What Decisions Can Be Made About Care Homes With an LPA?
From choosing a home to agreeing fees and treatment preferences, here’s what your attorney can and cannot decide.
Written by Anthony Dalton · Reviewed by James Tyrrell · Last reviewed
Care home decisions are among the most consequential an LPA attorney will ever face. They involve not just where someone lives, but how their money is managed, what treatment they receive, and who has a say in their day-to-day experience. The good news is that between a Health and Welfare LPA and a Property and Financial Affairs LPA, almost every aspect of care home life can be covered.
At a glance
- A Health and Welfare LPA covers decisions about care home placement, treatment preferences, and daily welfare.
- A Property and Financial Affairs LPA covers paying fees, managing assets, and dealing with local authority assessments.
- Having both types of LPA gives attorneys full authority over all aspects of care home decisions.
- Attorneys must always act in the donor’s best interests and consider their known wishes, values, and feelings.
Which LPA Covers Care Home Decisions?
Care home decisions split across both types of LPA. A Health and Welfare LPA covers the personal side — where the donor lives, the care they receive, what daily routines they follow, and who is involved in their life. A Property and Financial Affairs LPA handles the money — paying the fees, managing assets, and dealing with the financial side of moving into care.
This is one of the clearest reasons why having both types of LPA makes such a difference in practice. An attorney with only one type may find themselves unable to act on a major part of the decision.
Health and Welfare Decisions an Attorney Can Make
Under a Health and Welfare LPA, an attorney can make the following types of care home decisions when the donor lacks capacity:
Choosing a care home
Deciding which care home the donor should move into, taking account of their preferences, needs, and the quality of care available. This includes choosing between residential and nursing care.
Agreeing care plans
Participating in care planning meetings and agreeing to the day-to-day care the home will provide, including personal care, medication management, and activities.
Medical treatment decisions
Consenting to or refusing non-emergency medical treatment, unless the donor specifically granted life-sustaining treatment authority in the LPA.
Social contact and visitors
Decisions about who can visit the donor and their level of social engagement, though these decisions must always be made in the donor’s best interests and not used to isolate them.
Moving care homes
Deciding that the donor should move to a different care home if their current placement is not meeting their needs.
Financial Decisions an Attorney Can Make
Under a Property and Financial Affairs LPA, an attorney can handle the financial side of care home life:
- Paying care home fees — arranging regular payments from the donor’s bank account or assets
- Local authority assessments — dealing with means tests and financial assessments for council-funded care
- Selling property — if the donor’s home needs to be sold to fund care fees
- Managing investments and savings — drawing on assets as needed to meet care costs
- Accessing benefits — claiming Attendance Allowance or other benefits the donor may be entitled to as a care home resident
Key point: Care home fees in England can exceed £1,500 per week for nursing care. A Property and Financial Affairs attorney needs to understand the donor’s full financial picture to manage this properly and ensure nothing is missed.
What Attorneys Cannot Decide
Even with both LPAs in place, there are limits. An attorney cannot:
- Make decisions while the donor still has capacity — an LPA only operates when the donor cannot make a decision for themselves
- Refuse life-sustaining treatment unless this was specifically authorised in the LPA
- Act against the donor’s clearly expressed wishes without good reason
- Benefit financially from the arrangement unless the LPA permits it
- Ignore the care home’s own duties under safeguarding and care legislation
How the Best Interests Duty Shapes Care Home Decisions
Every care home decision made under an LPA must be made in the donor’s best interests. That sounds simple, but in practice it means weighing up a range of factors: what the donor’s past wishes were, what they would likely want now, their beliefs and values, their physical and emotional wellbeing, and the views of close family and carers.
If a family member disagrees with an attorney’s care home decision, or if the care home has concerns, the Office of the Public Guardian can investigate. Serious disputes can be referred to the Court of Protection for a ruling.
Key Takeaways
- Two LPAs needed — a Health and Welfare LPA covers personal care decisions; a Property and Financial Affairs LPA covers the money side. Both are needed for full authority.
- Health and Welfare authority — includes choosing a care home, agreeing care plans, consenting to treatment, and managing social contact.
- Financial authority — includes paying fees, managing local authority assessments, selling property, and claiming benefits.
- Best interests rule — all care home decisions must reflect what the donor would have wanted and what is in their genuine best interests.
- Disputes can be escalated — the OPG and Court of Protection can step in if attorneys and care homes disagree, or if concerns are raised about decision-making.
Common Questions About Care Homes and LPAs
Which type of LPA covers care home decisions?
A Health and Welfare LPA covers decisions about where someone lives and the care they receive. A Property and Financial Affairs LPA covers the financial side — paying the fees, managing assets, and dealing with local authority means testing. Having both gives full coverage.
Can a care home refuse to accept an LPA attorney’s decision?
A care home can raise concerns if they believe a decision is not in the resident’s best interests, but they cannot simply dismiss a valid LPA. If a serious dispute arises, the matter can be referred to the Office of the Public Guardian or the Court of Protection.
What if the person with the LPA cannot afford a care home?
A Property and Financial Affairs attorney can manage the donor’s finances to fund care, including dealing with local authority means-testing, selling property if needed, and managing ongoing fee payments. They may also be able to apply for local authority care funding on the donor’s behalf.
Can an attorney move a parent to a care home against their wishes?
Not if the person retains mental capacity — an LPA only operates when the donor lacks capacity. Even then, the attorney must act in the donor’s best interests, which includes considering what the donor would have wanted. Moving someone against their clearly expressed wishes would need strong justification and could be challenged.
This guide was last reviewed and updated on . Information is based on current legislation and OPG guidance for England and Wales.
Official Guidance
Relevant government resources
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