Care Home Fees by HSC Trust in Northern Ireland — Belfast, Northern, South Eastern, Southern, Western

Why Care Home Fees Vary by Trust

Northern Ireland's five Health and Social Care Trusts — Belfast, Northern, South Eastern, Southern, and Western — each set their own "standard rate" for care home placements. This is the maximum weekly amount the Trust will pay a care home to meet a resident's assessed needs.

The problem is straightforward: these standard rates are often lower than what care homes actually charge. The gap between what the Trust pays and what the home charges is what creates the need for third-party top-up fees. Understanding how your local Trust's rates work is the first step in knowing what a placement will actually cost your family.

How Standard Rates Work

When the Trust's financial assessment determines that a person qualifies for funding — meaning their capital is below the £23,250 upper threshold — the Trust contributes toward the weekly care home fees. But the Trust doesn't pay whatever the home asks. It pays up to its own standard rate for the type of care assessed as necessary.

There are two categories:

• Residential care — personal care and accommodation, no nursing
• Nursing care — everything above, plus care from a registered nurse

For nursing placements, the Trust also pays a flat-rate Registered Nursing Care Contribution (RNCC) of £100 per week directly to the home, on top of the standard rate. This £100 is non-means-tested and applies to self-funders and Trust-funded residents alike.

Trust-by-Trust Realities

The Department of Health sets the overall framework, but each Trust negotiates its own fee schedules with care homes in its area. These rates are not routinely published on Trust websites — families typically learn what the standard rate is only after the financial assessment has been completed and a placement is being arranged.

Belfast HSC Trust covers Belfast city and parts of Castlereagh. It has the highest density of care homes and, because of Belfast's property market, some of the highest top-up gaps. Homes in south and east Belfast routinely charge £200–£400 per week above the Trust's standard rate for residential placements.

Northern HSC Trust covers Antrim, Ballymena, Coleraine, Magherafelt, and surrounding rural areas. The Northern Trust area has some of the most stretched domiciliary care services in the region — 52% of all Trust-commissioned homecare visits in this area are 15 minutes or less. This pressure on home-based services means more people end up in residential placements sooner.

South Eastern HSC Trust covers the Ards Peninsula, North Down, Lisburn, and Down. It sits between Belfast's urban density and the rural challenges of the Southern and Western areas.

Southern HSC Trust covers Armagh, Craigavon, Dungannon, and Newry. Research by the Homecare Association found the Southern Trust paid an average hourly rate of just £18.08 for outsourced domiciliary care, against an estimated minimum delivery cost of £29.37 per hour under the Real Living Wage. This commissioning gap puts pressure on both home care availability and residential placements.

Western HSC Trust covers Derry/Londonderry, Omagh, Enniskillen, and Strabane. Rural geography means fewer care home options and longer travel distances for families visiting residents.

What This Means for Your Family's Costs

Regardless of which Trust area your parent falls under, the mechanics of the means test are identical across Northern Ireland: the same £23,250 upper capital limit, the same £14,250 lower limit, the same tariff income formula, and the same personal expenses allowance of £34.10 per week.

What differs is the size of the gap between the Trust's standard rate and what homes in the area actually charge. In practical terms, this means:

• If your parent is Trust-funded, the Trust must offer at least one home at its standard rate that meets the assessed needs. If the family prefers a home that charges more, a third party — typically an adult child — must sign a top-up agreement to cover the difference. The resident themselves cannot legally pay their own top-up.

• If your parent is a self-funder, the Trust's standard rate is less directly relevant because you're paying the home directly. But it becomes critical the moment capital drops below £23,250, because the Trust will then take over funding at its standard rate — and if the home charges above that, someone needs to start paying a top-up or the resident may need to move.

• Nursing placements always include the £100/week RNCC paid by the Trust regardless of funding status. Self-funders should verify whether the fees quoted by a home are before or after this deduction — some homes quote the gross rate, others the net.

How to Find Out Your Trust's Current Standard Rate

The standard rates are not published in a central, easily accessible register. To find the current rate for your Trust area:

1. Ask the social worker conducting the NISAT assessment or financial assessment. They can tell you the standard rate for the type of placement being recommended.
2. Contact the Trust's finance and benefits assessment team directly. Each Trust has a team that handles care home funding calculations.
3. Ask the care home itself. Homes that accept Trust-funded placements know the standard rate and can tell you the top-up amount, if any.

If you're comparing homes across Trust boundaries — moving a parent from one Trust area to another — the funding typically follows the person. The originating Trust remains responsible for funding the placement, at least initially, though cross-boundary placements can create administrative delays.

For a complete breakdown of the financial assessment process, property protections, and strategies for managing Trust negotiations, the Northern Ireland Care Funding Guide walks through every stage from the first NISAT assessment to a funded permanent placement.

See more Northern Ireland guides →