"When the money runs out": capital depletion and transition out of self-funded care

The project will investigate what happens in cases of capital depletion. 

Using the knowledge and understanding that we gain from the project, we will put together a set of resources to improve the experience of care home residents and family members in the future.

The research is funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research.

Philip KinghornDr Philip Kinghorn

Research Group Lead

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Summary of the Research

Many people pay the full costs of social care themselves. They may not approach the council because they know they are unlikely to get help. Even when the council assesses people as needing social care support, the person will have to pay the full cost of their care if they have savings/assets above £23,250.

Many care services are expensive and over time the person will use up a proportion of their savings.  When savings/assets fall below £23,250 people can request a needs and financial assessment from the council.  The council may step in at this point to meet some or all of the cost of care.  Little is known about people’s experience of asking for support, or what happens when there is a change from self-funding to council support.  This research will involve speaking to the different groups involved to fill this knowledge gap.  Proposed changes to the law (from 2023) may mean this shift from self-funding to council support affects more people.  Councils will need to manage this extra pressure (workload and financial) whilst supporting service users.

We will focus on care homes, because this form of care has a number of distinctive features.  Residents who self-fund care often pay higher fees than those supported by the council; this can be the case even in the same care home.  If the council will not pay the level of fees that residents previously paid privately, the resident may be moved to a new home, possibly outside their local area.  Alternatively, family members may contribute financially, to top-up what is paid by the council or, care providers may accept lower fees for the resident to stay in their home.

We’ll start by interviewing around 24 care home managers/owners, and about 10-15 people each from three other groups:

  • residents and their family;
  • people in councils who buy care services or conduct financial assessments;
  • those who provide independent advice. 

From initial interviews, we’ll build up a picture of what’s happening.  We’ll identify where there are gaps in that initial picture and where this is the case we will conduct additional interviews with those groups from whom more information is needed.  We expect to conduct up to 90 interviews in total.  When we have enough understanding of the transition from self-funding to council support, we will explore if and how this fits with economic theory.  For example, we could find that, as ‘big players’ in the market, councils push care providers into accepting low prices. There may be other circumstances where providers can charge councils more than the council would ordinarily pay. Economics is a way of understanding the choices that people make and the motivations behind those choices, particularly in the context of financial or time pressures.

We’ll use our overall understanding from the research to create resources to help councils, providers and independent advisers to support residents, improving their overall experience as they move from self-funding to council support.  We’ll also consider the motivation of these different groups to change current practices.

Our Case Study Regions

We are conducting this research within two case study regions, the West Midlands and the South East of England.  Within these two regions, there are 33 local authorities (councils) with responsibility for adult social care.  We will focus our work and our data collection within these 33 local authorities:

West Midlands

  • Birmingham
  • Coventry
  • Dudley
  • Herefordshire
  • Sandwell
  • Shropshire
  • Solihull
  • Staffordshire
  • Stoke-on-Trent
  • Telford & Wrekin
  • Walsall
  • Warwickshire
  • Wolverhampton
  • Worcestershire

South East

  • Bracknell Forest
  • Brighton & Hove
  • Buckinghamshire
  • East Sussex
  • Hampshire
  • Isle of Wight
  • Kent
  • Medway
  • Milton Keynes
  • Oxfordshire
  • Portsmouth
  • Reading
  • Slough
  • Southampton
  • Surrey
  • West Berkshire
  • West Sussex
  • Windsor & Maidenhead
  • Wokingham

Meet the team

The project team brings together expertise in health economics, social work and social care research.  The project also brings together academic researchers from the Universities of Birmingham and York, with partners from Age UK, and representatives with lived experience.

Research Lead

Dr Philip Kinghorn


Dr Rebecca Ince


How can care homes support our research?

There are two ways in which care homes can support the research:

  1. The University of Birmingham are looking to recruit care home and nursing home owners/managers to take part in a one-off interview, expected to last around 40-60 minutes.  Interviews can be conducted in-person, online or by phone.  Those taking part will be sent a £20 shopping voucher.
  2. Could you identify a resident or the friend/family member of a resident who might want to take part in an interview, expected to last around 40-60 minutes?  They could be interviewed in-person, online or by telephone, and they will be sent a £20 shopping voucher for taking part.  The University would advise you as to who they are looking for and give you an information leaflet that you can give to people who might be interested.  If they express interest in taking part, you would be asked to put them in contact with the research team.  You will be reimbursed for the time spent supporting the research.  There is no pressure on anyone to take part, it is entirely their decision, you will be reimbursed for your staff time regardless of whether they choose to take part or not.

We are looking to recruit care and nursing homes from either the West Midlands or the South East of England.

For more information please contact either Philip Kinghorn (p.kinghorn@bham.ac.uk or 0121 414 7620) or Rebecca Ince (r.n.ince@bham.ac.uk).

Information for Care Home Residents

To help us with our research, we would like to speak to people who have had experience of self-funding their own residential care at some point, but who later asked the council for help with funding.  To help people decide whether or not they would like to take part in the research, we have prepared a Participant Information Leaflet, which is available upon request from Dr Rebecca Ince.  We have also made an audio version of the Participant Information Leaflet available, which can be opened by clicking on the link below:

Open the Audio Participant Information Leaflet