Understanding who pays for a nursing home in the UK is one of the most important questions families face when an elderly relative can no longer live safely at home. Nursing home care can be expensive, and many people are unsure whether care is paid for by the individual, the local council, or the NHS. In the UK, nursing home funding depends on two main factors: care needs and financial situation . Some people pay for their own care, some receive help from their local council, and in certain situations the NHS may pay for care if the person has significant medical needs.
Do you have to pay for a nursing home in the UK?
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In many cases, people do have to pay for their nursing home care. This is because social care in the UK is means-tested, which means that whether you pay depends on your savings, assets and income.
Before any funding decision is made, the local council will usually carry out two assessments:
- A care needs assessment
- A financial assessment (means test)
The care needs assessment determines what level of care is required, and the financial assessment determines who will pay for the care.
How the financial assessment works
The financial assessment looks at a person’s:
- Savings
- Income
- Property
- Investments
If a person’s assets are above a certain threshold, they will usually have to pay for their own care. If their assets are below the threshold, the local council may contribute to the cost of care.
The financial rules can change over time, but in general, people with higher savings and assets are expected to contribute more towards their care costs.
Who can pay for a nursing home in the UK?
There are three main ways a nursing home can be paid for in the UK:
| Funding Source | Who Qualifies | What Is Paid |
|---|---|---|
| Self-funding | People with savings and assets above the threshold | Person pays full cost of nursing home |
| Local council funding | People with limited savings and assets | Council contributes to care costs |
| NHS Continuing Healthcare | People with significant medical needs | NHS may pay full cost of care |
Understanding which category applies is essential when planning long-term care.
Self-funding: paying for your own nursing home
Many people in the UK pay for their own nursing home care. This is known as self-funding.
People may pay using:
- Savings
- Pension income
- Investments
- Sale of property
- Rental income
- Financial support from family
Self-funding residents often have more flexibility and choice when selecting a nursing home, as they are not limited to homes within the local council budget.
However, self-funding can become difficult if a person lives in a nursing home for several years, which is why financial planning is very important.
Local council funding for nursing homes
If a person has limited savings and assets, the local council may help pay for a nursing home.
Before funding is approved, the council will carry out:
- A care needs assessment
- A financial assessment
If the council agrees to fund care, they will usually set a personal budget, which is the maximum amount they will pay towards the nursing home.
If the chosen nursing home costs more than the council budget, a top-up fee may be required.
NHS Continuing Healthcare
Some people may qualify for NHS Continuing Healthcare, which means the NHS pays for the full cost of care, including the nursing home.
This funding is not based on financial situation but on medical needs. People who require ongoing medical care due to complex health conditions may qualify.
The assessment process can be complex and involves an evaluation of the person’s health needs, mobility, cognition, behaviour, medication and overall care requirements.
Not everyone qualifies for NHS Continuing Healthcare, but it can be an important funding option for people with significant health needs.
What is a nursing home top-up fee?
A top-up fee is an additional payment made when the nursing home chosen costs more than the amount the local council is willing to pay.
Top-up fees are usually paid by:
- Family members
- Friends
- Charities in some cases
Before agreeing to a top-up fee, families should consider whether they will be able to pay the additional amount long term, as moving a resident later can be stressful and difficult.
What happens if you run out of money in a nursing home?
This is a common concern for families. If a person is paying for their own care and their savings fall below the financial threshold, the local council may start contributing to the cost of care.
However, the council may only pay up to a certain amount, and this may affect the choice of nursing home.
This is why it is important to contact the local council early if a person’s financial situation is changing.
Does the NHS pay for nursing home care?
The NHS may contribute to nursing home care in two main ways:
NHS Continuing Healthcare
The NHS pays for the full cost of care if the person has significant medical needs.
NHS-funded nursing care
If a person does not qualify for full NHS Continuing Healthcare but still needs nursing care, the NHS may pay a contribution towards the nursing care portion of the fees.
Do you have to sell your house to pay for a nursing home?
Whether a house must be sold depends on individual circumstances.
The value of the home may be included in the financial assessment if the person moves permanently into a nursing home. However, the home may not be counted if:
- A spouse still lives there
- A dependent relative lives there
- Other specific conditions apply
There are also deferred payment schemes, where the council helps pay for care and the cost is repaid later, often when the property is sold.
Can family members be forced to pay for a nursing home?
In most cases, family members are not legally required to pay for a relative’s nursing home, unless they agree to pay a top-up fee.
However, families often choose to contribute financially to ensure their relative can stay in a preferred nursing home.
How to plan for nursing home funding
Planning ahead can make a significant difference when it comes to paying for nursing home care.
Families should:
- Request a care needs assessment
- Request a financial assessment
- Check NHS Continuing Healthcare eligibility
- Understand nursing home costs in their area
- Plan finances early
- Seek financial advice if necessary
Planning ahead helps avoid emergency decisions and financial stress.
FAQ – Who Pays for a Nursing Home in the UK?
Do you have to pay for a nursing home in the UK?
Yes, many people have to pay for their own nursing home care, depending on their financial situation and assets.
Can the council pay for a nursing home?
Yes, the local council may contribute to the cost of care if a person has limited savings and assets and meets the eligibility criteria.
Can the NHS pay for a nursing home?
Yes, the NHS may pay for care through NHS Continuing Healthcare if the person has significant medical needs.
What happens if you run out of money in a nursing home?
If savings fall below the financial threshold, the local council may start contributing to the cost of care.
Do I have to sell my house to pay for a nursing home?
In some cases the property may be included in the financial assessment, but there are exceptions and deferred payment schemes.
What is a top-up fee in a nursing home?
A top-up fee is an additional payment made when the chosen nursing home costs more than the amount the council will pay.
Can family members be forced to pay?
Family members are not usually required to pay unless they agree to pay a top-up fee.
What is NHS-funded nursing care?
This is a contribution from the NHS towards the nursing care portion of nursing home fees.
How do I apply for council funding?
You can contact your local council to request a care needs assessment and financial assessment.
How long does it take to get funding approved?
The process can take several weeks, so it is important to apply early.
Need help understanding nursing home funding and options?
Understanding who pays for a nursing home, what funding options are available and how the system works can be complex. Taking the time to understand the process and compare different nursing homes can help families make informed decisions.
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