You've done the hard part — you've sat through the assessment, answered difficult questions about someone you love, and now you have a result. But for most families, the real challenge starts here.
Knowing your funding status is one thing. Knowing what to do about it on Monday morning is another.
Whether you've been told your relative qualifies for NHS-funded care, that they're borderline, or that they'll need to pay privately — the next steps matter enormously. Acting quickly, in the right order, with the right evidence can mean the difference between tens of thousands of pounds in care costs.
This guide covers what to do next for every scenario. Find your result below, then follow the steps.
Last updated: March 2026.
Find Your Scenario
Before diving into the detail, identify where you are. Your assessment result determines your next steps:
| Your result | What it means | Where to go |
|---|---|---|
| Fully funded (NHS) | The NHS should fund your care in full | Jump to Section 1 below |
| Borderline / not yet decided | Worth pursuing — evidence is key | Jump to Section 2 below |
| Council-funded | Council contributes based on a means test | Jump to Section 3 below |
| Self-funding | Above the capital threshold | Jump to Section 4 below |
| Self-funding with property | May qualify for a Deferred Payment Agreement | Jump to Section 5 below |
If you haven't yet had an assessment, start with our funding eligibility guide to understand the process.
Section 1: If You're Fully Funded by the NHS
This is the best possible outcome — but don't assume it's settled. Decisions can be reversed at review, and administrative errors are common.
What to do now
- Confirm the decision is formally recorded. Ask for written confirmation of the outcome, including the date it takes effect.
- Check when funding starts. It should be backdated to the date of the assessment — not the date the letter arrives.
- Are you being charged during the gap? If there's a delay between the assessment and the funding starting, you should not be paying care fees for that period. If you are, raise it immediately.
- Understand the review cycle. Funding is typically reviewed annually. Your relative's needs will be reassessed, and the decision can change.
- Know your rights if the decision is reversed. If a future review downgrades your relative's eligibility, you have the right to challenge it through the formal appeals process.
Your checklist
- [ ] Written confirmation of the funding decision received
- [ ] Start date confirmed and backdated to assessment date
- [ ] No charges being applied during the processing gap
- [ ] Review date noted in your diary
- [ ] Copies of all correspondence filed safely
Section 2: If Your NHS Continuing Healthcare Result Is Borderline
This is where most families find themselves — and where the right action in the next few weeks makes the biggest difference.
A borderline result means the assessment panel found your relative's needs were close to the threshold but didn't quite meet it. This does not mean they don't qualify. It means the evidence presented didn't demonstrate it clearly enough.
What to do now
- Request the completed Decision Support Tool. You have the legal right to see the full scoring document. This shows exactly how your relative was rated across each domain of need.
- Check whether any domain was underscored. Compare the scores against your daily experience. Families often find that assessors underestimate needs in areas like cognition, behaviour, or psychological needs — particularly for dementia.
- Gather additional evidence for the strongest domains. GP letters, hospital discharge summaries, medication charts, and daily care records all strengthen a case. Focus on the domains where your relative's needs are most severe. For a detailed guide on preparing evidence for each of the 12 domains, read NHS Continuing Healthcare: The Evidence That Actually Matters.
- Request a reassessment if you believe the scoring was wrong. You don't need a solicitor for this — structured evidence is more powerful than legal argument at this stage.
- Consider the Local Resolution process if you formally disagree with the decision. This is a structured review that must be requested within 6 months. Read our guide to appealing an NHS Continuing Healthcare decision for the full process.
Week-by-week plan
| Week | Action |
|---|---|
| Week 1 | Send a Subject Access Request to the GP for full medical records |
| Week 1 | Request daily care notes from the care home (they must provide these) |
| Week 2–3 | Compile evidence for the strongest domains — focus on severity, complexity, and unpredictability |
| Week 3–4 | Submit your request for reassessment or begin the Local Resolution process |
| Week 5–6 | Follow up if you haven't received a response — put everything in writing |
Section 3: If You're Council-Funded
Council funding means the local authority will contribute to care costs, but the amount depends on a financial assessment (means test). This is better than self-funding — but there are pitfalls families miss.
What to do now
- Check your personal contribution calculation is correct. The council will assess your relative's income and capital to determine what they should pay. Errors are common — particularly around pension calculations and disregarded income.
- Understand the "top-up" gap. If the care home charges more than the council's rate, someone needs to pay the difference. This is called a third-party top-up, and it often falls on the family.
- Know your rights. The council must offer at least one suitable care home placement at their standard rate — with no top-up required. If they don't, challenge it.
- Review annually. Circumstances change. Your relative's needs may increase (potentially qualifying for NHS funding), or their financial situation may shift.
A Critical Edge for Top-Ups: If the council offers a home but you prefer a different one that requires a top-up, do not just accept the care home's asking price. RightCareHome provides Market Sustainability and Improvement Fund (MSIF) data—showing exactly what the council pays for that specific home. You can use this data to negotiate the top-up down. If the council pays the home £900/week for other residents, the home shouldn't be demanding a £400/week top-up from you to meet a £1,300/week private rate.
Your checklist
- [ ] Financial assessment received and checked for accuracy
- [ ] Personal contribution amount confirmed in writing
- [ ] Top-up arrangement (if any) agreed and documented
- [ ] At least one no-top-up option offered by the council
- [ ] Annual review date noted
Section 4: If You're Self-Funding
Self-funding means your relative's capital is above the upper threshold — currently £23,250. But this isn't a permanent state. With care home fees averaging £1,000–£1,500 per week, capital reduces quickly.
What to do now
- Plan for the transition. Calculate roughly when your relative's capital will cross the £23,250 threshold. At that point, you should request a financial assessment from the council. For example, if your relative has £80,000 in savings and is paying £1,200 per week, their capital will cross the £23,250 threshold in approximately 11 months. At £1,500 per week, it takes roughly 9 months. Start the council conversation well before you reach the line — the financial assessment process takes 4–8 weeks.
- Keep detailed financial records. You'll need bank statements, asset valuations, and a clear paper trail when the time comes to apply for council funding.
- Claim Attendance Allowance. This is worth up to £114.60 per week (2026/27 rate) and is available to self-funders regardless of capital. Many families miss this entirely.
- Check Funded Nursing Care entitlement. If your relative is in a nursing home (not just residential care), they may be entitled to £267.78 per week towards nursing costs — paid directly to the home, regardless of assets.
- Do NOT give away assets. Local authorities actively investigate "deprivation of assets" — where someone has reduced their capital to qualify for funding. This includes gifts to family, transferring property, or unusually large purchases. The council can assess you as though you still own the assets.
Worked Scenario: The Self-Funder's 8-Week Sprint
If you've just been told you must self-fund, the next 8 weeks are critical for damage control.
The Situation: Mary (85) has been assessed as a self-funder. She is moving into a residential home quoting £1,400/week. She has £60,000 in savings (no property).
The 8-Week Plan:
- Week 1-2 (Negotiate): Mary's son uses RightCareHome's MSIF data to discover the local council pays this exact home £1,050/week. He negotiates the private rate down to £1,250/week. (Saving: £150/week).
- Week 3-4 (Claim): He applies for the higher rate of Attendance Allowance for Mary. (Income: £114.60/week).
- Week 5-6 (Map the timeline): He calculates her net drain. £1,250 fee minus £114.60 AA minus £200 State Pension = £935.40/week drain on savings.
- Week 7-8 (Set the alarm): Mary has £60,000. She needs to contact the council when she hits £23,250 (a gap of £36,750). At £935.40/week, this will take exactly 39 weeks. He sets a calendar alarm for Week 27 (12 weeks before the threshold) to initiate the council handover.
Result: By taking structured action immediately after the assessment, the family saves £7,800 a year in fees, boosts income by £5,959 a year, and prevents a panicked crisis 9 months down the line.
Key numbers
| Threshold | Amount | What it means |
|---|---|---|
| Upper capital limit | £23,250 | Above this — you pay the full cost |
| Lower capital limit | £14,250 | Below this — the council pays the full cost of care |
| Between limits | £14,250–£23,250 | "Tariff income" applies: £1 per week for every £250 of capital above £14,250 |
For a detailed breakdown of what counts as capital and what's disregarded, read our funding eligibility guide.
Section 5: If You Own Property
This is the section that causes the most anxiety. The short answer: you do not have to sell the family home immediately.
What to do now
- Understand the 12-week property disregard. For the first 12 weeks after your relative enters permanent residential care, the value of their property is ignored in the means test. This gives you time to make decisions.
- Apply for a Deferred Payment Agreement (DPA). This lets your relative defer care costs against the value of their property — essentially a loan from the council, secured against the home. The property doesn't need to be sold until after death or the agreement ends.
- Check whether the property is fully disregarded. If a spouse, partner, or dependent relative still lives in the property, its value is completely excluded from the means test. No DPA is needed.
- Apply early. Don't wait until the 12-week disregard runs out. DPA applications take time, and the council needs to carry out a valuation.
DPA checklist
- [ ] Property has adequate equity to cover projected care costs
- [ ] No spouse or dependent living there (or they've agreed to the arrangement)
- [ ] Application submitted to the council before the 12-week disregard ends
- [ ] Interest rate understood (currently around 4.75%)
- [ ] Administrative fee budgeted (up to £2,000)
- [ ] Legal charge on the property explained and understood
Example: On a property worth £250,000, with care fees of £1,100/week, the DPA debt after 2 years would be approximately £114,400 in care fees plus £10,200 in accumulated interest — total charge against the property of roughly £124,600. Remaining equity: £125,400.
For a full guide on property and care home costs, read Do I Have to Sell My Parents' House to Pay for Care?
When to Appeal
Not sure whether it's worth challenging a decision? Use this quick guide:
| Situation | What to do | Time limit |
|---|---|---|
| NHS funding rejected but you believe needs are health-related | Request Local Resolution through the relevant NHS body | 6 months from the decision |
| Means test calculation seems wrong | Request a recalculation from the council in writing | No formal limit, but act quickly |
| Deferred Payment Agreement refused | The council is legally obligated to offer one if you meet the criteria — challenge the refusal | No formal limit |
| Been self-funding for 6+ months without an assessment | Request a retrospective review — you may be owed a refund | Reviews can go back to April 2012 |
What Happens Next
Every family's situation is different, but the steps are predictable. The hard part isn't knowing what to do — it's doing it while caring for someone you love, managing your own life, and dealing with a system that rarely makes things easy.
The most important thing you can do right now is act within the first two weeks. Records requests, financial checks, and evidence gathering all take time. Starting early gives you the best chance of a good outcome.
If you want the process handled for you, the Funding Action Pack includes personalised template letters, evidence checklists tailored to your relative's conditions, and a week-by-week plan built around your specific assessment result.
Get Your Custom Funding Action Plan
Sources
This guide provides general information about care home funding and is not legal, medical, or financial advice. Capital thresholds, benefit rates, and interest rates quoted are for the 2026/27 financial year and may change. For guidance specific to your situation, contact your local council's adult social care team or a specialist care funding adviser.
The thresholds, timelines, and processes described in this guide are based on the following publicly available frameworks and legislation.
- NHS Continuing Healthcare National Framework (October 2022) — Governs the CHC assessment process, appeals (Local Resolution and Independent Review Panel), and retrospective reviews. Published by the Department of Health and Social Care. Available at gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care.
- Care Act 2014 — Establishes Local Authority duties for needs assessments (section 9), financial assessments (section 17), and Deferred Payment Agreements (sections 34–36). Available at legislation.gov.uk/ukpga/2014/23.
- Care and Support (Deferred Payment) Regulations 2014 — Sets the rules for DPA eligibility, interest rates, and administrative charges. Available at legislation.gov.uk/uksi/2014/2671.
- NHS Standing Rules Regulations 2012 — Establishes the legal duty on NHS bodies to assess individuals for CHC and the right to retrospective reviews. Available at legislation.gov.uk/uksi/2012/2996.
- UK GDPR, Article 15 (Subject Access Requests) — Your right to request medical and care records. Guidance at ico.org.uk.
- GOV.UK: Previously Unassessed Periods of Care — Policy for retrospective CHC reviews, including the April 2012 earliest reviewable date. Available at gov.uk/government/publications/retrospective-continuing-healthcare-funding.