OPTIONS A guide to care and independent living
Peterborough Winter 2017
Leaving hospital What’s next?
NHS continuing healthcare Who’s eligible?
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SOCIAL CARE
tips
FREE
guide CONTRIBUTORS: Age UK Cambridgeshire & Peterborough Alzheimer’s Society North West Anglia NHS FT NHS Choices Rutland County Council
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Contents The right place for your care.............................................................................................. 4-5 Help and advice while in hospital......................................................................................... 5 Leaving hospital.................................................................................................................. 6-7 Your experience as our patient at Peterborough City Hospital and Stamford Hospital... 8 Intermediate care................................................................................................................... 8 Hospital at home service........................................................................................................ 9 Community Matron service................................................................................................... 9 District nursing....................................................................................................................... 9 Reablement............................................................................................................................ 9 Keeping healthy.............................................................................................................. 10-11 When you need urgent help............................................................................................... 12 Mental health and wellbeing.............................................................................................. 13 Self-refer to Psychological Wellbeing service..................................................................... 13 Healthy and Independent in Rutland................................................................................. 14 The Care Quality Commission Social Care Top Tips............................................................ 15 NHS continuing healthcare............................................................................................. 16-18 Personalised care............................................................................................................. 19-20 What is NHS-funded nursing care?..................................................................................... 21 Paying for your own care and support.......................................................................... 22-23 Care services in your home............................................................................................. 24-25 The Motability Scheme........................................................................................................ 26 Alzheimer’s Society Services in Peterborough............................................................... 28-29 Age UK Cambridgeshire & Peterborough Services....................................................... 30-31 NHS hospitals and services in Peterborough...................................................................... 32 Useful contacts..................................................................................................................... 33
Welcome and
introduction
This guide is intended to help you, your carer and your relatives understand how your local health services can help you after discharge from hospital. Also information to help you to live independently or access support and care services in your area.
OCTAGON DESIGN & M ARKET I NG LTD
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The right place
for your care
This hospital, in partnership with other hospitals in the region, and your local authorities, recognise and support each patient to receive the right treatment, at the right place and by the right professional. An acute hospital Trust is a hospital that provides consultant-led health services within the National Health Service. Acute care is for patients who require emergency, medical or surgical services within a hospital environment. North West Anglia NHS Foundation Trust provides care for patients who require this level of care. Hospitals are the right place to be when you are in need of specific medical or surgical treatment. However, when your treatment has been completed, it is important that your stay is not delayed for the following reasons:
A ssess what your needs are likely to be when you are ready to leave. I nvolve relevant staff who can help in meeting those needs (e.g. social worker, occupational therapist, physiotherapist, district nurse)
S taying in hospital increases the risk of infection, muscle wasting and loss of independence.
M ake arrangements for equipment or services which need to be in place when you are medically ready to leave.
S ome people find it harder to return home the longer they stay in hospital due to loss of confidence and worry about being able to manage.
M ake sure that your carer is given any information, help or advice that is needed to aid your recovery.
B eds are needed for people who are very unwell, and who may be waiting in the Emergency Department for a bed to become available. P eople awaiting surgery, both urgent and non-urgent, may have their operations cancelled if a bed is unavailable. 4
It is good practice to start planning for your discharge as soon as you come into hospital or even before you arrive. This means that we can begin to:
All staff will work with you, and your carer or relatives, as a team, in order to discuss your discharge with you. We need to discuss any concerns you have at the earliest opportunity, e.g. your
safety at home, managing your personal care or domestic arrangements, your ability to move around and any equipment you may need. You will be given a predicted date for discharge based on when it is expected that your treatment will be completed. It is important that everyone involved is aware of this date so that we can all work towards it, and so that the necessary arrangements can be made.
These may include: Transport home. Patients will be expected to arrange their own transport when leaving hospital. See page 7 for more information. You will need: Suitable clothing and footwear if you are not already using them in hospital. Access to a key to your property. Adequate basic food stocks. Adequate heating in your home. A dequate support for your carer or family members.
A supply of your current medication will be ordered from the Hospital Pharmacy and delivered to you before you leave the hospital. If you have any questions or concerns about your medication please ask to speak to your pharmacist or a member of the nursing team. Relatives or carers coming to collect you can meet you on the ward, or a nurse can escort you to the main reception area. Finally, we understand that any hospital stay can be stressful and we need to support you and your relatives/carer during your time here. For most patients, being discharged from hospital to their home is straightforward. Some may need information and advice, or may need the support of social care from the local council. Some people have ongoing health, care and support needs which require a more detailed assessment. Staff from health and social care will work together to plan and deliver services to support people after discharge. Sometimes it is necessary to move to an interim destination whilst awaiting a care package or care home of choice. It is not possible to stay in hospital until such arrangements are in place. The hospital discharge team will arrange your interim destination for you. This guide explains some of these processes and explains the role of the hospital and social care team in the hospital discharge process, as well as the help and support available to you following your discharge.
Help and advice while in hospital If you or your family have any questions, worries, or you do not understand what is happening at any stage during your hospital stay, please speak to your nurse, doctor or ward manager. They will be happy to discuss any aspects of your care to ensure that you are fully prepared to be discharged. After discharge, if you have any concerns about your condition please contact your GP surgery. If you have any concerns about your medication, you can speak to your local pharmacist in the first instance.
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Leaving
hospital We aim to tell you a predicted discharge date and time within 24 hours of your admission to help you and your carers make arrangements to ensure the services you need are available. The date will be reviewed with you by the consultant on their ward round. Sometimes discharge dates need to change and when this happens we will give you as much notice as possible. If this happens, please share this information with your relatives and/or carers.
Where will I be discharged to? You will normally be discharged to your home address. However it may be necessary to transfer you to another facility to continue your care once you no longer need to stay in hospital. This place of care could be anywhere in your local authority area. We recognise that some people might lose confidence and become more dependent whilst in hospital, but we will work with you to maintain your independence. If additional support is needed after your hospital care, we may ask for your care to be 6
transferred to a community setting. The doctors, nurses and therapists involved in your care will discuss the following with you: ď Ź Are you able to return to your own home?
D o you need a short period of rehabilitation/intermediate care?
What happens on the day of my discharge?
D o you need nursing or social care support at home?
Leaving the ward: Unless otherwise informed, we will aim to discharge you by 10am. We will ensure that you are ready so that your bed can be prepared for a new patient. We will liaise with you and your relatives/carers about your discharge time.
D o you need to move into a care home rather than return home? We will liaise with social care and confirm these details with you.
Getting your medicines: Prescribed medication will be obtained for you to take home, if required. You may hear the ward nurses or doctors refer to these as ‘TTOs’. This stands for 'Tablets to Take Out'.
How you can help with your discharge from hospital
Any remaining medicines that you brought in to hospital with you will be returned to you (unless they are no longer needed and will be destroyed with your permission).
You have the most important part to play, and you can help us in several ways. We ask that you: T hink carefully about going home again and tell the ward staff without delay if you think there may be problems. T alk to your family or friends if you think you might need some support at home. A sk for a Social Worker to see you if you think you may need more support when you leave hospital with everyday tasks such as preparing food and shopping. E nsure that you have day clothes, shoes and a coat ready so that you can leave hospital fully dressed and comfortable. A rrange with family/friends or a carer to collect you from hospital at the agreed time. If you do not have anyone who can collect you and you are fit and able, the ward can arrange a taxi for you – please let staff know if that is the case. More information on transport is on the right.
A registered nurse will explain any new medication to you, identify any possible side effects and discuss with you how to obtain further supplies. Written information on potential side effects is also contained within each tablet packet. Your discharge letter: A discharge letter explaining your care and treatment and a list of your medications will be given to you and a copy sent to your GP electronically, or by post. We may lend you hospital equipment for short-term use at home. Please return it to the hospital as soon as possible when you no longer need it so that we can use it for other patients. If you need a follow-up appointment we will make this before you leave, or, if appropriate, we will write to you. If an appointment has not arrived within three weeks, please contact the outpatient appointments call centre on 01733 673555. Transport: Wheelchairs are available for use within the hospital and can be collected from the reception area in the atrium by the front entrance. We ask that you make your own arrangements for transport home. We can arrange taxis with a reputable firm if necessary, but you will need to pay for this, so please ensure you have enough money to pay the driver directly. Hospital transport is only provided if you meet specific clinical criteria which will be assessed by staff. Where transport is provided, please be aware that relatives and carers are not normally able to travel with you as this incurs an extra charge to the hospital. Information about Non-Emergency Patient Transport Services, including the eligibility criteria, can be found on Cambridgeshire and Peterborough Clinical Commissioning Group’s website at http://www. cambridgeshireandpeterboroughccg.nhs.uk/your-health-andservices/other-local-services/non-emergency-patient-transport/ 7
Intermediate care Your experience as our patient at Peterborough City Hospital and Stamford Hospital Tell us about your experience in our hospital. Your feedback is very important to us. You can tell us what you think in various ways: C omplete the patient feedback card that will be given to you on the ward. What you tell us about your hospital stay will be used to improve the experience our patients receive in the future. We would really appreciate you taking the time to fill out the ‘I Want Great Care’ questionnaire and handing it back to a member of ward staff before you go home. A lternatively, you can provide online feedback via the I Want Great Care website. (www.iwantgreatcare.org) I f you have a concern or complaint that has not been addressed by the ward team, or if you want to pass on praise or good comments about your treatment, please contact our Patient Advice and Liaison Service (PALS). The PALS team is located at the desk at the bottom of the lifts in the main atrium at Peterborough City Hospital. They can be contacted by telephone on 01733 673405 (between 8.30am and 4.30pm, Monday to Friday) or via email: PALS@pbh-tr.nhs. uk. Alternatively, you can write to them at: PALS, Department 003, Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough, PE3 9GZ. 8
If you are well enough to leave hospital, but need extra support before you can return home or once you are home, the Intermediate Care Team at Cambridgeshire and Peterborough NHS Foundation Trust can help. The Intermediate Care Service is for anyone over the age of 18 who is registered with a GP in the Peterborough area. Care can be provided in your own home or in one of the Intermediate Care Units, based at the City Care Centre, Thorpe Road, Peterborough, North Cambs Hospital, Wisbech or Princess of Wales Hospital, Ely. Intermediate Care is short-term support which aims to enable you to reach your maximum level of independence, through assessment and rehabilitation. The team is made up of nurses, physiotherapists, occupational therapists, GPs, therapy support workers and health care assistants. The Intermediate Care Unit (City Care Centre) is a modern, purpose-built 34 bed unit equipped with a wide range of facilities, including a gym, and a roof garden. The unit is made up of single rooms, each with a shower and toilet. All meals are provided, with a large menu to choose from each day. You will be encouraged to wear day clothes. There is also access to a small shop and cafeteria for yourself and visitors. Once admitted to the service you will be encouraged to develop goals and work with the team to achieve them. The team will be responsible for discussing how you will manage at the end of your stay and making any onward referrals, for example to social care for a longer term care package.
Hospital at home service The Hospital at Home service, aims to help people leave hospital early and prevent further hospital admissions. Patients receive the service if they require rehabilitation, if they have become unwell or if they are reaching the end of their life and require support to remain at home at this time. The service is delivered by a team of specially trained healthcare assistants who help to deliver care plans formulated by GPs, district nurses, physiotherapists and
occupational therapists. The healthcare assistants can perform tasks such as washing, dressing and help with meals and toileting, but the Hospital at Home staff can also support physiotherapy and occupational therapy programmes. The Hospital and Home service is provided by Cambridgeshire and Peterborough NHS Foundation Trust, but is supported by the charitable efforts of the Hospital at Home Friends Group.
Community Matron service If you have a number of long term conditions, such as diabetes, arthritis or heart disease, which put you at risk of needing further hospital care, you may be referred to the Community Matron Service operated by Cambridgeshire and Peterborough NHS Foundation Trust.
Community Matrons work with you to help coordinate your care with everyone involved and help you to manage your health. The matron can make a full assessment of your needs, help to co-ordinate the services you will receive and can work with your doctors to give you help and advice on how to manage your conditions.
District
nursing District nurses assess, plan and provide nursing clinical care in a patient’s own home if you are housebound. If, on discharge from hospital, you still require nursing care, for example for treatment following an operation, you may receive care from a district nurse.
Your matron will develop a care plan, with your input, which will outline your needs, the services you require, the goals you are working towards and what to do if your conditions get worse.
Reablement Reablement is short-term support designed to help people over the age of 18 increase their independence at home which they may have lost as a consequence of poor health, disability, an accident or a stay in hospital. This can include help with personal care, preparing meals and improving mobility. An Occupational Therapist will visit soon after reablement starts to discuss how best he/she can support you. Together, you will agree goals to work towards with your support workers. At first, you may need a number of visits per day, but as you progress this may reduce. Your progress will be reviewed regularly. A reablement programme can last anywhere from 6 hours to 6 weeks, depending upon the need. For further information, email: adultsocialcare@peterborough.gcsx.gov.uk or call 01733 747474. 9
Keeping healthy Taking care of yourself
painkillers
There are some simple steps you can take to look after yourself at home. This could range from managing a long-term condition, taking medication when needed or managing a cold to eating well and being active.
anti-diarrhoeal tablets/oral rehydration salts
There are lots of minor conditions you can treat at home using just your medicine cupboard and plenty of rest. These include coughs, colds, headaches, sore throat, minor cuts and grazes, bumps and bruises, indigestion and mild diarrhoea. It’s a good idea to have a medicine cabinet where you can keep some basic medication. In doing so it might save you going out if you’re not feeling well, or if the weather is bad. The following medicines might be useful:
plasters and bandages bite and sting relief spray or cream antiseptic cream indigestion treatment a thermometer cough medicine antihistamine medicine suncream Always follow the directions on medicine packets and information leaflets, never exceed the stated dose and make sure the medicine is not out of date.
Your local pharmacy Some of the things your pharmacy can help with includes aches, pains, stopping smoking, medicines advice, hay fever, coughs, colds, diarrhoea, allergies, skin conditions and flu jabs. You can talk to your pharmacist in confidence and you don’t need to make an appointment. It is possible to walk into any community pharmacy and ask to speak with the pharmacist. They may be able to spend some time with you or offer you an appointment for a consultation. All the discussions with your pharmacist can take place in person or by phone. Most pharmacies have a private consultation area where patients can discuss issues with pharmacy staff without being overheard by other members of the public.
Your local GP GPs, or General Practitioners, deal with a whole range of health problems. They also offer advice and run clinics, give vaccinations and some carry out simple surgical operations. You would normally see a GP or other healthcare professionals at their surgery. 10
If you have an illness or injury that won’t go away make an appointment with your GP or telephone for advice. They provide a range of services by appointment and, when absolutely essential, can make home visits. Some things GPs can help with are flu jabs, persistent ear pain, persistent back ache, persistent vomiting or diarrhoea, allergic reactions, long-term conditions, counselling and emotional problems.
Preventing falls There are several measures you can take to help prevent a fall. Simple, everyday measures around the home include: mopping up spills to avoid wet floors g etting help lifting or moving items that are heavy or difficult to lift removing clutter, trailing wires and frayed carpet using non-slip mats and rugs u sing high-wattage light bulbs in lamps and torches so that you can see clearly o rganising your home so that climbing, stretching and bending are kept to a minimum and to avoid bumping into things
such as a chair or bed. Hold on to the furniture with both hands to support yourself and when you feel ready, slowly get up. Sit down and rest for a while. If you are hurt or unable to get up, try to get someone’s attention by calling out for help, banging on the wall or floor or using your aid call button (if you have one). If possible, crawl to a telephone and dial 999 for an ambulance. Try to reach something warm to put over you, particularly your legs and feet, such as a blanket or a dressing gown. Stay as comfortable as possible and try to change your position at least once every half an hour or so.
Travel carefully in icy weather Icy pavements and roads can be very slippery. Take extra care if you go out and wear boots or shoes with good grip on the soles. Put grit or cat litter on your paths and driveway to lessen the risk of slipping. You should wait until the roads have been gritted if you’re travelling by car. Bear in mind that black ice on pavements or roads might not be clearly visible, and that compacted snow may turn to ice and become slippery.
g etting help to do things that you are unable to do safely on your own not walking on slippery floors in socks or tights n ot wearing loose-fitting, trailing clothes that might trip you up w earing well-fitting shoes that are in good condition and support the ankle t aking care of your feet by trimming toenails regularly, using moisturiser and seeing a GP or chiropodist about any foot problems
What should you do if you have a fall? If you have a fall, it is important to keep calm. If you are not hurt and you feel strong enough to get up, get up slowly. Roll onto your hands and knees and look for a stable piece of furniture, 11
When you need urgent Out of hours GP service Sometimes you might need to see a GP urgently in the evenings or at weekends. If your usual GP practice is closed then it’s still possible to see a GP or get advice from the GP over the phone. To contact an out of hours GP, just call 111 and you will be connected to the NHS 111 service, which can help you access the out of hours services across Cambridgeshire and Peterborough. NHS 111 is the phone number to call when you need medical help or advice urgently, but it’s not a life-threatening situation. Calling 111 will connect you to a team of fully trained call advisers, who are supported by experienced nurses and paramedics. They will ask you questions to assess the symptoms, and give you healthcare advice or direct you to the most appropriate and available local service. You should use 111 if: it’s not a 999 emergency y ou think you need to go to A&E or another NHS urgent care service but you’re not sure y ou don’t think you can wait for an appointment with your GP you don’t know who to call for medical help When an ambulance is required, they will dispatch one immediately – just as if you had originally dialled 999.
Minor Injury Units If your injury or illness is not serious, you can get help from your local Minor Injury Unit rather than going to an A&E department. These offer convenient access to treatment for a range of minor illnesses and injuries. Conditions that can be treated at the Minor Injury Units include wounds, bites, minor burns and scalds, eye problems, earache, and minor head injuries (with no loss of consciousness). 12
help
Peterborough Minor Illness and Injury Unit Also provides X-rays, wound stitching and applications of casts City Care Centre, Thorpe Road, Peterborough PE3 6DB. Tel: 01733 293 800. Opening hours: Monday-Sunday, 8am-8pm.
Stamford Hospital Minor Injuries Unit Ryhall Road, Stamford, Lincolnshire, PE9 1UA. Tel: 01733 678000 Opening hours: Monday-Friday, 9am-5pm.
North Cambridgeshire Hospital Minor Injuries Unit The Park, Wisbech, PE13 3AB. Tel: 01945 488 068. Opening hours: Monday-Friday, 8.30am-6pm; Closed Saturday, Sunday and Bank Holidays. MIU X-ray: Monday-Friday, 9am to 4.45pm.
Doddington Community Hospital Minor Injuries Unit Benwick Road, Doddington, PE15 0UG. Tel: 01354 644 243. Opening hours: Monday-Friday, 8.30am-6pm; Saturday, Sunday and Bank Holidays, 9am-5pm; Closed Christmas Day and New Year’s Day. MIU X-ray: Monday-Friday, 9am-5.45pm, Saturday 1pm-5pm and Sunday 1pm - 4.45pm.
Emergency department (A&E) or calling 999 You should only go to the Emergency Department or call 999 when it’s a critical or life-threatening emergency. Dialling 999 and stating that it’s an emergency situation will result in an ambulance being sent out to you. Emergency situations include: stroke, overdose, choking, blacking out, open wound with blood loss, loss of consciousness, acute confused state, fits, severe allergic reactions, breathing difficulties and persistent, severe chest pain. If you think you or someone else is having a heart attack then dial 999 straight away.
Mental health and
wellbeing
Depression and anxiety can affect anyone. People with depression frequently also suffer from anxiety. Depression: If you are depressed it is likely that you will have a loss of interest or pleasure in normally enjoyable activities. Symptoms include:
Diet - Eating a well-balanced diet and reducing the amount of sugar and caffeine in your diet can help.
too much or too little sleep changes in appetite and weight feeling irritable or anxious loss of energy feeling sad, guilty or hopeless
Alcohol - Alcohol does not help with depression and can make it worse. People suffering from depression should stop drinking alcohol.
Anxiety: Anxiety creates an unpleasant feeling that is typically described as uneasiness, fear, or worry. You may also get tiredness, headaches and sweating. Lifestyle changes are simple but an effective way to treat depression or anxiety. Sometimes they might be all you need. Even if you need other treatment as well, lifestyle changes go a long way toward helping lift depression. Lifestyle changes include: E xercise - It stimulates the body to produce hormones that prevent depression. Taking exercise can increase self-confidence and, if you join an exercise class, it can also improve your social life.
Sleep - It is very important to make sure that you are getting the amount of sleep you need because poor sleep has a strong effect on mood. Make sure you are relaxed before you go to bed, have a warm, milky drink and make sure that your bedroom is not too cold or too hot. Social support - Keeping in regular contact with friends and family can help or consider joining a class or group. If you are able, volunteering is a wonderful way to help others while also helping yourself.
Self-refer to Psychological Wellbeing service Cambridgeshire and Peterborough Foundation Trust provides a Psychological Wellbeing service that people can self-refer to. This service is set up to help those aged 17 and over who are suffering from mild to moderate depression and anxiety disorders including generalised anxiety, social anxiety, post traumatic stress, health anxiety, panic, phobia or obsessive compulsive disorder. Appointments are offered throughout the day, from Monday to Friday. Call 0300 300 0055. Lines are open from 9am to 5pm, Monday to Friday, excluding Bank Holidays.
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Healthy and Independent in Rutland
Rutland Health and Adult Social Care services are working closer together, including with the Voluntary and Community sector, to ensure that all Rutland residents are able to enjoy the best health and well-being throughout their life. The aim is to be able to access the right support and information to help manage, reduce, prevent or delay the need for care. All Rutland residents admitted to hospital will be supported to return home. A member of the Rutland Integrated Hospital Team will contact you to offer support for your transfer from hospital. Alternatively, you can contact the Team by calling 01572 722 577. The Rutland Hospital Team will support you to return home and can help you to think about your safety at home, managing personal care and domestic arrangements and your ability to move around. The Rutland Hospital Team will work with you to plan the next steps. Our aim is to get you home and back into your usual routines as soon as possible. If you cannot return directly home, for example because you are not mobile, you may continue your recovery in a community hospital or care home bed in or near Rutland. Wherever your next destination, you might also be offered a short course of therapy to give you the skills and confidence to thrive at home. ‘Rehabilitation’ is exercise helping to rebuild your strength and movement, while ‘reablement’ helps 14
you to learn new ways to accomplish day to day tasks that you might now find more challenging. The professionals working with you will explain what to expect from your personalised therapy programme and how long it will last, and will agree the aims with you. Depending how you get on, your therapy plan may be adjusted in duration, scope or intensity. If you would like to talk about what support may be available to help you to manage at home, you can contact Rutland’s Social Care team by calling 01572 722 577. Sometimes, you might just want a bit of support and advice, for example if you are living with a health condition, dealing with housing or financial issues, or even just feeling a bit isolated. You can also contact the Rutland Community Wellbeing Service who will be able to help you find solutions that work for you. Contact them on 01572 725 805 or by emailing info@rutlandrap.org.uk You can also find many support services and local organisations on the Rutland Information Service (RIS) website: ris.rutland.gov.uk
The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care. We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one. You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia. We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided. You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care. You can also call us to share an experience of care on 03000 61 61 61. Here are some tips to help you choose your care.
Social care Top tips 1
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The Care Quality Commission (CQC) registers all care homes and home care agencies. You can find out which ones support specific groups of people, such as people with a learning disability or those living with dementia. CQC’s Chief Inspector for Adult Social Care, Andrea Sutcliffe always uses ‘The Mum Test’: is a care home safe, caring, effective, responsive to people’s needs and well-led? In other words, is it good enough for my Mum (or anyone else I love and care for)? Look for care homes and home care agencies where the staff involve people who use services and their families and carers, and treat individuals with compassion, kindness, dignity and respect.
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Whether you are being cared for in your own home or in a residential setting, the staff looking after you need to be skilled, kind and supportive. They should also be capable and confident in dealing with your particular needs. You should always feel that their support is helping you to live the life you want to. A care home will be a home for you or your loved one. Residents should be treated as individuals with their likes and dislikes taken into account. Think about whether a home is close enough to family, friends, and community facilities. Look at how well-led and managed a home is. What does it have in place to ensure that it delivers high quality care? Does it promote meaningful activity and connect the home with the community?
If you or a loved one needs help with day-today care, you can contact your local council’s social services department. They will ‘make an assessment of your needs’ and depending on circumstances, may be able to help you access financial help. For more advice visit Age UK’s website www.ageuk.org.uk /home-and-care.
If you would like to organise your care yourself, you can find a care worker or personal assistant through an agency. Your local social services department should be able to provide details of approved agencies.
CQC’s ratings will identify services as:
Outstanding Good ● Requires improvement ● Inadequate ● This will help you make informed choices around your care. There’s also useful advice on the Social Care Institute for Excellence’s Find me good care website www.scie.org.uk/findmegoodcare/
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Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police. You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.
The Care Quality Commission has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.
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NHS continuing healthcare NHS continuing healthcare, also known as “fully funded NHS care”, is free care outside of hospital that is arranged and funded by the NHS. This means that you will receive care and support to meet your assessed needs at no cost to you. NHS continuing healthcare, also known as “fully funded NHS care”, is free care outside of hospital that is arranged and funded by the NHS. This means that you will receive care and support to meet your assessed needs at no cost to you.
Where can NHS continuing healthcare be provided? NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your home or in a registered care home.
Eligibility for NHS continuing healthcare NHS continuing healthcare is for adults. Children and young people may receive a “continuing care package” if they have needs arising from disability, accident or illness that can’t be met by existing universal or specialist services alone. To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a “multidisciplinary team”) as having a “primary health need”. Whether or not someone has a primary health need is assessed by looking at all their care needs and relating them to: what help is needed how complex these needs are how intense or severe these needs can be how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change. You should be fully involved in the assessment process and kept informed, and have your views about your needs and support taken into account. Carers and family members should also be 16
consulted where appropriate. A decision about eligibility should usually be made within 28 days of it being decided that the person needs a full assessment for NHS continuing healthcare. If you aren’t eligible for NHS continuing healthcare, you can be referred to your local authority who can discuss with you whether you may be eligible for support from them. If you still have some health needs then the NHS may still pay for part of the package of support. This is sometimes known as a “joint package” of care.
NHS continuing healthcare assessments Clinical commissioning groups, known as CCGs (the NHS organisations that commission local health services), must assess you for NHS continuing healthcare if it seems that you may need it.
For most people, there is an initial checklist assessment, which is used to decide if you need a full assessment. However, if you need care urgently – for example, if you’re terminally ill – your assessment may be fast-tracked.
Initial assessment for NHS continuing healthcare The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed, and be asked for your consent. Depending on the outcome of the checklist, you will either be told that you don’t meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you will be referred for a full assessment of eligibility. Being referred for a full assessment doesn’t necessarily mean that you will be eligible for NHS continuing healthcare. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment. The professional(s) completing the checklist should record written reasons for their decision, and sign and date the checklist. You should be given a copy of the completed checklist. You can download a blank copy of the NHS continuing healthcare checklist from GOV.UK. Full assessments for NHS continuing healthcare are undertaken by a “multidisciplinary team” made up of a minimum of two health or care professionals who are already involved in your care. You should be informed who is co-ordinating the NHS continuing healthcare assessment. The team’s assessment will consider your needs under the following headings: behaviour cognition (understanding) communication psychological/emotional needs mobility nutrition (food and drink) continence skin (including wounds and ulcers) breathing symptom control through drug therapies and medication altered states of consciousness other significant needs These needs are then given a weighting marked “priority”, “severe”, “high”, “moderate”, “low”
or “no needs”. The multidisciplinary team will consider: what help is needed how complex these needs are how intense or severe these needs can be how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time If you have at least one priority need, or severe needs in at least two areas, you should be eligible for NHS continuing healthcare. You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability. In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS continuing healthcare should be provided. The assessment should take into account your views and the views of any carers you have. You should be given a copy of the decision documents, along with clear reasons for the decision. You can download a blank copy of the NHS continuing healthcare decision support tool.
Fast-track assessment for NHS continuing healthcare If someone’s condition is deteriorating quickly and they are nearing the end of their life, they should be considered for the NHS continuing healthcare fast track pathway, so that an appropriate care and support package can be put in place as soon as possible – usually within 48 hours.
Care and support planning If you are eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs. Depending on your situation, different options could be suitable, including support in your own home and the option of a personal health budget. If it is agreed that a care home is the best option for you, there could be more than one local care home that is suitable. Your CCG should work collaboratively with you and consider your views when agreeing your care and support package and the setting where it will be provided. However, they can also take other factors into account, such as the cost and value for money of different options. 17
NHS continuing healthcare reviews If you are eligible for NHS continuing healthcare, your needs and support package should normally be reviewed within three months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs. If your needs have changed, the review will also consider whether you are still eligible for NHS continuing healthcare.
Refunds for delays in NHS continuing healthcare funding CCGs should normally make a decision about eligibility for NHS continuing healthcare within 28 days of getting a completed checklist or request for a full assessment, unless there are circumstances beyond its control. If the CCG decides that you are eligible, but takes longer than 28 days to decide this and the delay is unjustifiable, they should refund any care costs from the 29th day until the date of their decision. If your CCG decided that you weren’t eligible for NHS continuing healthcare, but then revised this decision after a dispute, it should refund your care costs for the period between their original decision and their revised decision.
If you are not eligible for NHS continuing healthcare If you are not eligible for NHS continuing healthcare, but you are assessed as requiring nursing care in a care home (in other words, a care home that is registered to provide nursing care) you will be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the cost of your registered nursing care. This is known as NHSfunding nursing care and is available irrespective of who is funding the rest of the care home fees. NHS England has issued guidance on how people can be compensated following eligibility disputes and delays in receiving NHS continuing healthcare.
Frequently asked questions about NHS continuing healthcare I have a local authority support package that works well. I am now eligible for NHS continuing healthcare – will my support package change? If you are concerned about changes to your care package because of a move to NHS continuing healthcare, your CCG should talk to you about ways 18
that it can give you as much choice and control as possible. This could include the use of a personal health budget, with one option being a “direct payment for healthcare”. If you’re still not satisfied, you may want to complain. Can someone refuse an assessment for NHS continuing healthcare? If they do refuse, will they be able to get services from their local authority? An assessment for NHS continuing healthcare can’t be carried out without someone’s consent, so it is possible to refuse. However, if they do refuse, although they will still be entitled to an assessment by the local authority there is no guarantee that they will be provided with services. This is because there is a legal limit on the type of services that a local authority can provide. If you refuse to be assessed for NHS continuing healthcare, the CCG should explore your reasons for refusing, and try to address your concerns. If someone lacks the mental capacity to consent to or refuse an assessment, the principles of the Mental Capacity Act will apply and in most circumstances an assessment will be provided in the person’s best interest. My relative is in a care home and has become eligible for NHS continuing healthcare. The CCG says the fees charged by this care home are more than they would usually pay, and has proposed a move to a different care home. I think a move will have a negative effect on my relative. What can we do? If there is evidence that a move is likely to have a significantly detrimental effect on your relative’s health or wellbeing, you should discuss this with the CCG who will take your concerns into account when considering the most appropriate arrangements. If the CCG decides to arrange an alternative placement, they should make efforts to provide a reasonable choice of homes. Is it possible to pay top-up fees for NHS continuing healthcare? No, it is not possible to top up NHS continuing healthcare packages, like you can with local authority care packages. The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you get from the NHS. These private services should be provided by different staff and preferably in a different setting. Content supplied by:
Personalised care If your local authority agrees to pay for some or all of your home care needs, it must offer you choice over how to meet your needs – this is known as personalisation of your care and support. A good assessment of your needs will help you begin to think about the kinds of things you may want to do to meet you care and support needs. Following this, you will be involved in planning out how you would like to meet your needs, and be given a personal budget, and can choose to take a direct payment. Self-directed support through good planning, personal budgets and direct payments is often called “personalised support” or “personalisation”. It gives you choice and control over how your needs are met, and enables you to do the things you value the most.
Personal budgets A personal budget is the amount of money the local authority allocates for your care, based on its assessment of your needs. You can be put in charge of this “budget” either by telling the local authority how you would like it spent, or by the council giving you the money so that you can directly pay for your own care (a direct payment). It could also be given to a separate organisation (such as a user-controlled trust) that will spend the money on your care as you see fit, if you prefer. These are commonly known as Individual Service Funds. Additionally, you can choose a combination of the above (for example, a direct payment with some council-arranged care and support), often called a mixed package.
Direct payments Direct payments give you the most control over your care, and mean that if you are unhappy with the services you’re getting, you can decide to change who gives you the care services without the process of going through the local authority. However, with this freedom comes the responsibility of accounting for how the budget is spent to ensure it is meeting your needs, and additional responsibilities if you decide to become an employer and hire a personal assistant with your direct payment.
The Money Advice Service has a guide to using direct payments.
What does personalised support mean for me? Personalisation means that you will have to spend some time and effort thinking about your care and support needs, the outcomes you wish to achieve, and how you may want to meet your needs. Depending on the choices you make, there may be some additional responsibilities. For example, if you decide to request a direct payment to cover the cost of homecare, you could use the payment to hire an individual, giving you the responsibilities of an employer. Alternatively, you could hire careworkers through an agency, which removes the legal obligations of being employer, but may potentially add costs and may remove some of the benefits of having the same person provide your care. Read more about how to choose care services.
How does personalised care and support work? You and your social worker or care manager will work together to create a care and support plan. This plan details your care and support needs, and will be used to work out the value of your “personal budget”. Your support plan should consider: what’s important to you, including your interests, lifestyle, personal tastes and the people in your life your hopes for the future, such as whether you’d like to study or take on more hobbies outside the home what limitations you currently have and how you want to change what you want to achieve by managing your own support Ensure that you include information about how you’ll manage your money and what you’ll spend the money on (including personal assistants, transport, housing adaptations, therapists and respite services). You will need to clarify how you will manage your money. If you choose to receive your personal budget as a direct payment, the local 19
authority may pay the money straight into a bank account that you control (you must set up a new bank account to do this) or they may give you a pre-paid card. Alternatively, you may prefer your personal budget to be managed by the local authority or by someone else, such as: a friend or family member (the local authority must agree to this) a broker, independent social worker or an advocate y our care manager or social worker Discuss these options with your social worker or carer and consider which option is best for you. If someone else will be looking after your money, you may need to create a “decision-making agreement”. A decision-making agreement should state how they will look after your money and what decisions they can and can’t make on your behalf. The local authority may want to check what you do with your money, to make sure you’re spending your budget appropriately and that your care and support needs are being met. You may need to keep receipts where possible (especially for large purchases), so that you can show them you’ve spent your money responsibly. If you choose a direct payment, the council will give you a direct payment agreement that will set out the terms and conditions. If you’re struggling to manage your money, the local authority should advise you on how to make your money work best for you.
Checking your care plan is meeting your care and support needs You should meet with your local authority at least once a year to discuss whether your care plan is working. This is an opportunity to discuss whether your needs are being met in the best way, and it’s also your chance to talk about changes you want to make for the future. You don’t have to wait for a review meeting to change the way in which you spend your budget. You can change things as you go along. If you want to make a big change, consult your care manager or social worker, who may arrange a review. Content supplied by:
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You can ask for a review meeting about your care plan at any time. To prepare for a review, you should provide any receipts you’ve kept since you were awarded a personal budget. If someone is managing your funds for you, get them to join the review meeting.
Disagreements about care plans and personal budgets If you’ve been informed that you’re not eligible for services, or you don’t agree with the amount allocated to you in your personal budget, you can request a reassessment. Speak to your social worker or care manager about being reassessed, or phone your local authority social services department and request a complaints form. Find out how direct payments and personal budgets work.
What is NHS-funded nursing care? NHS-funded nursing care is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this registered nursing care.
Who is eligible for NHS-funded nursing care? You may be eligible for NHS-funded nursing care if: you are not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse you live in a care home registered to provide nursing care
How will my needs be assessed? You should be assessed for NHS continuing healthcare before a decision is made about whether you are eligible for NHS-funded nursing care. Most people don’t need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven’t already had one, your clinical commissioning group (CCG) can arrange an assessment for you.
Outcome of the assessment If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the care home. Services provided by a registered nurse can include planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care. If you’re not eligible for NHS-funded nursing care and you don’t agree with the decision about your eligibility, you can ask your CCG to review the decision.
What is the rate of payment for NHS-funded nursing care? NHS-funded nursing care is paid at the same rate across England. In April 2017, the rate was set at £155.05 a week (standard rate). Before October 1 2007, there were three different levels or bands of payment for NHSfunded nursing care – low, medium and high. If you moved into a care home before October 1 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date. If you moved into a care home before October 1 2007, and you were on the high band, NHS-funded nursing care is paid at a higher rate. In April 2017, the higher rate was set at £213.32 a week. You’re entitled to continue on this rate unless: you no longer have nursing needs y ou no longer live in a care home that provides nursing y our nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £155.05 a week, or y ou become entitled to NHS continuing healthcare instead.
Deferred payment agreements A deferred payment agreement is an arrangement with your local council that enables you to use the value of your home to help pay care home costs. If you are eligible, the council will make payments to the care home on your behalf as an ongoing loan, on which interest will be charged, using your home as security. You can delay repaying the council until you choose to sell your home.
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Paying for your own care and support Many people who use care and support services will pay for all of the costs. This is known as being a “self-funder”. The cost of your care will vary depending on its type, intensity, specialisation, location and duration. For example, a place in a residential care home will cost hundreds of pounds a week. To make decisions that have such major financial implications, you may want to seek independent financial advice and it’s always worth researching the costs of alternatives first. For example, if you are considering a care home place, the cost should be weighed against the cost of care and support that may help you remain in your current home, such as homecare.
How much will care cost? If you are thinking about your future care needs or are facing immediate decisions about care options, it can be helpful to get an idea how much care can cost. Inevitably, the price you would pay will depend on your particular circumstances and needs. The costs also vary depending on where you live. Unfortunately, care homes and homecare agencies tend not to provide this information publicly but you may find it helpful to search for and contact care services in your area to get some idea of likely costs.
The ‘cap on care costs’ Currently, it is not easy to plan for your future care needs, as it’s hard to estimate how long you will need care for and how your circumstances may change. From April 2020, a “cap” on the costs of meeting your eligible care needs (but not accommodation associated with care or nursing costs) is being introduced. The cap means that, once reached, the local authority will take over paying the cost of their eligible care needs. The cap will not cover your daily living costs. These costs include expenses such as rent, food and utilities and the costs you would face even if you did not have care needs. It is important to note that daily living costs will be a nationally set figure. This figure will be a “notional” amount rather than the actual costs. This is designed to support consistency and enable people to plan. To benefit from the cap once it comes in, you will need to contact your local authority to see if your needs are eligible. If you are seen to have eligible care needs, the local authority will open a “care account” for you. This account records your progress (the amount of costs you have incurred) towards the cap. 22
The cap does not begin until April 2020 and any costs incurred before this will not count towards the cap. The BBC’s care calculator can estimate how much you may have to pay for care services depending on where you live in England, once the new rules are in place. This will give you an idea of how the cap will work for you, but actual costs will vary to reflect your individual circumstances and needs and how they change over time. For more information on how paying for care is changing from 2020, read about the changes in the Care Act.
Ask for help from your local authority It’s worth checking whether you’re eligible for meanstested support from your local authority or other financial support – for example, through a care needs assessment and a financial assessment. Few of us will have the income or ready access to the cash to pay for our ongoing care needs, and you may need to look at selling or remortgaging any property you may own. The new Care Act means more people may be able to benefit from “deferred payments”. Deferred payments can help people avoid being forced to sell their home in a crisis in order to pay for their care by having the council temporarily cover the cost – usually until you sell your property. Following the Care Act, every local authority in England has to make deferred payment agreements available. As an alternative, you may be able to enter an “equity release scheme” with a financial organisation. Equity release can pay for the fees from the value of property you own. However, you should consider which of these options best meets your needs, and what the overall costs to you will be. Before taking such significant financial steps as equity release, you might want to get independent financial advice. You can find information on equity release for care at home from Which? Elderly Care or the Money Advice Service’s equity release information. If you’re planning ahead, you may consider arranging an investment or insurance plan to fund your care. Again, it may be worth taking independent advice on financial arrangements before making major changes. Because of the new rules, there are likely to be more financial products emerging that are designed to help people pay for care.
You may also want to explore whether the NHS would meet some or all of your care and support costs, or you may have entitlement to benefits that may help you meet costs. Read about other ways of funding care.
Advice on paying for care Even if your local authority is not able to help fund your care, it will be able to make an assessment of your care and support needs. From this, the local authority can provide you with access to a range of information and advice available locally. You can also get independent advice from: The Money Advice Service website: offers information on paying for care or the option to speak to an online adviser. You can call the Money Advice Service on 0300 500 5000. The Society of Later Life Advisers: the society can also help you find advice on how to make financial plans for care in your old age. Find Me Good Care: a website of the Social Care Institute for Excellence. It has advice on all aspects of planning and funding social care. Age UK: has great advice for older people and those planning for their later years. Carers UK: an excellent resource of advice for carers who need to help someone else. Which? Elderly Care has a guide to financing care.
Deferred payments if you are unable to pay for care services Care home fees are a big financial commitment, and the decision to go into a care home is often made at a moment of crisis or urgency, such as when being discharged from hospital. This can make finding the money to pay for fees (usually several hundred pounds a week) challenging for people funding their own care. In particular, if you own property outright but have little in the way of savings, you may be expected to fund your own care but have little immediately available money to pay for it. Some people going to stay in a care home for a long time find that they have no option but to sell their property to pay the care home fees. Your council may be able to help you if you are at risk of having to sell your home. Where there is a delay in selling the property, or you don’t want to sell the property immediately, you may be eligible to have your care fee payment “deferred”. This is where the local authority helps you to pay your care fees temporarily, and you repay the costs to the local authority at a later date. If the local authority agrees to the deferred payment and pays the care home fees, it will take payment from the money raised once the property is sold. This can be: during your lifetime if you choose to sell your home
o nce you die, the local authority can be repaid from your estate All councils must offer people the chance to defer payment if they meet a set of eligibility criteria. A deferred payment scheme is only available if you don’t have enough income to cover your care home fees, and you have less in savings than £23,250. In these circumstances, the savings don’t include the value of your property, but does include money in bank accounts. The local authority will put a “legal charge” (similar to a mortgage) on the property and will then pay the remaining care fees in full. You will then be assessed to see whether they are able to pay a weekly charge to the authority. Your ability to pay is based on your income less a set “disposable income allowance” (currently £144 per week). Before considering deferred payments, you should look into whether the property will or won’t be counted in how your capital is calculated. For instance, it may be disregarded because your partner still lives there, and if it is a deferred payment agreement wouldn’t be necessary. It’s wise to get independent financial advice before agreeing to a deferred payment, and it’s worth bearing in mind that choosing deferred payments can impact on some welfare benefits.
Protection for self-funders While you may have the savings in place to afford care services, if you lack the capacity to make the arrangements, the local authority can step in to help. The local authority can also help people who lack capacity by negotiating fees with a care provider and paying them directly. The local authority will need to be reimbursed. Anyone entering into a contract for care services should be given adequate information about the fees. Care providers should supply: i nformation about the fees charged for various services provided arrangements for paying the fees the fees charged for any additional services If your capital falls below the set levels for local authority funding (currently £23,250), you will be eligible for reassessment for help with funding your care.
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Care services in If you need help around the home, a good option is to have a care worker come in to your home to help you.
Types of care and support Care and support comes in many forms and has many names used to describe it, including home help, care attendants and “carers” (not to be confused with unpaid family or friends who care for you). Care and support can suit you if you need: personal care, such as washing or dressing housekeeping or domestic work, such as vacuuming cooking or preparing meals nursing and health care companionship Care and support can be very flexible, in order to meet your needs, and the same person or agency may be able to provide some or all of these options for the duration of your care: long-term 24-hour care short breaks for an unpaid family carer emergency care day care sessions ranging from 15-minute visits to 24-hour assistance and everything in between If you already know what you want, you can search NHS Choices directories for: local care and support services and agencies a list of national care and support organisations services that can help you stay safe and well in your home on a long-term basis; these services, often known as “supported living services”, can include financial, help with medication, advocacy, social and practical support a place to live in a family who will care for you, known as “shared lives services” or adult placement services If you believe that you might benefit from some help at home, the first thing to do is to contact your social services department to ask for an assessment of your care and support needs. To contact social services, go to GOV.UK: find your local authority. If you are eligible for care and support services, the local authority may provide or arrange the help themselves. Alternatively, you can arrange your own care, funded by the local authority, through direct payments or a personal budget. 24
your home
If you have chosen direct payments or a personal budget, or you aren’t eligible for local authority help and want to get care privately, you can arrange it in several different ways.
Independent care and support agencies If you use an independent care and support agency, you or the person you’re looking after has to find the care agency and pay them. The agency will provide a service through a trained team of care workers, which means you may not always have the same person visiting your home, although the agency will do its best to take your choices into account. Independent care and support providers are regulated by the Care Quality Commission (CQC). Care and support agencies must meet CQC’s national minimum standards and regulations in areas such as training and recordkeeping. The CQC has the power to inspect agencies and enforce standards. Care and support agencies must vet care and support workers before engaging them by taking up references and carrying out Disclosure and Barring Service (DBS) checks on potential employees. Care and support agencies can also: t ake over the burden of being an employer – for example, payroll, training, disciplinary issues and insurance t rain their care and support workers through national qualifications and service-specific training r eplace workers when they are ill, on holiday or resign p ut things right when they go wrong An agency will want to see you and the person you’re looking after so that they can assess your needs. This also means that a joint decision can be made about the most appropriate type of care and support. You can find out more from the UK Homecare Association.
What are the disadvantages of using a care and support agency? The main disadvantage is the cost of using an agency. The agency will charge a fee on top of the payment made to the care worker to cover their running costs and profit. You normally have to make a regular payment to the agency, which includes both the worker’s earnings and the agency’s fee.
Questions to ask when using a care and support agency The fees some agencies charge can be quite high. Before deciding to go ahead with an agency, you should ask questions about the fee and what it covers, including: Does the agency check references? What training and supervision do they provide? What is their complaints policy? Who will be responsible for insurance? Is there any out-of-hours or emergency contact if needed? Will they be able to provide staff if your own care worker is ill or away? (If an agency contracts to provide care every day, it must ensure that it does.)
Hiring a personal assistant You can hire a “personal assistant” to act as a care and support worker for you. Personal assistants can offer you all that you’ll get from an agency worker, but you’ll also get the continuity, familiarity and ongoing relationship with your assistant. However, if you employ a personal assistant, you will then have the legal responsibility of an employer. This will include arranging cover for their illness and holidays. GOV.UK has more information on becoming an employer, while Which? Elderly Care also has advice on employing private individuals.
Care and support from charities Charities such as Age UK and Carers Trust can provide home help and domestic assistance services. The Carers Trust supports carers by giving them a break from their caring responsibilities through care and support services. Marie Curie Nurses can provide practical and emotional support for people near the end of their lives in their own homes.
Safeguarding vulnerable groups The DBS makes decisions about who is unsuitable to work or volunteer with vulnerable adults or children. It makes this decision based on information held by various agencies and government departments. The service decides who is unsuitable to work or volunteer with vulnerable adults or children. If someone who is barred from working with children or vulnerable adults is working, volunteering or trying to work or volunteer with these groups, they are breaking the law. They could face a fine and up to five years in prison. Employers must apply for an enhanced DBS check (formerly known as a CRB check) when taking on new employees or volunteers to work with vulnerable adults
or children. This includes a check of the barred lists. If an organisation fails to make the relevant checks, they can be penalised. If an organisation dismisses an employee or volunteer for harming a child or vulnerable adult, they must tell the DBS. The DBS must also be notified if any employee or volunteer harms a child or vulnerable adult, but isn’t dismissed because they leave voluntarily. If their organisation does not tell DBS, they will be acting illegally. Questions can be answered by the DBS call centre on 0870 909 0811, or by email.
Employing a care worker on a private basis If you employ a care worker privately, you will not be obliged to use the DBS scheme, but you can use it if you choose to. You need to ask social services or the police to make the checks on your behalf. The care worker must have already applied to be vetted, and must consent to the check. If you have concerns about the suitability of someone you employ privately to work with a vulnerable adult or child, you can ask social services to investigate the matter. They can refer the worker to the ISA on your behalf.
Manual handling If you need help to move, or you need someone to lift you (such as getting out of bed or getting on to the toilet), this can put the person doing the lifting at risk of injury. This “manual handling” can result in back pain and in the most serious cases, permanent disability if not done correctly. The law says that employers must take reasonable precautions to ensure their employees don’t do any manual handling that carries a risk of them being injured. This applies to you if you directly employ a personal assistant to care for you (but most likely will not if you hire someone through an agency). It is particularly important to consider insurance in this situation. This would cover any risk of the care worker injuring themselves, as well as any risk of them causing an injury. There are rules around the risk assessments you need to carry out, and the Health and Safety Executive produces advice on safe manual handling.
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The Motability Scheme The Motability scheme allows some disabled people getting DLA, PIP or War Pensioners’ Mobility Supplement to obtain a car, powered wheelchair or scooter. The scheme uses some or all of your mobility benefit payments to cover the cost of “contract hire” or “hire purchase” of an appropriate vehicle. You can also pay an extra amount of money if you want a more expensive vehicle. With hire purchase, the price of the car will be agreed directly with the Motability dealer, and you will own the vehicle outright at the end of the agreement. With contract hire, you won’t own a vehicle, but you
NHS Choices have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does NHS Choices endorse any of the products or services. All information and figures correct at the time of going to print.
will get a new car every three years, full insurance for the driver and passengers, servicing, maintenance and repairs, vehicle excise duty, replacement tyres and breakdown cover. Adaptations to the car can be made if needed, although there may be an extra charge for some adaptations. Under the Motability scheme, cars can also be adapted for people in wheelchairs. If you don’t need or want a car, you can transfer your allowance to lease a scooter or powered wheelchair.
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Contact and Support We are here to answer any questions you may have about the Mobility Scheme. You can contact our Customer Services team directly or one of our Scheme partners depending on the nature on your enquiry. Tel: 0300 456 4566. Opening times: 8am-7pm Monday to Friday, 9am-1pm Saturday, Monday 9am-11am is our busiest period. You may find it easier to call outside these times.
If you have specialist Minicom equipment, call our textphone number on 0300 037 0100 or speak to us through a British Sign Language (BSL) interpreter for Deaf customers who have an enquiry about the Motability Scheme. 26
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Alzheimer’s Society Services in Peterborough If you think you may have a form of dementia, or are caring for a person who has dementia, Alzheimer's Society Peterborough provides a range of support services for people with dementia, their families and their carers.
Someone to talk to You can phone at any time during our opening hours to talk in confidence with a member of our Dementia Support Team. Our staff are here to listen when you just feel the need to talk, or to offer information and advice on specific issues.
Dementia Adviser Our Dementia Adviser provides information, advice and guidance to people with dementia and will support people through diagnosis, or later on.
Support from Dementia Support Workers Our Dementia Support Workers give personalised practical and emotional support to people with dementia and their carers.
An innovative project providing structured musical stimulation for people with dementia and their carers. Singing is an enjoyable activity and provides a way for people with dementia to express themselves and socialise with others in a fun, supportive group. Groups run fortnightly.
Dementia Café Anyone who has dementia or is caring for a person with dementia is welcome to attend the Cafés which are held most Thursday afternoons at selected venues. Each Café is staffed by Alzheimer’s Society workers and volunteers. We usually invite a guest speaker to talk at the café, this may be a solicitor, pharmacist or dietician or anyone the group have expressed an interest in listening to.
The Carer Information and Support Programme (CrISP)
We can also arrange for a Dementia Support Worker to visit you at home or see you at the Dementia Resource Centre to provide information, advice and support.
Our Carer’s Information Support Programme is a series of five workshops for carers of people with dementia. This programme is for anyone caring for a person with a diagnosis of dementia and aims to offer structured information to inform and support the caring role. Carers do not necessarily have to live with the person with dementia.
Information
Activity Groups
We also have a wide range of information and advice sheets which include specific information on different types of dementia, care issues and understanding the needs of the person with dementia.
We offer a wide range of activity groups including Knit & Knatter, Current Affairs Discussion Group and Arts & Crafts. These services offer people with dementia the opportunity to meet others in a relaxed setting.
Home Visits
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Singing for the Brain
What should I do now?
What is a Dementia Friend?
For information, advice and support, please call us on 01733 893853. We are open from 9am to 5pm, Monday to Friday
A Dementia Friend learns a little bit more about what it is like to live with dementia during a Dementia Friends Information Session and then turns that understanding into action.
Alternatively you could visit us at: Alzheimer’s Society, Dementia Resource Centre, 441 London Road (entrance via York Road), Millfield, Peterborough PE1 2PE
Membership All members of Alzheimer’s Society receive a monthly national magazine. The more members we have, the greater our lobbying power. Membership is free to carers and people with dementia. Email: peterborough@alzheimers.org.uk
What is a Dementia Friends Champion? Dementia Friends Champions are volunteers who run information sessions where they talk to people about being a Dementia Friend in their communities. It's easy to get involved. Dementia Friends Champions will attend a training course, receive support as and when they need it and be part of a growing network of people creating dementia friendly communities together.
Dementia Friends Programme Dementia Friends is a national initiative that is being run by the Alzheimer’s Society. It aims to improve people's understanding of dementia and its effects. Through the Dementia Friends programme, we aim to change the way the nation thinks, talks and acts. To book your place, please visit www.dementiafriends.org.uk
How will it work? We will train and develop a group of volunteers as Dementia Champions to spread the word about what dementia is and what action individuals can take in their community. We will then ask them to recruit Dementia Friends who will then receive a basic information session on dementia and be encouraged to take action.
How can I get involved? It's easy to get involved. Just visit www.dementiafriends.org.uk and book onto a Dementia Friends Information session. Alternatively, you can contact your local Alzheimer’s Society office for more information about volunteering.
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Age UK Cambridgeshire & Peterborough Services Age UK Cambridgeshire and Peterborough is your local independent charity working with and for older people across Cambridgeshire and Peterborough. Our objectives are to help older people to maintain their independence, health and well being by providing services that meet individual needs. We recognise that you want a choice in how you are supported, to continue to remain independent in your own home. The following services are designed to offer you support and help keep your independence.
Information & Advice This is a free and confidential service. We provide rights based information, which can be used with confidence to make informed decisions and choices, on a range of issues including: income and benefits, housing, health and social care. We have a range of FREE fact sheets and guides.
Social Connections We aim to reduce social isolation by bringing people together, providing opportunities to meet people and develop friendships. Day Club based at Steve Woolley Court: An opportunity to meet friends and participate in various activities. Friendship Clubs: Across the city and its borders there are 12 Friendship Clubs that meet regularly for companionship and an opportunity to socialise. These clubs organise outings, quizzes and guest speakers, many of the clubs offer a freshly cooked two course lunch and meet on a weekly basis. Befriending: We visit older people in their own homes for one hour per week for company and To find out more about any of our services – call us on:
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conversation to help prevent feelings of loneliness. Sunday Lunch Club: Our club meets alternate Sundays at Mellows Close in Peterborough for a home cooked two course Sunday Lunch, activities and social contact. Volunteering: We have a whole range of volunteering opportunities, from befriending, fundraising and administration - please get in touch to find out more.
Practical Services Our services offer a range of support so that you can be happier in your own home, stay safe and remain independent. We have an experienced team who provide a trusted service. Our services include: Home Support: Help with household tasks such as cleaning, laundry, shopping, meal preparation etc. Gardening: We can support you with one off or regular gardening jobs to help keep your garden neat and tidy. Home Checks: Working alongside Adult Social Services Occupational Health teams we can assess your home for aids and adaptions to enable you to keep safe in your own home. N.B. Charges are made for some services.
0300 666 9860
E: infoandadvice@ageukcap.org.uk or visit: www.ageukcap.org.uk
Love later life Insurance, Products and Services Most of us want to remain independent and to keep doing things in life we love most. Age UK Enterprises offers a wide range of products and services designed for the over 50s. Home Insurance – Cover for Buildings, Contents or both is available with no hidden admin fees and the choice to pay by monthly instalments at no extra cost (0% APR Representative) Car Insurance – Cover with no upper age limit and the choice to pay by monthly instalments at no extra cost (0% APR Representative) Motor Breakdown – Cover wherever you are in the UK including Roadside, Recovery and Home Services^. Travel Insurance – Choice of Single Trip or Annual Multi-trip cover with no upper age limit and cover for existing medical conditions wherever possible*. Funeral Plan – Your family will be spared the worry of having to make all the arrangements, and the financial strain of paying for them will be eased. Acceptance is guaranteed if you are over 50 and there are easy payment options. Personal Alarms – If you want to remain independent and have peace of mind, Personal Alarms could be the service for you. Professional and friendly help in an emergency,
any time of the day and night. No obligation home demonstration available upon request or order online and connect the unit yourself with Easy-Connect. Wills and Legal Services – In association with leading law firm Irwin Mitchell, we offer a range of legal services providing advice in relation to Wills, family and relationships, personal injury, buying or selling a home and rights at work. Age UK Home, Car and Travel Insurance are administered by Ageas Retail Limited. Age UK Motor Breakdown is provided by Intana Assistance. Age UK Funeral Plans are provided by Dignity. Brought to you by Age UK Enterprises Limited. Age UK Personal Alarms are provided by PPP Taking Care Limited and brought to you by Age UK Trading CIC.. ^ Only available in Mainland Great Britain. * Subject to medical screening and acceptance by the underwriters. Age UK Cambridgeshire and Peterborough is an appointed representative of Age UK Enterprises Ltd which is authorised and regulated by the Financial Conduct Authority for insurance mediation and introducing potential annuity customers. ACOEE2777V1JUL17
To find out about insurance, products and services – Call us on 01733 307124 (Direct dial to Age UK Enterprises Insurance, Products and Services only)
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NHS hospitals
and services in Peterborough
Peterborough City Hospital
Stamford
Orthopaedics & Spine Specialist Hospital 1 Stirling Way, Peterborough, Cambridgeshire, PE3 8YA 01733 333156
Fitzwilliam Hospital Milton Way, Bretton, Peterborough, Cambridgeshire, PE3 9AQ 01733 261717
Edith Cavell Campus, Bretton Gate, Peterborough, PE3 9GZ 01733 678000
Market Deeping
CROWLAND
Dementia Resource Centre (entrance on York Road), 441 London Road, Millfield, Peterborough PE1 2PE 01733 893853
PETERBOROUGH
Whittlesey
The Lindens, 86 Lincoln Road, Peterborough, PE1 2SN 0300 666 9860
Stamford & Rutland Hospital Ryhall Road, Stamford, Lincs PE9 1UA 01780 764151
Rutland Integrated Hospital Team – supports the discharge of Rutland patients, including those hospitalised in the area. They can be contacted on: 01572 722 577 (see p14). The locations on the map indicate where services operate out of.
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Healthwatch Rutland, Land’s End Way, Oakham, Rutland, LE15 6RB Telephone: 01572 720381 Email: info@healthwatchrutland.co.uk
Useful contacts A
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Action on Elder Abuse 020 8835 9280 We work to protect, and prevent the abuse of, vulnerable older adults. Action on Elder Abuse, PO Box 60001, Streatham SW16 9BY I www.elderabuse.org.uk I enquiries@elderabuse.org.uk
Integrated Care Council 01379 678243 (Formerly the National Homecare Council) The Integrated Care Council is a body which brings together British public and independent sector organisations who commission or directly provide support for people living at home.
Admiral Nursing DIRECT 0845 257 9406 This helpline has been set up to provide people with an opportunity to talk through their worries and concerns about themselves, friends or relatives with dementia. The lines are open on Tuesdays and Thursdays between 11am and 9pm. Callers can leave messages any time and request a call back I direct@fordementia.org.uk Age UK Cambridgeshire & Peterborough 0300 666 9860 Providing practical services and support to make later life better. The Lindens, 86 Lincoln Road, Peterborough PE1 2SN I www.ageukcap.org.uk I infoandadvice@ageukcap.org.uk Alzheimer's Society 01733 893 853 The UK's leading support and research charity for people with dementia, their families and carers. I www.alzheimers.org.uk I peterborough@alzheimers.org.uk Arthritis Care 020 7380 6500 Working with and for all people with arthritis to put them in control of their arthritis and their lives. Arthritis Care, Floor 4, Linen Court, 10 East Road, London N1 6AD. I info@arthritiscare.org.uk
C CareAware 0161 707 1107 A one stop shop for free advice on care fee funding for older people. I www.careaware.co.uk I enquiries@careaware.co.uk Care Quality Commission (CQC) 03000 616161 National Correspondence, Citygate, Gallowgate, Newcastle upon Tyne NE1 4PA I www.cqc.org.uk I enquiries@cqc.org.uk Carers Trust Peterborough 01733 645234 Comprehensive support services for unpaid family carers of all ages in Peterborough. 60 St Mark’s Street, Peterborough PE1 2TU I www.carerstrustpeterborough.org I carers@carerstrustpeterborough.org Carers UK 0808 808 7777 Prevents carers from becoming emotionally drained, and from forgetting to take care of themselves. 20 Great Dover Street, London SE1 4LX I General enquiries: 0207 378 4999 I Advice line: 0808 808 7777 I www.carersuk.org I info@carersuk.org Cruse Bereavement Care 0844 477 9400 Cruse Bereavement Care is here to support you after the death of someone close. I www.cruse.org.uk I helpline@cruse.org.uk
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DIAL (Disability Information Advice Line) 01733 265 551 DIAL Peterborough provide information and advice to disabled people, their family and professionals on all aspects of living with a disability. DIAL Peterborough, Cresset Centre, Peterborough PE3 8DX Disability Benefits Helpline – 0845 712 3456 for Disability Living Allowance and Attendance Allowance I Textphone: 0845 722 4433 I w ww.direct.gov.uk/en/Dl1/Directories DG_10011169
E Elderly Accommodation Counsel 020 7820 1343 The Counsel's aim is to help older people make informed choices about meeting their housing and care needs. It was founded in 1984 and became registered as a charity in 1985. It is now more commonly known as EAC. I www.eac.org.uk
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Healthwatch Peterborough 03451 202064 The new independent consumer champion created to gather and represent the views of the public at both national and local level. I www.healthwatchpeterborough.co.uk Healthwatch Rutland 01572 720381 I www.healthwatchrutland.co.uk I info@healthwatchrutland.co.uk
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Mind (National Association for Mental Health) 020 8519 2122 The leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. I www.mind.org.uk I contact@mind.org.uk
N National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis. I www.nos.org.uk NHS 111
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P Peterborough Citizens Advice Bureau 16-17 St Mark's Street, Peterborough, PE1 2TU I www.peterboroughcab.org.uk
0844 855 2122
Parkinson's Disease Society I www.parkinsons.org.uk
0800 800 0303
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Royal Voluntary Service 0845 608 0122 A volunteer organisation that enriches the lives of older people and their families across Britain. We support older people by giving time and practical help to help them get the best from life. Royal Voluntary Service, Cardiff Gate, Beck Court, Cardiff Gate Business Park, Cardiff CF23 8RP I www.royalvoluntaryservice.org.uk Rutland Community Wellbeing Service 01572 725805 Healthy lifestyles, emotional and financial wellbeing. I info@rutlandrap.org.uk Rutland County Council – General enquiries I www.rutland.gov.uk I enquiries@rutland.gov.uk
01572 722577
Rutland Housing MOT 01933 410084 I spirehomes.careandrepair@longhurst-group.org.uk Rutland Information Service Online directory of organisations, activities and services in Rutland covering things to do, health and wellbeing, care options and staying independent. I http://ris.rutland.gov.uk
S Stroke Association 0845 3033 100 Advice and information for stroke patients and their families. I www.stroke.org.uk
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The Department of Work and Pensions I www.dwp.gov.uk The Pension Service 0845 606 0265 I w ww.dwp.gov.uk/about-dwp/customerdelivery/the-pension-service Every possible care has been taken to ensure that the information given in this publication is correct at the time of going to print. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. Octagon Design & Marketing Ltd has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Octagon Design & Marketing Ltd endorse any of the products or services. No reproduction by any method whatsoever of any part of this publication is permitted without prior written consent of the copyright owners. Octagon Design & Marketing Ltd. ©2017. Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire, DN10 6AB. Telephone: 01302 714528 Options Peterborough is published by Octagon Design and Marketing Ltd with editorial contributions from North West Anglia NHS Foundation Trust, the CQC, Age UK, the Alzheimer’s Society, NHS choices and Rutland County Council. The editorial contributors have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor do the editorial contributors endorse any of the products or services.
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Garden Lodge Residential Care Home
Registered for 10 elderly clients, residential and dementia care. Set in extensive garden & an uplifting family environment Visitor’s welcome at any time - NCA member
T: 01733-252980
37a Lincoln Road, Glinton, Peterborough, PE6 7JS E: gardenlodge37a@aol.com
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Our homes offer a wide range of services and provide high standards of care, creating a safe and friendly place to live for all of the people who use our services.