Your first step : A guide to Elderly Care

You have decided to move into a care home because you are finding it difficult to cope; or you are caring for a parent or relative and feel that a care home would be in their best interests.

So what is the first step or indeed steps?

First of all you need to decide between the following two options:

• Local authority homes
• Private homes (independent sector)

Local authority homes

These are homes in which the residents have some or all of their fees paid for by their social services department (within their local authority). Private homes (independent sector)

These homes are owned by private bodies, for example BUPA, and contain residents who are paying for their fees themselves. If you are looking to pay for all of your fees then you can choose whatever home you like. All you have to do is to make a list of homes that you are interested in and visit these in turn.

The home will carry out a ‘needs assessment’to make sure that they are able to provide the right type of care for you.

Many people assume that private homes only cater to wealthy residents but the opposite is true. Many of the residents in these homes are receiving help towards their fees from their local social services department.

If you are looking for help from your social services department to pay some, or all of the fees then the process is much the same. They will also carry out a needs assessment and also a financial assessment to see if you are able to contribute towards the cost of your care.

What care home should you choose?

You should have a choice of home whether you are paying for it yourself or with help from your local authority.

If you choose a home within the independent sector then you have an unlimited choice.

You still have a choice if your local authority is helping you with the costs. They will have a list of homes within your area but if you don’t feel any of these are suitable then you don’t have accept any of them.

If you decide to look elsewhere and find a home which does accept local authority residents then your social services department will help with this.

But only as long as the following applies:

• The home of your choice is suitable for your needs.
• There is a place available in that home.
• The home doesn’t cost more than what the local authority would normally pay for someone with your needs.
• Your local authority can agree upon a contract with the home which will ensure that your needs are met.

More expensive choice of care home

If the home of your choice costs more than your local authority normally pays then you have one of two options:

• They may agree to pay the extra costs if your needs are such that they would be best served at this particular home.
• A member of your family or a charity are willing to pay a ‘top up’ to the local authority contribution to the fees. You are not allowed to make this contribution yourself as you will have already been assessed as to what you can afford.

As with anything in life it pays to ‘shop around’. No two homes are alike so visit several ‘possibles’ before making a decision.

A the end of the day you need to be certain that you will enjoy living there so it is wise to spend a fair amount of time investigating homes before you make a move.

Fees are covered in more detail in our paying for elderly care section.

Needs assessment

If you are applying to your local authority for help with fees then you will have to undergo a ‘needs assessment’.

A needs assessment is basically, a review of your current state of health and day to day living. This is designed as a means of determining the level and type of care that would best suit you.

This is followed by a ‘care plan’: a report put together by a care manager which contains details of your needs and what form of care would address those needs.

Note: a ‘care manager’ is someone appointed by social services to handle your case.

The needs assessment can be held at your local social services department or at home if necessary.

Information for a carer

If you are a carer for someone in your family who requires a needs assessment then it can help if you make a list of all the tasks you do when looking after this person. You can then hand this to the social worker.

This can be done if the person you are looking after requires help at home or from a care home.

The assessment itself is usually conducted by one person but it may include your GP if complex care is required. You can talk to the assessor in confidence without the person you care for being present.

All information is kept strictly confidential.

What does a ‘needs assessment’take into account?

The needs assessment looks at the following:

• The problems the person has and the type of care they need.
• The tasks you undertake as a carer for them.
• The amount of time spent caring for them.
• If anyone else is involved in their care.
• If you are a live-in carer.
• Your opinions and preferences.
• Your own state of health.

The results of the needs assessment will determine the care plan. This will include the type of care the person you are looking after needs, as well as services that will help you.

The care plan should show which services are for the person you look after and which are for you as their carer.

Social services can then arrange either of the following for the person you are looking after:

• A short stay in a respite care home
• Moving into a residential care or nursing home

Once the type of care has been decided on then social services have to provide that care, irrespective of whether the funds are there or not. Especially in the case of someone who would be a severe risk of harm if services were not available to them.

But, they are within their rights to ask the person being cared for to make a contribution to their care.

However, before they do this they will carry out a financial assessment.

The financial assessment

If you are the person who requires care, and have undergone a needs assessment then this will be followed by a financial assessment.

Social services will look at your financial affairs, in particular the amount of income and capital you have which will help to determine your contribution (if any) to the cost of your care.

So what do they treat as ‘income’ and ‘capital?’

Income is seen as a private and/or State pension, interest on your savings and benefits such as Attendance Allowance, Pension Credit or the ‘care’ part of Disability Living Allowance.

Capital is seen as savings, any property you own and investments.

Make sure you are getting all the benefits you are entitled to. The reason for this is that the assessment will determine the amount of your contribution based upon you receiving all the relevant benefits.

Issues of paying for care are covered in more detail in our paying for elderly care section.