Sometime soon, you may be asked a question the country has avoided for thirty years. Who should pay for social care?
Baroness Louise Casey, who leads the government’s independent commission on adult social care, announced in July 2026 that her team will begin testing the views of hundreds of thousands of people. Not just experts and providers. The public. That includes families like yours, and questions that cut close to home: what should the state provide, what should individuals pay, and what should families be expected to do themselves?
Here’s what the Commission is, what it might change, and, just as important, what stays exactly the same while it does its work.
What the Casey Commission is
The Commission is an independent review of adult social care in England, set up by the government and chaired by Baroness Casey, who has spent her career leading difficult public-service reviews. Its job is to produce a plan for a system that everyone agrees is under strain.
It works in two phases.
- Phase one, reporting during 2026: recommendations for medium-term improvement, including a plan for a “national care service”. You can read what that idea could mean for families in our guide to the National Care Service.
- Phase two, reporting in 2028: the long-term questions, above all how care should be funded and who should pay.
The Commission has already shown it can move quickly on specifics. In March 2026 it made urgent recommendations on safeguarding, dementia and motor neurone disease, which the government accepted.
Casey’s argument for asking the public directly is straightforward. Care reform has collapsed twice in living memory, in 2010 and 2017, because funding proposals were turned into election weapons before the public ever understood the trade-offs. Her view is that reform will only stick if people are brought into the decision honestly. She has also been blunt about one thing: expecting families alone to carry the weight of caring for older relatives is, in her words, simply not sustainable.
Who pays for care right now
While the Commission deliberates, the current rules apply. They confuse almost every family who meets them for the first time, so here is the short version.
Social care is means-tested. The NHS is not. A hospital stay costs you nothing. Help with washing, dressing and daily life at home is assessed against your savings and income.
The key number is £23,250. If the person needing care has capital above that, they pay for their own care in full. Between £14,250 and £23,250, the council contributes on a sliding scale. Below £14,250, the council pays the assessed cost, though most people still contribute from their income. For home care, the value of the home they live in is normally excluded from the calculation. That is different from residential care, and it catches many families out in a good way.
Two routes are not means-tested at all. Attendance Allowance is paid to people over State Pension age who need help with personal care, regardless of savings. Many families we meet have never claimed it. NHS Continuing Healthcare covers the entire cost of care for people whose needs are primarily health needs, though the assessment bar is high.
Council-funded care can be taken as Direct Payments. That means the person, or their family, chooses the provider rather than taking the council’s arranged one. Our Direct Payments guide explains how.
Our costs and funding page sets out all four routes with current figures, and our guide to what home care costs in Newark puts real numbers against typical care patterns.
What might change
Nobody knows yet, including the Commission. But the options being discussed in public are worth knowing, because one or more of them will likely shape the 2028 report.
- A cap on lifetime care costs. Once a person has spent a set amount on eligible care, the state picks up the rest. Legislated in 2014, twice delayed, and cancelled in 2024. The idea keeps returning because it answers the fear families feel most: costs without limit.
- Free personal care. Scotland already funds personal care at home for those assessed as needing it. England has debated following for years.
- A more generous means test. Raising the £23,250 threshold would bring more people into council funding without redesigning the system.
- Some form of social insurance or estate contribution. Everyone contributes during their lifetime, or from their estate, so no individual faces catastrophic costs alone.
Each of these costs billions, which is precisely why the public is being asked, rather than told. Be wary of anyone who tells you which way it will land.
What to do if you’re arranging care now
Three practical points, and they apply whatever the Commission eventually recommends.
Plan around today’s rules, not tomorrow’s possibilities. The final funding report is due in 2028. Legislation and implementation would follow. A parent who needs help this autumn should get help this autumn.
Claim what already exists. Before any reform, most families leave money unclaimed. Attendance Allowance alone is worth up to £114.60 a week in 2026-27, tax-free and not means-tested.
Keep records of care spending. If a cap on care costs ever arrives, evidence of what you have spent may matter. Keep invoices, assessments and care plans. A folder and ten minutes a month is enough.
Frequently asked questions
What is the Casey Commission? An independent commission on adult social care in England, chaired by Baroness Louise Casey. It reports in two phases: medium-term recommendations and a plan for a national care service during 2026, then a final report on long-term reform and funding in 2028.
Who currently pays for social care? It depends on means. Above £23,250 in capital, you self-fund. Below that, the council contributes after a needs and financial assessment. Attendance Allowance is not means-tested, and NHS Continuing Healthcare covers the full cost where needs are primarily health needs. Our costs and funding page has the detail.
Will the Commission change what I pay? Not yet, and possibly not for years. Today’s rules still apply, and families arranging care now should plan around them.
How do I give my views? The Commission’s public engagement exercise launched in 2026 and aims to hear from hundreds of thousands of people. Details are at caseycommission.co.uk.
Questions about paying for care in Newark?
The national debate will run for years. Your family’s situation is probably more urgent, and usually simpler to untangle than it looks.
Call us on 01636 646915, email hello@helpingathome.co.uk, or request a care assessment. We’ll tell you plainly what care would cost, and which funding routes are worth exploring for your situation.
Helping at Home is CQC-rated Good and holds a 9.9 out of 10 rating on homecare.co.uk, based on reviews from families across Newark-on-Trent and the surrounding area.
