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8 September 2021 | Comment | Article by Lisa Morgan

What does the £86,000 social care cost cap actually mean?

Following the UK government’s announcement on funding for social care in England, further clarification is needed on what exactly the care cap is.

The current care system and capital limits do not differentiate between personal care, daily living or accommodation costs and care homes charge for their service holistically, except for the ‘nursing care’ component of care which is paid for through the NHS nursing funding care contribution.

However, within the black and white of the UK government’s paper Building Back Better: Our Plan for Health and Social Care (PDF) it refers the cap of £86,000 on the cost of ‘personal care’.

Whilst there is no clear reference in the paper, according to BBC News: Will the cap really fix the social care system?, the government confirmed the accommodation-related costs of care - those associated with daily living, such as; food, energy bills and the physical building - would not count towards the cap.

The government has not confirmed how much people are likely to pay for the accommodation costs, but previous reference of the cap following the 2014 Care Act suggested people's contribution to these accommodation costs should be fixed at £12,000 a year. This is now likely to be higher.

The other point of consideration must be the reference to the local authority arranging the care to find ‘better value care’.

In the 2014 Care Act, which was later abandoned, the cap was due to be £72,000. However, this was not as it first seemed.

It did not mean that once an individual had spent £72,000 on care home fees that the local authority would completely fund their care thereafter. Rather, when the cap was reached depended upon the rate of care fees that a local authority was prepared to pay. For example, if a local council was willing to pay £500 a week for care then, for individuals falling within that local authority’s responsibility, the £72,000 cap would not be reached until 144 weeks of care had been paid for. This was true even if, in reality, an individual was paying £720 a week for their care.

Further, the cap would not even be reached in this instance (after 144 weeks) if the care fee included the accommodation costs. This is because the cap on care costs in the Care Act (as it now appears to be with the new cost cap) was just that; it placed a cap on care costs only and the cost of accommodation and living expenses were therefore still needed to be met by the individual receiving the care or, their family.

This is obviously in stark contrast to NHS continuing healthcare: What makes someone eligible, where the NHS is responsible for all costs including accommodation costs for individuals who received care primarily because of their health needs.

The vast majority of people have their home as their only real asset. The new system will continue to ensure local authorities offer deferred payment agreements, which is an accruing charge on the property, which will need to be settled on the sale of the property or death of the individual. Therefore, it remains that no one should be forced to sell a home during the care recipients lifetime.

It will remain to be seen as more details emerge from the UK government. However, as more information is coming to light, the cap contained within the paper may prove to be somewhat disappointing for the majority of those in care homes who pay more than the rate that the local authority is willing to pay and also for those who will still be required to fund the accommodation element of their care which is likely to run into hundreds of pounds a week.


More information

For advice on the topics discussed in this post, visit our Nursing Care Fee Recovery team page.


Author bio

Lisa Morgan is a Partner and Head of the Nursing Care department. She is regarded as an experienced and specialist solicitor leading in the niche area of continuing healthcare.

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Disclaimer: The information on the Hugh James website is for general information only and reflects the position at the date of publication. It does not constitute legal advice and should not be treated as such. If you would like to ensure the commentary reflects current legislation, case law or best practice, please contact the blog author.

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