A family has recovered more than £160,000 in care home fees after their late aunt was found to have wrongly paid privately for care that should have been funded by the NHS.
The settlement from the NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board has restored the inheritance the elderly widow – identified only as Ms B to protect her family’s privacy – had intended to leave for her family.
The woman’s niece said: “My aunt was a much-loved and cherished member of our family, and her sister and I became responsible for her care during the early stages of her dementia. After a few years it became clear that, despite our best efforts, she needed more care than we could provide, so we arranged for her to move into a lovely residential care home.
“Very soon, all of her savings had been used to pay for care costs. We arranged a deferred payment agreement with the local council and, by the time she passed away, well over half the equity in her flat had also been used.
“We inherited her estate, but by then it was a much smaller amount than my aunt had worked hard for and intended for us.”
Ms B had lived independently in Marlborough, Wiltshire, before moving into residential care in December 2015 aged 85 as her health deteriorated.
Despite complex care needs, she continued to pay privately for her care until she died in March 2020 at the age of 90.
After her savings had been exhausted, her family entered into the deferred payment agreement with the local council. Ms B’s flat was later sold to repay the loan, significantly reducing the value of her estate.
It was only after Ms B died that her family discovered she may have been eligible to have her care costs covered under the NHS Continuing Healthcare scheme, a non-means tested benefit that covers the full cost of care for adults with a primary health need.
The family approached Liverpool-based Emerald Law Solicitors in 2022 and after reviewing care home, medical and adult social care records and wider clinical evidence, the firm successfully argued that Ms B should have been eligible for the funding from 4 August 2017 until her death on 1 March 2020.
Oonagh Murphy, managing director at Emerald Law Solicitors (pictured), said: “This case is deeply moving because it shows what families can lose when they are not given the right information at the right time.
“Ms B’s family were already dealing with the pain of watching someone they loved become increasingly unwell. They should not also have had to face the financial devastation of using savings, property and debt to pay for care that should have been funded by the NHS.
“For us, this is about access to justice. Families should not miss out on support simply because the system is difficult to understand, or because they do not know what questions to ask.
“Many people assume that if they are told to pay privately, that must be the end of the matter. This case shows that it is not.
“If a loved one has complex health needs and is paying privately for care, it is worth checking whether NHS Continuing Healthcare should apply. For some families, that question could change everything.”
She added: “We are seeing more families who have spent years privately funding care without anyone clearly explaining that NHS Continuing Healthcare may have applied.
“Our message is simple: do not assume there is nothing you can do. If your loved one has significant health needs, ask the question.”
