Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
4. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains how NHS Continuing Healthcare works in practice where care is delivered in a person's own home. It covers what the package can include, how it is commissioned, the problem of sourcing packages locally, whether family members can be paid, personal health budgets and direct payments, continuity of carers, and what to do where the Board says home care cannot be arranged.
NHS Continuing Healthcare funding at home
Home packages under NHS Continuing Healthcare can be very substantial, including two carer calls and waking nights. The recurring difficulty is not eligibility but whether a package of that size can actually be sourced locally.
What a home package can include
Personal care visits at whatever frequency is assessed, two carer calls where handling requires it, waking or sleeping night support, nursing input, equipment, and specialist input such as therapy or continence services. Packages of forty hours a week or more are not unusual where needs are high, and some people receive continuous support.
How it is commissioned
The Integrated Care Board commissions the package, usually through agencies it contracts with. It must meet assessed needs and will consider how they can be met safely and sustainably. The care plan is what determines the package, so where the plan is thin the package will be too, which makes the plan worth as much attention as the eligibility decision.
The sourcing problem
This is the practical reality. High dependency packages, particularly with two carers or overnight cover, are difficult to source in many areas. A Board may propose a care home on the basis that the home package cannot be arranged. Ask for that to be explained in writing, including which providers have been approached and when, rather than accepting a general statement about local availability.
Can family be paid to provide care
This is a common question and the answer is not straightforward. Boards have policies on whether close family living in the same household can be paid from a personal health budget, and they vary. It is sometimes possible in defined circumstances. Ask the Board for its written policy rather than assuming either way.
Personal health budgets and direct payments
Adults eligible for NHS Continuing Healthcare have a right to have a personal health budget, which can be taken as a direct payment allowing the person or their representative to arrange care directly. That often solves the continuity problem where agency provision is unreliable, at the cost of employer responsibilities.
Continuity of carers
Where a person's needs require consistency, for example because only familiar staff can interpret their communication or manage their distress safely, that is an assessed need rather than a preference. Say so explicitly and get it into the care plan, because it affects how the package must be commissioned.
Key takeaway
Home packages can be substantial and eligibility does not depend on setting. The real constraint is sourcing, so require any claim that a package cannot be arranged to be evidenced in writing, and consider a personal health budget where continuity is the problem.
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Frequently asked questions
How much care can a home package include?
Whatever the assessment identifies, including multiple daily visits, two carer calls, waking or sleeping nights, nursing input and equipment. Packages of forty hours a week or more are not unusual where needs are high.
Can a family member be paid to provide the care?
Boards have differing policies on paying close family in the same household from a personal health budget, and it is sometimes possible in defined circumstances. Ask for the written policy rather than assuming.
The Board says it cannot source a home package. What now?
Ask for that in writing, including which providers were approached and when. A general statement about local availability is not the same as evidence that the package cannot be arranged.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.