Continuing healthcare and long-term residential care

All nursing care is free. This is a fundamental of the NHS. However, not all care is nursing care and a good deal of care is classed as social care. The social care element is not free and there are circumstances where you would have to pay for the social care you receive (such as the so called ‘hotel costs’ of any residential care).

If you have been the subject of an Order under Section 3 of the Mental Health Act 1983, then you are entitled to free after care under Section 117.

Otherwise, you will receive a health assessment. If – and this is a big if – your primary need is nursing care, then you will not pay any fees for your care at all. All your costs and fees will be paid for by the Local Authority, including the social care elements, and the hotel costs of any residential care. This is the case, regardless of what wealth you may have. This is referred to as Continuing Healthcare or CHC for short.

If, on the other hand, nursing care is not the primary need, then yes, you may have to pay a contribution to your care (the nursing element, if there is one, will still be free and
paid for). Your income and savings, including the value of your home, will be assessed and you will contribute to the cost of your care arrangements, down to capital savings of £23,250. There is more on this in our paying for care guide.

How do I apply for CHC?

Let’s be honest; it is not in the interests of the Local Authority for anyone to be awarded CHC. Local Authorities have budgets and their resources are constantly under pressure. The process is a difficult one. There is an initial assessment of your health and a checklist is completed. The second stage is a far more detailed assessment when your health needs will be judged against set criteria using a standardised toolkit and marks awarded for each one.

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