For families considering moving a loved one into a care home, understanding the costs is an essential part of the process. The fees can be high, and they will usually be the family – or the person needing care – who pays. However, a lot of misinformation can surround the cost of care home fees, especially about what you really have to pay.
In this guide, you’ll find an overview of what the fees cover, how they vary across the country, and what you can expect to pay for services at different levels, whether it’s a care home for assisted living or a nursing home for residents with serious health needs who require round-the-clock clinical support.
What are care home fees?
Care home fees are the charges that families pay to a home to care for an elderly person. Care homes charge for the service of helping people with everyday life and caring for them and keeping them safe. Care homes charge different amounts depending on what the person living there wants and how poor or rich they are. The first step is to figure out how much the care home will cost.
When an elderly person has to move into a care home, it can be a stressful time for the family. It can also be hard on the body. The new place is empty and unfamiliar. Care for the elderly is 24/7 with no breaks. Care fees add up quickly, and not all elderly people have the money. For some families, it means paying from their own money. The care home decides how much to charge. Most people might think that care home fees mean only the cost of the room. This is untrue, as care home fees also include daily living expenses, personal care, food, and accommodation.
How fees are charged in the UK
Care home fees have just one purpose: to cover the cost of providing a bed and care for the resident. But there is no single fee; fees are charged in different ways by different homes and can include extra costs for some services or levels of comfort. The total cost is usually between £500 and £600 a week, but can go much higher, especially for nursing care.
Some homes charge a single fee that covers all costs; for example, £510 a week for a single bedroom with bathroom, laundry, heating, care, food and drinks, and all other services. These fees seem attractive because extras are included. But items such as holiday fees or laundry can be hidden costs. Other homes avoid these hidden extras but charge much higher base fees that include using newspapers and having a small amount of laundry done.
Some charging systems focus on the cost of care rather than comfort. For example, the social services assessment might estimate that it costs £442 a week to have a care home bed provided by the local authority residential care. If a private home charges £450 a week for standard accommodation and £600 a week for a luxury room, residents pay the full fee for the extra comfort.
What affects the cost
Several factors affect the cost of care homes in the UK. The two main costs for families are location and care needs. On average, a place in a care home costs families more in London than in other regions. Within London, costs are higher in inner areas than in outer areas, reflecting higher property prices.
According to a recent report from LaingBuisson, the average cost of a residential care home is £667 a week, and a nursing care home is £811 a week. Families who pay for care are expected to contribute their entire income plus a small amount set by the government. Families with more than £23,250 in savings pay full fees, while families with less than £14,250 have their savings disregarded, leaving them only to pay their income and the small allowance. Families with savings between £14,250 and £23,250 have a weekly contribution taken from their savings and added to their income. Care costs are capped at £86,000 over a person’s life, and a further £55,000 of costs are subsidised for people with smaller incomes who live in a more expensive part of the country. Care costs increase with inflation and are also constrained by a market mechanism that ensures an adequate number of places at a reasonable price.
Example costs for different care types
LaingBuisson reports average annual fees for receiving care at home or in a residential or nursing care home, but costs can vary still more dramatically. Paying for care helps people with care tasks, like washing, dressing, and eating. Care can be funded by the local authority, paid for privately, or a combination of both.
In 2020, the average local authority spent on domiciliary care was just over £50 per hour in England – about £27,000 a year for 520 hours. In 2022–23, the average local authority weekly fee for care for an individual in a care home without nursing was about £973 in England and £775 in Scotland, while the comparable average for an individual in a care home with nursing was £949 and £855, respectively.
Care is funded on a means-tested basis. If an individual has savings above £23,250 (in England, £29,750 in Wales, and £18,750 in Scotland) they can expect to pay full cost and receive no help from the local authority. If an individual has savings below the upper threshold, a separate savings test is undertaken to determine whether the savings constitute a capital asset that can provide income for their care. The income tax on capital interest is included in the income test.
How to check if you qualify for help
Please feel free to request your local council to evaluate your care and support needs. If you do not have such needs, the council can still assist you in determining your potential eligibility for financial support with care costs and care home fees. If you lack the resources to pay for assistance at home or in a care home, you deserve to receive support.
Support from the Local Authority may take the form of financial assistance or the council organising your care for you. If you qualify for a financial contribution, the amount of your contribution will depend on how much the council feels you can afford. If the council arranges your care, it will match the type of care home services you require with the necessary quality and taking your preferences into account. It will also decide where you should go for care.
Ways to reduce costs
Care home fees can be high, so knowing how to save money is a big help. Because of the different ways to get care at home and in care homes, families have many choices. These choices can bring down care costs and at the same time be much better for the person needing care.
Families should ask different care home providers the right questions. The answers can make a big difference. Things like meals, entertainment and staff-to-resident ratios can all vary from one provider to another. Some have more choice and quality in meals than others, or more activities for residents. Some have better staffing levels, leading to better choices and faster service. Getting it right can make living in a care home fun. Getting it wrong can make the experience tedious and frustrating, leading to more problems.
Asking how often new staff start work is valuable too. Too many new staff can mean too many different faces, causing worry and confusion for residents with memory problems. Staff who stay longer also know the residents better, and that leads to better care. As do staff who have good training and support. Having ready answers to these questions can help families find the right care home for their loved one. One where the care of residents is the staff’s main concern.
Planning and budgeting tips
There are things you can do to prepare for care home fees. Here are some ideas:
1. Muddle through Daily Life and Contribute a Little More: You might not need a care home just yet. Usually, the support you need is local. Family, friends and local benefits can help. Just a little extra help from other people might keep you at home.
2. Get Some Help for Free: Lots of services help older people in the home for nothing. You didn’t have to pay for that support. Social services, community groups, churches and charities may provide transport, meals, shopping, gardening, home repairs, household chores and company.
3. Use the Internet: Free information and forums on the Internet can help you to keep going at home with a few adjustments.
4. Pay for Part-Time Support at Home and Get Free Help Too: You might not need 24-hour care. Think about paying for part-time help at home. Specialist care agencies, registered with social services, can send someone in for a few hours each day or week. Family and friends might be willing to fill the gaps for free.
5. Think of Fixing a Few Problems: You might not be able to put off going into a home, but making some changes at home might help you stay longer.
6. Make a move to a More Accessible Home: Lots of people move to a more accessible home before going into a care home. A smaller place, with level access and no stairs, is easier to care for, more immediately accessible and much safer.
7. Look into New Ways of Getting Paid for Carers: In some parts of the UK, you can buy in your own care. Care is purchased from your chosen agency or by personal assistants employed by you. Under these systems, budgets can be varied and interest-free loans taken out to buy equipment.
8. Come to Terms with the Ideas of Moving into a Care Home: You probably wish you didn’t have to go into a care home. But facing the reality of making that move will be a big step towards it being positive, not negative. Start to plan for the move.
What to ask when visiting a home
You will know quite quickly if a care home is right. It should feel friendly and relaxed. The home’s smell and appearance should be pleasant. Staff should be talking and laughing with residents. Think about what you see and hear. If things do not seem right, do not ignore your gut feeling.
Questions to ask:
1. Is the home registered? The law says all care homes for old people in England and Wales must be registered. Ask to see the registration certificate. You can also check online at the Care Quality Commission. In Scotland, Social Care and Social Work Improvement Scotland has an online register. In Northern Ireland, the Regulation and Quality Improvement Authority keeps a register.
2. What is the quality of care? CQC and Care Inspectorate reports show the quality of care. The reports cover safety, health, cleanliness, staff and suitability of the building. Reports are available online.
3. How much is the fee? Fee rates are usually published for each room type. Could you confirm whether the published fee is the final fee? Some homes charge extra for activities such as hairdressing, shop visits and day trips. Do not forget to ask what is included in the fees.
4. Are nursing staff on duty day and night? Find out if qualified nurses are always available.
5. What is the staff-resident ratio? CQC and Care Inspectorate reports state the average staff-resident ratio. You should feel able to ask this question directly.
6. What are the staff like? Could you look at how staff interact with residents? Are they polite and respectful? Do they seem to enjoy their work?
7. Are staff trained in appropriate areas and given ongoing training? Staff should have training in the care and needs of people in residential homes. Staff must also be ready for difficult situations. Regular updates are essential.
8. What arrangements are there for breakfast? Can residents have breakfast when they want? Is there variety? Can staff help residents who wish to help?
9. Are residents free to choose how to spend their day? Find out if the staff provide support. Residents should be able to enjoy their hobbies and learn new things.
10. Do people look clean and tidy? All residents should look clean and comfortable. Check their hair, clothes and teeth.
11. Do residents seem happy? Look for noise or chatter. People should not just be watching TV. Could you check for photos of residents enjoying activities?
12. What do residents think? Chat with residents alone. What do they say about the food, care and activities?
Next steps
Once you have been given an estimated weekly care home fee, the next step is to check what services are actually included in that fee. The better homes will offer you a detailed breakdown of what their estimated charge covers. These breakdowns vary from home to home, but commonly include:
• How much of the fee goes towards accommodation and meals?
• How much is spent on nursing care if applicable.
• How much is spent on the general running costs of the home associated with your care and welfare, broken down (staffing costs, heating, lighting, laundry, phone and other administration, activities, supplies).
• Any optional extras not included in the fee (e.g. hairdressing).
• Additional fees for follow-on treatment (homes with specific registered uses).
• How much is charged for short-term admissions (respite care) or for long-stay clients receiving a lower local authority-funded rate?
The main question should be whether the stated care home fee matches what you, as a potential resident, might have to pay.
Conclusion
The average cost of care home services is at least £6000 a year. These costs are not prepared for or insured against; merely getting a free assessment is the easy part, and only some may get it. What worries families is having to pay for someone else’s care sure is. One does not want them to be unhappy while one is paying them anyway. The alternatives are also not so attractive; it is especially sad when the family tries to save them from long-term care. The most robust and safest calls for financial help come from married couples; a little insolvency for one spouse guarantees capital-shielded fees. The £ 25,000 annual capital costs seem too high, even for holiday arrangements.
At some stage, longevity and care home fees become horrifically large; even charging a £ 30,000 entry fee would save families between £ 10,000 and £ 15,000 a year for those certainly needing long-term care. No simple formula is likely to suffice, and no one wants to get it wrong for long-term care. However, it is wise to realise that all care home costs involve losses, sometimes soberly wrapped up for all to see. Postponing choices until financial losses seem less troublesome usually means that choices are considered at precisely the “wrong” time. Parents or in-laws are not actively—indeed, probably happily—using the money they have saved, so it makes sense to assist with that choice while it is easy to make.