Unlike healthcare, social care and support are not free for everyone at the point of need in the Scotland, or the rest of the UK. In Scotland, a certain amount of free personal care and nursing care is available to all who are assessed as needing it, regardless of assets and income. However, there is no automatic right to receive care and support and the free personal and nursing care will not necessarily cover all of an individual’s needs.
Free personal and nursing care are two elements of the social care support available in Scotland. SPICe regularly receives enquiries from MSPs and their staff about free personal care, this blog looks at some of the frequently asked questions.
What is free personal and nursing care?
Schedule 1 of the Community Care and Health (Scotland) Act 2002 sets out the elements of personal care that local authorities cannot charge for.
The Scottish Government summarises these as:
- “personal hygiene – bathing, showering, hair washing, shaving, oral hygiene and nail care
- continence management – toileting, catheter or stoma care, skin care, incontinence laundry and bed changing
- food and diet – help with eating, special diets and food preparation
- immobility problems – dealing with being immobile
- counselling and support – behaviour management, psychological support and reminding devices
- simple treatments – help with medication (like eye drops), application of creams and lotions, simple dressings and oxygen therapy
- personal assistance – help with dressing, surgical appliances, prostheses, mechanical and manual aids, help getting in and out of bed, and using hoists”
Likewise, any nursing care, such as giving injections or managing pressure sores, cannot be charged for. Where someone is living in the community, nursing care is provided by the NHS board and would not be subject to a charge. If someone moves into a care home and an assessment confirms the need for free personal care and/or nursing care then the local authority will pay the care home directly for providing both elements.
What care services can be charged for?
Local authorities can charge for other types of practical and non-personal care services available to those opting for care at home, including:
- help with housework
- laundry
- shopping
- services outwith your home such as day care centres or lunch clubs
- cost of supplying food or pre-prepared meals
- supply and monitoring of personal alert alarms
If someone is looking to their local authority to arrange non-personal care services a financial assessment would be carried out to assess how much they will pay towards the cost of these services.
Why does my relative have to pay care home fees if they’re receiving free personal care?
For someone living in a care home, accommodation and other living costs, such as food, are not covered by free personal and nursing care. The Care Information Scotland website has further information about personal and nursing care in care homes. This is an area which often confuses people, and they might wonder why they or their relative are having to pay care home fees when they’ve been assessed as needing free personal care. One way to think about it is to imagine someone living in their own home: they cover their own mortgage costs, food, bills and overheads such as council tax, but they might still be eligible to receive free personal care. The local authority wouldn’t cover the other costs. So, when someone needs to move into a care home, that becomes their home and they are paying the provider for those costs – bills, food and overheads. These are sometimes referred to as ‘hotel costs’. This is why some people might be required to sell their home in order to fund their care home place, even if they are receiving free personal and nursing care.
Who is eligible for free personal care?
Any adult in Scotland who is assessed by their local authority as needing personal care is entitled to receive it free of charge.
Free personal and nursing care was introduced in Scotland by the Community Care and Health (Scotland) Act 2002. At first, only those aged 65 and over were eligible. Following a campaign and the introduction of Frank’s Law, it was extended to any adult assessed as needing it from 1 April 2019.
Free personal and nursing care is provided regardless of a person’s income, wealth, marital or civil partnership status, condition, or whether they live at home or in residential care.
However, as highlighted above, this does not mean that free personal care is automatically available to every adult who feels that they need it.
Local authorities have a statutory duty to conduct an assessment of need. If need is established, then any personal care elements of social care support are provided free of charge. While a local authority cannot charge for personal care, they can charge for other elements of care services.
What are the current payment levels for personal care?
The Personal and Nursing Care payment rates are nationally agreed rates. These are reviewed annually by the Scottish Government in secondary legislation. This is how much the local authority will pay a care home for a resident receiving free personal care and/or nursing care following the local authority assessment. Or, if the individual is still living in their own home, this is the amount of their care costs that will be covered.
From 1 April 2025, the rates for Scotland are:
- £254.60 a week for personal care
- £114.50 a week for nursing care
This represents a rise of 2.37% for 2025-2026. This is in line with the GDP Deflator, the inflationary measure used by the Scottish Government to calculate Personal and Nursing Care payment rates.
During the Health, Social Care and Sport Committee’s consideration of the Amendment Regulations on 4 March 2025, the Minister for Social Care, Mental Wellbeing and Sport said:
“[…] we are operating in an extremely challenging financial context. As such, although there is no doubt that I would have preferred to increase it beyond that, it is simply not possible this year”
How are payments for personal care paid? Do they come directly from the Scottish Government to an individual?
Payments for personal care are statutory payments made by local authorities.
If an eligible individual stays in a care home, then their local authority will make the payment directly to the care home for any free personal care they are eligible for.
For people receiving care at home, personal care payments can be paid directly to individuals or to care providers. This all depends upon which option a person has chosen under Self-directed Support.
What is Self-directed Support and what are the different options?
Self-directed support (SDS) was introduced under the Social Care (Self-directed Support) (Scotland) Act 2013.
SDS aims to help people make informed choices and have greater control over how their care and support is organised and delivered. SDS covers all adult and children’s social care and support, not just care and support for older people. It is important to note that the 2013 Act did not introduce any new rights, although it does make reference to rights created elsewhere, such as the right to live with dignity, to participate in the life of the community and parental rights.
There are four options for self-directed support which the local authority is required to offer and discuss with everyone who has been assessed as needing care and support. The four options are:
Option 1 – the supported person receives a direct payment from the local authority. (It is important to note that this is not a social security benefit, which are governed by very different rules and legislation. Unlike social security benefits, direct payments are different from one person to another, and can be revised, and are not set out as set rates for everyone.) The local authority will decide how much money they will give to the supported person towards their support. The supported person receives this money and uses it to arrange their own support, which can include employing staff and/ or buying goods and services. With this option, the supported person has the most choice and control over how their outcomes will be achieved, but also has the most responsibility for arranging support, which may include employer responsibilities.
Option 2 – the supported person decides on the support they want, and support is arranged on their behalf. The local authority will decide how much money they will give to the supported person towards their support. The supported person can use the money to choose goods and services, for example from a registered support provider, and then the support is arranged on their behalf. This can be arranged by the local authority or a third party (such as a support provider) managing the money on behalf of the supported person. This way, the supported person has full choice and control over how their support is arranged but does not have to manage the money, or be responsible for employing someone.
Option 3 – after discussion with the supported person, the local authority decides and arranges support. The local authority will decide how much money can be spent to meet the assessed and agreed needs and outcomes. The supported person asks the local authority to choose and arrange the support that it thinks is right for them. With this choice the supported person is not responsible for arranging support, and has less direct choice and control over how support is arranged.
Option 4 – the supported person uses a mixture of ways to arrange their care and support. Some people will want to have direct control of how some parts of their support is arranged but not other parts. Option 4 lets the supported person pick the parts they want to have direct control over and what parts they want to leave to the local authority.
When do payments start?
The Scottish Government’s guidance on free Personal and Nursing Care payments states that:
“Payments will commence once the personal and/or nursing care service is being provided or when the supported person moves into a care home and is provided with personal and/or nursing care. It does not start before and will not be backdated for example, to the date of referral or assessment.”
Is there a set legal timeframe in which care assessments must be completed?
No, neither the Community Care and Health (Scotland) Act 2002, nor the earlier Social Work (Scotland) Act 1968 established a timeframe within which a care needs assessment must be completed.
The Scottish Government has set a waiting time target of providing personal care to adults assessed as having critical or substantial needs within six weeks of their assessment.
In the recently passed Care Reform (Scotland) Act 2025, section 27, yet to be commenced, would place a duty on Scottish Ministers to prescribe a timescale for assessments for those diagnosed with a terminal illness.
If someone feels that they have been waiting too long for an assessment they could lodge a complaint with their local authority. Details of how to complain are available on a council’s website.
Useful sources of further information
- SPICe briefing: Adult Social Care and Support in Scotland
- Scottish Government: Free personal and nursing care: questions and answers
- Care Information Scotland
Julia Hurst, Enquiries Officer and Anne Jepson, Health and Social Care Team
SPICe