Care Funding Guide

NHS Continuing Healthcare (CHC)

What it is: NHS Continuing Healthcare is a package of ongoing care arranged and fully funded by the NHS for adults aged 18 and over in England whose primary need for care arises from a health condition rather than a social care need. If eligible, the NHS covers the full cost of care, including care at home.

Eligibility

There is no diagnosis or condition that automatically qualifies a person for CHC. Eligibility is assessed holistically across 12 care domains (including behaviour, cognition, communication, mobility, nutrition, skin integrity, and medication needs) using the Decision Support Tool (DST). The key test is whether the individual has a primary health need.

How to Apply

1. Request a CHC checklist screening. This is often triggered after a hospital admission, or by your GP, district nurse, or social worker.
2. If the checklist indicates potential eligibility, a full multidisciplinary team (MDT) assessment is arranged.
3. The MDT completes the DST and makes a recommendation to your Integrated Care Board (ICB).
4. The ICB makes the final eligibility decision. You should be informed within 28 days of the full assessment.

Fast-Track CHC

Where a person has a rapidly deteriorating condition that may be entering a terminal phase, a Fast-Track CHC decision can be made within 48 hours. This ensures urgent care funding is in place without delay.

Direct Payments

What it is: If you qualify for local authority social care funding, you may choose to receive a Direct Payment. This is a cash sum paid to you (or a nominated person) so you can arrange and purchase your own care rather than having the council arrange it for you.

How Direct Payments Work

• You must have been assessed as needing care under the Care Act 2014.
• A financial assessment determines how much you contribute and how much the council pays.
• The payment is made into a separate account (often a dedicated direct payment account).
• You use the funds to employ a care worker directly, or engage an agency like Kome Care.
• You keep basic records showing how the funds are used (the council may audit these).

Who Qualifies?

Adults (18+) who have been assessed as needing care under the Care Act 2014, and who are not excluded categories (e.g. under a Mental Health Act section). Children's direct payments are also available under different legislation.

Using Direct Payments with Kome Care

You can use your Direct Payment to purchase care from Kome Care. We can work with you to design a care plan that fits within your direct payment budget. Contact us and we will handle the paperwork together.

Attendance Allowance

What it is: Attendance Allowance (AA) is a weekly benefit for people aged 65 and over who have a physical or mental disability and need help with personal care. It is not means-tested, so you can receive it regardless of your income or savings.

Rates (2024/25)

How to Claim

Apply online at GOV.UK or call the Attendance Allowance helpline. You will need to complete a questionnaire about how your condition affects you. You must have needed help for at least 6 months (or be terminally ill under special rules). Most claims take around 40 days to process.

Personal Independence Payment (PIP)

What it is: PIP is a benefit for working-age adults (typically under 65, though existing recipients can remain on it after 65) with a long-term health condition or disability that affects daily living or mobility. It is not means-tested, and it does not depend on National Insurance contributions.

The Daily Living Component

The Daily Living component of PIP is relevant to home care. It is paid at two rates, standard and enhanced, and is assessed through a points-based assessment covering activities such as preparing food, washing and bathing, managing medication, and engaging with other people.

Claiming PIP

Start your PIP claim by calling the DWP PIP new claims line. You will be sent a PIP2 'How your disability affects you' form to complete. A telephone or face-to-face assessment with a healthcare professional is usually required. Decisions typically take 12–16 weeks.

Local Authority Funded Care

What it is: Under the Care Act 2014, local councils in England are required to assess anyone who appears to need care or support and, if eligible, to arrange and fund care (subject to a means test).

The Care Needs Assessment

Anyone can request a care needs assessment from their local authority. This assessment looks at how your needs affect your ability to achieve outcomes important to your wellbeing. You do not have to be in crisis or at high risk to request one.

The Financial Assessment (Means Test)

Once a care need is established, the council carries out a financial assessment to determine how much you should contribute. The key thresholds (England, 2024/25) are:

Which London Boroughs Does Kome Care Work With?

We work across all 32 London boroughs and the City of London. Our care coordinators have established relationships with local authority commissioning teams and can facilitate smooth referrals from social workers.