How Does Paying for Care Work in the UK?

When a parent begins to need extra support, one of the first questions people face is, “How does paying for care work in the UK?” It is rarely something families have planned for, and the system can feel difficult to understand, particularly when these stressful decisions must be made alongside work and other responsibilities.

In the UK, how care is funded depends upon whether you live in England, Northern Ireland, Scotland or Wales. However, care broadly falls into two categories. Healthcare, provided by the NHS, is free at the point of use. This includes GP appointments, hospital treatment and nursing care. Social care is different. It covers day-to-day support such as help with personal care, meals, supervision or remaining safe.

Who Pays for Elderly Care in the UK?

In England and Northern Ireland, eligibility for local authority funding largely depends upon whether a person’s savings are below £23,250. Those with savings above this threshold generally have to privately fund their own care and, in most cases, arrange it themselves. In Scotland, the criteria differ, with free personal care available. In Wales, there is a cap on home care costs, for example.

In England and Northern Ireland, any adult who appears to have care needs is entitled to request a care needs assessment. However, due to stretched resources, it can take many weeks for one to take place, and the local authority may decide that a face-to-face assessment is not required.

Where a person’s savings fall below the threshold, the starting point should be a care needs assessment. For those who will be privately funding care, one may not always be necessary if funding and care arrangements are clear. However, more complex situations can arise - for example, where a person lacks capacity to make their own decisions or where there is disagreement between family members and the person needing care. In these circumstances, involvement from social services remains advisable.

A care needs assessment should consider the type of support required to maintain safety, wellbeing and independence. However, it is more complex than this, as specific eligibility criteria must be met. If eligible needs are identified, a financial assessment will then take place.

How Much Can You Have in Savings Before Paying for Care?

There is often a mistaken belief that receiving support from the local authority means care will be free. This is not the case. In England and Northern Ireland, the financial assessment considers savings, assets and income. Where savings exceed £23,250, individuals are usually expected to pay the full cost of their care.

Where savings are below this level, the local authority may contribute towards the cost, but the person will still be required to make a financial contribution based on income and available assets.

Do You Have to Sell Your House to Pay for Care?

The family home is often a source of concern. If care is provided at home, the property is disregarded in the financial assessment. When care at home no longer meets a person’s needs and residential care is required, the property may be taken into account, although there are circumstances in which it will still be disregarded.

There are also mechanisms such as Deferred Payment Agreements, which can allow someone to retain ownership of their property during their lifetime rather than selling immediately.

Is Local Authority Care Free?

Local authority involvement does not automatically mean care is free. Even where funding support is provided, the financial assessment calculates how much a person must contribute towards their own care costs. The local authority may then contribute the remaining amount based on the assessed care budget.

Care fee funding is complex. Whether a person is privately funding their care or receiving local authority support, there may be Department for Work and Pensions (DWP) benefits available. Depending on a person’s financial circumstances, it may also be appropriate to seek advice from an independent financial adviser.

There are a wide range of care options available, including domiciliary care, live-in care, residential care and nursing homes. Deciding which option is most appropriate, who has authority to make decisions, and how care will be funded can feel daunting and overwhelming - particularly for those balancing caring responsibilities alongside full-time work.

For many employees, these decisions are made under significant pressure, often alongside full-time work, family responsibilities and ongoing worry about a parent’s wellbeing Grace Consulting works in partnership with businesses to provide care advice to employees throughout the UK as part of their employee benefits scheme. This support gives people access to clear, practical guidance on funding, assessments and care options, helping to reduce uncertainty at a time when clarity matters most.

There has been ongoing discussion about changes to how care is funded in England, including proposals to cap lifetime care costs. For now, families need to plan based on the current system, while staying aware that reforms may come in the future.

Paying for care is rarely just a financial matter. It often involves difficult conversations, concern for a parent’s wellbeing and uncertainty about what lies ahead. Having access to clear, reliable advice at an early stage can make those decisions feel more manageable and less overwhelming.