Who Pays for Home Care? The Means Test Explained

1. The care needs assessment

Section 9 of the Care Act 2014 gives everyone who appears to need care a right to an assessment, whatever their means. In Hertfordshire you request it through the council’s online form or through HertsHelp on 0300 123 4044. A social worker or assessor looks at what you can and cannot do day to day against the national eligibility criteria (the Care and Support (Eligibility Criteria) Regulations 2015): two or more outcomes, such as washing, dressing, eating or maintaining the home, that you cannot achieve without help, with a significant effect on your wellbeing.

2. The financial assessment

If you have eligible needs, section 17 lets the council assess what you can afford, under the Care and Support (Charging and Assessment of Resources) Regulations 2014 and Annex B of the statutory guidance. For care at home the value of the home you live in is disregarded, which is also why deferred payment agreements (borrowing against the home to pay fees) are a care home mechanism and rarely arise for home care. Capital includes savings, investments and property other than your home; income includes pensions and most benefits, with Attendance Allowance counted only if the council is funding the care it was awarded for. The Minimum Income Guarantee is the amount of weekly income the council must leave you with; the Department of Health and Social Care sets the figure each April.

3. The care and support plan

The council produces a care and support plan and a personal budget: the amount it will pay towards your eligible needs. You can take it as a Direct Payment and choose your own regulated provider, or let the council arrange a provider from its framework. If you choose a provider whose rate is above what the council pays, the difference is a top-up.

NHS Continuing Healthcare is for adults whose needs are primarily health needs, judged across twelve care domains using the national Decision Support Tool after a checklist screening. It is not means tested and, where awarded, the NHS pays the full cost of care at home, including the provider’s fees. The Fast Track pathway allows care to be funded within days for someone whose condition is deteriorating rapidly and who may be approaching the end of life. Ask the GP, district nurse or hospital discharge team to complete the checklist; you are entitled to be involved in the assessment and to see the decision in writing.

If someone does not qualify for full Continuing Healthcare but has a registered nursing need, NHS-funded nursing care applies only in nursing homes, not at home. Equipment, continence products and district nursing visits remain free from the NHS whoever pays for the care itself.

Attendance Allowance is for people over State Pension age who need help with personal care or supervision because of illness or disability. It is not means tested, not taxed and does not depend on having a carer; it is paid at a lower or higher weekly rate depending on whether help is needed by day, by night or both. The claim form is long and the award is based on how your needs affect you on a bad day as well as a good one. Personal Independence Payment is the equivalent for people under State Pension age. Carer’s Allowance is paid to someone who cares for at least 35 hours a week for a person receiving Attendance Allowance or PIP, subject to an earnings limit. Pension Credit can be increased for a severely disabled person and opens the door to other help. Current rates and rules are on GOV.UK and change every April.

The Homecare Association’s Minimum Price for Homecare for 2026 to 2027 is £34.42 an hour; its October 2026 fee survey found councils in England pay an average of £25.37. Hertfordshire County Council sets its own rates by contract. Because most private rates, including ours, sit above the council rate, a family taking a Direct Payment may need to top up. Our cost of home care in Hertfordshire page states our fees in full. Whichever route you expect to use, the first practical step is the same: request the needs assessment, because it is free, it records what help is needed, and it is required before the council or the NHS will fund anything.