Arranging Care and Help at Home
There are many people who might benefit from extra support at home or who have a friend or relative in need of help. The right care and support can make the difference between staying in your own home and having to move somewhere else.
The information below gives an overview of the different kinds of help that are available‚ how to arrange them and what assistance might be available with the cost:
Local authority social services departments
If you are having difficulty coping at home, you should get in touch with your local authority social services department, or your family doctor (GP), to see if they can give you some advice or support. The first step towards getting help from social services is to ask that the authority carry out a care (or needs) assessment. This is the process by which the social services department finds out about the sort of help and support you may need. The local authority is obliged to carry out an assessment of your needs if you appear to be someone who might need the type of assistance it can provide.
Each local authority sets ‘eligibility criteria’ that are used to decide who qualifies for services provided or arranged by the authority. They should publish information about these criteria. Your needs are assessed against the eligibility criteria and if they meet the criteria for a particular service, social services must provide it.
If you have a carer (someone who helps look after you), your carer should, with your permission, be involved in your assessment. Under the Carers and Disabled Children Act 2000, carers have the right to an assessment of their own needs, even if the person cared for does not want one. A carer in this context is someone who provides - or intends to provide - ‘substantial and regular’ care, under the Carers (Recognition and Services) Act 1995. It does not include those who provide care on a professional basis.
If you are not satisfied with the assessment or are unhappy with the decision reached, you can make a complaint through the local authority’s complaints procedure. Each authority must have a designated complaints officer who can provide you with further information about the complaints procedure. As well as using different eligibility criteria, individual local authorities can also adopt different ways of delivering services. The authority can provide services directly using its own staff or may arrange for services to be provided by another organisation such as a charity or a private agency. They do this by making a contract with the organisation for the service.
Charges for local authority services
Each local authority has the power to charge for the home care services which it provides and virtually all do so. When setting their charging policies, authorities have to respect certain minimum requirements set out in guidance issued by the Government.
Direct Payments
Local authorities can also make Direct Payments, whereby service users are provided with funds to purchase care themselves. A Direct Payment is money given to an individual to arrange the community care services that they have been assessed as needing, instead of the local authority providing or arranging the services itself. We can help you employ your own Personal Assistant, (PA), through our recruitment agency website, www.sunshinepersonnel.co.uk.
Local authorities are required to offer Direct Payments to older people who meet certain criteria. To be eligible for Direct Payments you must be able to manage the payment, alone or with assistance. You cannot be forced to use Direct Payments if you would rather the authority arranged or provided your services. Some services, such as permanent places in care homes, are excluded from Direct Payments. Directs Payment can only be used to meet the person’s needs as assessed under the local authority’s eligibility criteria. Ask your local authority for further information about its Direct Payments scheme.
Care Support: Finding the Right Advice
Coming to terms with the fact that a loved one may need additional support can be difficult and the types of care available can be confusing.
What you need is practical advice on matters that are important to you, the carer, such as which care solution is right for you both, where you can apply for care funding to assist with care fees, to finding care support.
Care support ranges from short-term respite care at home to give carers a much needed break from their role, to live-in care; support from a fully-trained and assessed live-in carer who can be on hand 24 hours a day, 7 days a week if needed.
www.Support4Homecare.co.uk offers Bespoke Care Advice
You needn’t muddle your way through the maze of care solutions and their associated costs, because help is at hand. www.Support4Homecare.co.uk can help guide you through the options for live-in care funding and home care funding. Each family has different circumstances, needs and requirements so Support 4 Homecare offers useful, tailored advice to help carers explore what care funding options may be available.
Gaining supportive advice on care fees can make all the difference to the quality of your loved one’s life and could even make it possible for them to stay in their own familiar and comfortable surroundings.
If you are a carer and you need advice to help you give the best care that you can to your loved one, then contact www.Support4Homecare.co.uk for help.
Each member of our team will pull out all stops to ensure that we supply you with the nurse, care worker, or other health and social care professional, whose skills and experience match the requirements of the person who requires our service.
We are available to you 24 hours a day, 365 days a year.
Equipment and adaptations
There is a wide range of disability equipment available to help people who have difficulty carrying out particular tasks. Adaptations are changes made to your home to enable you to live independently. These could include alterations to the building such as widening a door for a wheelchair or the installation of equipment such as stair or grab rails, handles in the toilet or bathroom, or a ramp to the front or back door. We can help with advice and equipment assessments through Sunshine Mobility; www.sunshinecaresupplies.co.uk.
You can request that the local authority arrange an assessment by an occupational therapist to help identify how your needs could best be met. Equipment is provided free of charge but you may have to contribute towards the cost of adaptations. Presently, adaptations provided by the local authority costing less than £1000 are free of charge. Assistance with more expensive adaptations is provided through Disabled Facilities Grants. These grants are means-tested. Some aids may be available on loan from the British Red Cross, your local Age Concern, the Women’s Royal Voluntary Service (WRVS) or other organisations.
The Government is planning to introduce a new ‘retail model’ for the provision of community equipment in England. This is intended to offer service users greater choice and control over the equipment they can obtain.
There is a charity called the Disabled Living Foundation which can provide further information about different types of equipment
Alarm systems
Some older people who live alone or who cannot get out appreciate the security of knowing that they can contact someone in an emergency. Many different kinds of personal alarm schemes are available. It is worth checking whether the local authority offers any assistance with arranging and paying for an alarm system. A factsheet on alarm systems can be obtained from the Disabled Living Foundation
Day care
Day care is care provided outside the home in a day centre or other establishment. The type of care offered can range from a chance to meet other people, to share activities and a meal, to specialist care, for instance for people with dementia. Ask what is available in your area. If social services run the day centre, or subsidise it financially, you might have to be assessed as needing the service under the local authority’s eligibility criteria to be able to attend. Other organisations, such as local Age Concerns, may run day centres which are open to all older people. If you feel that there is a need for a particular kind of care, ask whether it might be arranged.
Personal care
Personal care is help with tasks such as getting up and dressing, washing and bathing and getting ready for bed. The local authority is sometimes the main provider of personal care, employing care workers directly or commissioning services from private agencies and voluntary organisations.
Individual Budgets
The introduction of Individual Budgets may have an effect on the way that personal care services are provided. There is likely to be an increase in the use of Personal Assistants, ( PA’s ), as service users exercise more choice and control over who actually provides these types of services. The Government has recently been working towards greater ‘personalisation’ in the provision of services in social care. This will have an effect on the way that services such as equipment provision are provided by local authorities and the NHS. At the heart of this is the plan to introduce Individual Budgets. Individual Budgets are a method of self-directed support similar to Direct Payments. However, they can include more than just personal social care services, which Direct Payments presently cover. For example, funding streams from community equipment and the Disabled Facilities Grant may be included in an upfront and transparent provision of funding. The aim is to provide the flexibility to allow those who are satisfied with their existing arrangements to carry on with them, whilst giving others the opportunity to build up more individually tailored support services.
Attendance Allowance
There is a benefit called Attendance Allowance that is paid to people over 65 who need certain levels of personal care. A similar benefit called Disability Living Allowance is available for the under 65s.
Laundry
Some social services departments provide a laundry service for people with incontinence, or who cannot manage their laundry for other reasons. Ask if such a service is available in your area.
Meals at home
Individual local authorities will have their own arrangements for providing meals at home. In some areas the scheme will be run by the local Age Concern or Women’s Royal Voluntary Service (WRVS) organisation on the authority’s behalf. Many offer meals for people with special diets. Some provide a freezer for people at home, and then deliver frozen meals so that people can heat their own, using a microwave or steamer (which may also be supplied) when they wish. Meals may be offered any number of days per week. What is available to you will depend on your needs and on the policy of the local authority.
Respite care
Respite care usually consists of extra services provided for a limited period of time to allow the cared-for person, or their carer, to have a break from their usual routine. It may take the form of increased support in the home or of a stay in a care home. It could be for a night, or a day, or a longer period such as a week or two weeks. If your carer needs a break they can ask social services for a carer’s assessment. Vouchers may be available from the local authority to assist with the cost of care needed while the carer has a break. Further information for and about carers is available from Carers UK. We supply Respite Care at Home through our Live in Care service, www.sunshinecare.co.uk and Respite Care in our Residential Care Services, such as www.retreatcare.com.
Community health services
Your family doctor (GP) should be able to put you in touch with community health services. If necessary, arrangements can usually be made for you to be seen at home.
Services which may be available include:
District or Community Nurse or Health Visitor;
Chiropodist;
Continence Advisor;
Physiotherapist;
Community psychiatric nurse;
Hospice at home or Macmillan nurse;
Intermediate care.
NHS Direct is a telephone advice and information service staffed by experienced nurses. It provides advice and information about health, illnesses, and health services. NHS Direct is available throughout England by calling 0845 46 47 (lo-call rate) or at its website: www.nhsdirect.nhs.uk.
Locally there should be a Patient Advice and Liaison Service (PALS) to provide support and information about health services to patients, carers and families in the area.
Intermediate care services are provided for limited periods, usually of no more than six weeks, to prevent people from having to go into hospital, or having to stay in hospital unnecessarily. The service might be provided at home or in a care home.
Specialist nursing or care at home for people with a terminal illness may be available through Macmillan nurses provided by Cancer Relief, Marie Curie Foundation nurses or from a local hospice. Ask your doctor if there is local support of this kind.
Finding a care worker
You can find a care worker through an agency or by employing someone directly. Remember that if the local authority has assessed you as needing services it has a responsibility to ensure that those services are available to you. This means providing or arranging services for you if necessary. If you want to directly employ a Personal Assistant, (PA), we can help you through our Recruitment Agency website: www.sunshinepersonnel.co.uk; or through our Domiciliary Care Agency services website: www.sunshinecare.co.uk.
Employment agencies
Agencies that provide nurses or care workers who carry out personal care tasks have to be registered with the Care Quality Commission. Agencies are regularly inspected by the Commission to ensure that they comply with national minimum standards for this type of care provider, including requirements to provide detailed information about their services and to have written contracts with users. CQC can provide lists of agencies in your area. It is important to be clear about the type of help that you need in order to establish whether a particular agency and its staff can meet your needs.
A local authority needs assessment can be useful for this, even if you do not want the authority to arrange your services.
Discuss with the agency how your needs can best be met. For example, depending upon the level of care you need, it may not be possible for one person to provide it all. A planned rota of workers can help to minimise disruption and provide continuity.
Employing a care worker yourself
You can employ a care worker (or other help) directly rather than go through an agency. This can be complicated and it is important to be clear about what you are taking on, particularly in relation to any contract of employment and possible financial commitments such as National Insurance contributions, sick pay and holiday pay. For more information see www.sunshinecare.co.uk.