Who is Responsible for Care Home Fees?

A common concern for families is whether they will be held responsible for a relative's care home fees. The legal framework in Northern Ireland is clear: the primary responsibility for paying for care rests with the individual receiving it. This principle is a cornerstone of the Charging for Residential Accommodation Guide (CRAG) 2015 [1].

The Resident's Responsibility

The financial assessment conducted by the Health and Social Care (HSC) Trust is designed to evaluate the resident's own financial resources. The assessment is comprehensive, taking into account both the resident's income and their capital assets to determine their ability to contribute to the cost of their care.

Strategic Guidance: When completing the financial assessment form, our general advice is to provide the bare minimum of information required by the Trust. You should only provide details relevant to the resident's own finances. Do not fill out any information regarding a spouse's income or assets on the means assessment form, as this information is not relevant to the resident's individual assessment and is not required.

"The 1972 Order requires that a person is charged for residential accommodation... If a resident is unable to pay the standard rate, the Trust must assess his ability to pay, and decide what lower amount should be charged." - CRAG 2015, 1.004-1.005

This means that the resident is the only person who is legally obliged to pay for their care from their own funds. The assessment will determine the exact amount of this contribution.

Are Relatives Liable?

In the vast majority of cases, children, grandchildren, or other relatives are not legally responsible for paying for a family member's care home fees. The means test is based solely on the financial situation of the person entering care. There is no requirement for family members to contribute from their own income or savings.

The Concept of "Liable Relatives"

While the general rule is that relatives are not liable, the CRAG guidance does contain a provision for "liable relatives." However, this term is very narrowly defined and applies only in specific circumstances:

Liable Relative	Circumstances
Spouse or Civil Partner	A spouse or civil partner can be considered a liable relative. However, the assessment process for couples is designed to ensure that the spouse or partner remaining at home is not left without sufficient resources to live on.
Parent of a Child	A parent is liable for the care costs of their child if the child is under the age of 16.

It is extremely rare for HSC Trusts to pursue a liable relative for contributions, especially in the case of a spouse. The regulations are structured to assess a couple's resources jointly and then ensure the partner remaining in the community retains a fair share of their joint income and capital.

No Obligation for Third-Party Top-Ups

Sometimes, a resident may choose a care home that is more expensive than the rate the HSC Trust is willing to pay. In these situations, a "top-up" payment may be required to cover the difference. It is important to understand that family members are under no obligation to make these top-up payments.

If a family does decide to contribute to a top-up, this is a voluntary arrangement. It is crucial to have a clear written agreement with the care home that outlines the terms of these payments, as they are a private contract between the family member and the care home.

Important Note: While there is no legal obligation for a third party to pay a top-up fee, if the family chooses not to pay it, the HSC Trust may determine that the current accommodation is more expensive than necessary to meet the resident's assessed needs. In such cases, the Trust may arrange for the resident to be moved to a different care home that accepts the standard rate without requiring a top-up.

References