Understanding how adult social care is funded in England is genuinely complicated — and deliberately so, according to many who have tried to navigate it. There is no single national fund that pays for everyone’s care. Instead, a patchwork of local authority budgets, NHS contributions, means testing, and personal finances determines who gets what, from whom, and for how long.
This guide cuts through the complexity and explains, in plain language, how care funding actually works in England in 2026 — who pays, how eligibility is assessed, what a personal budget is, how direct payments work, and what options are available if local authority funding does not cover the full cost.
Who Is Responsible for Funding Adult Social Care?
In England, adult social care is the responsibility of your local council — specifically, its adult social care department. Local authorities receive funding from central government and council tax receipts, and they use it to commission or directly provide care for eligible adults in their area.
The NHS funds healthcare — including nursing in care homes, community nursing, and continuing healthcare for people whose primary need is health-based. The boundary between ‘health’ and ‘social care’ is one of the most contested and consequential lines in English public services, and families frequently have to fight to ensure that needs are correctly categorised.
The Means Test: Who Gets Funded?
Local authority social care funding is means-tested. This means your income and assets are assessed to determine how much — if anything — the council will contribute to your care. In England in 2026, the following thresholds apply:
| Capital Threshold | Outcome |
| Below £14,250 | Local authority pays the full cost (above a minimum income threshold) |
| £14,250–£23,250 | Sliding scale contribution from both the individual and the council |
| Above £23,250 | Individual is expected to self-fund their care in full |
Note: For supported living, the means test applies to the care and support element only. The housing cost (rent) is assessed separately, and Housing Benefit may cover it regardless of capital assets in some circumstances. This is an important distinction that many families are not aware of until they are deep into the process.
What Is a Personal Budget?
If the local authority determines that an individual has eligible care and support needs and that they qualify for funded support after the means test, it will agree a personal budget. The personal budget is the total amount of money the council allocates to meet that person’s eligible needs.
The personal budget is not cash handed to the individual — it is a notional figure that is then used to commission support. However, individuals and families have significant choice in how it is used:
Option 1: Local Authority Managed Account
The council commissions a care provider on your behalf, using its existing contracts and frameworks. You have limited choice over which provider delivers your support, but you have no administrative responsibility for managing the budget.
Option 2: Direct Payments
The council pays the personal budget directly to the individual (or to a nominated person or trust on their behalf). The individual then uses that money to arrange and pay for their own care — including hiring personal assistants, contracting with an independent provider like AESN Care, or paying for day services. This model gives the greatest flexibility and control, but also requires the individual or a trusted person to manage employment law, payroll, and contractual responsibilities.
Option 3: Third-Party Direct Payment
For those who want the flexibility of direct payments but not the administrative burden, a third party — often a family member, a trust, or an independent support broker — holds and manages the direct payment on their behalf.
NHS Continuing Healthcare (CHC): When Health Funds the Whole Cost
NHS Continuing Healthcare is a package of ongoing care arranged and funded entirely by the NHS — not the local authority — for adults whose primary need is health-based. If a person’s care needs are mainly driven by a health condition (rather than social needs), they may be eligible for CHC. If awarded, CHC funding covers the full cost of care, including accommodation in a care home, with no means test.
CHC is frequently refused at initial assessment, and the threshold (‘primary health need’) is applied inconsistently across different ICB areas. A significant proportion of successful CHC awards are the result of families challenging initial refusals. If you believe someone’s needs are primarily health-based, it is always worth pursuing a formal CHC assessment.
What If the Personal Budget Does Not Cover the Actual Cost of Care?
One of the most common frustrations for families is the gap between the personal budget the council agrees and the actual cost of appropriate care in the local market. Providers are not obliged to accept local authority rates, and specialist care for complex needs — including autism, dual diagnosis, and behaviours that challenge — consistently costs more than standard rates reflect.
Options include: asking the council to review and uplift the personal budget; seeking a ‘top-up’ from family funds (permitted under the Care Act in specific circumstances); challenging the adequacy of the budget through the complaints process; or requesting an independent review.
AESN Care and Funding
AESN Care works with both local authority commissioners and self-funding individuals and families across England. We are transparent about our costs and work with families to explore all available funding options, including direct payments and CHC pathways. Contact us for a no-obligation conversation about funding your care.
How Adult Social Care Funding Works in England: A 2026 Guide for Families
Understanding how adult social care is funded in England is genuinely complicated — and deliberately so, according to many who have tried to navigate it. There is no single national fund that pays for everyone’s care. Instead, a patchwork of local authority budgets, NHS contributions, means testing, and personal finances determines who gets what, from whom, and for how long. This guide cuts through the complexity and explains, in plain language, how care funding actually works in England in 2026 — who pays, how eligibility is assessed, what a personal budget is, how direct payments work, and what options are available if local authority funding does not cover the full cost. Who Is Responsible for Funding Adult Social Care? In England, adult social care is the responsibility of your local council — specifically, its adult social care department. Local authorities receive funding from central government and council tax receipts, and they use it to commission or directly provide care for eligible adults in their area. The NHS funds healthcare — including nursing in care homes, community nursing, and continuing healthcare for people whose primary need is health-based. The boundary between ‘health’ and ‘social care’ is one of the most contested and consequential lines in English public services, and families frequently have to fight to ensure that needs are correctly categorised. The Means Test: Who Gets Funded? Local authority social care funding is means-tested. This means your income and assets are assessed to determine how much — if anything — the council will contribute to your care. In England in 2026, the following thresholds apply: Capital Threshold Outcome Below £14,250 Local authority pays the full cost (above a minimum income threshold) £14,250–£23,250 Sliding scale contribution from both the individual and the council Above £23,250 Individual is expected to self-fund their care in full Note: For supported living, the means test applies to the care and support element only. The housing cost (rent) is assessed separately, and Housing Benefit may cover it regardless of capital assets in some circumstances. This is an important distinction that many families are not aware of until they are deep into the process. What Is a Personal Budget? If the local authority determines that an individual has eligible care and support needs and that they qualify for funded support after the means test, it will agree a personal budget. The personal budget is the total amount of money the council allocates to meet that person’s eligible needs. The personal budget is not cash handed to the individual — it is a notional figure that is then used to commission support. However, individuals and families have significant choice in how it is used: Option 1: Local Authority Managed Account The council commissions a care provider on your behalf, using its existing contracts and frameworks. You have limited choice over which provider delivers your support, but you have no administrative responsibility for managing the budget. Option 2: Direct Payments The council pays the personal budget directly to the individual (or to a nominated person or trust on their behalf). The individual then uses that money to arrange and pay for their own care — including hiring personal assistants, contracting with an independent provider like AESN Care, or paying for day services. This model gives the greatest flexibility and control, but also requires the individual or a trusted person to manage employment law, payroll, and contractual responsibilities. Option 3: Third-Party Direct Payment For those who want the flexibility of direct payments but not the administrative burden, a third party — often a family member, a trust, or an independent support broker — holds and manages the direct payment on their behalf. NHS Continuing Healthcare (CHC): When Health Funds the Whole Cost NHS Continuing Healthcare is a package of ongoing care arranged and funded entirely by the NHS — not the local authority — for adults whose primary need is health-based. If a person’s care needs are mainly driven by a health condition (rather than social needs), they may be eligible for CHC. If awarded, CHC funding covers the full cost of care, including accommodation in a care home, with no means test. CHC is frequently refused at initial assessment, and the threshold (‘primary health need’) is applied inconsistently across different ICB areas. A significant proportion of successful CHC awards are the result of families challenging initial refusals. If you believe someone’s needs are primarily health-based, it is always worth pursuing a formal CHC assessment. What If the Personal Budget Does Not Cover the Actual Cost of Care? One of the most common frustrations for families is the gap between the personal budget the council agrees and the actual cost of appropriate care in the local market. Providers are not obliged to accept local authority rates, and specialist care for complex needs — including autism, dual diagnosis, and behaviours that challenge — consistently costs more than standard rates reflect. Options include: asking the council to review and uplift the personal budget; seeking a ‘top-up’ from family funds (permitted under the Care Act in specific circumstances); challenging the adequacy of the budget through the complaints process; or requesting an independent review. AESN Care and Funding AESN Care works with both local authority commissioners and self-funding individuals and families across England. We are transparent about our costs and work with families to explore all available funding options, including direct payments and CHC pathways. Contact us for a no-obligation conversation about funding your care.
Autism in Adults: What Support Is Available Under the Care Act 2014?
For many autistic adults and their families, navigating the social care system is one of the most exhausting and opaque challenges they face. The legal framework exists — the Care Act 2014 creates clear duties for local authorities — but knowing your rights and how to exercise them is a different matter. This guide explains, in plain language, what autistic adults in England are legally entitled to and how to access it. This guide is for autistic adults aged 18 and over, their families and unpaid carers, and professionals supporting them through the system. It covers eligibility, assessment, what support looks like in practice, and how to challenge decisions you believe are wrong. What the Care Act 2014 Says About Autism The Care Act 2014 is the primary legislation governing adult social care in England. It creates a duty on local authorities to carry out a Care and Support Needs Assessment for any adult who appears to have care and support needs, regardless of diagnosis, financial situation, or likelihood of eligibility. Autism — at any level of support need — is a recognised condition under the Act’s framework. Critically, the Care Act does not require an autism diagnosis to trigger a needs assessment. If an adult appears to have needs, the local authority must assess. A diagnosis strengthens a case for eligible needs but is not a legal prerequisite. The Right to a Care and Support Needs Assessment Any autistic adult who appears to have care and support needs can request a free Care and Support Needs Assessment from their local authority. The local authority cannot refuse this assessment based on assumptions about the person’s level of need, their financial situation, or their living arrangements. You can request an assessment by contacting your local council’s adult social care team. In practice, this means phoning the duty line or submitting a written request. There is no specific form required — a letter, email, or telephone call is sufficient to trigger the duty. If the person lacks mental capacity to request an assessment themselves, a family member, carer, or advocate can request one on their behalf. What Happens During the Assessment? The assessment is carried out by a qualified social worker or assessor from the local authority’s adult social care team. It is meant to be a conversation — a collaborative exploration of the person’s needs, goals, and daily life — not a form-filling exercise. Under the Care Act’s person-centred principles, the assessment should consider: what the person can and cannot do in their daily life due to their autism; the impact of those difficulties on their wellbeing; what outcomes they want to achieve; and what support would help them achieve those outcomes. For autistic adults who may find the format of a formal assessment challenging, reasonable adjustments must be made. This can include: conducting the assessment in a familiar environment rather than a council office; allowing a trusted person to be present; using written or visual communication formats; or breaking the assessment into shorter sessions. The National Eligibility Threshold After the assessment, the local authority applies the national eligibility threshold to determine whether the person has ‘eligible needs’ under the Care Act. Needs are eligible if: they arise from a physical or mental impairment or illness (autism meets this test); as a result, the adult is unable to achieve two or more specified outcomes; and as a consequence of not achieving those outcomes, there is or is likely to be a significant impact on the adult’s wellbeing. The specified outcomes include: managing and maintaining nutrition; maintaining personal hygiene; managing toilet needs; being appropriately clothed; maintaining a habitable home environment; developing and maintaining family or other personal relationships; accessing and engaging in work, training, education, or volunteering; making use of necessary facilities or services in the local community; and carrying out any caring responsibilities for a child. For autistic adults, these outcomes are frequently affected. Sensory sensitivities may make maintaining a habitable environment extremely difficult; communication differences may create barriers to maintaining relationships; executive function difficulties may affect managing nutrition, hygiene, or appointments. These are genuine, assessable needs — not preferences. What Support Can Be Provided? If needs are found to be eligible, the local authority has a legal duty to meet them. For autistic adults, the support provided through a care and support plan may include: Supported living — living independently with tailored support from a provider like AESN Care Community outreach support — regular visits to assist with daily living skills, appointments, or social activities Day services or structured activities — providing routine, skills development, and social connection Direct payments — where the person manages their own personal budget and employs or arranges their own support Short breaks and respite for family carers Specialist autism-informed support addressing sensory needs, communication preferences, and executive function What If the Local Authority Refuses to Assess or Rejects Your Claim? If a local authority refuses to carry out an assessment when the adult appears to have needs, that refusal may be unlawful and can be challenged. Write to the Director of Adult Social Services stating that you are requesting a statutory assessment under Section 9 of the Care Act 2014 and that the duty to assess has been triggered. If needs are assessed but found ineligible, you have the right to request a review of the decision, make a formal complaint to the local authority, refer to the Local Government and Social Care Ombudsman, or seek legal advice about a potential judicial review if the decision is irrational or ignores relevant evidence. The autism charity Autistica, the National Autistic Society, and local INGO organisations offer advocacy support to autistic adults and families navigating these processes. AESN Care’s Autism-Specialist Support AESN Care provides autism-informed care and support across England. Our teams are trained in autism-specific communication approaches, positive behaviour support, and sensory-aware support planning. We work with local authority commissioners and families to deliver flexible, person-centred support that genuinely enables autistic adults to live
