Local councils are responsible for providing help and support for the elderly.
Community care services
Services available can include:
- support for personal care needs
- monitoring devices
- daycare
- lunch clubs
- support over-night
- respite care, which includes staying in a care home for a short period
- equipment to help with everyday tasks and increase safety, like handrails
- meal delivery
- transport services
Who qualifies for support?
Each council has its own set of eligibility criteria. If community care services seem to be required, a free Care Needs Assessment should be conducted.
The assessment looks at whether independence and wellbeing would be at a high, moderate, low, or critical risk if care services were not provided.
Due to budget limitations, services are often only given to people who are classified as having critical or substantial needs. But councils should always consider the need for support if it could prevent problems from developing in the future.
The Care Needs Assessment
To obtain an assessment, contact the adult social services department. If there has been an accident that has resulted in hospitalisation, the assessment may be arranged by a hospital social worker before discharge, or the GP may make a referral.
The assessment normally takes place at home (although it can also be completed online or over the phone). A friend or family member should be present to take notes.
Questions will be asked about what activities can be managed independently, where challenges exist, and where the person being assessed would like help. As an example:
- dressing and undressing
- getting up and going to bed
- eating and drinking
- washing and bathing
- moving around the home
- managing medications
- housework and shopping
- social and cultural activities
Questions will be asked about any support that is already in place. It’s important to say if this help is not going to continue in the long term.
After the assessment, a care plan (or support plan) will be provided, which will give details of the help that can be provided.
The care plan should include information about:
- the services, who will arrange them, and how much they will cost
- the needs and any risks that might be faced
- why the services are being provided and how they will help
- what will happen if there is an emergency
- any support that is already in place
- the date the care plan will be reviewed.
The plan could include, for example, help with personal care, equipment or adaptations for the home, and services to help anyone who is providing unpaid care. A package that includes social care, nursing care, health services, and housing services could be proposed.
If the council decides that help is required, support services should be put in place without unreasonable delay. If you feel the wait has been unreasonable, you can make a complaint using the social work department's complaints procedure.
Find the council website here→
Who pays for care at home?
Personal care and nursing care provided at home by the local council is free for people over 65 who have been assessed as needing it. This entitlement is regardless of income, capital assets, marital or civil partnership status. Free personal care includes:
- services to support personal hygiene e.g. help with bathing, shaving, mouth, teeth and nail care.
- personal assistance e.g. help with dressing, to get in and out of bed and use of a hoist if necessary.
- help to manage continence e.g. toileting, catheter or stoma care, bed changing and laundry.
- food and diet including help with eating and the preparation of meals (but not the cost of supplying food).
- dealing with the problems of poor mobility and enabling outdoor activities.
- counselling and support e.g. safety devices and psychological support.
- simple treatments e.g. help with medication, application of creams and drops.
Once assessed as needing support, a choice of four options will be offered:
Option 1: Receive a budget and choose and manage care services yourself. This is called a Direct Payment.
Option 2: You choose a care provider and the council arranges and manages the service.
Option 3: The council chooses a care provider and arranges and manages the service.
Option 4: A mixture of the above.
A private contribution towards the costs of any help that is classified as ‘non-personal care’ such as domestic help, lunch clubs, meals on wheels, community alarms or help to shop may still be required.
Each council has discretion about which ‘non personal care’ services it will charge for, and what the charge is. Fees vary for similar services in different parts of Scotland. A means test will be applied. A copy of the charging policy should be available on the council website.
If nursing care is needed at home, this will be arranged and provided for free by NHS Scotland. Ask the GP to start the application process.
What pays for a care home?
If the council’s assessment shows that you need care in a care home, they will help arrange a suitable placement and carry out a financial (means) assessment to determine how much you need to contribute.
If you are assessed as needing it, the council will pay fixed weekly amounts for personal care and, where applicable, nursing care. These payments are made directly to the care home.
You will still be responsible for paying:
- accommodation (sometimes called “hotel” costs)
- any additional care fees not covered by the council
- personal expenses
Current payment rates (Scotland)
- £254.60 per week for personal care
- £114.55 per week for nursing care
Capital thresholds (means test)
If your savings (capital) are:
Below ~£22,000 → the council will contribute towards your care home fees
£22,000 – £35,500 → you will pay a means-tested contribution
Above ~£35,500 → you are considered self-funding (but still receive free personal and nursing care if eligible)
Council contribution (standard rates)
Where the council is contributing towards your care home place, it will usually pay up to:
- £1,013.05 per week for nursing care homes
- £881.98 per week for residential care homes
These are standard rates, not guaranteed funding levels. The actual amount paid depends on:
your assessed care needs and the fees charged by the care home. You can choose your care home. However, if the home costs more than the council’s standard rate, you (or a third party) will usually need to pay the difference. This is known as a “top-up fee.”
Important clarification
Free personal and nursing care covers specific care elements only.
It does not cover accommodation or all care home costs, so most people will still need to contribute financially.
Why request a care needs assessment?
Even if you don’t qualify for council funding right now, a care needs assessment is still helpful:
- You’ll get advice on what type of care home suits your needs.
- You'll get advice on what type of care home suits your need.
- You’ll receive payments for personal and nursing care.
Help with paying for care
Hospital-Based Complex Clinical Care (HBCCC)
HBCCC allows people to get the complex medical care they need outside of a hospital whenever possible. The NHS covers the cost of this medical care.
For example, if you are discharged to a care home, you’ll only pay for accommodation and social care costs.
Who is eligible?
Eligibility is based on one question:
Can your care needs be met anywhere other than a hospital?
If you’ve been in hospital for a while, a consultant and a team of specialists will assess your needs. If the answer is "yes," you’ll be discharged to the most suitable setting, such as:
- Your own home with support
- A care home
- Supported accommodation
At this point, your local council’s charging policies will apply, and you may have to contribute towards the cost of your care. The council will carry out a financial assessment to work out how you need to contribute towards care costs.The NHS will remain responsible for meeting any medical needs after discharge from hospital.
HBCCC replaced NHS Continuing Healthcare in Scotland in 2015. If you received this care before 2015, you will continue to get it if you remain eligible.
NHS-Funded Nursing Care (FNC)
If you move into a nursing home and don’t qualify for HBCCC, the NHS might help with nursing care costs. This is called NHS-funded nursing care (FNC).
The NHS pays a flat rate directly to the care home for nursing care.
In Scotland, this funding is usually provided by the local council instead of the NHS. Anyone assessed as needing personal and/or nursing care is entitled to this support.
How does FNC affect other benefits?
If you receive FNC, some benefits may stop after four weeks, such as:
- Attendance Allowance
What benefits can I get in Scotland while living in a care home?
Before a means test, check that you’re claiming all the benefits you’re entitled to. These will be considered in your funding assessment. Some benefits will stop when you move into a care home permanently, so notify your local benefits office.
Benefits you may still receive include:
- State Pension (Basic or New)
- Pension Credit
- Attendance Allowance
How does moving into a care home affect my pension?
Moving to a care home won’t stop your State Pension, but it will count as income during your means test. You may need to use your pension to help pay care home fees.
Personal Expenses Allowance (PEA)
If you’re state-funded, most of your State Pension will go towards your care home fees. However, you’ll keep a small amount for personal use. In Scotland, the Personal Expenses Allowance is £34.50 per week.
Finding services
Search by county for home care→
Search by county for a care or nursing home→
Search for self employed carers with PodConnect->
Quality checking
The Care Inspectorate is the independent regulator of health and adult social care in Scotland which monitors and evaluates registered care services. All care services in Scotland must be registered with the exception of self employed carers.
Evaluation of services is based on 5 key questions:
- How well supported is the users wellbeing?
- How good is the leadership?
- How good are the staff?
- How good is the care setting?
- How well is care and support planned?
A six-point scoring scale is used to describe the quality:
6 = Excellent, outstanding or sector leading
5 = Very good, the service has some major strengths
4 = Good, the service has important strengths, with some areas for improvement
3 = Adequate, strengths just outweigh weaknesses
2 = Weak, priority action is required
1 = Unsatisfactory, urgent remedial action is needed
To check the details of registered home care agencies or care homes in the area of your choice (and read their inspection results), use the search function on the Care Inspectorate website.