PART 7Payability when person is residing in certain accommodation or is detained in custody

Payability exceptions: care homes and hospitals30

1

Subject to the following paragraphs, regulation 28(1) or, as the case may be, regulation 29(1) does not apply to C in respect of the first 28 days of any period during which C is someone to whom that regulation applies.

2

Where, on the day on which C’s entitlement to personal independence payment commences, C meets the condition in section 85(2) of the Act (care home residents: costs of qualifying services borne out of public or local funds) or section 86(2) of the Act (in-patient treatment: costs of treatment, accommodation and related services borne out of public funds), paragraph (1) does not apply to C in respect of any period of consecutive days, beginning with that day, on which C continues to satisfy that condition.

3

Regulation 28 or, as the case may be, regulation 29 does not apply where C is residing in a hospice and is terminally ill, and the Secretary of State has been informed that C is terminally ill—

a

on a claim for personal independence payment;

b

on an application for a revision or a supersession of an award of personal independence payment; or

c

in writing in connection with an award of, or a claim for, or an application for a revision or a supersession of an award of, personal independence payment.

4

In paragraph (3), “hospice” means 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, other than —

a

a health service hospital in England (within the meaning of section 27532 of the National Health Service Act 2006);

b

a hospital in Wales vested in –

i

an NHS trust;

ii

a Local Health Board; or

iii

the Welsh Ministers,

for the purpose of functions under the National Health Service (Wales) Act 200633;

c

a health service hospital in Scotland (within the meaning of section 108(1)34 of the National Health Service (Scotland) Act 1978);

d

a hospital maintained by the Defence Council; or

e

an institution similar to a hospital mentioned in any of the preceding sub-paragraphs of this paragraph.

5

Regulation 28(1) does not apply to a case where, during any period the total cost of the qualifying services35 are met —

a

out of the resources of the person for whom the qualifying services are provided, or partly out of that person’s own resources and partly with assistance from another person or a charity36; or

b

on that person’s behalf by another person or a charity.

6

In this regulation —

  • NHS trust” means a body established under section 18 of the National Health Service (Wales) Act 2006; and

  • “Local Health Board” means a body established under section 11 of that Act.

7

In the application of these Regulations to Scotland, “charity” is to be construed as if these Regulations were an enactment to which section 7 of the Charities Act 201137 (application in relation to Scotland) applied.