This paper reports the findings of research funded by The Nuffield Foundation on older people paying the full cost of their long-term residential or nursing home care in England. The research had three stages; a national postal survey directed at the senior finance officer in social services departments, follow-up telephone interviews with a sample of them, and interviews in five case study areas. Those interviewed included social services staff (including a legal adviser), care home providers, self-funding residents and relatives. These self-funding residents were commonly relatively physically independent on admission to the care home. Despite central government directives that needs assessments should be available regardless of a person's means, it is a common policy to encourage older people in this situation to admit themselves directly to care homes without a needs assessment. Wide variation was found in local authority practice in respect to being prepared to make a contract with a care-home provider for older people able to meet the full costs of care.
