The community care link explains some of it.
The Penderels Trust, amongst others, is a service that will deal with some of the paperwork of being an employer.
Some of these services can be contracted out and many councils have commissioned support organisations to help service users handle these responsibilities.
- from communitycare link above
Basically it works something like this (this is an approximation of the case of J, who I did some work with two years ago):
J had an accident and was rendered paralysed from the waist down. Lives with his father who doesn't make a substantial wage, live in a very very modest house. After being discharged from hospital they needed services and adaptations.
GP refers to Occupational Therapy who come out and fit ramps to the steps up the front and install a wheelchair accessible platform lift in the lounge because stairs are an impossibility. Also there is a referral to social services, who come out and make an assessment of what J's needs are, they also assign him a worker who is tasked with helping him return to a normal life, look for social and educational opportunities. This worker also calls me in to help with the benefit situation.
I help him fill in forms for Disability Living Allowance, because he is paralysed he gets the highest rate of mobility component, which can be used to purchase an adapted car, or not, up to you. Because he is not continent and needs substantial help with his toilet needs, day and night, he also gets the highest rate of the care component of DLA. In total that's about £110pw, non-means tested.
Because he is getting above the middle rate of care, and his father is no longer working so is earning below the ceiling, his father can get Carers Allowance for looking after him. That's £53.10pw. Then there is Income Support, with various disability premiums added on to it. Housing Benefit too. If the person was working and making National Insurance contributions for a qualifying period then Incapacity Benefit (now called Employment and Support Allowance) is a possibility. Doesn't add up to a lot of money, but it's not bad, helps people a great deal.
Going back to the social services assessment - you have two basic options. You never see the money involved and social services purchase services for you. Alternatively, as in Direct Payments or Individual Budgets, you are given the money, you have to spend it on social care. You then employ people yourself, taking on the employers responsibilities, or you can pay some of the Direct Payment money to someone like Penderels who do the paperwork and take responsibility for making sure that the employers responsibilities and duties are met. Direct Payments give you the freedom to purchase the services you want and employ the people you want.
People of independent means have the freedom to bypass all this completely and purchase the care they want directly from their own pockets. Also, there are trusts, foundations and charities set-up to help people, usually something specific like a spinal injuries trust etc. There's a local trust that I know of that only makes payments to other small charities to help fund core admin costs, something that can be difficult to recover from projects funded by govt or big national organisations. Someone like Hawking may well have had a trust set up in his name to help cover some costs, the one area that fame may well have influenced his care - something that J doesn't get.
Bear in mind though that we are purely talking about social care and care at home. The care that Hawking receives in an NHS hospital is not dependent on any of the above.
On the subject of the IBD editorial - we haven't established where exactly the day to day care he is getting now comes from or how it is funded. The above should show that a very significant level of social care is possible without being independently wealthy, the govt's care agenda is all about independent lives and choice, but this is not the NHS it's a different structure.
We have established though that Hawking developed his ALS long before he was well-known, he was still a graduate student, much NHS care would have been necessary. He did survive.