Dementia Care Home Fees: Complete Cost Guide

Specialist dementia care homes average £1,400+ per week (Laing Buisson Care of Older People UK Market Report, 2024). If your relative's assets exceed £23,250, they pay in full (Care Act 2014). But dementia frequently qualifies for NHS Continuing Healthcare — which covers 100% of care costs with no means test.

TL;DR: Specialist dementia care home fees average £1,400+/week — over £73,000/year (Laing Buisson, 2024). Anyone with assets above £23,250 pays in full under the Care Act 2014 means test. Around 60,000 people in England receive NHS Continuing Healthcare, which covers 100% of fees with no means test (NHS England, 2023–24). Dementia is one of the most common qualifying conditions — but most eligible people are never assessed.

Dementia Care Home Costs in 2025-26

For families weighing whether to self-fund or pursue NHS Continuing Healthcare, the starting figure matters. Specialist dementia care averages £1,400+ per week (Laing Buisson Care of Older People UK Market Report, 2024) — more than £73,000 per year. That figure climbs further in London and the south-east, where costs run 20–30% higher (Laing Buisson Care of Older People UK Market Report, 2024).

In contrast, standard residential care — without specialist dementia provision — typically costs £800–£900 per week (Laing Buisson Care of Older People UK Market Report, 2024). Nursing care for someone with dementia, where a registered nurse is present on-site, sits at £1,000–£1,200 per week (Laing Buisson Care of Older People UK Market Report, 2024).

We've seen many families surprised to learn that self-funders typically pay 30–40% more than the local authority rate for the same care (Competition and Markets Authority Care Homes Market Study, 2017). Care homes charge this premium because councils negotiate bulk rates. If your relative is self-funding, they are likely paying the most expensive rate in the building.

Who pays for dementia care home fees?

The means test is set by the Care Act 2014. The current thresholds are:

• Above £23,250 in assets: your relative pays the full care home fee themselves (Care Act 2014).
• Below £23,250: the local authority contributes, but your relative still pays an assessed contribution from their income.

Assets include savings, investments, and property — unless a spouse or civil partner still lives in the property. Your relative keeps a personal expenses allowance of £30.15 per week regardless (DHSC, 2024–25).

From October 2025, the upper threshold rises to £100,000 under the Health and Care Act 2022 (s.140). However, this change means more people will receive local authority support — but it does not reduce the total cost of care. It shifts who funds it. Age UK provides a detailed breakdown of how the means test works in practice.

What the means test does not tell you is this: if your relative qualifies for NHS Continuing Healthcare, the means test becomes irrelevant. The NHS pays the full cost. Assets, income, and property do not affect the calculation.

Sources: Laing Buisson Care of Older People UK Market Report, 2024; Care Act 2014; National Framework for NHS Continuing Healthcare (2022).

Does dementia qualify for NHS Continuing Healthcare?

NHS Continuing Healthcare (CHC) is NHS-funded care for people whose primary need is a health need, not a social care need. There is no means test. The NHS pays 100% of the cost, including the care home fee.

Notably, dementia is one of the most common conditions to meet the CHC threshold — particularly in its moderate to advanced stages. The National Framework for NHS Continuing Healthcare (2022) assesses individuals across 12 care domains. Dementia typically affects several of them at once:

• Cognition: disorientation, memory loss, inability to make decisions safely
• Behaviour: agitation, aggression, wandering, distress
• Communication: loss of language or ability to express needs
• Continence: incontinence requiring managed care
• Skin integrity: pressure sore risk from immobility

Scoring "Priority" or "Severe" in the cognition or behaviour domain is common in advanced dementia. As a result, when multiple domains score at that level, assessors are required to consider whether the person has a "primary health need" — which triggers full NHS funding under the National Framework for NHS Continuing Healthcare (2022).

Around 60,000 people in England currently receive CHC (NHS Continuing Healthcare Statistics, 2023–24). Research by Independent Age found that many more are eligible but are never assessed — often because families were not told CHC existed, or because a refusal was never challenged (Independent Age, Turned Away: How the NHS is Failing People Who Need Continuing Healthcare, 2023).

If your relative has advanced dementia with challenging behaviour, frequent falls, complex medication needs, or continence requirements, their clinical picture may support a strong CHC case. Read our full guide to CHC eligibility and dementia.

The CHC Assessment Process for Dementia

You do not need a GP referral to start the CHC process. Any family member can request a CHC checklist assessment in writing from the local Integrated Care Board (ICB). A registered nurse or social worker — from the care home or GP surgery — completes the checklist.

If the checklist is positive, a full multidisciplinary team (MDT) assessment follows, typically within 28 days. The MDT reviews all 12 domains using a structured Decision Support Tool. The ICB then makes the final funding decision. For families exploring other ways to manage these costs, our guide to avoiding care home fees compares all four legal routes.

If your relative is in hospital and moving to a care home, the process is even more time-critical. Under the National Framework for NHS Continuing Healthcare (2022, paragraph 44), the hospital must complete a CHC checklist before discharge to a care home. Many hospitals do not do this routinely. If it was not done, you can request a retrospective assessment. See our hospital discharge guide for the steps to take.

A few practical points:

• Attend the MDT assessment. Family members who hold a Lasting Power of Attorney can attend and provide evidence. This matters — the MDT does not always have access to the full picture of someone's daily needs.
• Bring evidence. A daily care diary, medication list, and records from the GP or consultant strengthen the case significantly.
• Do not sign self-funding agreements before the CHC outcome is known. Once you have committed to self-funding, unwinding that arrangement is harder — though not impossible if a retrospective assessment finds CHC should have applied.

Can someone with dementia be refused CHC?

Yes — and it happens frequently. From our casework, ICBs have a financial incentive to fund care through the local authority rather than through the NHS, because NHS-funded care comes from the ICB's own budget. Social care costs fall on the council instead. This is a structural tension the National Framework for NHS Continuing Healthcare (2022) acknowledges but does not eliminate.

Common reasons ICBs give for refusing CHC to someone with dementia:

• Needs are described as "social" rather than "health" needs
• Care is classed as routine or predictable, rather than requiring specialist nursing input
• The assessment was conducted at an unrepresentative time

If your relative is refused, you can challenge the decision through the ICB's internal appeals process. The strength of that appeal depends almost entirely on the quality of the evidence you present. A detailed care diary showing daily behavioural episodes, continence incidents, falls, and medication administration carries significant weight. Clinical records — nurse's assessments, GP letters, consultant reports — can change the outcome.

If the ICB appeal fails, you can escalate to an NHS England formal complaint and then to the Parliamentary and Health Service Ombudsman. Consequently, families who prepare evidence carefully and pursue appeals have significantly better outcomes than those who accept a first refusal. Our guide to CHC funding and dementia covers the strategies that overturn refusals.

Our main CHC funding guide covers the full appeals process in detail.

What should you do before agreeing to self-fund dementia care?

Most families reach the point of arranging a care home under pressure — following a hospital admission, a crisis at home, or a social worker's recommendation. In that pressure, the CHC process is often not mentioned. Meanwhile, Attendance Allowance can help offset daily living costs regardless of savings, even while a CHC application is in progress. This is how families end up self-funding care the NHS was obligated to pay for.

Before signing any care home agreement or agreeing to pay fees, take these steps:

1. Request a CHC checklist assessment in writing from the ICB. You can do this directly — you do not need permission from a GP or social worker.

2. Do not sign self-funding agreements until you have the CHC outcome. If a care home needs an interim arrangement, make clear in writing that any self-funding is provisional pending the CHC assessment.

3. Start a care diary now. Record daily: any episodes of confusion, agitation, or distress; continence incidents; falls or near-misses; medication given and any refusals. This evidence base is what makes or breaks an assessment.

4. Gather clinical records. Ask the GP and any specialists — geriatricians, psychiatrists, neurologists — for their most recent assessments and letters. These are your relative's right to access.

5. Attend the MDT assessment with evidence. If you hold a Lasting Power of Attorney for health and welfare, you can attend and speak on your relative's behalf. Use that right.

6. Appeal if refused. A first refusal is not final. ICBs routinely reconsider when families present well-organised clinical evidence.

Dementia care home fees are among the highest costs in the care system. The NHS is required to fund that care in full when the CHC threshold is met. The threshold is met more often than families are told.

If you are not sure whether your relative would qualify, use our eligibility checker to get an initial indication based on their current care needs.