Long-term care options: Something worth smiling about?

When the need for long-term care arises, whether it’s for you or a close relative, most people have very little idea of where to start. What indeed are the available options, and which one best matches your or your loved one’s needs? We take a look at this in closer detail.


  • Your starting point is to gain an understanding of your or your loved one’s care requirements – a care needs assessment by social services can help with this.
  • Care can then either take place in the home (usually costing anything from £10,000 a year) or in a care home (typically costing upwards of £30,000 a year) – most people in England and Northern Ireland with savings or investments exceeding £23,250 will have to self-fund this.
  • Your Wellesley financial adviser can support you with the practical and financial aspects of the process.

If you or a loved one needs long-term care, it can be difficult to know where to start. Factors such as the intricacies of the current care system, a lack of clarity in how care is funded and a common misconception that the NHS will financially cover all our needs only serve to further complicate the matter.

Pressing questions that may come to mind could be around the cost of in-home care and care-home fees, and how to understand the best option at such an important life stage.

There are many cogs that operate within the care system, therefore it’s important to have a perception of the different types of care available, how they meet your or your loved one’s needs, and how you are going to go about paying for them.

Pinpoint the needs

If you or a loved one feel that life is more difficult to manage nowadays, it’s important to assess what level of care is required before taking any action. While this may seem obvious, it’s often a tremendously difficult and emotive topic to raise with those around you.

There are some crucial questions worth asking, such as: Is there a need simply because you or your close relative is getting older and could do with a bit more help? Or is it down to a physical or mental medical problem that needs regular support? Also, how are things potentially going to develop in the months and years ahead?

A point of contact is the Social Services department of your local authority – you can approach them to request a care needs assessment, which will enable them to pinpoint the requirements and either arrange care or signpost you in the right direction.

The different types of care available

Once you can answer the above questions, it then becomes more straightforward to understand the type of care needed. On the whole, this can fall into two main categories.

1. Care in your own home – also known as ‘domiciliary care’

Many people might think that needing care involves moving to a care home – but that isn’t necessarily the case. In-home care can often tackle many daily challenges, such as the provision of meals and help with the cleaning and gardening, to frequent support with personal care or medical issues, or even full-time live-in care.

Adaptations could also be made to your home to make life easier – for example, installing a stair lift or a walk-in shower with a seat, which would then enable you to stay in your own home for as long as possible (support may be available from your local authority for minor adaptions).


2. Residential care or nursing care

As with in-home care, there can be a range of residential care options available. On the one hand, there are residential homes offering personal care, such as help with washing, dressing and taking medication. They often organise social activities too, such as coffee mornings, visiting entertainment and outings (subject to COVID-19 restrictions, of course).

On the other hand, nursing care homes can offer all of the above, together with more specialised nursing or dementia care from qualified nursing professionals. Many homes offer both types of support.

Some care homes are registered to provide both kinds of care.

When working out what the best option is, be mindful of the fact that each experience is unique – and the situation is likely to change over the years – so it’s essential to understand what’s best for you or your loved one according to your own individual circumstances.

Paying for care

When social services carries out a care needs assessment, if they conclude that some form of care is needed, you will be offered a means test to calculate whether you’re entitled to some financial support.

Bear in mind, though, that the amount a local authority will pay for a care home or home support is extremely limited – in England and Northern Ireland, an individual requiring care who has savings or investments exceeding £23,250 is likely to have to meet the entire cost themselves. What’s more, if you move to residential care and are a homeowner, the expectation is that you’ll use the equity in the property to fund the care – in other words, by selling the house or using an equity release scheme.

What this amounts to is that most people will have to fund some, or all, of their care themselves. Costs can vary, depending on a range of factors, such as geographical location, the level of support required, and whether the care is at-home or residential.

As a general rule of thumb, you might expect to pay around £10,000 to £15,000 a year for basic care at home1 – this might cover someone coming in for a couple of hours on a daily basis. Naturally, if more care is needed, those fees can quickly increase.

When it comes to residential care homes, the national average for a basic level of care is approximately £35,000 a year,2 but this average fluctuates across regions throughout the UK. Should more specialised nursing or dementia care be additionally required, you could expect to add at least another £12,000 or so per year on top – perhaps even more.3

While these figures might prove unnerving, it’s really important to avoid panicking and instead seek expert financial advice. A Wellesley adviser can support you in working out the best way to structure your finances to meet the costs, and also ensure you maximise on any tax relief or available allowances, meaning the next steps are as smooth as possible.

If you or a close relative needs long-term care, your Wellesley financial adviser can help you with the practical and financial aspects of the process and offer reassurance, giving you something to smile about during what can be a difficult decision at this important stage of life.


1,2,3 Laing Buisson Care of older people, UK market report 2018/19

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