Care Home Fees After a Death¶

Care home fees rarely stop neatly on the day of death. The estate owes the fees up to the date of death plus a short post-death period, and where a Deferred Payment Agreement is in place against the deceased's property, the local authority is owed for the years it covered care during the deceased's lifetime. Family members are not personally liable for any of this — the fees are debts of the estate — but the executor needs to handle them.

The more interesting question is whether the deceased should have been receiving NHS Continuing Healthcare funding (which is 100% NHS-paid and not means-tested) but wasn't. The retrospective CHC claim against the relevant Integrated Care Board can produce significant refunds — sometimes tens or hundreds of thousands of pounds — to the estate.

This guide covers all four strands: the final invoice, the Deferred Payment Agreement, Funded Nursing Care, and retrospective CHC claims.

If you can only do one thing today: Find out whether the deceased was ever assessed for NHS Continuing Healthcare. Ask the care home, the GP, or the local Integrated Care Board (the body that took over from CCGs in July 2022). If the deceased had substantial health needs and was never formally assessed — or was assessed and found ineligible on grounds you think were wrong — the estate can pursue a retrospective CHC claim for a refund of fees plus interest, with no statutory time limit for care received from 1 April 2012 onwards. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]

Who pays the final invoice¶

Outstanding care home fees are a debt of the estate and are paid by the executor from estate funds. They rank as ordinary unsecured debts in the statutory order — paid after secured debts and funeral costs but before residue passes to beneficiaries.

Family members are not personally liable for the deceased's care home fees. This applies regardless of who was the main family contact during the resident's lifetime. The two narrow exceptions:

A third-party top-up agreement, signed by a family member to pay the difference between the local authority contribution and the care home's actual fee. Some top-up agreements end on the resident's death; others create a continuing personal liability for any unpaid top-ups up to that point. Read the agreement carefully.
A guarantor clause in the original care home contract, signed by a family member as guarantor for the full fees. This is unusual but does happen, particularly with smaller independent homes. Where a guarantee is in place, the family member is liable for any shortfall the estate cannot cover.

For couples where the deceased's spouse or civil partner remains in the same care home, the survivor's contract continues against the survivor's own income and assets; the survivor does not inherit the deceased's care fee debt unless they signed something specifically.

The post-death charging period¶

The Competition and Markets Authority (CMA) issued binding guidance in 2018, refreshed in 2021, on what care homes can fairly charge after a resident dies. The guidance applies UK-wide and is enforceable through trading-standards authorities and through individual contract challenges. [source: gov-uk/cma-care-homes-consumer-protection-2026-04-30.html]

The CMA's working position:

Care homes can charge fees for a defined post-death period to cover the practical realities of clearing the room — typically 3 days at a flat rate, or up to 10 days where the room is being cleared at a slower pace. The contract specifies the exact period.
Charges should stop when a new resident moves in or the room is otherwise re-let, regardless of whether the contractual clearance period has expired.
Storage fees for belongings beyond the agreed clearance period need to be reasonable and clearly set out in the original contract.
Re-letting fees or "lost-revenue" charges for the period between death and a new resident moving in are unfair contract terms and not enforceable. [source: gov-uk/cma-care-homes-consumer-protection-2026-04-30.html]

Where the final invoice includes charges that look outside the CMA framework, the executor can challenge them in writing to the care home manager. Most challenges resolve at this stage. If they do not, the trading-standards authority for the area or the relevant ombudsman (the Local Government and Social Care Ombudsman in England, equivalent bodies elsewhere) can take complaints. [source: gov-uk/cma-care-homes-consumer-protection-2026-04-30.html]

How care was funded during the resident's lifetime¶

To understand what the estate may owe — or be owed — the executor needs to know how the resident's care was funded. Three main routes apply across the UK, with thresholds varying by jurisdiction:

Self-funding — the resident paid the full fee from their own resources (income, savings, pension, sale of assets) because their capital was above the local authority's upper threshold:

England: £23,250 upper threshold; £14,250 lower threshold. (Held at these levels since 2010; planned reform delayed.) [source: gov-uk/cma-care-homes-consumer-protection-2026-04-30.html]
Scotland: £35,000 upper; £21,500 lower.
Wales: £50,000 upper for residential care, no lower threshold.
Northern Ireland: £23,250 upper; £14,250 lower (matching England).

Local authority funded — the resident's capital was below the upper threshold; the local authority assessed need and contributed (above the lower threshold) or covered the full fee (below the lower threshold). The resident may still have paid a contribution from income.

Deferred Payment Agreement — the local authority paid fees during the resident's lifetime, secured against the resident's property. On death, the amount becomes due. Detail below.

A material number of self-funders have had their assets fall below the upper threshold during their lifetime without being reassessed. A retrospective check with the local authority's adult social services department can establish whether a financial reassessment should have been triggered, which would have shifted some or all of the cost onto the local authority. Where a reassessment was missed, the estate can recover overpayment — usually back to the date the assets fell below the threshold.

Deferred Payment Agreements¶

A Deferred Payment Agreement (DPA) is a formal contract between the resident and the local authority, recorded as a charge against the resident's property at HM Land Registry. The local authority pays the care home fees during the resident's lifetime; the deferred amount accrues interest and administrative charges; the total becomes due on death.

How it works after death:

The local authority issues a final settlement statement within a few weeks of the death, setting out the deferred capital, accrued interest, and any administrative fees. The total can be £30,000 to £200,000+ depending on how long the DPA ran.
The executor is expected to repay within 90 days, or to demonstrate that the property is being actively marketed for sale. The 90-day window is administrative practice rather than a strict statutory deadline; most local authorities will extend on request where the executor is engaging in good faith.
Where the property is sold, the local authority is paid from the sale proceeds at completion, before any residue passes to beneficiaries. The DPA charge is removed from the title at completion as part of the conveyancing process.

The interest rate on a DPA is set by central government regulation — typically Bank of England base rate plus a small margin. The administrative charges vary by local authority but are often £200 to £500 in setup costs plus periodic charges. Over 5 to 10 years these can add £10,000 to £30,000 to the total bill, payable from the estate by the executor. The local authority's settlement statement itemises the breakdown.

DPA debt ranks as a secured debt of the estate in the statutory order — paid before unsecured debts but after other secured debts (a residential mortgage on the same property typically takes priority, although DPA documentation usually rules this out by requiring the property to be free of mortgage when the DPA is signed).

Funded Nursing Care¶

Funded Nursing Care (FNC) is a smaller NHS contribution paid directly to nursing homes (not residential care homes without nursing) for the registered-nurse component of the resident's care. It is paid even where the resident does not qualify for full NHS Continuing Healthcare. The current rates: [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]

Standard rate: £254.06 per week (April 2025 rate); rising to £267.68 per week from April 2026. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Higher rate: £349.50 per week (£368.24 from April 2026), payable only to the small group of pre-2007 residents who were assessed at the higher band before the system was unified.

FNC is paid by the local Integrated Care Board direct to the care home, reducing the fee the resident or local authority pays. Where the resident has been paying the full fee but the FNC was not being applied, the executor can recover the FNC retrospectively from the ICB. This is a smaller but cleaner claim than full CHC.

FNC applies in England and Wales in the form described above. Scotland's equivalent is built into the free personal-and-nursing-care system; Northern Ireland has a parallel scheme administered by the Health and Social Care Board.

Retrospective NHS Continuing Healthcare claims¶

The largest potential refund is from a retrospective CHC claim. CHC is the NHS-funded care package available to people whose primary need is healthcare rather than social care. Eligibility is based on the nature, intensity, complexity, and unpredictability of the person's needs, assessed against a national Decision Support Tool covering 12 care domains. Where someone qualifies, the NHS pays 100% of their care costs — fees, accommodation, food, and care — without means-testing. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]

The Parliamentary and Health Service Ombudsman has repeatedly criticised the inconsistency of CHC decisions. Many residents with substantial health needs are never formally assessed; many others are assessed and wrongly found ineligible. Where the deceased had advanced dementia, severe neurological conditions, complex nursing needs, or multiple interacting health conditions requiring regular clinical intervention, the executor should consider whether a retrospective claim is worth pursuing.

Procedure:

The executor writes to the local Integrated Care Board (ICB) — the NHS body that took over CHC commissioning from CCGs in July 2022. The executor identifies the period of care under review (start date, end date) and asks for a retrospective CHC review.
The ICB requests medical and care-home records from the relevant period and convenes a panel to apply the Decision Support Tool retrospectively. Records may need to be obtained from GPs, hospitals, the care home, and any community nursing teams.
The panel produces a written decision. Where eligibility is found, the NHS refunds 100% of the fees paid during the eligible period plus interest at the Retail Prices Index rate from April 2015 onwards.
Where the decision is unfavourable, the executor can appeal through the NHS complaints process and ultimately to the Parliamentary and Health Service Ombudsman.

Timing: there is no statutory deadline for retrospective claims relating to care from 1 April 2012 onwards. Care before 1 April 2012 cannot be claimed against retrospectively (the deadline for those passed in March 2013). Records do degrade over time, so claims become harder to assemble after several years; the practical sweet spot is within 3 to 5 years of the period under review. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]

Specialist help: a number of specialist advisors handle retrospective CHC claims on a no-win-no-fee basis (typically 25–40% of the recovered sum). Worth considering for substantial estates where the period of care was long. For shorter or simpler claims, the executor can run the process themselves with the ICB; the paperwork is involved but not specialist.

Scotland: free personal and nursing care¶

Scotland operates a different system. Since April 2002 (extended to all adults in April 2019 under "Frank's Law"), personal care is provided at no charge to anyone the local authority assesses as needing it, regardless of capital or income. Nursing care is also free where provided in a registered nursing home. Accommodation and food costs remain payable by the resident (or by the local authority where the resident's capital is below the Scottish thresholds).

The current free personal care rate paid by the local authority is £255.50 per week (April 2025); the free nursing care rate is £114.55 per week. These are paid directly to the care home and reduce the resident's bill, with any residual cost paid by the estate via the executor after death.

After death in Scotland:

The estate pays any accommodation and food charges outstanding up to the date of death, plus any post-death period the contract specifies.
The estate does not pay for personal or nursing care; the local authority covers those.
Where the resident was paying for personal care that should have been free, the estate can recover the overpayment from the local authority — analogous to a Scottish version of the retrospective CHC claim, but simpler in mechanics.

NHS Continuing Healthcare does not operate in Scotland under that name. Long-term care for people with overwhelming health needs is covered by the local NHS Health Board on case-by-case discretionary funding.

Northern Ireland¶

Northern Ireland operates a system closer to England's, with means-tested care funded by Health and Social Care Trusts rather than local authorities. The thresholds match England's. The Northern Irish equivalent of CHC is the HSC Continuing Care assessment, administered by the Health and Social Care Board. Retrospective claims work similarly to the English route. [source: gov-uk/cma-care-homes-consumer-protection-2026-04-30.html]

A short checklist¶

In the first 4 to 6 weeks the executor should:

Get the final invoice from the care home; check it against the contract and the CMA guidance.
Ask whether Funded Nursing Care was being applied; recover from the ICB if not.
Where a Deferred Payment Agreement is in place, contact the local authority for the final settlement statement.
Check whether the deceased was ever assessed for NHS Continuing Healthcare; consider a retrospective claim if not.

In the longer term:

For substantial CHC claims, consider engaging a specialist advisor.
For DPA repayment, coordinate with the conveyancer handling any property sale.
Settle outstanding fees from the estate before distributing residue to beneficiaries.

What this guide doesn't cover¶

This guide covers care home fees specifically. It does not cover the rest of the care home process (When someone dies in a care home), the broader probate process (How to apply for probate), the order of debt payment from the estate (Debt after death), or the practical mechanics of clearing the deceased's belongings (Personal belongings after a death).

It also does not cover at-home care that the deceased was receiving in their own home (hourly carers, live-in carers, council homecare). The retrospective CHC claim applies equally to at-home care; the FNC and DPA mechanisms generally do not.

If you're struggling, you don't have to do this alone. Samaritans (116 123, 24/7) | Cruse Bereavement Care (0808 808 1677) | Mind (0300 123 3393)

Next: Power of attorney after death

Last verified: 30 April 2026 against NHS Continuing Healthcare guidance and CMA care-homes consumer-protection guidance.