Paying for home care: private funding, local authorities and NHS support

Paying for care can feel complicated, partly because there are several different routes and each has its own rules. This guide explains the main options for care at home in England. It's a starting point, not financial or legal advice. Funding rules change, and eligibility always depends on individual circumstances, so please check with the organisations linked below.

Paying privately

If you pay for care yourself, you're often called a 'self-funder'. You can arrange care directly with a provider of your choice, and you don't need a council assessment to do so. Many families start this way, particularly when care is needed quickly. Our guide to home care costs explains what affects the price and how to compare quotes.

Even if you expect to pay for yourself, you can still ask your council for a needs assessment. It can help you understand the support available, and it's useful to have one in place if your savings later reduce.

Council support: the needs assessment

Anyone who appears to need care and support can ask their local council's adult social care team for a needs assessment. It's free, and you're entitled to one whatever your income or savings. The council will look at what help you need and whether your needs meet national eligibility criteria. Family carers can also ask for a separate carer's assessment.

In North London, contact the adult social care team of the borough where the person lives, such as Camden, Islington, Barnet, Haringey, Hackney or Enfield. The NHS guide to getting a needs assessment explains the process.

The financial assessment (means test)

If the council agrees you have eligible needs, it will carry out a financial assessment to work out how much you should contribute. In England for 2026 to 2027:

• If your capital (savings and investments) is over £23,250, you'll usually pay the full cost of your care.
• If it's between £14,250 and £23,250, you'll contribute from your income, plus an amount based on your capital (£1 a week for every £250 above £14,250).
• If it's below £14,250, your capital is ignored and you contribute from your income only.

For care in your own home, the value of the home you live in is not counted. Councils must leave you with a minimum amount of income, and charging policies can vary between councils, so ask yours for details. The NHS guide to self-funding has more information.

Direct payments

If the council is contributing to your care, you can usually ask to receive its contribution as a direct payment. This is money paid to you (or someone acting for you) to arrange your own care, rather than the council arranging it. Direct payments give you more choice over who provides your care and when. You'll need to keep records of how the money is spent.

Hedgerow welcomes clients who use direct payments. Your council can explain how direct payments work in your area.

NHS Continuing Healthcare

NHS Continuing Healthcare (often called CHC) is a package of care arranged and funded by the NHS for adults whose needs are mainly health-related, known as having a 'primary health need'. It's not means-tested, and it can fund care in your own home as well as in a care home.

Eligibility depends on the nature, complexity, intensity and unpredictability of someone's needs, not on a particular diagnosis. The process usually starts with a screening checklist, followed by a full assessment by a team of health and social care professionals if the checklist suggests it's needed. There's also a fast-track route for people with a rapidly deteriorating condition who may be nearing the end of their life.

If someone receives CHC funding at home, it's normally provided as a personal health budget, which gives more say over how care is arranged. The NHS Continuing Healthcare guide explains eligibility and how to ask for an assessment.

NHS-funded nursing care

You may also hear about NHS-funded nursing care. This is a contribution towards the cost of registered nursing care for people living in a care home that provides nursing. It doesn't apply to care at home, but it's worth knowing about if you're also considering a nursing home.

Eligibility versus choosing a provider

It helps to keep two questions separate. The first is whether someone is eligible for council or NHS funding. That's decided by the council or the NHS through their assessments, not by a care provider. The second is who provides the care. Depending on how funding is arranged, you may be able to choose a provider, for example through direct payments or a personal health budget, or the council or NHS may arrange it with providers they work with.

Other help worth checking

• Attendance Allowance is a benefit for people over State Pension age who need help with personal care because of an illness or disability. It isn't means-tested. See gov.uk/attendance-allowance.
• Personal Independence Payment (PIP) may be available to people under State Pension age. See gov.uk/pip.
• Carer's Allowance may be available to people who spend at least 35 hours a week caring. See gov.uk/carers-allowance.

Where to get independent advice

• Your local council's adult social care team
• NHS social care and support guide
• Age UK advice line
• Citizens Advice
• A regulated independent financial adviser who specialises in later-life care, if you're planning how to fund care long-term

If you'd like to talk about care for yourself or someone close to you, we're happy to explain how we work with private, direct-payment and NHS-funded clients. You can also read our home care FAQs.

This guide is general information about care in England and isn't medical, legal or financial advice. Last reviewed 14 October 2026.