Paying for care for an older parent in the UK: a starter guide

If you are reading this, something has shifted at home. A fall. A hospital stay. A diagnosis. A long stretch of small worries that finally added up to "we need more help than this".

The first thing you discover, after the worry, is the admin. Who pays. What the council does. What the NHS does. What "self-funding" means. Why nobody seems to give you a straight answer. This piece does not solve the whole system; nobody does. It gives you the shape of it, in plain English, so you know what to ask for.

Two systems, not one

The UK has two systems that get tangled up in conversations about caring for an older parent: the NHS (free at the point of use, for medical needs) and adult social care (means-tested, run by local councils, for non-medical needs like washing, dressing, getting out of bed, meals).

It matters because the same older person can need help from both. A stroke would put them in the NHS system for the medical bit. The fact that they now need help getting dressed each morning is social care, which sits with the council.

Almost every conversation about "paying for care" is about the social care side. The NHS bit is usually clearer: it is free unless they go private deliberately.

The means test, briefly

If your parent is offered social care from the council, they will get a financial assessment. The means test in England (different thresholds apply in Scotland, Wales and Northern Ireland) is roughly:

• Savings above £23,250. They pay for their own care in full. Often called "self-funding".
• Savings between £14,250 and £23,250. Sliding scale. The council pays some, your parent pays some.
• Savings below £14,250. The council pays in full, though your parent's income (pension, attendance allowance) is usually taken into account up to a protected weekly amount.

"Savings" here means capital: cash in the bank, ISAs, premium bonds, shares. It also includes the value of the home in certain situations (mostly residential care, not care at home).

The means test does not look at family savings. Your inheritance is not part of the calculation. The council assesses your parent's resources, not yours.

The bit that surprises people

The £23,250 threshold is the same whether the care is at home or in a care home. The big difference is whether the house counts as capital.

• For care at home, the home your parent lives in is excluded from the means test. It does not count as capital.
• For permanent residential care, the home counts as capital unless certain people still live there: a spouse, a relative over 60, a disabled relative, or a child under 16.

This is the bit that turns a "we can afford this" into a "we cannot afford this" the moment a parent moves into a care home. For most middle-class families with a paid-off house, residential care self-funding is the default. The home eventually has to be sold or its value liquidated to pay the fees.

There is a deferred payment agreement scheme where the council pays the care home fees and recovers the cost from the eventual sale of the property after the parent's death. Worth knowing about. Independent Age has the clearest explanation of how these work.

NHS Continuing Healthcare, the exception that pays in full

If your parent's primary need is medical rather than social, the NHS pays for their care in full, regardless of savings. The route to this is called NHS Continuing Healthcare or CHC.

CHC is a high bar. It is meant for people whose needs are predominantly health-related: complex, ongoing, intense. Late-stage dementia with significant behavioural needs sometimes qualifies. Advanced Parkinson's, MND, severe stroke recovery, end-of-life care often do. The process involves a screening followed by a full assessment using a tool called the Decision Support Tool.

Two things worth knowing:

• CHC is widely under-claimed. Families assume they would not qualify because the threshold sounds high, and never ask for the screening. Always ask. The screening is free.
• Decisions can be appealed. Roughly a third of refused CHC applications are overturned on appeal. Use the free phone advice line at Beacon CHC for an honest read on whether to appeal.

The free things, in the order to do them

Before you spend a penny, two things to request from the council. Both free, both legally guaranteed.

1. A Care Needs Assessment for your parent. Done by the council's adult social care team. They visit, ask questions, observe, and produce a recommendation of what support would help. This is the gateway to everything else. Even if you are going to self-fund, do this first; the recommendations are useful.
2. A Carer's Assessment for you. Separate to your parent's. Looks at the impact of caring on you. Can result in small grants, paid respite, equipment, training, sometimes a regular hour of paid help so you can step away. Wildly underused.

To start either, search "[your council name] adult social care" and there is usually an online form. Or phone the council and ask for adult social care. They are legally required to assess.

What people quietly miss

• Attendance Allowance. Not means-tested. £73 a week (lower rate) or £108 a week (higher rate) in 2025-26 for over-65s who need help with personal care, regardless of savings. The form is long; the money is real. Most people who could claim it do not.
• Council Tax discounts. A "severe mental impairment" discount of 25% or 100% applies when someone with dementia lives in a household. Most councils do not advertise this. You have to ask.
• NHS-funded nursing care. If your parent is in a care home and has nursing needs, the NHS contributes a fixed weekly amount to the nursing element of the fees (£235 a week in 2025-26). The care home claims this; it should be reflected in the bill.
• Care home top-ups. If the council is paying and the chosen home costs more than the council rate, a third party (often family) can top up the difference. Make sure the top-up is sustainable; if you stop, the home can ask the parent to move.
• Self-funder rates. Care homes often charge self-funders more than they charge the council for the same room. Always negotiate.

The order of operations that works

If you are at the beginning of this, the order that gives you the best information for the least money:

1. Request the Care Needs Assessment for your parent (council).
2. Request the Carer's Assessment for yourself (same council).
3. Check whether Attendance Allowance is being claimed; if not, claim it.
4. Get a free 30-minute call with Age UK or Independent Age before any decisions about residential care.
5. If the situation is medical, ask the NHS team (often the discharge team in hospital) for a CHC screening.
6. Before any deferred payment agreement or property decision, see a specialist solicitor. Local councils maintain lists.

What this all costs in the real world

Rough 2025 numbers for England. Yours will vary by region and provider:

• Home care visits: £25 to £35 per hour. A typical "two visits a day" package is roughly £400 to £550 a week.
• Live-in carer: £900 to £1,400 a week, depending on complexity.
• Residential care home (no nursing): £900 to £1,500 a week.
• Nursing care home: £1,200 to £2,000 a week.

The fastest way to make these numbers feel manageable is to be sure you are claiming everything your parent is entitled to. Attendance Allowance and the higher-rate Council Tax discount alone can be over £200 a week of effective support before any council contribution.

Where Getwello fits

Getwello does not pay for any of this. Where it earns its place during the months around these decisions is in the coordination. The shared visit calendar is where the paid carers, the family rota, and the GP appointments all sit so everyone in the Circle is looking at the same picture. The daily check-in is a quiet reassurance that the package of care, paid and family, is actually landing day by day. If you are starting a new home-care package, our piece on bringing Mum home from hospital: what week one actually looks like is the one we hear quoted most by families in the first month of a new care arrangement.

For the broader admin around all this, Lasting Power of Attorney and Carer's Allowance are the two posts to bookmark.