Home care charges in Northern Ireland: what’s free and what isn’t

In Northern Ireland, personal care at home arranged by your Health and Social Care Trust is free in 2026/27, whatever your savings, income or property. There is no means test and no weekly charge for help with washing, dressing, toileting, eating or medication. What can still cost money is domestic home help for some people under 75, meals, respite in a care home, and any care you buy privately on top of, or instead of, the Trust’s package.

In short

• Trust-arranged domiciliary (home) care costs nothing in Northern Ireland, with no financial assessment. The Department of Health’s own guidance says these services “are not charged for in Northern Ireland”.
• Under the Department’s Home Help Model Scheme, Trusts can charge for domestic help, but not to people aged 75 or over or those on Pension Credit or Income Support.
• Respite in a residential or nursing home is charged. For the first 8 weeks of a temporary stay the Trust can set a fair amount instead of doing a full assessment.
• Attendance Allowance (£76.70 or £114.60 a week in 2026/27) is not reduced because you get free care at home, so it can help pay for extra hours.
• Disabled Facilities Grants, run by the Housing Executive, are means-tested and go up to £35,000, or £70,000 in some cases.
• If you buy care from an agency while you wait for a Trust package, you pay the agency’s full price.

Why home care is free in Northern Ireland

The difference is in the law. The Health and Personal Social Services (Northern Ireland) Order 1972 requires Trusts to charge for residential care and nursing home places, and the 1993 Assessment of Resources Regulations set out how. Nothing in that system requires a charge for care delivered in your own home. The Department’s main care management circular, HSC (ECCU) 1/2010, says all its rules on financial assessment apply only to residential and nursing home care.

The Department confirmed in its 2007 report on free personal care that Northern Ireland has “never charged for domiciliary care”. Its 2022 continuing healthcare guidance repeats the point: if your needs can be met by a care package in your own home, “there is currently no charge to the individual”.

England is different: councils means-test home care, leaving a single person over Pension Credit age a Minimum Income Guarantee of £241.45 a week. Our guide to paying for care in Northern Ireland covers the full picture, including care homes. This article goes deeper on home care only.

What is free and what can be charged

The line between personal care and domestic help matters. The Department describes home help as “assistance with domestic tasks which fall largely outside the definition of personal care”. If a carer helps your mother wash and dress, then tidies the kitchen, the personal care part is free regardless of age. Our guide to what counts as personal care explains the distinction.

How to get free home care from your Trust

Care is arranged by the five Health and Social Care Trusts: Belfast, Northern, South Eastern, Southern and Western. Ask the GP, a hospital ward or the Trust’s adult services team for a needs assessment. Anyone can ask, including a family member, with your parent’s agreement.

1. Assessment. A care manager or social worker assesses needs, often using the Northern Ireland Single Assessment Tool (NISAT). Department guidance says money must never be the reason for refusing an assessment.
2. Eligibility. Trusts use regional access criteria for domiciliary care, set in circular HSS (ECCU) 2/2008. Risks to independence are banded as critical, substantial, moderate or low, and those most at risk get priority.
3. Care plan. You should get a plan setting out visits, tasks and times. Check it covers evenings and weekends if needed. Our guide on how many hours of home care helps you judge whether the hours fit the need.
4. Start date. Packages often start later than families expect. Ask for the expected start date in writing and who to call if it slips.

From hospital, the Trust may offer reablement first. See care after hospital discharge (written mainly for England).

Direct payments and self-directed support

Under self-directed support, your parent can take their personal budget as a direct payment, a managed budget (the Trust holds the money but your parent decides how it is spent), a Trust-arranged service, or a mixture. The Carers and Direct Payments Act (Northern Ireland) 2002 is the legal basis.

• The Trust decides the amount, based on assessed needs. There is no charge deducted, because the care itself is free.
• Direct payments do not affect other benefits.
• Your parent must consent and be able to manage the payments, with help if needed.
• The money can pay an agency or a personal assistant your parent employs. As the employer, they become responsible for pay, checks and records. See our comparison of agencies and private carers.

Before choosing an agency that charges more per hour than the Trust allows for, ask the Trust in writing how any shortfall would be handled. Get the answer before the contract is signed.

Worked example: free care, plus private hours

Eileen, 81, lives alone in Coleraine in the Northern Trust area. She has £48,000 in savings and owns her house. After a fall, the Trust assesses her as needing two visits a day for help with washing, dressing and meals, about 10 hours a week.

• Trust package: £0. Her savings and house are not looked at, because there is no financial assessment for home care.
• Wait for the package: four weeks. Her family buy 10 hours a week from an agency. If the agency charges £28 an hour (an illustration; ask local agencies for real prices), that is £280 a week, or £1,120 for the four weeks.
• Attendance Allowance: Eileen claims the higher rate of £114.60 a week, as she needs help day and night. Free Trust care does not reduce it, so it can pay for an extra private sitting service once the package starts.
• Domestic help: because she is over 75, any Trust home help with cleaning is also free.

If Eileen instead moved into a care home, her £48,000 would put her over the £23,250 upper capital limit and she would pay the full fee. That gap is why it is worth comparing home care against a care home carefully before agreeing to a placement in Northern Ireland.

Who can be charged for home help

The Home Help Model Scheme lets Trusts charge people under 75 for domestic help in line with their ability to pay, unless they get Pension Credit or Income Support. The income raised is small, and in 2007 the Department recommended winding the scheme up, so practice varies. Ask your Trust whether it charges at all and, if so, confirm the charge covers domestic tasks only. Personal care stays free at any age.

Benefits that sit alongside free care

Benefits are paid at UK-wide rates through the Department for Communities. Attendance Allowance is £76.70 or £114.60 a week and is not means-tested. A family carer giving 35 hours or more a week may get Carer’s Allowance of £86.45, with an earnings limit of £204 a week. Check Pension Credit too, because it also removes any home help charge.

Respite and short breaks

Respite at home, such as a sitting service, is part of free domiciliary care. Respite in a care home is charged, sometimes at a locally agreed rate. Direct payments can sometimes fund short stays of usually no more than four weeks, if the Trust agrees. Our guide to respite care costs covers the options.

Mistakes to avoid

• Paying privately without asking the Trust. Some families buy care for months without knowing a free package was available.
• Assuming a care home costs the same. Home care is free, but a care home place is means-tested and can use up savings and the house. See will I have to sell my house to pay for care in Northern Ireland.
• Not challenging too few hours. Free does not mean you must accept a package that does not meet the need. Ask for a review.

Complaints about home care

Raise concerns with the agency or the Trust’s complaints manager first, usually within six months of becoming aware of the problem and normally no later than 12 months after the event. The Trust should reply in full within 20 working days. The Patient and Client Council gives free help on 0800 917 0222. If you are still unhappy after the Trust’s process ends, you have six months to go to the Northern Ireland Public Services Ombudsman (NIPSO).

Home care agencies are registered and inspected by the Regulation and Quality Improvement Authority (RQIA). RQIA does not investigate individual complaints, but it uses concerns to inform its inspections.

Scotland and Wales charge for home care differently again: see home care charges in Scotland and home care charges in Wales.

Frequently asked questions

Is home care free in Northern Ireland?

Yes. Personal care at home arranged by your Health and Social Care Trust is free in 2026/27, with no means test. Help with washing, dressing, toileting, eating and medication costs nothing, whatever your savings. Some Trusts can charge people under 75 for domestic help such as cleaning, unless they get Pension Credit or Income Support.

Do I have to tell the Trust about my savings to get home care?

No financial assessment is needed for Trust home care in Northern Ireland, because personal care at home is not charged for. The Trust may only ask about money if it charges for domestic home help for someone under 75 who is not on Pension Credit or Income Support. Savings only become relevant if a care home place is needed.

Do over-75s pay for home help in Northern Ireland?

No. Under the Department of Health’s Home Help Model Scheme, people aged 75 or over are not charged for home help, and neither are people receiving Pension Credit or Income Support. Personal care at home is free at any age once the Trust has assessed it as needed.

Can I use direct payments for home care in Northern Ireland?

Yes. If the Trust assesses your parent as needing care, they can take a direct payment instead of Trust services and use it to pay an agency or employ a personal assistant. The Trust sets the amount based on assessed needs. Direct payments do not affect other benefits, but records and receipts must be kept.

Does free home care stop Attendance Allowance?

No. Attendance Allowance, £76.70 or £114.60 a week in 2026/27, is not reduced because the Trust provides free care at home. It usually stops only after 28 days in a care home when the Trust is helping with the fees, or during long hospital stays. Many families use it to pay for extra private hours.

Is respite care free in Northern Ireland?

Respite at home, such as a sitting service, is part of free domiciliary care. Respite in a residential or nursing home is charged. For the first eight weeks of a temporary stay the Trust can charge an amount it considers reasonable, and your home is not counted as capital while you plan to return to it.

Sources

• Department of Health: Circular HSC (ECCU) 1/2010, Care Management, Provision of Services and Charging Guidance
• Department of Health: Continuing Healthcare in Northern Ireland guidance, 18 May 2022
• Department of Health: Report on free personal care and alternative options
• nidirect: Support to stay in your own home
• nidirect: Direct payments for care
• nidirect: Paying your care home fees (temporary stays)
• nidirect: Disabled Facilities Grants
• nidirect: How to complain or raise concerns about health services
• Northern Ireland Public Services Ombudsman: FAQs
• Carers and Direct Payments Act (Northern Ireland) 2002

General information, not legal or financial advice. Figures for 2026/27, checked October 2026.

Reviewed by The Care Panel team on 29 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.