authority, the local authority is obliged to consider alternative ways in which the self-funders eligible needs are met. For example, moving to specified accommodation which is more affordable to the local authority. The local authority has a duty to consider the impact of such circumstances on the individual wellbeing of the self-funder and this will be done via either a review of a care and support plan, or Care Act factsheet 2: Legal duties for assessment of needs for care and support, if the self-funder is not known to the local authority.

When the local authority has arranged care and support for a self-funder, the local authority must keep the care and support plan under review. This must be done no less than yearly but may be undertaken more frequently if the self-funder’s circumstances change.

What happens after charging reform?

The local authority’s obligation to provide financial assistance to meet eligible needs will increase as the threshold for determining a self-funder will change from the UCL of £23,500 to £100,000. This means that there will be an increase in the number of individuals who are eligible for financial support from the local authority towards the cost of their care and support.

The maximum amount that a self-funder will be expected to pay towards the cost of care and support will be £86,000 (under current proposals). The elements of care and support that are considered are those incurred to meet the outcomes specified in the Care and Support plan, for example support from a third-party to enable an individual to get washed and dressed.  

When a self-funder approaches the cap, the local authority will have to notify the self-funder in advance and provide information for when they reach the cap and agree in advance how the self-funder would like their needs to be met once the cap is reached.

Fees incurred due to costs of daily living, for example hotel fees such as the cost of food and drink, will not be considered when calculating the cap on care costs. However, if an individual requires support with eating, this will be deemed to be a personal care cost and will contribute towards it.