A guide to choosing the services basket in the long-term care benefit: what the basket includes, how to decide between care hours and a day centre, when a cash component is possible, and how to change the mix when needs change.
The basket is not money — and that is the starting point
Many people expect the long-term care benefit to arrive as a transfer into an account. In most cases it is given as a basket of services — that is, as actual services rather than as free money.
The logic behind this is to make sure the help reaches the person. In practice it means the family has to choose the mix in which it wants to receive that help.
That choice is not technical. It directly affects daily life, so it is worth thinking about seriously rather than accepting the first mix offered.
What may be included
The components and conditions are published on the National Insurance Institute's website and are updated. The following list is a general road map for a conversation with the authorised body.
- Personal care hours at home from a carer
- Attendance at a day centre for older people, including transport
- Disposable incontinence products
- A personal alarm for emergencies
- Laundry services, in relevant situations
- A partial cash component, under certain conditions and for some of those entitled
How to decide between hours and a day centre
This is the central decision, and there is no single answer. The practical way to settle it is to break the week down into hours and ask where exactly the difficulty lies.
If the problem is the morning — shower, dressing, a meal — care hours at home are usually the answer. If the problem is loneliness, a lack of structure or a need for supervision across the daytime hours, a day centre may give more.
There are also combinations: a day centre on some days and care hours on others. It is worth establishing which combinations are possible at the level that has been set.
Common mistakes in choosing
The first mistake is choosing whatever sounds biggest. A high number of hours is not necessarily what will help, if they are spread across hours when they are not needed.
The second is not asking about combinations. Families sometimes assume they have to choose one, when combined options exist.
The third, and the commonest, is staying with the initial mix for ever. Needs change — the condition worsens, a carer leaves, the family moves — and the mix is not updated. You can approach the authorised body and ask for it to be looked at again.
When money can be received instead of services
Under certain conditions and for some of those entitled there is an option of receiving a cash component instead of part of the services. The conditions and rates change and are published on the National Insurance Institute's website.
This option mainly suits someone who already employs a carer privately, or where the family arranges the care itself and does not need the service on offer.
This is a question to put directly to National Insurance rather than relying on someone else's experience, because the rules are complex and they change.
Frequently asked questions
What does the services basket in the long-term care benefit include?
Usually personal care hours at home, attendance at a day centre including transport, incontinence products, a personal alarm, and sometimes laundry services. The components and conditions are published on the National Insurance Institute's website.
How do you choose between care hours and a day centre?
Break the week down into hours and check where the difficulty lies. If the problem is in the morning — care hours. If the problem is loneliness or a need for supervision across the day — a day centre.
Can different services be combined?
In many cases yes, for example a day centre on some days and care hours on others. It is worth establishing which combinations are possible at the level that has been set.
Can you receive money instead of services?
Under certain conditions and for some of those entitled there is an option of a partial cash component. The conditions and rates change, so this should be established directly with National Insurance.
Can the mix be changed after it has been set?
Yes. Needs change, and you can approach the authorised body and ask for it to be looked at again. A common mistake is staying with the initial mix even when it no longer suits.
Official sources for further checking
This is general information and does not replace personal medical, legal or insurance advice. Eligibility is determined by the documents and rules that apply to each case.
