Three things decide who pays. Most families work through them in the wrong order, and it costs them.
✓ Every figure dated and sourced✓ No commission, no sales calls
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Do this first
Most people start with their savings, then the council, and treat the NHS as a long shot. It is the wrong way round. NHS Continuing Healthcare is not means-tested. Where it applies, the NHS pays the entire cost of the placement — not a contribution towards it — however much money or property you have.
It is decided on health needs, not on a diagnosis. A checklist can be started by a nurse, doctor, other healthcare professional or social worker, and a decision on whether you go through to a full assessment should usually be made within 28 days. Asking costs nothing and delays nothing.
NHS-funded Nursing Care is the smaller, far more common payment. It is for people in a nursing home who need care from a registered nurse but do not qualify for Continuing Healthcare. From 1 April 2026 it is £267.68 a week, paid by the NHS directly to the home.
You qualify whether or not you are paying for your own care. It is not means-tested, and this is the part that is routinely missed — self-funding families pay full nursing fees for years without ever claiming it. Over a year that is £13,919.
Ask the home one question, and get the answer in writing: “Is the fee you have quoted me before or after the NHS nursing contribution?” There is no standard answer. Some homes deduct it from your invoice, so the quoted fee is what you pay. Others receive it on top of the fee they quoted you. The same headline number, two very different bills.
Rate in force from 1 April 2026, up 5.4% from £254.06. Higher rate £368.24 for people who moved in before 1 October 2007 on the previous high band. Source: NHS England. See also nursing home costs and how we source our figures.
You may have read that care costs in England would be capped at £86,000 over a lifetime. That reform was due to start in October 2025 and was cancelled in 2024. Nothing has replaced it.
The commission now examining long-term reform is not expected to report in full before 2028. Plan on the rules as they are, not the rules as they were announced — and treat any advice written before 2025 with care, because a great deal of it assumes a cap that never arrived.
These are the statutory amounts. If you find one of them out of date anywhere on this site, tell us: we correct within three working days and log every correction publicly.
The capital limits have not moved since 2010. 2026/27 is the sixteenth consecutive year they have been frozen, which means more people fall above them every year without becoming any better off.
Capital limits, tariff income and personal expenses allowance: Department of Health and Social Care local authority circular, published 17 February 2026. Nursing contribution: NHS England. Attendance Allowance: GOV.UK. All checked 28 August 2026.
A top-up is the gap between the council’s rate and a more expensive home you have chosen. It is normally paid by a third party — a relative, a friend, a charity — not by the resident.
The council must first offer at least one suitable home at its own rate, with no top-up at all. If it cannot show that one is genuinely available, it should not be asking your family for a top-up. If you are told there is nothing, ask for that in writing.
The resident may pay the top-up themselves only in narrow, specified circumstances: during the 12-week property disregard, under a deferred payment agreement, or where the care is section 117 after-care under the Mental Health Act 1983.
Before anyone signs. The written agreement has to set out how it will be reviewed and what happens if the payments stop. Read those two clauses first. A top-up is a commitment for as long as the placement lasts, and fees rise every April — so work out what £150 a week becomes in three years, and ask now what happens if it becomes unaffordable.
Care and Support and After-care (Choice of Accommodation) Regulations 2014. Fuller detail on council-funded care homes.
The most common thing families believe about care fees is not true. There is no seven-year rule. That belongs to inheritance tax. Councils have no equivalent time limit and can look at a transfer made at any point in the past.
The test is about motivation and expectation, not dates: was avoiding care charges a significant reason for the transfer, and could you reasonably have expected to need care at the time? If a council decides you deprived yourself of assets deliberately, it can assess you as though you still owned them. The money is gone; the bill is not.
People give the house to their children at seventy on the strength of that rule and find out at eighty-two that it did not work. If a large sum is involved, take independent advice — before the transfer, not after.
Funding is one half of the decision. The other is the home itself, and the rating on its wall may be years old: how to read a CQC rating, or check a specific home in your council area.
We take no money from care providers. No home or operator pays to appear here, to rank higher, or to change how it is described, and nothing on this page has been shown to a provider before publication. Found something wrong? Tell us — we fix errors within three working days. Reviewed 28 August 2026. Next review February 2027, after the 2027/28 circular. This is information, not financial or legal advice.