Who pays for a care home in 2026/27: NHS Continuing Healthcare, NHS-funded nursing care, council funding and self-funding explained

The four routes, in order of who is checked first

In England a care home place is paid for in one of four ways, and they are assessed in a fixed order. First the NHS asks whether the person's health needs are severe enough for NHS Continuing Healthcare, which pays everything. If not, and the person needs a registered nurse, the NHS pays a flat weekly contribution called NHS-funded nursing care. Then the council means-tests the person: if their capital is above £23,250 they are self-funding; if it is below, the council pays part or all of the fee and the person contributes from income. The 2026/27 figures below apply from 1 April 2026 and are the ones in use at all eleven Abbey Total Care homes.

Route one: NHS Continuing Healthcare

Continuing Healthcare, usually shortened to CHC, is full NHS funding for someone whose main need is a health need: complex, intense or unpredictable, and beyond what a council is expected to provide. It is not means-tested and it covers the whole care home fee. The process starts with a checklist, completed by a nurse, social worker or GP, followed by a full assessment using the decision support tool if the checklist is positive. The integrated care board for where the person lives makes the decision. A person whose condition is deteriorating rapidly and who may be entering a terminal phase can be fast-tracked, with funding expected within days.

Most people in nursing homes do not qualify. Dementia alone does not qualify; a stable condition managed well by nurses usually does not qualify. Families should still ask for the checklist to be done, because the outcome can be appealed and is reviewed as needs change.

Route two: NHS-funded nursing care

If the person does not qualify for CHC but has been assessed as needing care from a registered nurse, the NHS pays the home a fixed amount each week towards the nursing element of the fee. For 2026/27 the standard rate in England is £267.68 a week, up from £254.06 the year before. A higher rate of £368.24 applies only to a small group who were already on the old high band before October 2007. The payment goes directly to the home and is shown as a deduction on the invoice; the family or the council pays the balance. It is not means-tested.

Every Abbey Total Care home provides nursing care, so residents assessed as needing a nurse receive this contribution whichever home they are in.

Route three: council funding after a means test

The council where the person normally lives carries out a needs assessment under the Care Act 2014 and then a financial assessment. The figures for 2026/27 are:

Capital includes savings, investments and usually the person's home. The home is ignored while a spouse or partner lives there, and in some other cases involving dependent relatives. Where the home does count, it is disregarded for the first twelve weeks of a permanent placement, and the council must offer a deferred payment agreement so the property does not have to be sold during the person's lifetime; the debt is settled from the estate later, with interest and an administration fee.

Councils pay up to the rate they set for the type of care needed. If a family chooses a home that costs more than the council's rate, a third party, usually a relative, can pay the difference as a top-up. The resident cannot normally pay their own top-up except during the twelve-week disregard or under a deferred payment agreement.

Route four: self-funding

Anyone with capital above £23,250 pays the full fee themselves until their capital falls to that level, at which point they can ask the council to assess them. Self-funders are still entitled to NHS-funded nursing care if they need a nurse, and should still ask for a CHC checklist. Attendance Allowance continues to be paid to self-funding residents and should be claimed. It is worth asking the council for a needs assessment even when self-funding, because the council can arrange the placement and in some areas negotiates rates.

Which council covers each Abbey Total Care home

The council responsible is the one where the person lived before the move, not where the home is. These are the councils for the areas around our homes.

What to do this week

• Ask the hospital or GP for a Continuing Healthcare checklist if the person has significant health needs.
• Contact the person's own council for a needs assessment and a financial assessment.
• Gather bank statements, pension details and the property position; the financial assessment needs them.
• Visit the homes you are considering and ask for the weekly fee in writing, showing the NHS-funded nursing care deduction.
• Use the care home finder to see which Abbey home is nearest and call it directly.