Care at Home : A guide to Elderly Care

If you are finding it increasingly difficult to manage your home but want to remain as independent as possible then you will probably require care at home. Your social services department provides a wide range of services that help to make things easier for you. This means that you can stay in your own home safely and comfortably.

If you don’t want to go through social services then there is the option of approaching private agencies or a local charity/voluntary association.

In regard to cost: in either case you will have to pay towards the cost of care at home.

It may be the case that you could do with some help preparing meals, going to the shops, bathing or dressing/undressing yourself. Social services will assess your ‘care needs’and from this, arrange a suitable form of care.

Services offered by your local authority

Social services may provide some or all of the following:

• Respite care: this is designed to give you or the person who looks after you a short break.
• Luncheon clubs: a place which serves a hot meal to people and enables them to socialise with others.
• Social clubs and/or day care: these are places which enable elderly people to meet, socialise with others and to participate in a number of activities. Usually includes a hot meal.
• Meals on wheels: a service where a hot meal is delivered to your door.
• Home help: this is where someone comes to your home to help you with daily household jobs such as doing your laundry or cooking.
• Live-in carer: this is a specially trained person who lives with you on a 24 hour basis. They can assist you with all forms of household tasks and personal care.
• Pop-in care: someone who drops in to help you with a small but necessary job such as doing your shopping.
• Personal care: this type of care attends to your ‘intimate’ needs such as going to the bathroom or bathing.
• Night sleeper/sitter: a service in which someone is available to attend to your needs during the night. This is also designed to provide reassurance.
• 24 hour personal alarm system: a type of alarm system which offers help on a 24 hour basis.
• Adaptations to your home: ways of making your home easier to live in. These include hand rails, a bath hoist or a stair lift.
• Improvements to your home: these include central heating, cavity wall insulation and draught proofing.
• Employing a carer: help with employing someone to look after you on a regular basis. Social services can arrange this or you can employ someone directly from a private agency.
• Warm Front Scheme: this is a government-run scheme available to people aged 60 or over. It provides funding for heating and home insulation. Note: Warm Front is available in England and Wales only. There is a similar scheme in Scotland called The Energy Assistance Package.

This information should be accessible via your local library and your GP’s surgery. In fact, your GP is a good person to discuss this issue with as he/she is familiar with your medical history and what you may need. Your local authority should display this information on its website as well as being available in a printable document format. If not then request this information from your social services department.

The process for applying for help is usually this:

• You contact social services
• You explain your needs
• They carry out a needs assessment
• They arrange for the appropriate service/s to be provided

Contact social services

You can find the telephone number of your social services department in a local directory or from their website.

Social care assessment

The care assessment involves a social worker making a note of your needs and seeing if these match their ‘eligibility criteria’. If anyone looks after you as a carer then it will also take their needs into account.

They will then make a decision on the type of care you need.

This care can be arranged via social services or if you prefer, you can ‘buy in’the care you need through a system called ‘Direct Payments’.

Direct payments

A direct payment is money given to someone to arrange and pay for their own care. They have to give their consent to this and be able to manage this on a regular basis. If you are already getting help from social services then they must offer this as an option to you. There are likely to be some situations in which this is not appropriate but social services will give you a reason for this refusal.

If you are approaching social services for the first time then they will carry out a needs assessment beforehand.

This assessment will affect the amount of payment you receive.

If you are refused help from social services then this will also include direct payments. But if there is a change to your circumstances in the meantime then ask them for a re-assessment.

A direct payment is paid into your bank or building society account. It can also be paid into a National Savings or Post Office account.

Direct payments CAN be used to pay for:

• Services which will cater to your needs as noted in your care assessment.

They cannot be used for:

• Permanent or long term stay in a care home. But they can be used to pay for short, temporary stays subject to social services approval.
• Services from your spouse, partner or a relative - unless there are exceptional circumstances.

You will be expected to keep a written record of these payments which shows how the money has been spent. This can also include receipts from care agencies and timesheets, signed by carers. If you are a carer then you can apply for a direct payment. But they cannot be used to buy services for the person you are looking after. They are designed to be used for support that you require.

If you are receiving this payments and there is a change in your circumstances or you don’t want to continue with this service then contact social services.

Care plan

The results of the care assessment will determine the type, or types of services you need. These results are used to develop a ‘care plan’-a scheme which outlines the type of care you will receive.

You will be given a copy of the care assessment and the plan.

You will also be given the name of someone who is responsible for your care. This is your ‘care manager’.

Social services will then arrange these services for you. There may be some types of services which are not provided by social services but they still have a duty to arrange them.

These services may be provided by a charity or a private agency.

There is the option to buy in the care you need via a system of direct payments. Social services provide the funding and you arrange the services you need.

Paying for care at home

In an ideal world no-one would have to pay for these services but local authorities have limited budgets and competing demands upon these.

Your care assessment is in effect, a ‘means test’in that it looks at your financial situation and determines the amount you can contribute to your care.

Social services can charge you for any of their services but the amounts must be what are deemed as ‘fair’. In other words, they must be affordable and comparable to the type of service that is being provided. This applies to people living in England, Wales or Northern Ireland.

The rules are slightly different for people living in Scotland. If you are aged 65 or over then you don’t have to pay for personal care but you will have to pay for other services such as home help etc.

If you think the charges set by social services are too high then ask them to review your case.

If you are not happy with the level of service provided or don’t think that they are right for you then make a complaint. Social services will have a complaints procedure in place but if you are unsure as to how to go about doing this then ask for advice from Age Concern or the Citizen’s Advice Bureau.

Other forms of help

There are local voluntary organisations which can offer help and support that social services don’t. For example, help with gardening or small jobs around the house such as changing light bulbs. They may also be able to pick up your pension from the post office. The Women’s Royal Voluntary Service (WRVS) and Age Concern may be able to help as can a friend or neighbour.

There is a scheme called ‘Supporting People’which is run by the government and provides all manner of help. This includes financial help as in making sure you have claimed all the benefits you are entitled to, access to a community alarm and advice about making adaptations to your home.

Your local authority will have a Supporting People team so contact them for more information.

You may prefer to employ a carer to come in and look after you as a private arrangement rather than have help from social services. This means finding a private care agency but be careful when you do. Make sure that you find a reputable agency and a carer which you are comfortable with and can trust.

The Counsel and Care charity have useful information on what to look for in a care agency.

The United Kingdom Home Care Association can give you a list of care agencies within your area.

Benefits entitlement

It is worth checking to see if you are claiming all the benefits you are entitled to.

If, for example, you don’t have much money coming in each week then you might be entitled to the Pension Credit. This is a benefit which basically, tops up your present income.

Even if you have savings, or a second pension you may still be entitled. Plus if you are entitled to Pension Credit then you may also be entitled to Housing Benefit (if you rent your home) and Council Tax Benefit. Another possible benefit is a Cold Weather payment.

If your level of savings is too high and excludes you from claiming the Pension Credit then you may still be eligible for Housing Benefit and Council Tax Benefit.

There are other benefits such as Disability Living Allowance and Attendance Allowance which can provide you with some extra money if you require personal care.

The Directgov and Help the Aged websites contain more information about this (see our links page). Another useful source is the Department for Work and Pensions (DWP) website.