Above the threshold: what to do when social services won't help

Social services say that they are under no obligation to assess our elderly parent with early-stage dementia as they are above the income threshold and we just have to 'get on with it.' The doctors have said social services should be helping us put care in place, even if we should be paying for it ourselves. I'm totally in the dark here. Who's right?

This is a real question posted by an adult child on Mumsnet, and the doctor was right. The council was wrong. The reason this confusion happens to so many families is that the UK care system has at least three overlapping layers of funding and responsibility, and almost no one explains them upfront. When social services says you have 'too much money for help,' what they usually mean is that you do not qualify for council-funded care. That is a much smaller statement than the one they tend to deliver, and it leaves families dropped into the deep end with no map.

This piece walks through the map. It is written for adult children of an elderly parent in early-stage decline, but the same structure applies whether your loved one is recovering from a stroke, living with multiple sclerosis, or simply struggling to manage the practical parts of daily life. We will look at what the council still has to do under the Care Act 2014, where the care funding ladder actually sits, the one NHS pot of money many self-funders qualify for and never claim, and a short list of what to do this week if you have been told to 'get on with it.'

What the council still has to do, regardless of your savings

The most common piece of misinformation families receive is that the council does not have to assess an elderly parent if the family is above the financial threshold. That is not the law. Under the Care Act 2014 section 9, an English local authority has a duty to carry out a needs assessment whenever it appears that an adult may have a need for care and support. The assessment itself is free, and it is a statutory right. According to Age UK, you have a right to an assessment regardless of how much money you have or what your needs are.

The means test, which looks at savings and income, only happens after the needs assessment. It decides who pays, not whether an assessment is done. In England the current upper capital threshold is £23,250: above that line the council will usually expect a family to self-fund, but the assessment itself still happens. Below the lower threshold of £14,250 your loved one only contributes from income. Between the two, the council taper applies. The thresholds are slightly different in Scotland and Wales; the Care Information Scotland and Welsh Government's social care pages set out the local figures.

If a council refuses to assess on financial grounds alone, you can ask for the refusal in writing, escalate through the council's formal complaints process, and where needed contact the Local Government and Social Care Ombudsman. Age UK has a free advice line for England (0800 678 1602) which talks people through that escalation step by step.

Where the care funding ladder actually sits

When your council says you are above the threshold, what they have done is point you toward the bottom of a three-rung funding ladder without telling you the other rungs exist.

The top rung is NHS Continuing Healthcare. This is the NHS, not the council. It is for people whose needs are primarily health needs rather than social care needs, and it is not means-tested. If your loved one qualifies, the NHS pays for the entire care package, in their own home or in a care home, no matter how much money is in the bank. We will come back to this in the next section because most families never get told it exists.

The middle rung is council-funded social care, which is what we have been talking about. Means-tested, organised by the local authority, free or partially free depending on the financial assessment. If your loved one qualifies, the council either commissions the care directly or hands the family a Direct Payment, which is a regular budget paid into a bank account so the family can choose their own carer.

The bottom rung is self-funded private care. This is where most older people in the UK actually sit. According to Age UK, about half of older people receiving care at home pay for it themselves. The council does not commission the care, the carer is engaged privately by the family, and the cost varies hugely depending on whether the family uses a managed home care agency, an introductory agency, or hires a self-employed carer directly.

Most families discover they are on the bottom rung the same way the Mumsnet poster did: by being told they have 'too much money.'

NHS Continuing Healthcare, the part most families miss

NHS Continuing Healthcare, often shortened to NHS CHC, is the pot of money many self-funders never claim. It is funded by the NHS, not the council, and it is not means-tested. Eligibility is decided by a Decision Support Tool run by the NHS, which looks at the nature and intensity of the person's needs across twelve domains including behaviour, cognition, communication, mobility, nutrition, continence, skin, breathing, drug therapies, and altered states of consciousness.

If a person's needs are judged primarily health-related rather than social, NHS CHC will fund the entire care package. According to NHS England, tens of thousands of people are receiving CHC funding at any given time, but uptake varies hugely by region, which suggests many people who qualify never get assessed. The Alzheimer's Society notes that families of people living with advanced dementia, in particular, often miss CHC because the assessment is rarely offered automatically.

You can request a CHC checklist assessment from your loved one's GP, district nurse, or hospital discharge team. If the checklist suggests they might qualify, a full assessment follows. The whole process is free, and it can be done while your loved one is at home, in hospital, or in a care home.

What to do this week if your council has said no

If you have been told your family is above the threshold and there is no further help, the practical sequence is roughly this. First, ask the council to put their refusal in writing, citing which section of the Care Act they are relying on. Second, ask for a needs assessment in writing, separately from the financial conversation. The two are different and the council has a duty to do the first regardless of the second. Third, ask your loved one's GP about an NHS Continuing Healthcare checklist, particularly if the health picture is complex or there is a recent diagnosis. Fourth, contact Age UK or Carers UK for written advice you can refer back to.

While those wheels turn, families usually need to start care now. That means moving to the bottom rung, the self-funded route. Here the choice is between a managed home care agency, an introductory agency that connects you to self-employed carers, or hiring a carer directly through a personal network. Each route has trade-offs. Managed agencies are turn-key but expensive and tend to rotate carers. Introductory agencies are cheaper because the carer keeps more of the hourly rate, and the family meets the carer before any arrangement begins. Direct hiring is the cheapest in cash terms but the family carries full employer-style responsibilities.

The harder reality of self-funding

Self-funding can feel lonely. There is no case worker to phone, no rota that gets handed back to you each week, no automatic safety net if a carer is sick. The family is the case manager. The trade-off is choice: families can pick a carer who speaks their loved one's language, who shares cultural or religious touchpoints, who can be there on the days that actually matter rather than the days a council rota allows.

The system was not built to make this easy. Care Act assessments are still being refused on financial grounds in some areas despite the statutory duty. NHS CHC assessments are uneven across England. Means thresholds have not been raised in several years and have failed to keep pace with care costs. Until the system catches up, self-funders are doing two jobs at once: paying for the care and managing it. Knowing the layers, and your rights inside each layer, is the difference between drowning in the system and steering through it.

If you would rather not navigate this alone, we are a London introductory care agency. We help families find self-employed carers who are DBS-checked, insurance-verified, and reference-checked. Families meet the carer in person before any commitment begins, and the carer keeps almost all of what the family pays. We work with families paying privately and with families using Direct Payments. If you want to talk it through with a real person, please email hello@hibantcare.com or visit hibantcare.com.

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