Effect on entitlement of an individual spending time in care homes, hospitals or hospices
An individual who is entitled to the daily living component is entitled to still be paid it for the first 28 days of their stay in a care home. This 28 day period may comprise of one or more separate periods, providing there are no more than 28 days between the periods.
The individual stops being paid the daily living component on the 29th day of their time spent in a care home (ADP regs, Reg 27(2)) . This is called non-payment of assistance.
The non-payment of assistance enables an individual’s entitlement to ADP to continue while they are resident in a care home.
This is because the daily living component is intended to meet the extra costs experienced by individuals with a disability or long-term health conditions.
In most cases, when they are in a care home, the costs of their care will be paid for by the local authority or other public funds.
In Scotland, Free Personal and Nursing Care (FPNC) Franks Law offers free personal care for people
- Of all ages
- Whose local authority decides they need this service after assessment
Please see the following operational guidance which details how to Ask for information about alternative accommodation.
Non-payment of the daily living component of ADP ensures that a person does not receive support for the costs of their care twice.
Non-payment of ADP applies to hospital admissions for individuals aged 18 and over as well. On the 29th day of a period in hospital, an individual stops being paid the daily living and mobility components of ADP (ADP regs, Reg 28(2)).
For this to be the case, an individual aged 18 or over also:
- has to be undergoing medical or other treatment as an in-patient at a hospital or similar institution
- has to have any of the costs of the treatment, accommodation and any other related services borne out of public funds (ADP regs, Reg 28(1)).
Borne out of public funds means the cost of treatment accommodation and any other related service is paid if the individuals is undergoing medical or other treatment in:
- A hospital or similar institution under
- The National Health Service Act 2006
- The National Health Service (Wales) Act 2006
- That National Health Service (Scotland) Act 1978
- A hospital or similar institution maintained or administered by the Defence Council (ADP regs, Reg 28(4)).
Entitlement to payment of the enhanced rates of ADP daily living and/or mobility component(s) is unaffected by residence in a hospice where the individual has a terminal illness (ADP regs, Reg.29). However if admission is a result of an individual becoming terminally ill, they may be entitled to further assistance if they aren’t already in receipt of the enhanced daily living and mobility component of ADP (ADP regs, Reg.26)
The above Paragraph refers only to a “Hospice”, meaning a ‘hospital or other institution whose primary function is to provide palliative care for persons resident there who are suffering from a progressive disease in its final stages (ADP regs, Reg 29(2)) . However a hospice can also be a facility, ward or similar within a care home or a hospital. Where a palliative care unit has been established as a part of a hospital or a care home the same rules apply if the individual is resident there and not terminally ill. In a care home the individual will stop being paid the daily living component of ADP after 28 days, and in a hospital an individuals will stop being paid both the mobility and the daily living component after 28 days (ADP regs, Reg 27(2)&28(2)). This 28 day period may comprise of one or more separate periods, providing there are no more than 28 days between the periods.
The exceptions to these rules in this section are discussed in the Exceptions section .
The individual who is receiving ADP has a legal duty to inform Social Security Scotland about entering and leaving a care home or being admitted and discharged from hospital, (SS(S)A 2018, s. 56) if this change is likely to affect their payments. The case manager will then make a determination without application.
They must tell Social Security Scotland about time spent in a care home and time spent in hospital as soon as is reasonably practicable.
An individual might not inform Social Security Scotland immediately after they have entered a care home or a hospital. This might result in the case manager making a determination without application after the individual has spent 28 days in a care home or a hospital. In this case, the individual may accrue an overpayment before their payment of the daily living and/or mobility component has been stopped. This would happen in instances where the individual failed to notify the change as soon as was reasonably practical.
There are different rules about applying for ADP when living in alternative accommodation. Please see the section on Applications while spending time in alternative accommodation for a full explanation of this rule.