Capital Depletion

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.

The project team brought together expertise in health economics, social work and social care research. The project also brought 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

Researcher

Dr Rebecca Ince

Co-Investigators

• Dr Denise Tanner
• Dr Kate Baxter
• Anne Hastings (Age UK – Solihull)
• Professor Yvonne Birks

• Some older people worry about "running out of money" from the point of moving into residential care, but are unlikely to be offered a financial assessment until after funds have depleted below the upper capital limit.
• Older people with funds above £23,250 approaching local authorities for support with choosing a care home and advice regarding finance, are seemingly sent away with little more than a list of care providers.
• The prospect of the resident having to move to a different care home is distressing, particularly for the family.
• Fee negotiations can be protracted and time consuming.
• Participants used phrases relating to battles and fighting when referring to fee negotiations and efforts to keep the resident within their current care home.

We have co-produced a leaflet which provides advice for residents self-funding their own residential care. The leaflet is equally relevant to anybody who is supporting someone in a care home.

Organisations other than the University of Birmingham are permitted to share and promote this information leaflet publicly, but on the conditions that they: (i) do not change text or edit formatting; (ii) acknowledge the University of Birmingham.

Download the PDF version of the leaflet: Self Funded Care Research UoB Resource [PDF, 2MB]

Download the accessible version of the leaflet (optimised for screen-reading software): Self-Funded Care Research leaflet - accessible [DOC.X, 164KB]