OPTIONS A guide to care and independent living
Liverpool & Sefton Summer 2018
Leaving hospital What’s next?
NHS continuing healthcare Who’s eligible?
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SOCIAL CARE
tips
Healthcare services Choosing the right one
FREE
guide CONTRIBUTORS: Age Concern Liverpool & Sefton The Royal Liverpool and Broadgreen University Hospitals NHS Trust NHS Choices Sefton Council
Outreach has been providing high quality home care in the Southport, Bradford and surrounding areas for over 13 years.We employ local people to meet the needs of local residents. We provide care services in the Sefton area including Churchtown, Marshside, High Park, Southport, Kew, Birkdale, Ainsdale,Woodvale, Formby, Freshfield, Hightown and some areas of Banks, Crosby, Maghull and Lydiate. Professional Care Outreach offers a wide range of services based on our experience.We combine a structured and professional approach and our staff offer a wealth of experience in all levels of care and management.
Tel: 01704 517470
www.outreachcare.co.uk
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Contents
The right place for your care.............................................................................................. 4-5 Leaving hospital.......................................................................................................................5 Your hospital team..................................................................................................................6 The assessment process............................................................................................................6 Therapies..................................................................................................................................6 Dementia Practitioner.............................................................................................................6 Intermediate Care....................................................................................................................7 Intermediate Care – Aiming to get you home.................................................................. 8-9 Intermediate Care at Home: Liverpool Out of Hospitals Service..........................................9 What is the Liverpool Home First?.......................................................................................10 Our commitment to you........................................................................................................11 When you leave hospital.......................................................................................................11 Useful contacts.......................................................................................................................11 The Friends and Family Test..................................................................................................12 Sefton Social care and wellbeing.................................................................................... 14-15 NHS continuing healthcare............................................................................................. 16-17 Taking charge of your own personal budget................................................................ 18-19 What is NHS-funded nursing care?.......................................................................................19 Self-funding: paying for your own care and support................................................... 20-21 Care and support: what's available................................................................................ 22-23 Driving and using public transport................................................................................. 24-25
Going home from hospital? Age Concern Liverpool and Sefton are here to help........................................................................................................... 26-27 The Care Quality Commission Social Care Top Tips..........................................................28 Useful Contacts......................................................................................................................29 NHS Hospitals and services in Liverpool...............................................................................30
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.
The Royal Liverpool and Broadgreen University Hospitals NHS Trust
O C T A G O3 N DE S IGN & M A RKETING LTD
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The right place
for your care
Your local 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 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. The Royal Liverpool and Broadgreen Hospitals provide 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: • Beds are needed for people who are very unwell, and who may be waiting in the Accident and Emergency department for a bed to become available. • People awaiting surgery, both urgent and nonurgent, may have their operations cancelled if a bed is unavailable. • There is a risk of acquiring infections in hospital, so leaving at the earliest opportunity means this is less likely. • Some people find it harder to return home the longer they stay in hospital.
Leonard Cheshire Disability “Freshfields” Freshfields is a modern, purpose built resource offering nursing, residential and day services for 33 adults with physical disability For further information contact: J. Perry, Service Manager Freshfields LCD Home, College Path, Formby, Merseyside L37 1LH T: 01704 870119 F: 01704 834408 E: freshfields@leonardcheshire.org
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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: • Assess what your needs are likely to be when you are ready to leave. • Involve relevant staff who can help in meeting those needs (e.g. social worker, occupational therapist, physiotherapist, district nurse). • Make arrangements for equipment or services which need to be in place when you are medically ready to leave. • Make sure that your carer is given any information, help or advice that is needed to aid your recovery. 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 an expected 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 are normally expected to arrange their own transport. • 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. • Adequate support for your carer or family members. We aim for patients to be discharged before 10am but if this is not possible, it is likely that you will move to the Hospitality suite which enables us to prepare the bed for the next patient. The Hospitality suite is a comfortable and safe place to wait for your transport. Relatives or carers coming to collect you can meet you in the Lounge 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 carer during your time here. You can also help us by moving from hospital when you no longer need our services. We will discuss with you the sort of help you and your carer may need when you return home, to make the transition as easy as possible. Your Hospital Case Manager is the member of the team who will meet you on the ward and, along with the ward staff will begin planning your discharge from hospital. 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 services. Some people have ongoing health and social care needs which require a more detailed assessment. Staff from health and social care will work together to plan and deliver services to support such people after discharge. This guide explains some of these processes and explains the role of the hospital and Social Care team in the hospital discharge process.
Leaving
hospital
You will be transferred from hospital when your consultant led team decide that you are clinically ready to leave hospital and that you no longer require an acute hospital bed. For the majority of patients, you will go home from hospital with no additional support required. In some cases you may require some extra support to regain your independence. Your hospital team will help you, your family and carers to access these services if you need them. Your safe and timely transfer from hospital will also allow new patients who need acute hospital treatment to be admitted without delay. We fully support your transfer out of hospital for the following reasons: 1. To support you to regain your independence 2. Some people find it harder to return home the longer they stay in hospital 3. Acute beds are needed for people who are very unwell, and delays in transfer may result in patients waiting in the Emergency department for a bed to become available. 4. Although we work hard to ensure the highest standards of care there is a risk of acquiring infections in hospital. Leaving hospital as soon as you are medically fit means this is less likely and reduces the risk of any complication.
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Your Hospital
Team
A Multi – disciplinary team including your Hospital Case Manager, Consultant team, Matron and ward nurses, Occupational Therapists, Physiotherapists and Social Workers will begin to plan your transfer from hospital as soon as you are admitted. This team of clinical experts will explain their key roles to you if they are involved in your hospital care.
The assessment Your assessment begins as you are admitted to the ward area and is a way of working out what your needs are and which ones might be putting you at risk. The assessment process will start with discussions with your Hospital Case Manager, with you and your family / carers. This process of information gathering and clarification of the situation will indicate which members of the multi disciplinary team need to be involved in your assessment.
process Your Hospital Case Manager will work alongside you to: • Identify your needs • Establish which members of the Multi disciplinary team may need to be involved in your care and assessment • Provide you with information about services that could support you as you are discharged from hospital
Therapies You may be referred to a therapist to assist in planning for your discharge from hospital. This could be someone from a number of different professions; a dietician, occupational therapist , physiotherapist or a speech and language therapist. They will discuss with you and assess what you are able to do; and what
you might need more help with. They will then discuss with you what treatment, help or support is available to improve your independence. The therapists will discuss with the other members of the hospital team their findings and together with you and your family make a plan for your discharge from hospital.
Dementia practitioner
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During your hospital stay we have a dementia practitioner who is available to provide support for patient’s relatives and carers.
admitted to the hospitals or their carers will also receive information as to relevant advice in order to support them following their hospital stay.
Dementia patients will receive a ‘This Is Me’ document in order to deliver specific care needs along with the opportunity to take part in bedside activities. Every dementia patient
Shaun Lever – Dementia Practitioner, Royal Liverpool and Broadgreen University Hospitals 0151 7062000 bleep 5111; 0151 7064727
Intermediate Care Here in Liverpool, intermediate care can support people as they are discharged from the acute hospital who are not quite ready to return home.
• Over the age of 18
This period of intermediate care can provide rehabilitation from therapy staff or a period of reablement prior to returning home. Your hospital team will work with you to assess your level of need and which intermediate care service which would suit your needs should you require it.
Intermediate care is provided under Health and Social Care joint Commissioning arrangements and is free of charge whilst you are on the intermediate care pathway.
All patients who no longer need acute care but cannot return home and do not require specialist care are eligible for intermediate care if they meet the following criteria:
• Resident of Liverpool or • Registered with a Liverpool GP
People may be eligible for intermediate care following an episode of acute care for a further short period of recovery and or reablement. This can benefit patients and enables a more accurate assessment of your ongoing care needs prior to returning home or before long term care is considered.
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Intermediate Care
– Aiming to get you home
The aim is to help you to relearn daily living skills so you do not need long-term support or go back into hospital.
• Provides a service to support hospital discharges, admissions and respite specialising in care and support for people with dementia. A new purpose built integral day You need to know what you want to achieve facility has been attached to the main and how this will be done in hospital building and is fully operational. to establish your reasons for going The new build provides into Intermediate Care through Re-ablement carer support, drop-in your multi disciplinary team services help to facilities, café, day support, assessment. First route out ensure people community outreach work, of hospital should always be advocacy, crisis intervention, receive the right your own home. If this is not possible, then the Intermediate level of support at health and well being advice and support. Care aims to get you home and to eliminate dependency on long term support.
the right time.
Liverpool City Council provides a model of health and social care support through community bed based centres. The model creates a circle of health and social care support for adults. The Model of care: Each facility supports intensive short-term community bed based services under the umbrella of re-ablement services. Re-ablement services help to ensure people receive the right level of support at the right time. We aim to support patients as they are discharged from hospital to reduce the length of time you stay in hospital and can offer a more realistic assessment of your future support needs. We operate a Multi Disciplinary Team approach which comprises of Social Worker, Community Matron, Therapists, General Practitioner, Access coordinator (social care) and appropriate attendees related to your care programme.
Sedgemoor (30 beds) 41 Sedgemoor Road, Norris Green, Liverpool L11 3BR. Tel: 0151 256 1810 8
Venmore (25 beds)
Hartnup Street, Liverpool L5 1UW Tel: 0151 263 2888 • Provides a service to support hospital discharges and admissions for people who have had a stroke. Service delivery is supported by the acute trust through Physiotherapist, Occupational Therapists, Speech and Language specialists and a range of social and health support services for individuals and their carers. An integral day facility has been commissioned and this will provide a unique opportunity to support people who have poor or limited mobility, are prone to falls.
Granby (30 beds) 50 Selbourne Street, Liverpool L8 1YQ Tel: 0151 233 8631 • Is a specialist intermediate care unit, designed specifically to help you regain mobility and confidence, in order to live independently again. Once admitted to Granby, you will be assessed by a qualified team of a Physiotherapist, Occupational Therapist and Social Worker, who will develop an individual therapy programme specifically to meet your needs. This may involve staff working with
you on a daily basis to complete exercises to improve your mobility and to ensure that all support you may need is in place. Intermediate Care bed based services provide assessment, care and treatment for you and discuss with you and your family or carer what care and support you need. During your stay, you may move from one part of our service to another depending upon your assessed needs. This may include transfer to an alternative care setting. During your admission you will be assessed by our therapy team who will discuss any treatment plans, goals and frequency of interventions with you. Therapy treatment may be delivered on the ward or in the gym and will consist of chair based exercises, walking practice and functional activities, treatments will be carried out by a member
of the multi disciplinary team where it is deemed appropriate to do so. It may be necessary to carry out a home assessment prior to your discharge and if so we will ask you to provide access to your home and ensure that you have appropriate outdoor clothing for the assessment. If the Multi disciplinary team deems that you are medically fit for discharge but you are not ready for discharge home, you may move to another part of the service dependent upon your assessed needs. This may include transfer to an alternative care setting. If required you will be assessed by a Social Worker or community care assessor to find out if you require ongoing support at home.
Intermediate
care at home:
Liverpool Out of Hospitals Service Liverpool Out of Hospital Service (LOOHS) is a multidisciplinary team of Health and Social Care professionals including Nurses, Occupational Therapists, Physiotherapists, Podiatrists, Social Workers and Support Workers. LOOHS supports people and their carers when they are in health and / or social care crisis. The aim is to prevent people from being admitted to hospital if possible, support people to return home after a recent hospital admission, and enable people to live at home rather than in a care home, if they choose. The rehab and reablement elements of the service aim to enable people to recover from recent loss of function, due to an illness,
or fall, for example. Therapists work in partnership with the local authority to develop a plan of care and rehab to enable people to regain their independence. LOOHS tends to provide lots of support in the beginning and gradually reduces this support as people become more independent, but identifies that some people will need that care and support for the long term, and arranges that for them. If you are assessed as requiring support from LOOHS you will be referred by a health or social care professional in the hospital. Contact details For more information please contact Liverpool Out of Hospitals Services. Tel: 0151 285 3715 9
What is Home First? Home First is a partnership service provided by Liverpool City Council, the Royal Liverpool and Broadgreen University Hospital, Aintree University Hospital, and Liverpool Community Health Trust.
transport if you are otherwise unable to make the journey. When you are at home, the Home First support team will help you to get back to doing day-today tasks. You will also get support from health staff if you need it.
Home First helps you to return home as soon as possible when you no As far as possible, we will do our longer need hospital treatment. best to provide support at a The service will try get you back Every week, convenient time for you. to doing all the things you the Home First were able to do before your How long does Home support team will hospital stay. First last? check how you’re Most people do not need Research shows that people Home First for longer than progressing. are less likely to need long-term three weeks and it is not care and will stay independent provided for more than six weeks. for longer if they are supported to continue their recovery at home instead Every week, the Home First support of staying in hospital. team will check how you’re progressing. When you are able to take care of yourself safely the How does Home First work? service will end. When you are almost ready to be discharged one What if I still need care? of the hospital team, such as a physiotherapist If it becomes clear whilst you are having Home or an occupational therapist, will check if Home First that you will need long-term support, your First is right for you. needs will be assessed by a social worker and a If it is, arrangements will be made for you to care plan will be put in place. return home as soon as you are ready, including Liverpool City Council’s Help to Live at Home care providers will give this new support. Will I be charged? There is no charge for the Home First service. You may be asked to contribute towards the cost of any Help to Live at Home support you need. To work out your contribution, you will be offered a financial assessment. The assessment looks at your income and any savings you might have. You will only ever be asked to pay a fair amount that takes into account your income and any savings you might have. If you refuse to have a financial assessment you will be asked to pay the maximum contribution. 10
Our commitment to • Patients should receive the right treatment, at the right place and by the right professional • We place a high priority on keeping your stay in an acute hospital bed to a minimum • Once your consultant led team assesses that you are medically fit for transfer, we will aim to transfer you from hospital on the same day • You will be transferred from the Royal Liverpool and Broadgreen University Hospitals Trust when you are ready to leave hospital as there are more
appropriate services and facilities available to you • We will aim to transfer you from hospital before 10am on your day of transfer and if you require transport, we will arrange this for you • If there is a delay in your transfer, the hospital provides Discharge Suites where you will be looked after until you leave the hospital • The suites are a comfortable area where you can watch television, read papers and be provided with refreshments (Including breakfast and light lunch)
When you leave It is important to know that the majority of patients will be transferred home directly from hospital.
If you no longer require consultant led care and there is a delay in the start of your care package or preferred community based placement, you cannot
you
hospital
choose to remain in an acute hospital bed. You will be transferred to a bed within a non hospital setting (within 48 hours) whilst this is arranged. We will only transfer you when the appropriate placement has been identified and confirmed.
Useful contacts; Alzheimer's Society Alzheimer's Society staff and volunteers provide both local information and over 2,000 services across England, Wales and Northern Ireland to people affected by dementia in their communities. Our local services include day care and home care for people with dementia, as well as support and befriending services to help partners and families cope with the demands of caring. From Alzheimer's Café's and innovative 'singing for the brain' sessions to memory-book projects and group outings, our services provide both practical support and an essential point of human contact. Glaxo Neurological Centre Norton Street, Liverpool, Merseyside L3 8LR. Tel: 0151 298 2444
PSS Provide information on dementia including news, training, forums, chat rooms, downloads, memory
games, telephone support, and a dementia café for people with dementia, their carers and health / social care professionals. 18-24 Seel Street, Liverpool, Merseyside L1 4BE. Tel: 0151 702 5555
Age UK Age UK is the UK’s largest charity working with and for older people. Age UK aims to improve later life for everyone. We want to make a difference to the lives of older people – here and in more than 40 other countries – by providing information and advice, lifeenhancing services and vital support. We develop products that are specifically designed for people in later life, and fund pioneering research into aspects of getting older. Age UK will campaign. 5 Bold Street L1 4DJ. Tel: 0151 7077020 11
The Friends and Family Test What is the Friends and Family Test? The NHS wants to ensure that you have the best possible experience of care. The Friends and Family Test is a way of gathering your feedback about this experience and helping to drive improvement in hospital services. When you receive care as an inpatient or in an Accident and Emergency (A&E) department, you will be given the opportunity to give your feedback by answering a simple question about your experience. The results will provide a way for you to easily compare NHS hospitals so that you know where you and your family can get the best possible care. The information will also give the NHS invaluable information on what patients think of services, which can be used to help make improvements if required. How will it work? When you are discharged, or within the 48 hours that follow, you will be asked to answer the following question: “How likely are you to recommend our ward/A&E department to friends and family if they needed similar care or treatment?” You will be invited to respond to the question by choosing one of six options, ranging from ‘extremely likely’ to ‘extremely unlikely’. It is really important to us that you tell us why you gave your answer, so please answer any follow-up questions. Your answer will not be traced back to you, and your details will not be passed on to anyone, so please tell us exactly what you think. A member of your family or a friend is welcome to help you give your feedback to the question if you are unable to. Do you have to respond to the question? Your feedback is extremely important and will help to continually improve our services however you do not have to respond to the question. You can opt
Where can I get more information? For more information on the Friends and Family Test, please visit www.nhs.uk/friendsandfamily. For information about how the test will be carried out in your hospital, please contact its Patient Advice and Liaison Service (PALS). 12
out by informing the hospital staff before your discharge. This may take up to 72 hours to set up on the system so you may still receive a text. You can respond to the text message ‘STOP’. This will normally ensure you are no longer contacted in this way but if you do experience any problems please contact our customer relations team who will ensure that this is addressed. You can contact the team on 0151 706 2000 or by email at pals@rlbuht.nhs.uk How will the results be used? Your hospital will gather the results and analyse them rapidly to see if any action is required. It will publish the results and you will also be able to see results for other hospitals to see how they compare. Where will the results be published? The results will be published on the NHS Choices website (www.nhs.uk). Hospitals may also publish their results in their annual reports and quality accounts. Does this replace the existing compliments or complaints procedure, or other forms of feedback used by the hospital? No, you can still pass your compliments or complaints to your hospital in the normal way. Hospitals can continue to use existing ways of gathering feedback, in addition to the Friends and Family Test.
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Sefton Social care and wellbeing Most people want to live independently in their own homes for as long as possible. We encourage you to take care of your long term health and wellbeing by supporting and signposting you to a range of activities and events in your local community. These are available through libraries, leisure centres or through the voluntary, faith and community sector. You can find full details of what is available in your local community through The Sefton Directory www.seftondirectory.com
Adult Social Care If you think you need additional help and support to maintain your independence or are struggling to live at home then you may be entitled to help from adult social care. Your social care assessment An assessment means collecting information about you and your life and talking with you about the difficulties you have and how they affect your wellbeing. This helps us to understand your situation, what your needs are and how to plan for the future. Things we will look at during your assessment: •W ho (if anyone) you would like to be involved in your assessment. If you have a carer then we will need to speak to them •W hat you are finding difficult and how this is affecting you in your daily life •Y our daily routine and how you manage •Y our health and how it affects you, including medication, recent visits or contact with GP or hospital • L ooking after yourself (e.g. washing, dressing, meals, shopping, managing your home and finances) • T hings you enjoy doing • T hings that are important to you • S upport already available to you – what’s working 14
• • • •
well (e.g. help from family and friends, equipment and aids, paid carers) Anything that has worked well in the past If you are a carer, how your caring role affects you day to day What about things you do well? What would you like to achieve / do more of?
Who can have an assessment? Any adult who may have needs for care and support can have an assessment. Anyone who looks after another adult and may need help to enable them to continue to care can have a Carers Assessment. What if I don't want an assessment? You can refuse to have an assessment but we may still need to talk to you if we are concerned about your safety and wellbeing. We can still give you information and advice about arranging your own support and accessing activities and groups in your community. If you are offered an assessment but refuse this time, you could still change your mind at a later date. Carers Support You are a carer if you provide regular and substantial unpaid help to someone who is frail or disabled, or mentally or physically ill, and who cannot manage without your support. You may not live in the same house, and you do not have to be related to the person you look after. Carers are now able to have an assessment. The local authority will assess whether the carer has needs and what those needs may be. This assessment will consider the impact of caring on the carer. Anyone wanting help, advice or assistance completing the carers needs assessment should contact Sefton Carers Centre on 0151 288 6060 Find out more here: www.sefton.gov.uk/social-care/ care-and-support-for-adults
Living Well Sefton Public Health teams work to help people in Sefton to be healthy and happier. It's something you can do regardless of your age or your circumstances and it’s our job to help you. There are parks, healthy places and a long coastline for you to enjoy. If you want to be healthier we can help you with information about how and where you can do it. If you want to start click www.livingwellsefton.org.uk or ring 0300 323 0181. Living Well Sefton is a FREE service with a focus on supporting people with issues that may be affecting their health and wellbeing. It is collaboration of various Sefton organisations which have the expertise and knowledge to share with you. As part of the service, there are a number of Living Well Mentors to talk to and they work with you on a one-to-one basis to identify health areas to see where small tweaks can be made but may have a big impact on improving your health. What Living Well Sefton can offer Physical Activity – Research shows that physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer’s disease. That is where we can help. Our partners offer sessions, workshops and activities you can join which will not only burn calories they make you feel better because you are meeting different people and being active. From walking groups, walking football and a Steps to Health programme As well as this, our Living Well Mentors can provide in-depth support by working out how physically active you want to be and tailoring a plan just for you. Stop Smoking - It has been recognised for some time that stopping smoking is the single best thing anyone can do to improve their health because smoking is the biggest cause of preventable death and disease in the country. Smoke free Sefton is an established, nurse-led stop smoking service which can help anyone wanting to quit cigarettes. People are up to four times more likely to stop with this kind of support and they can be reached via our service. Alternatively, the stop smoking team have clinics throughout the borough at different times to be as flexible as possible.
Alcohol - Many people may not realise the amount they drink could be having an adverse affect on their health. Weight Management - Managing your weight should be done in tandem with regular physical exercise, eating a healthy diet and watching how much you drink. Our Living Well Mentors can help you set goals and give details of other ways you can manage your weight such as joining one of their healthy cooking or weight management courses Mental Wellbeing - Our partners offer a variety of programmes, services and activities to give your wellbeing a boost. They range from: benefits and debt advice, luncheon clubs to provide a place to meet as well as eat, a film club, gardening groups, confidence and assertiveness courses and learn skills to cope with life’s stresses. Think Differently, Cope Differently is a five-week course our partners deliver and it is designed to increase your wellbeing by improving positive thinking, eating more healthy, learning relaxation skills and other ways of coping.
Reporting an adult safeguarding concern Safeguarding is work that helps vulnerable adults to keep their independence, wellbeing and choice and to live a life free from abuse, including neglect. It is important to understand that Safeguarding is everyone's responsibility, including yours. We all have a role to play in preventing abuse. If you see something, report it as quickly as possible to stop it getting worse. Are you concerned about adult abuse? • Do you think a vulnerable adult is being harmed or is at risk of being harmed by someone else or is neglecting themself? • Are you worried that a vulnerable adult is living in circumstances (at home or in care) where they are being treated badly or neglected? If you've answered yes to either of these questions, then please call 0345 140 0845 to report your concerns. Don't worry if you are not sure. All reports will be looked into and no action will be taken unless it is needed.
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NHS continuing healthcare Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.
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.
Am I eligible 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”). The team will look at all your care needs and relate them to: • what help you need • how complex your needs are • how intense or severe your needs can be • how unpredictable they are, including any risks to your 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 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 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’s 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. 16
Depending on the outcome of the checklist, you’ll 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’ll be referred for a full assessment of eligibility. Being referred for a full assessment doesn’t necessarily mean you’ll 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 in writing the reasons for their decision, and sign and date it. 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 assessment for NHS continuing healthcare 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 given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”. 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.
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Fast-track assessment for NHS continuing healthcare If your health is deteriorating quickly and you’re nearing the end of your life, you 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. An organisation called Beacon gives free independent advice on NHS continuing healthcare. Visit the Beacon website or call the free helpline on 0345 548 0300.
Care and support planning If you’re 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’s agreed that a care home is the best option for you, there could be more than one local care home that’s 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.
NHS continuing healthcare reviews If you’re eligible for NHS continuing healthcare, your needs and support package will 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’re still eligible for NHS continuing healthcare.
Refunds for delays in NHS continuing healthcare funding CCGs will 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 you’re 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’re not eligible for NHS continuing healthcare If you’re not eligible for NHS continuing healthcare, but you’re assessed as requiring nursing care in a care home (in other words, a care home that’s registered to provide nursing care) you’ll be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the cost of your registered nursing care. NHS-funded nursing care is available irrespective of who is funding the rest of the care home fees. Read more information from NHS England about NHS continuing healthcare.
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I have a local authority support package that works well. I’m now eligible for NHS continuing healthcare – will my support package change? If you’re concerned about changes to your care package because of a move to NHS continuing healthcare, your CCG should talk to you about ways 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”.
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Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority? An assessment for NHS continuing healthcare can’t be carried out without your consent, so it’s possible to refuse. However, if you refuse, although you’ll still be entitled to an assessment by the local authority there’s no guarantee that you’ll be provided with services. There’s 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.
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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’s evidence that a move is likely to have a detrimental effect on your relative’s health or wellbeing, discuss this with the CCG. It will take your concerns into account when considering the most appropriate arrangements. If the CCG decides to arrange an alternative placement, they should provide a reasonable choice of homes.
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Is it possible to pay top-up fees for NHS continuing healthcare?
No, it isn’t 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. 17
Taking charge of your own personal budget If your local authority agrees to pay for some or all of your home care needs, it must offer you choice and control over how your needs are met. You’ll be given a personal budget, and can choose to receive it as a direct payment.
Read more about how to choose care services.
Personal budgets
Creating your care plan
A personal budget is the amount of money the local authority allocates for your care, based on its assessment of your needs.
You and your social worker or care manager need to work together to create a care plan. This plan details your care and support needs, and can be used to work out the value of your personal budget.
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 you can directly pay for your own care (a direct payment). It can 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. You can choose a combination of the above (for example, a direct payment with some councilarranged care and support), often called a mixed package. Find out how personal budgets work.
Direct payments Direct payments give you the most control over your care. If you’re unhappy with the services you’re getting, you can decide to change who gives you the care services without having to go through the local authority. But you have to be able to account for how you spend the budget. And you have responsibilities as an employer if you hire a personal assistant with your direct payment. The Money Advice Service has a guide to using direct payments.
The pros and cons of taking charge of your personal budget Being in control of your own personal budget means you have to spend some time and effort thinking about your care and support needs and the outcomes you want. There may be extra 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. 18
Alternatively, you could hire care workers through an agency. This removes the legal obligations of being an employer, but may cost more and may remove some of the benefits of having the same person provide your care.
Your care plan should include: • 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 Make sure 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). Clarify how you’ll receive your money. If you choose to receive your personal budget as a direct payment, the local 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 or an independent social worker • your care manager or social worker Discuss these options with your social worker or carer to work out which option is best for you.
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If someone else will be looking after your money, you may need to create a decision-making agreement. This should state how they’ll 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 your care and support needs are being met. You may need to keep receipts (especially for large purchases) so you can show them you have spent your money responsibly. If you choose a direct payment, the council will give you a direct payment agreement that sets out the terms and conditions. If you’re struggling to manage your money, the local authority can advise you on how to make your money work best for you.
Disagreements about care plans and personal budgets
Check your care plan is working 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 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.
If you have been told that you’re not eligible for services or you don’t agree with the amount allocated to you in your personal budget, you can ask for a reassessment.
You can ask for a review meeting about your care plan at any time. To prepare for a review, provide any receipts you have kept since you were awarded a personal budget.
Speak to your social worker or care manager about being reassessed, or phone your local authority social services department and request a complaints form.
If someone is managing your funds for you, get them to join the review meeting.
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 NHSfunded 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 2018, the rate was set at £158.16 a week (standard rate). Before October 1 2007, there were three different levels or bands of payment for NHS-funded 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 2018, the higher rate was set at £217.59 a week. You’re entitled to continue on this rate unless: • you no longer have nursing needs • you no longer live in a care home that provides nursing • your nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £158.16 a week, or • you become entitled to NHS continuing healthcare instead. 19
Self-funding: paying for your own care and supp If you have more than £23,250 in savings (not including the value of your home or your pension), you may have to pay the full cost of your care. This is known as being a self-funder. The number of people paying for their own care is growing. While some people are eligible for funding from their council, many end up paying for all of their care.
Arranging your care as a self funder If you’re paying for your own care, you do not need to have a needs assessment first - you can go directly to a homecare agency or care home and organise it yourself without involving social services. But, it’s a good idea to have a needs assessment before arranging your care. This is because you will then have a clear idea of what your care needs are. You will know, for example, whether you need a professional carer to come in for 2 hours a day or 2 hours a week - and what specifically they should help you with. Ask for a copy of your needs assessment, so you have a record of your assessed needs. Request a needs assessment from your local council’s social services department.
• no, you won’t have to sell your home to pay for help in your own home • yes, you may have to sell your home if you need to move permanently into a care home. Social services works out how much you’re expected to pay towards your care and support through a financial assessment or means test. Your property will not be included in the means test if you’re arranging for help in your home. Your property will usually be included in the means test if you need to move permanently into a care home. Sometimes it won’t be included, for example if it’s still the main home of your partner.
Alternatives to selling your home The main ways to avoid selling your home to pay care home fees are: • releasing money from your home • renting out your home • deferred payments
Once you know what your care needs are you can either:
Releasing money from your home
• organise your care package yourself or
Equity release allows you to release money from your home without selling it.
• ask social services to commission and arrange it on your behalf (this option depends on where you live, some councils do not offer this service)
How much will care cost? Care is expensive and the bills can mount up. Knowing how much you’ll pay and how costs might change will make things less stressful. Homecare Homecare is where a professional carer comes to your home, for example for a couple of hours a day, to help you with tasks like getting washed and dressed, and household chores like preparing meals, cleaning and gardening. The recommended hourly rate is around £18.00, but this will vary according to where you live. Live-in homecare costs from around £650 a week. It can cost as much as £1,600 a week if you have complex needs. Care homes There are 2 types of care home. A residential home offers only personal care. A nursing home offers nursing care as well as personal care. • a room in a residential home costs around £600 a week • a room in a nursing home costs around £840 a week These prices will vary according to where you live and the type of care you need. For example, serious medical conditions like dementia can increase the cost. 20
Will I have to sell my home?
Make sure you get independent financial advice before considering this.
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The Money Advice Service has more information on equity release.
• NHS care such as NHS continuing healthcare, NHS-funded nursing care and care after you’ve been discharged from hospital
Renting out your home
• benefits such as Attendance Allowance. Make sure you’re claiming all the benefits you’re entitled to with this online benefits calculator: https://independentage.entitledto.co.uk/home/start
If you need to fund your care in a care home but don’t want to sell your home, you could consider renting it out and using the income to help pay your care home fees.
• equipment or home adaptations that cost less than £1,000
Deferred payments
If your savings run out
Where there is a delay in selling your property, or if you don’t want to sell it immediately, you may be eligible to have your care fee payment postponed. This is known as deferred payments. It’s where the council temporarily covers the cost of your care and you repay them later.
If your savings fall below £23,250, you might be eligible for council help.
If the local council agrees to the deferred payment and pays your care home fees, it will take payment from the money raised once the property is sold. This can be:
Contact your local council about 3 months before you think your savings will reach this level and ask for a reassessment of your finances and care needs. Councils will only provide funding from the date you contact them for help. So if your capital has already dropped below £23,250 before you contact them, you won’t be reimbursed.
• during your lifetime if you choose to sell your home
Get advice on paying for care
• once you die, in which case the local council can be repaid from your estate
The system of paying for care is complex and every case is different.
A deferred payment scheme is only available if you don’t have enough money to cover your care home fees, and you have less than £23,250 in savings. In these circumstances, the savings don’t include the value of your property, but do include money in bank accounts.
You can get independent advice about paying for care from:
What you may be able to get for free Even if you are a self-funder, you may be eligible for some free care and support regardless of your income, including:
• The Money Advice Service. Call their helpline on 0300 500 5000. • The Society of Later Life Advisers • Age UK • Which? Elderly Care • Independent Age 21
Care and support: what’s available? If you need help around the home, a good option is to have a care worker come into your home to help you. Home care costs around £18 an hour. Depending on your circumstances, this may be funded by your local council or you may have to pay yourself.
Types of care and support Care and support comes in many forms and there are 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 • help with cooking or preparing meals • nursing and healthcare • companionship Care and support can be very flexible. 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 • supported living services – these are services that can help you stay safe and well in your home on a long-term basis, including financial help, help with medicines, advocacy, social support and practical support • a place to live with a family who will care for you – this is known as shared lives services or adult placement services
Funding home care If you believe you might benefit from some help at home, the first thing to do is to contact your local authority’s social services department to ask for a care needs assessment. If you’re eligible for care and support services funded by your local council, your local council may provide or arrange the help themselves. Alternatively, you can arrange your own care, funded by the council, through direct payments or a personal budget. If you choose direct payments or a personal budget, or you aren’t eligible for council funding and want to get care privately, you can arrange it in several different ways: • using a care and support agency • hiring a personal assistant • getting care and support from a charity, such as Age UK 22
Independent care and support agencies If you use an independent care and support agency, you or the person looking after you 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. Care and support providers are regulated by the Care Quality Commission (CQC). They must meet the CQC’s national minimum standards and regulations in areas such as training and record keeping. 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: • take over the burden of being an employer – for example, payroll, training, disciplinary issues and insurance
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• train their care and support workers through national qualifications and service-specific training • replace workers when they’re ill, on holiday or resign • put things right when they go wrong An agency will want to see you and the person looking after you so they can assess your needs. This also means you can make a joint decision about the right type of care and support. Find out more from the UK Homecare Association.
How much does a care and support agency cost? Using a care and support agency can be expensive. The agency will charge a fee on top of the payment made to the care worker to cover their running costs and profits. 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 Before deciding to go ahead with an agency, you should ask questions about the fee and what it covers. These include: • Does the agency check references? • What training and supervision do they provide? • What’s their complaints policy? • Who’s 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 is contracted to provide care every day, it must do that.
Hiring a personal assistant Instead of using an agency, 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 continuity, familiarity and an ongoing relationship with an assistant. But if you employ a personal assistant, you have the legal responsibility of an employer. This includes arranging cover for their illness and holidays. Which? Elderly Care has advice on employing private individuals. Get more information on becoming an employer.
Care and support from charities Charities such as Age UK and Carers Trust can provide home help. Carers Trust also 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.
Complaining about care and support You have the right to make a complaint about any aspect of care and support. It’s a good idea to ask a care and support agency or charity about their complaints policy before you start to use their carers. Read more about how to make a complaint about the care and support you or someone else is receiving. If you are finding it difficult to make a complaint, find out how an advocate can help you. 23
Driving and using public transport Although mobility problems make it harder to get around, transport has been getting more accessible for disabled and elderly people over the years. You can get help: • using public transport • getting discounts on public transport • from the NHS with travel costs • finding community transport schemes If you have mobility problems and you need a car to get around, you may be able to get help with costs through: • discounted or free road tax • a Blue Badge parking permit • help with the cost of leasing a vehicle through the Motability scheme
Using public transport with a disability All public transport vehicles have to be “accessible” so disabled passengers can use them. Public transport also has to accept guide dogs or assistance dogs. But if you’re using public transport, it’s worth contacting the transport operator before you travel to make sure they’re able to offer the assistance you require. Buses and trains usually have priority seating for older people and people with disabilities. They also usually have space and wide doors for wheelchairs. Some buses, trains and trams are fitted with automatic ramps. The London Underground is being upgraded to improve stepfree access. Staff at Underground stations are also trained to help people move around the underground system – for example, by helping you avoid escalators and calling ahead to arrange for assistance at your destination.
Discounts on public transport for older people and disabled people Older people and people with disabilities can travel free on local buses anywhere in England between 9.30am and 11pm Monday to Friday, and at any time during the weekend and on bank holidays. Some authorities offer free travel for longer, and some allow a companion to travel with the pass holder for free. You may have to apply through your local authority, but in most areas you can apply online for an older person’s bus pass or for a disabled person’s bus pass. If you often travel by train, it’s probably worth getting a Disabled Railcard Card. This gives you a third off the price of rail tickets. Check the criteria to see if you’re eligible. Children aged 5 to 16 with disabilities are eligible for a Disabled Person’s Railcard. This lets an adult to travel with them for a third of the cost of an adult fare, while the child pays the normal child fare. Taxi and private hire companies can provide wheelchairaccessible vehicles if you ask for one when you book a vehicle. Some councils also give free taxi vouchers to people who find it difficult to use public transport because they’re frail or disabled.
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Cars and parking Road tax reductions If you’re disabled or have a serious long-term condition, you might be eligible for a reduction in your road tax, or even be exempt from it altogether. Find out more on GOV.UK about vehicle tax exemption and vehicle tax reduction. Blue Badge disabled parking scheme If you have severe mobility problems that make using public transport difficult, you may be able to get a Blue Badge parking permit for your car. This lets you park closer to places you wish to visit, such as in marked disabled parking bays. You may also be able to: • park for free within certain time limits in some places • park on single and double yellow lines • stay longer in on-street time-limited parking bays Blue Badge schemes are run by councils. Most councils will let you apply for a Blue Badge online. Central London is exempt from the national Blue Badge regulations and the central London boroughs of Kensington and Chelsea, Camden, Westminster and City of London don’t fully operate the Blue Badge scheme. But if you’re exempt from road tax or have a Blue Badge permit, you may be able to get an exemption from paying the central London congestion charge. NHS help with travel and transport costs If you pay to travel to a hospital or other NHS premises for NHS-funded treatment or diagnostic tests, you may be able to claim a refund of reasonable travel costs. Find out more about the Healthcare Travel Costs Scheme and who’s eligible.
Community transport schemes These schemes provide transport to and from hospitals, doctors’ and dentists’ surgeries, and opticians and chiropodists. Many areas offer a free “Dial-a-Ride” service, offering door-to-door transport for people unable to use normal buses. Some schemes require you to register and may charge a fee. Carers may be able to travel with you for an additional charge. Check with your local council whether your area has a community transport scheme. The British Red Cross runs a similar transport service in some areas. Contact your local Red Cross branch for information.
Motability scheme The Motability scheme allows disabled people to use their mobility benefits to lease a car, powered wheelchair or scooter. You can also pay an extra amount of money if you want a more expensive vehicle. The Motability Scheme is open to anyone who gets: • the higher rate mobility component of Disability Living Allowance (DLA) or Personal Independence Payment (PIP) • the War Pensioners’ Mobility Supplement (WPMS) • the enhanced rate mobility component of Armed Forces Independence Payment.
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.
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Going home from hospital? Age Concern Liverpool & Sefton are here to help When you’re ready to go home, if you are over 50 and a Liverpool or Sefton resident then we are here to help and support you. Please note that services marked with a ▲ are free of charge.
Help with personal care and daily living tasks After a spell in hospital you may find that the everyday living tasks you used to take for granted are now a bit more challenging. Our Homecare Service can help. We can provide support with everyday tasks such as cleaning, making a meal, getting up and going to bed, washing, dressing, grooming, going to the toilet; in fact all of the things we tend to take for granted and need to do every day. The homecare service can also escort you to follow up appointments or trips out if you are feeling a bit anxious about going out on your own. We can also provide a shopping service and we have a range of daily living aids to help you in your home – please call us for a catalogue.
Dementia Day Care A Dementia Day Care Service has recently opened in Clubmoor, providing care, activities and opportunities to socialise for older people living with 26
dementia between 8am and 6pm, weekdays. It is perfect for carers who want to work or who just need a break and a bit of “me time”; but need to know that the person they care for is safe and having a good time.
Many people about sum help emerge we can p persona
The Poppy Centre
When you are settled back at home, if you find that you are bored or lonely and want to get out, make friends and enjoy a older wide range of activities then why e worry not try our Poppy Centre. It offers mmoning a 3 course meal and a friendly in an atmosphere in a modern, welcoming environment. The Poppy Centre is ency, so based in Clubmoor, North Liverpool provide a but is attended by people from all over al alarm. Liverpool and South Sefton.
Information & Advice ▲ Often after a spell in hospital it is more difficult to cope with everyday tasks. If you find that this is true, you may qualify for extra financial help. Our advisors are here to provide expert advice, information and signposting. They also have the ability to answer an extremely wide range of queries; from where can I get a tip-up-kettle to how can I get my house adapted to suit me. Whenever you want to find anything out from a trustworthy source – give us a call.
Cancer Support ▲ Free practical support for older people who have been recently diagnosed with
cancer including help with cleaning, shopping and other household tasks. The service is funded by Macmillan Cancer Support
Products to make life easier When you come out of hospital we can arrange products designed to make it easier for you to get around your home such as rollators. We are able to arrange stair lifts, which will make all parts of your home accessible again. Many older people worry about summoning help in an emergency, so we can provide a personal alarm. If you are in trouble, are feeling unwell or have a fall, you just push the button on a pendant or simple wrist watch type device and help can be on its way in moments. These alarms are perfect to provide peace of mind both for you and your family; who will know that you can summon help whenever you need it 24/7.
The Befriending and Reablement Service ▲ Designed to support you to regain daily living skills and re-engage with your local community after discharge from hospital and it can provide ongoing befriending if you would benefit from a regular visitor or support to access a friendship group. Currently operating in Sefton (funded by Sefton NHS) it will be available in Liverpool from late September 2018 (thanks to funding from the Big Lottery).
For further information about our all of our services please call 0151 330 5678 or 01704 542993 27
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)?
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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.
Safeguarding adults who receive social care
10 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.
Useful contacts A
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Action on Elder Abuse 080 880 88141 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
Elderly Accommodation Counsel 0800 377 7070 Elderly Accommodation Counsel (EAC) is a national charity that aims to help older people make informed choices about meeting their housing and care needs. I www.eac.org.uk I info@firststopadvice.org.uk
Admiral Nurses 0800 888 6678 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 www.dementiauk.org I direct@dementiauk.org Age Concern - Liverpool & Sefton 0151 330 5678 or 01704 542 993 An independent charity whose objective is to make the lives of older people in Liverpool as fulfilling as possible. 179 Townsend Lane, Clubmoor, Liverpool L13 9DY I www.ageconcernliverpool.org.uk I mail@ageconcernliverpoolandsefton.org.uk Alzheimer's Society 0151 298 2444 The UK's leading support and research charity for people with dementia, their families and carers. Neurosupport Centre, Norton Street, Liverpool, Merseyside L3 8LR I www.alzheimers.org.uk I liverpool@alzheimers.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 4all Liverpool, Knowsley, 0845 601 1990 Sefton & Warrington Looking after a family member or friend? Get in touch for expert advice, information and support. 5 de Hallivand Drive, Liverpool, Merseyside L24 8RN I merseyside@carerstrust4all.org.uk I www.carerstrust4all.org.uk/liverpool-sefton-warrington.html Cruse Bereavement Care 0808 808 1677 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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Disability Rights UK Disability Rights UK is the leading charity of its kind in the UK. They are run by and for people with lived experience of disability or health conditions. Ground Floor, CAN Mezzanine, 49-51 East Road, London N1 6AH I www.disabilityrightsuk.org I enquiries@disabilityrightsuk.org Disability Benefits Helpline – for 0845 712 3456 Disability Living Allowance and Attendance Allowance I Textphone: 0845 722 4433 I www.direct.gov.uk/en/Dl1/Directories DG_10011169 Options Liverpool & Sefton is published by Octagon Design & Marketing Ltd with editorial contributions from The Royal Liverpool and Broadgreen University Hospitals NHS Trust, the CQC, Age Concern Liverpool & Sefton, Sefton Council and NHS Choices. The editorial contributors and publisher have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the editorial contributors and publisher endorse any of the products or services.
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Integrated Care Council 01379 678243 The Integrated Care Council (ICC) is a body that brings together British health and social care, public and independent sector organisations that commission or directly provide support for people living at home. I www.integratedcarecouncil.co.uk
K Knowsley Carers Centre 0151 549 1412 143 Bewley Drive, Kirkby, Knowsley L32 9PE I knowsley.carers@btconnect.com I www.knowsleycarers.co.uk
L
Liverpool Citizens Advice Bureau 0344 848 7700 2nd Floor, 1 Union Court, Cook Street, Liverpool, L2 4SJ I www.liverpoolcab.org.uk I bureau@liverpoolcab.org
M
Mind (National Association 0300 123 3393 for Mental Health) The leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. www.mind.org.uk I contact@mind.org.uk
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National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis. I www.nos.org.uk National Rheumatoid Arthritis 0800 298 7650 Society (NRAS) or 0845 458 3969 Provide information, support and advice for people living with Rheumatoid Arthritis. I www.nras.org.uk NHS 111
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P Parkinson's Disease Society I www.parkinsons.org.uk
0800 800 0303
R
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
S Sefton Council I www.sefton.gov.uk Stroke Association 0845 3033 100 Advice and information for stroke patients and their families. I www.stroke.org.uk
T 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 The Royal British Legion 25-31 Williamson St, Liverpool, L1 1EB
0333 011 4311
Every possible care has been taken to ensure that the information given in this publication is accurate. 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. 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. Š2018. Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire, DN10 6AB. Telephone: 01302 714528
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Aintree University Hospital Longmoor Lane Liverpool, Merseyside L9 7AL Tel: 0151 525 5980
SEFTON
in Liverpool & Sefton
NORTH LIVERPOOL
CITY CENTRE
The Royal Liverpool and Broadgreen University Hospitals
179 Townsend Lane, Clubmoor, Liverpool L13 9DY. Tel: 01704
NHS Trust
542 993 or 0151 330 5678
Royal Liverpool University Hospital Prescot Street, Liverpool L7 8XP Tel: 0151 706 2000
SOUTH LIVERPOOL
The Royal Liverpool and Broadgreen University Hospitals
The Royal Liverpool and Broadgreen University Hospitals
NHS Trust
Royal Liverpool University Dental Hospital Pembroke Place, Liverpool, Merseyside L3 5PS Tel: 0151 706 5253
NHS Trust
Liverpool Women’s Hospital Crown Street, Liverpool, Merseyside L8 7SS Tel: 0151 708 9988
Spire Liverpool Hospital 57 Greenbank Road Liverpool, Merseyside L18 1HQ Tel: 0151 733 7123
Broadgreen Hospital Thomas Drive, Liverpool, Merseyside L14 3LB Tel: 0151 706 2000
“Committed to Caring for the Elderly”
PEACEHAVEN HOUSE 101 ROE LANE, SOUTHPORT, PR9 7PD • 01704 227030 • www.peacehavenhouse.com
★★★★★ Peacehaven House is set in a quiet suburb of Southport. Conveniently located to the local shops in Churchtown and seaside resort of Southport, Peacehaven House was established in 1949 as a Registered Charity to provide care for the elderly in Southport. Over the years the building and gardens have been sympathetically extended and refurbished, we now have 54 bedrooms, multiple lounges, two dining rooms, a conservatory and beautiful gardens with paved walkways, a summer house and a majestic rockery/waterfall feature. We are a ‘not for profit’ charity led organisation, this registered charity was formed on the 5th December 1949. Being a charity led organisation has many advantages for the residents at Peacehaven as we are able to re-invest any surplus generated into improving facilities or extras and we are not beholden to shareholders. We run the home for the sole purpose of the residents and the residents truly come first at Peacehaven. Peacehaven has ample parking for visitors right by the front door, with wheelchair access to the main building. Rooms are located mainly on the ground floor, while first floor rooms can be accessed by the stairs or lift. There are 54 bedrooms, many of which have en-suite toilet facilities and enjoy stunning views of the lovely gardens. Rooms are equipped with beds, furniture, shaving points, electrical sockets, mirror and wash basins and residents are welcome to bring along their own furniture.
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The locations on the map indicate where services operate out of.
NHS Hospitals and services
Afton Lodge Residential Care Home
Afton Lodge is a tastefully converted property, providing residential care for the elderly. It provides a homely environment and features a TV lounge and a quiet lounge. There is also an extensive walled garden and patio area with full disabled access. The home welcomes Service Users funded by Social Services and those who are privately paying clients. This home is inspected and accredited by CQC, in accordance with statutory government regulation. Afton Lodge also currently holds a five star PQR rating, which is an independent quality assurance mark and is also recognised as Investors in People. Our dedicated staff are headed by a registered manager, who has many years of experience in caring for the elderly. Our managers provide hands-on supervision to maintain our tradition of excellence. All Staff are DBS checked and trained to an appropriate level, many with NVQ qualifications. Accommodation is fully inclusive of laundry. Our trained chefs prepare a wide range of home cooked food using fresh local produce. The choice is based on traditional recipes and daily alternatives are provided at every meal time. Special diets are also catered for.
Services we offer ❖ Residential and personal care ❖ Dementia ❖ Short and long stay care ❖ Day care ❖ Intermediate care ❖ Re-ablement care ❖ End of life / palliative care ❖ Home care and support ❖ Cohort beds for hospitals Support and facilities ❖ Personal healthcare ❖ Activities ❖ Dining and accommodation ❖ Laundry service ❖ Disabled / wheelchair access ❖ Lifts to all floors ❖ Specialised equipment available for assisted bathing etc. ❖ Car parking available ❖ Special diets available
Health and personal care ❖ GP services available on request ❖ Chiropody visits on a regular basis ❖ Hairdresser visits ❖ Optician and dentists by arrangement Leisure activities ❖ Newspapers and music ❖ Pop quiz ❖ Shopping trips and hairdressing ❖ Karaoke ❖ Bingo and skittles ❖ Cheese and wine tasting ❖ Dominoes ❖ Social events Accommodation ❖ Nurse call in every room ❖ Rooms decorated to a high standard ❖ Double rooms also available ❖ TV in rooms ❖ Internet facility available
Afton Lodge Residential Care Home 9-15 St Catherines Road, Bootle, Liverpool L20 7AL Tel: 0151 922 6183 Email: aftonlodge@regency.care Website: www.regency.care Facebook: www.facebook.com/rhcltd Twitter: @Regency_HC 31
Parkhaven Trust is a registered charity based in Maghull providing a wide range of services to support older people and people with dementia.
Our Services Kyffin Taylor House - Residential home that offers care for older people with dementia James Page Nursing Home - Nursing care for older people Harrison House - Residential home for older people The Willow Centre - Day & Respite service for people with dementia Parkhaven Court - Extra care housing scheme for people with dementia
Deyes Lane – tenanted housing with care for people with a learning disability We aim to provide the highest possible quality of care with a person-centred approach. Visitors are always welcome and each home provides varied menus, which are nutritionally balanced and offer choice. We have a dedicated Activities Coordinator who organises a meaningful programme of activities. We are a committed provider of dementia care and use our expertise and experience to enrich the lives of service users.
“The dedication of our staff is what sets us apart …” For more information please contact
For more information please contact Michelle Whitney on 0151 526 4133 or Email: Michelle.Whitney@parkhaven.org.uk Visit our website: www.parkhaven.org.uk Registered Charity No: 210163
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You’ve started to notice the signs that an aging parent needs help: Dad can’t find his meds, Mum won’t talk about that mysterious dent on the car, you stop by the house only to discover the kettle left boiling on the stove. These are universal “something’s not right” signs that remind us – no matter how much we try – we just can’t be there for our aging loved ones all the time. We know everyones experience is different, but do you recognise these signs your aging parent needs some help? Missed Medication : The Lost Walker : A Bruised Knee : Mail Piling Up : His Unshaven Face : The Untidy Garden : Piles of Laundry : An Empty Fridge : Another Missed Doctor’s Appointment : A Torn Shower Curtain : Home Instead Senior Care Offer In-Home Care Services That Can Help Seniors With The Tasks We All Perform Each Day To Stay Happy At Home, Healthy & Engaged with Life. Call Today For Our Free No-Obligation Care Consultation or visit www.homeinstead.co.uk
Southport 01704 547 938
ALLCARE COMMUNITY CARE SERVICES CQC overall rating: good
Personal care and support promoting independence in the home. Respite Services in Southport
The services we offer include:
At AllCare Community Care Services we understand that everyone wants to retain their independence as long as they possibly can, and that your need for home support in Southport changes from month to month.
• Personal care and support
We cover all hours from 24 hour care to a 30 minute visit each week. From the occasional help with getting to an appointment, through respite services and holiday relief to long term home help in Southport area including Birkdale, Ainsdale and Churchtown, we can help. Short Breaks or Long-Term Care Whether your permanent carer needs a short break, or you’re looking for long-term care in order to live independently in your own home, our qualified, caring staff can help. Our offices are open from 7am - 11pm, seven days a week, 52 weeks in the year, so there’s always someone to contact in an emergency.
• Escorting to appointments • Sitting Services • Carer Relief • Short Breaks • Shopping and Meal Preparation • Companionship Our services are offered to anyone who needs assistance on a long or short term basis to live independently on their own. Call us Today If you need personal care in the Southport area, then call us now on 01704 550482 and we’ll be happy to discuss your requirements with you. Alternatively, you can send us an email for an immediate response. AllCare Community Care Services provide the best in quality personal care and support to promote independence in the home.
1st Floor Crown House, 10-16 Coronation Walk, Southport PR8 1RE
Tel: 01704 550482 Email: pauline.oakden@allcareccs.co.uk www.allcarecommunitycare.co.uk 33
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“Homely, caring and person centred with a good reputation.”
Promenade Promenade Care Care Home Home Residential, Respite, Holiday Residential, Respite, Holiday Care and New Care Days Care and New Care Days
Providing excellent standard of care within homely environment. Premier position on Southport’s Promenade overlooking King’s Gardens. CQCanRegistered – Fully Compliant in allaCare Standards Town centre and its amenities are within easy reach from rear gardens of the home.
A good emphasis on social and recreational activities for those who wish to take part and our own coach ensures frequent trips out. • Fully trained dedicated staff • Personalised care plans • Home cooked meals • daily choice of menu and diets catered for • 2 lifts • Hair dressing salon • complimentary manicureS, massage ETC • Private visitor room • COFFEE LOUNGE • ACTIVITIES TEAM
Local Funding Accepted
10-12 The Promenade, Southport PR8 1QY (next to Royal Clifton Hotel) For more information, to visit, a brochure or just to chat please call
01704 538553 Fax: 01704 538250 E-mail: info@promenadecarehome.co.uk www.promenadecarehome.co.uk Good
Good in all care standards
CARE DAYS
Just a small number of places available, why not try our…
Flexible morning, afternoon & full day sessions
A great opportunity to meet new friends and socialise Fun and laughter throughout our activity sessions Small group activities, quizzes, bingo etc. Coach trips and outings (weather permitting)
Or something more relaxing Why not try – Indian Head Massage, Soothing Massages, Reflexology or a Pampering Manicure Visiting hairdresser at an additional charge
Refreshments and snacks throughout the day • 3 course choice of lunch menu • 2 course choice of tea menu
£42 Full Day / £21 Half Day Newly available Care days with accommodation suite - short and long stays
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Orchard Lodge Care Home EXCELLENT CARE 30-32 Gordon Road, Seaforth, Liverpool L21 1DW Telephone: 0151 474 6375
♦ Privacy ♦ Dignity ♦ Individuality ♦ Independence ♦ Freedom of Choice
We are committed to providing the highest standards of care in comfortable, safe and relaxed surroundings. We aim to meet the personal needs of all of our clients in a way that respects the privacy and dignity of the individual and promotes independence. ♦ 20 Single and 3 Double Bedrooms ♦ Spacious Dining Room and Residents’ Lounge ♦ Conservatory Overlooking Garden ♦ Passenger Lift To All Floors ♦ 24 Hour Dedicated Care Staff ♦ Choice of Own GP ♦ Optional outings, activities, holidays and entertainments For more information or for an informal chat, please call our Registered Manager, who will be happy to answer any questions. 0151 474 6375
Designed by: Octagon Design & Marketing Ltd, Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire DN10 6AB. Tel: 01302 714528 Email: info@octagon.org.uk