A Simple No-Nonsense Approach to Funding
The costs of funding for care can be substantial and intimidating for those who are not familiar with it. At Total Community Care, we provide services for a large range of clients who have varied routes for funding the costs of their care.
Our aim is to have a straight forward approach which simplifies the process as much as possible. Ideally, this provides our clients with an agreed, all-inclusive fixed standard monthly rate.
The rate covers items such as recruitment and training along with annual leave and other costs. This methodology allows us to focus attention on the most important aspect – the quality of the care itself.
Funding Routes
There are two main ways by which funding is accessed. These are commonly known as:
- Statutory Funding
- Non-Statutory Funding (also known as Self-Funding)
We are more than happy to assist clients through either process.
Statutory Funding
What is statutory funding?
Statutory funding is when an individual is deemed to be eligible to receive money from the state for the costs of their care. This money comes from one of two sources – either:
- Health Care
- Social Care
There are some similarities, but equally some significant differences, between health and social care.
The money can only be accessed following an appropriate assessment of an individual’s needs by a health or social care professional (such as a social worker or nurse). This assessment is a vital stage in establishing what an individual needs and thus the level of funds that will be allocated to purchase their care.
(a) Health Care
If an individual is deemed appropriate for funding from this route they are likely to have received an assessment called a Decision Support Tool (DST).
This is most commonly undertaken through the local Continuing Health Care (CHC) team on behalf of the Clinical Commissioning Group (CCG).
If funding is completely (100%) through this route then it is not means tested and an individual would not be expected to contribute to the cost of the care in any way.
To give an individual as much control and independence as possible they might well be offered a Personal Health Budget (PHB) which gives them the freedom to purchase their own care directly.
(b) Social Care
In this instance, if an individual is deemed to have social care needs then they will again be eligible for funding. They would, however, be subject to means testing which might ask them to contribute to the cost of their care.
Once more, it is possible that individuals will be offered the opportunity to consider Direct Payments which allow an individual to purchase their care directly.
Joint Funding
It is possible to have funding from both Health and Social Care and this is sometimes known as joint funding.
Self-Funding
Find out more about Non-Statutory Funding (also known as Self-Funding)
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Non-Statutory Funding
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This route is also called ‘self funding care’ and often describes a situation, whereby an individual or family decide to pay for care privately.
Self Funding Care
In some instances, this is as a result of a settlement following an insurance claim where there is an amount allocated for care. It is, however, always worth checking to confirm whether an individual is eligible for any assistance towards the care costs from a statutory source.
The Ever-Changing Landscape of Funding
Overall, the subject of funding can be complicated and changes over time as a result of legal precedents and interpretation of eligibility criteria.
Here, at Total Community Care, we understand the importance of good quality care and the significance of getting the right resources to pay for this care.
Once again, we are more than happy to assist individuals and families with the often daunting task of sorting out the best way of funding a client’s needs.
In the meantime, here are some useful links:
Personal Health Budgets (PHBs)
What do we mean by a Personal Health Budget?
Personal Health Budgets were introduced as a way of personalising care around what matters to people and their individual needs. It is a sum of money to support an individual’s identified healthcare and wellbeing requirements. A Personal Health Budget enables people with long term health conditions and disabilities more choice and control over the money spent on the care and services they receive, so that their needs are met in the most appropriate way for them.
The actual care provided is planned and agreed between the individual, or their representative, and local Clinical Commissioning Group (CCG). Further information is available on https://www.england.nhs.uk/personal-health-budgets/what-are-personal-health-budgets-phbs/ and visit your local CCG website for more information about personal health budgets in your area.
Personal Health Budgets and NHS Continuing Health Care funding
Where care needs are assessed as primary health needs individuals may be eligible for NHS Funded Continuing Healthcare. Adults eligible for NHS Continuing Healthcare funding have a legal right to a Personal Health Budget (since 2014). For more information about this provision and eligibility criteria see :https://www.england.nhs.uk/personal-health-budgets/personal-health-budgets-in-nhs-continuing-healthcare/.
Amount of a Personal Health Budget
The amount is based on an assessment of an individual’s health and wellbeing needs and the cost of meeting those needs. A Care and Support plan detailing how the Personal Health Budget will be spent needs to be agreed by your NHS team.
What can a PHB be used for?
For a variety of services to help meet an individual’s agreed health and wellbeing outcomes including: personal care, therapies, equipment, in line with an individual’s personalised care and support plan. It is not for emergency care or normal GP care, medical tests, seeing a consultant or medication.
How is this funded?
The funding for the Personal Health Budget comes from your CCG, and your Council where care and support is joint funded.
At TCC we work closely with CCGs and individuals to ensure a comprehensive assessment of health and wellbeing needs and the provision of high quality care and support that works for them, in line with the PHB in NHS Continuing Healthcare framework.
Common Myths about PHBs?
You do not have to become an employer of your own staff, For individuals who choose to have a PHB there are different options available of managing the budget to make it “hassle free”. Perhaps speak to one of our experienced staff to explain this further.