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Paying for Care at Home: What Are the Real Options?

When families start talking about care, the financial aspects can be daunting. You can sit together and agree that Mum isn’t as steady as she was or that Dad shouldn’t be on his own at night anymore, but as soon as someone asks how it will be paid for, the room often goes quiet.

There is a lot of noise around funding. One person says the NHS will cover everything. Another insists the council will make you sell the house. A neighbour swears there’s no help at all. It’s no wonder people feel overwhelmed.

In reality, the system is more structured and, in many cases, more reasonable than it first appears. There are a few main routes. Some depend on savings and income. Some depend on care needs. One depends entirely on health needs, and sometimes families use a combination. When you look at each piece calmly, it becomes far easier to see where you might fit.

Most families begin by self-funding

For live-in care in particular, this is the most common starting point.

Self-funding simply means using personal resources such as pensions, savings, investments, or rental income. Sometimes adult children contribute, or a property is put up for rent to create a monthly income. Every family’s situation is slightly different, and there is no single “right” way that works for everyone.

One of the benefits of self-funding is the amount of flexibility it gives you. You’re not waiting for assessments to be completed before putting support in place. You choose the provider. You decide when care begins. You shape the daily care around your loved one’s life, not around an external timetable.

At Eximius, live-in care starts at £1,550 (please confirm – I believe this is the fee for LA funded?) per week. Some families begin privately while they look into other funding options at the same time. It does not have to be a fixed, permanent decision. Even if you expect to pay privately, it can still be wise to request a Local Authority assessment so you clearly understand where you stand.

How Local Authority funding works

If someone has eligible care needs under the Care Act, their local council has a duty to assess them. The process has two parts.

First comes a needs assessment, which looks purely at what support is required, not finances. If the person meets the eligibility criteria, the council then carries out a financial assessment.

In England, the key savings threshold is £23,250. If a person has assets above that level, they will usually fund their own care. If their savings fall below it, the council may help. Importantly, if someone remains living in their own home, their property isn’t included in the assessment.

After both assessments are complete, the council sets a personal budget. This personal budget goes through the total cost of the agreed care package, how much you need to contribute, and how much the council will pay. In some cases, the outcome is full self-funding. In others, it is partial support. Full council funding does happen, but it is typically given to people with lower levels of savings and income.

Personal budgets offer more choice than people realise

A common misconception is that if the council contributes, they take over completely. That is not necessarily the case.

A personal budget can be paid directly to you as a Direct Payment, allowing you to arrange care yourself. Alternatively, the council can organise services on your behalf. Some families choose a combination of both.

Direct Payments give you more control. It lets you choose a care provider that feels right for your family. You can opt for live-in care rather than shorter visits. You can tailor support around routines that already exist. There is some admin involved, but many families feel the flexibility is worth it.

If the council’s standard rate doesn’t fully cover the provider you prefer, you are allowed to top up the difference yourself. This is quite often how families keep a loved one at home with one-to-one support, rather than moving into a residential setting. Local Authority funding does not automatically mean limited options. With the right structure, there is room for choice.

NHS Continuing Healthcare

This is the funding stream that tends to generate the most discussion.

NHS Continuing Healthcare is fully funded by the NHS and is not means-tested. It is awarded based entirely on health needs, not on savings or property. Eligibility depends on whether your loved one has what is described as a primary health need. The assessment process goes through an initial checklist and, if that indicates potential eligibility, a more detailed review.

It is most commonly awarded in situations involving advanced neurological conditions, severe dementia with significant risks, complex wound care, highly unpredictable symptoms, or the need for intensive clinical care. The criteria are strict, and not everyone qualifies. However, when someone does meet the threshold, it means their care costs are covered in full.

A combination of NHS and private support

For many families, the answer lies somewhere in the middle.

For example, a person may receive NHS services such as district nursing, physiotherapy, occupational therapy, or specialist palliative input. At the same time, the family privately funds live-in care to provide daily practical and emotional support at home.

In that arrangement, the NHS manages clinical elements while the live-in carer ensures safety and companionship around the clock. It is not NHS-funded live-in care, but it can work very effectively.

Attendance Allowance and Personal Independence Payment

These benefits rarely cover the full cost of care, yet they can help with a big chunk of the costs.

Attendance Allowance is available to people over State Pension age who have care needs. It is not means-tested. Personal Independence Payment supports those under State Pension age and is awarded based on the person’s need and not income.

For some families, these payments help offset weekly fees and ease financial pressure.

Why early planning helps

Funding shapes decisions. When conversations happen during a hospital discharge or a sudden decline, choices feel rushed and reactive. When you look into your options earlier, you have space to think.

You can request a needs assessment, no commitment necessary. You can understand what your likely personal budget could be, and you can explore whether a top-up is manageable. You can compare live-in care with other options calmly. Being prepared changes the tone of the whole process.

How Eximius supports families

At Eximius, funding conversations are part of almost every initial discussion. Families often arrive unsure what they are entitled to or worried in case they’ve misunderstood something they have been told. We talk it through in plain language, we explain how assessments work, and we offer a realistic view of what might apply.

We also believe funding should support good care rather than limit it unnecessarily. Live-in carers are not simply covering shifts. They are choosing to share their daily life with the person they support. That continuity, that familiarity, is often what allows someone to remain at home with dignity and confidence.

For many families, combining Local Authority support with a personal contribution makes that possible. For others, private funding provides the speed and flexibility they need. There is no single correct route, only the one that fits your circumstances.

If you are unsure where you stand financially, the first step is a chat with us. When you understand your options clearly, the fear around money tends to soften. Once that happens, you can focus on what really matters: putting the right care in place, in the right way, at the right time.