Home Care
What is home care?
For many people it is important to stay at home in their own, familiar surroundings near to friends and family. At the same time, remaining independent may also be very important to you but that can mean you need a little extra help. Some carefully chosen home care (sometimes known as domiciliary care) can often be the perfect solution to getting a little help whilst retaining a good level of personal freedom.
Why choose home care?
Reasons for choosing homecare can vary. Sometimes after a stay in hospital, someone might find they need some help whilst they recuperate. Others can find that a long-term condition or disability means they need some help at home.
How you access that care at home can also vary. After a stay in hospital someone may carry out an assessment of your situation to see if home care will benefit you. You and your family will be fully involved in looking at what will suit you best.
Alternatively, you or those close to you might notice changes in you being able to manage the day-to-day things you normally cope with easily, like preparing meals or looking after yourself. If this happens, you can contact a home care agency to discuss your specific requirements. Alternatively, you can contact Adult Social Care.
Councils have a duty to carry out a care needs assessment for anyone who might need help, which is very useful in helping you make care and support decisions. It will equip you with information that will be invaluable in finding the right help.
How home care can help you
The level of home care provided can be tailored to meet your needs – from a visit once a day to a much greater amount of help. Home care agencies can help with personal care such as washing and dressing.
You might be surprised to learn that even those with quite significant health conditions can get a level of skilled personal care that can enable them to stay in their own home. Some agencies will provide ‘live-in’ care, where a care worker will stay with you at home to support you throughout the day and night.
Shared Lives
This service offers long term respite or day support for people either within the Shared Lives Carer’s own family home or in the service user’s home. The person can either live with the family permanently, or go to stay with them for overnight short breaks, or for a few hours per week. The Shared Lives Scheme is usually available to any vulnerable adult over 18, who meets their local council’s eligibility criteria.
If you would like to live in a Shared Lives home and be cared for by a Shared Lives carer, or to become a Shared Lives carer, then you (or a family member, relative, friend, neighbour or any other adult) should contact your local council or adult social care provider.
Finding home care
This website allows you to search by postcode or region for care homes, care homes with nursing and home care providers that meet your requirements across the country. Your search can then be saved and emailed to others.
There is a professional body, the United Kingdom Homecare Association (UKHCA), which requires its members, home care providers, to comply with a code of practice. This code includes a commitment to treat customers with dignity and respect and operate at a level above the legal minimum required in legislation. All providers must also be registered with the Care Quality Commission (CQC).
Social care regulations do not apply to cleaners, handymen or gardeners. However, some homecare agencies are increasingly providing staff who can help meet these needs too.
You might decide that you want to employ a personal assistant to provide your care privately
or have a member of your family who can provide the level of care you need.
However, the benefits of using a regulated agency include:
- assessing your care needs and tailoring a plan to meet those needs;
- advertising, interviewing and screening suitability of workers;
- arranging necessary insurance cover;
- providing training and development for care workers;
- managing workers’ pay, including compliance with the National Minimum Wage;
- managing employment relationships, including sickness, absence and disciplinary matters; and
- managing health and safety issues.
Carefully chosen home care, with a good quality provider, is an excellent way to retain your independence, whilst getting the help you need to stay happy and safe. It can offer the opportunity to stay at home, in familiar surroundings, whilst getting the help you need to stay happy and safe.
Live-in Care
If your loved one requires care around the clock but would like to remain in their own home, 24-hour live-in care may be a suitable support system for them. It is understandable that most people would prefer to live in their own home rather than move into a care or nursing home but, if your relative is feeling increasingly isolated or lonely, then this will have to be considered alongside their physical needs and, at that stage, a care or nursing home may be the better option.
Live-in care can be a useful service to offer short-term respite to carers who may want to have a holiday or just need a break. Live-in care can also be useful when an urgent need for care is placed upon families and hospital discharge relies on having the right amount of care and support in place in your loved one’s home. In this regard, a live-in carer would help with recuperation and rehabilitation whilst working alongside professionals in the community, but this may only be for a limited period of time.
Dementia Care
Where do I go for dementia information?
Usually the initial point of contact to access care services for those living with dementia or Alzheimer’s disease is either their GP (for healthcare solutions) or Adult Social Care services (for most other services).
If you are concerned about your persistent forgetfulness – or the memory difficulties of a friend or family member, it is important to consult a GP. He or she can undertake an initial examination and can then refer you to a memory clinic for further dementia tests.
The types of dementia support available are likely to involve the NHS, Adult Social Care and voluntary agencies. Some examples of dementia services and support for people with dementia include:
- specialist day centres;
- memory cafes;
- respite or short breaks;
- assistive technology and community alarms;
- home care;
- community equipment;
- extra care, sheltered housing; and
- carers’ support groups.
Supporting someone living with dementia
If you know someone who is worried about their memory, encourage them to visit their GP.
The more support you can give someone, the better life with dementia can be, especially in the early years.
Too often people fear dementia and this causes them to avoid people with the condition, making them feel isolated and stigmatised. With the right support, people can live well with dementia and continue to do the things they enjoy for a number of years following diagnosis. Focus on the person’s abilities not their disabilities. Encourage them to continue with hobbies or interests whenever possible; a good understanding of dementia will enable you to communicate and support the person better.
When someone is living with dementia, they need:
- reassurance that they are still valued, and that their feelings matter;
- freedom from as much external stress as possible; and
- appropriate activities and stimulation to help them to remain alert and motivated for as
long as possible.
A person living with dementia is not being deliberately difficult; often their behaviour is an attempt to communicate. If you can establish what this is, you can resolve their concerns more quickly. Try to put yourself in their place and understand what they are trying to express and how they might be feeling. Understanding someone’s life history can also help to understand what they may be expressing.
Dementia day centres
In the earlier stages of dementia, day care support can offer vital help. A good day opportunity will be able to offer a range of activities and support that will enable the person with dementia to retain skills and remain part of their local community.
Specialist day care for people with dementia should be organised and run with the needs of
people with dementia in mind, aiming to build on their strengths and abilities. Activities will vary but may include outings, entertainment, personal care, meals, hairdressing and support for carers.
Attendance at day centres can be offered from a just a few hours a week to a number of days.
Respite care for dementia
Spouses, partners and relatives who care for a person with dementia can have an
assessment and may need a break from caring. This is known as ‘respite care’ and may be a regular short break of a few hours a week or a period of a few weeks. It may be planned or be required in an emergency.
Regular respite care might involve the person with dementia attending a day centre or a care
worker visiting the person’s home to give the carer a break. If the relative caring for a person wishes to go on holiday or is unable to care because of illness or an emergency, a period of respite care may be provided in a care home or a care worker may provide care in the person’s own home.
Dementia home care
People with dementia may struggle in new environments and may function better and be more content in the familiar surroundings of their own home.
If homecare is an option, Adult Social Care or the homecare provider can assess the person’s needs and a support plan can be drawn up. The person with dementia should participate as fully as possible in the assessment and planning. If they are unable to participate, family members can assist or an advocate may be required.
The person with dementia will respond best to stable care staff who know them well. Continuity of care can be provided by either care agencies or carers employed directly by the person or his or her family. Staff can be employed if the person pays privately or receives a direct payment from Adult Social Care to contribute towards the cost of care.
Dementia care homes
According to the Alzheimer’s Society, one third of people with dementia live in a care home and more than two thirds of care home residents have dementia or memory problems.
Having dementia doesn’t change who the person is, each person with dementia is a unique individual with their own emotional, physical and social needs and a set of hopes, aspirations and values. Meeting these needs with an individually tailored care plan enables the person to experience the best possible quality of life. Subsequently, a good care home will offer a person-centred approach to dementia care. This means that the unique qualities and interests of each individual will be identified, understood and accounted for in any care planning.
The person with dementia will have an assessment and an ongoing personalised care plan, agreed across health and social care that identifies a named care co-ordinator and addresses their individual needs.
They must also have the opportunity to discuss and make decisions, together with their carers, about the use of advance statements, advance decisions to refuse treatment, Lasting Power
of Attorney and Preferred Priorities of Care.
It is important that care and support options are tailored as one size does not fit all. Some options can work well for one individual but prove to be stressful and unsuitable for another person. Make sure staff know the person with dementia by providing life-story books, telling staff about their likes and dislikes and providing belongings that bring comfort and have meaning for the person with dementia.
Within the home, much is down to the attitude and skills of the manager and the staff. Do
they provide an environment that enables a person with dementia to exercise choice and
personal preferences even in the later stages of the condition? Who is the person in charge of
championing dementia care best practice in the home?
Dementia-specific training is needed to ensure that care home staff have an understanding of how best to support and care for people with dementia.
The design of a care home specialising in dementia should be based on small group living, preferably with accommodation on one level and opportunities to go in and out of the building within a safe and accessible environment. Plenty of natural light and an easy way of finding one’s way around the building and grounds are essential for minimising disorientation.
Dementia Friends
People with dementia sometimes need a helping hand to go about their daily lives and feel included in their community. Dementia Friends is an initiative to change people’s perception of dementia. It gives people an understanding of dementia and the small things they can do that can make a difference to people living with dementia – from helping someone find the right bus to spreading the word about dementia. Visit www.dementiafriends.org.uk for further information.
End of Life Care
What is end of life care?
‘How we care for the dying is an indicator of how we care for all sick and vulnerable people. It is a measure of society as a whole and it is a litmus test for health and social care services.’
Although the subject of dying is often painful to contemplate and as a society we do not discuss death and dying openly, the way care professionals approach the process is incredibly important for the individual, their family and carers. The Department of Health has a Strategy for every organisation involved in providing end of life care. Each is expected to adopt an overall co-ordination process, such as the Gold Standards Framework, whilst developing the best possible outcome for clients.
Those being cared for should have the opportunity to discuss their personal needs and preferences with professionals who will be supporting them. These are recorded in an Advance Care Plan so that every supporting service is aware of the client’s wishes.
All health and social care staff must be trained in communication regarding end of life care and should be trained accordingly in assessing the needs of clients and carers.
Programmes available
The Gold Standards Framework (GSF)
This can be used in various settings, for example hospitals, primary care and care homes, to improve the co-ordination and communication between different organisations involved in providing care for someone near the end of their life.
‘Preferred Priorities for Care’ (PPC)
This document is an example of an Advance Statement and is designed to help people prepare for the future and gives them an opportunity to think about, talk about and write down their preferences and priorities for care at the end of life.
End of life care is support for people who are approaching death and includes palliative care. It helps people to be as comfortable as possible and to die with dignity. It also includes support for their family or carers. Despite general reluctance to broach this sensitive area, it is worthwhile asking potential care providers their approach to end of life care and whether they are following national strategies for implementing best practice within their home.
Financing Home Care
Paying for home care
Local councils provide upfront information on how much people can expect to pay and how charges are worked out. This information must be made available when a needs assessment is carried
out and written confirmation of how the charge has been calculated must be provided after a
financial assessment.
People with more than £23,250 in capital including savings have to pay the full cost of care. The value of the home is not counted when working out charges for non-residential care. If you have more than £23,250 you should tell Adult Social Care if your savings are likely to fall below this amount.
The rules around financial assessments are set in Government regulations and guidance to ensure your finances are assessed in a consistent and transparent way. This ensures people are only required to pay what they have been assessed as being able to afford.
Adult Social Care will work with you to assess your finances and will also carry out a full benefit check and may be able to assist you with claiming your full benefit entitlement.
You don’t have to contact the council to arrange home care services, you can contact providers directly.
Other ways to fund your care and support
If you do not qualify for a financial contribution from Adult Social Care there are various ways in which you could consider paying for care and support. It is important that you seek independent financial advice when considering funding options. There are independent financial advisers that focus specifically on care funding advice, often referred to as specialist care fees advisers. They are regulated by the Financial Conduct Authority (FCA) and must stick to a code of conduct and ethics and take shared responsibility for the suitability of any product they recommend.
The Society of Later Life Advisers (SOLLA) aims to assist consumers and their families in finding trusted accredited financial advisers who understand financial needs in later life. Search its website www.societyoflaterlifeadvisers.co.uk/find-an-adviser to find a SOLLA-accredited independent financial adviser.
The Money Advice Service is a free and impartial money advice service set up by the Government. It offers free and unbiased advice. Tel: 0300 500 5000 or web: www.moneyadviceservice.org.uk
Financial assessment for social care
To see whether you will need to contribute towards the cost of your care and support, your council will conduct a financial assessment. This will look at your:
- Capital – for example, any property you own, bonds and shares
- Savings – any savings you have in bank accounts
- Income – including benefits, pension and any income you might get from a job
Most people will have to pay something towards the cost of their care.
Is my home included?
The value of your home is included as part of your capital in the social care financial assessment if you are moving into residential care, except in limited circumstances. It is not included if you are receiving care in your own home.
If you want to know whether you will need to sell your home to pay for your care, read our information on deferred payment agreements.
How much do I have to pay for care?
If you choose not to have a financial care assessment, you will be responsible for paying the full cost of your care and support.
If you have income, capital and savings of less than £14,250, you may be asked to contribute part of your income and the local authority may pay the rest.
If you have income, capital and savings between £14,250 and £23,250, you are likely to have to contribute towards the cost of your care. You may need to contribute part of your income. People are usually asked to pay £1 for each £250 they have in capital and savings above £14,250.
If your capital and savings amount to more than £23,250, you will probably have to pay the full cost of your care yourself.
Choosing your own care home
If you are eligible for support from the council and you are moving into a care home or care home with nursing, you will be given a choice of homes that charge the amount the council would usually pay for someone with your needs.
If you choose a residential home that charges more than the council pays, you will need to find someone else to meet the additional amount. This is called a ‘third party payment’ or ‘top-up’.
Running out of money
If you are worried about running out of money because of paying for care, speak to your council. They will want to give you a care assessment and a financial assessment if your savings are likely to reduce to £23,250 through payment of care home fees.
You should let the council know well in advance so that you can plan for your care fees together. However, bear in mind that the local authority must undertake an assessment of your needs and financial circumstances before deciding if it can contribute towards the cost of your care.
You might want to read our information on third party payments for social care if:
- The council doesn’t already pay for your care but might in the future
- You are living in a care home that costs more than the council will pay for your needs
- You have a home care service that costs more than the council says it will pay
If the council is going to start paying towards your care and one of these applies to you, a third party payment may help you avoid moving to a new care home or from changing care service.
Understanding your rights before moving into care is essential and there are several financial products and specialist companies that may be able to help.
You should look at getting financial and legal advice before you decide on how to fund your care.
Financial support for care fees
You may be able to get some support with your care fees even if you are paying for all of your care.
Social care benefits
You could get social care benefits without the local authority looking into how much you have in savings and capital.
Attendance Allowance (AA) and Personal Independence Payments (PIP) are non-means-tested, non-taxable benefits from the Department for Work and Pensions.
There are different rates depending on the level of your needs. Everyone who needs care should consider claiming these benefits, however, they will not be paid if the council is paying for your care in a care home.
If you get the mobility component of Disability Living Allowance or Personal Independence Payment, you will continue to receive this, even if you move into a care home, and it is not included in your financial assessment.
You may also want to apply for Universal Credit (if you are under pension age) or Pension Credit (if you are over pension age).
What is NHS Nursing Care Contribution?
If you live in a care home that provides nursing care, even if it is just temporary, you could get a non-means-tested Registered Nursing Care Contribution (sometimes called Funded Nursing Care) towards the cost of your nursing care.
You should speak to the nursing home about getting this. The money is paid directly to the home.
Can I get NHS Continuing Healthcare?
NHS Continuing Health Care (NHS CHC) is fully-funded care and support, provided and paid for by the NHS. This means that if you have a primary healthcare need, the NHS should provide and pay for your care – all of it, including care home fees.
Getting NHS CHC can be difficult, as the criteria you must meet are strict. If you are eligible, you are likely to have severe issues surrounding your health.
It’s important to note that not everyone who needs care has a primary healthcare need – you won’t be automatically entitled to this funding because you are living with dementia or have an ongoing illness. However, everyone who is discharged from hospital into a care setting should be offered an NHS Continuing Healthcare assessment.
Eligibility for NHS CHC depends on an assessment of the nature, intensity, complexity and unpredictability of the care that is required to manage your needs.
If you are eligible for Continuing Health Care, you can receive the services in any setting, including your own home or in a care home. The NHS will pay if you need healthcare from a community nurse or a therapist as well as personal care to help at home.
Self-funding your care
Paying for care can be an expensive and long-term commitment, so it is wise to seek specialist information and advice on paying for care before entering into any arrangements.
It is important that you seek specialist advice from appropriately qualified and regulated financial advisers.
Will I have to sell my home to pay for my care?
Twelve-week property disregard
If the value of your home is included in your financial assessment but your other capital and savings are less than £23,250, the council may share the cost of the first twelve weeks of permanent residential care, provided it agrees that this type of care is needed.
This is called the twelve week property disregard period.
Deferred Payment Agreements
After the twelve-week property disregard period, you may be offered a Deferred Payment Agreement.
This means you shouldn’t have to sell your home during your lifetime to pay for your care. Any care fees paid by the council will be charged against the value of your home, and must be repaid once the house is sold or from your estate.
Interest is payable throughout the period of the loan and there is also a one-off fee to join the scheme which covers all legal and administrative costs for the lifetime of the deferred payment agreement.
The council may limit the amount of the loan, depending on the equity in your property.
Third party payments
If you are eligible for the council’s support, you will be offered a choice of homes that meet the local authority’s funding rates.
If you decide to live in a more expensive residential home, you will need to find someone who can pay the difference between what the council will pay and the amount the home charges. This is called a ‘top-up’ or ‘third party payment’.
If you already live in a care home, and no top-up was required when you moved there, the home may seek to introduce one later, which would need to be agreed first with the local authority.
This may happen if a change to your arrangements is made at your request or with your agreement, for example you move to a nicer room.
Can I pay my own top up fees?
Top up legislation says that you are not allowed to make this additional payment yourself, except in limited circumstances. The responsibility usually falls to a family member, friend or charity.
If you are thinking of paying someone else’s top-up fees, you should be aware that the amount may increase, usually once a year. You must be confident that you can afford the top up fees for as long as they are required.
If the third party payments stop being paid for any reason, speak to your council. You may have to move to a cheaper home within the local authority’s funding levels.
It is important to note that councils have a duty to offer you a place at a home that accepts their funding rates. If no such place is available, a top-up should not be charged.
Seeking financial advice
Planning for your future care and support needs can be complicated and funding care can be expensive. Everyone is encouraged to seek unbiased, expert advice from independent financial advisers to help work out how to pay for long-term care.
Professional advice may be helpful in enabling you (and your family) to identify the most suitable and cost-effective solution to paying for care. Some solutions may help you to avoid paying care home fees.
Independent financial advisers are regulated by the Financial Conduct Authority (FCA). Unlike advisers who are tied to particular providers, specialist care fees advisers can offer advice on products from across the whole market.
A list of independent financial advisers can be found on the Society of Later Life Advisers website. You can also call SOLLA on 0333 202 0454.
There are also organisations that will provide free advice about funding care. These are a good place to start if you are looking for information and want to see what sort of options are available.
Useful Information
Services developed in partnership with the voluntary sector
Adult Social Care usually works with and funds voluntary and community organisations and charities to deliver preventative care services. These are a vital form of support and help to maintain independence, social inclusion, and delay or avoid the need for more formal services.
Examples include:
- day services, day care, lunch clubs and social groups;
- befriending, visiting and telephone contact services;
- support schemes to help people being discharged from hospital;
- support for carers;
- respite care or short breaks;
- advocacy, information and advice; and
- handyperson / handyman schemes.
Healthy lifestyles
A healthy lifestyle can include eating a healthy diet and taking part in exercise.
Healthy eating – we all need a balanced diet and exercise to ensure that we have good physical and mental health.
Active ageing – there are specialised activity programmes for older people which aim to improve independence, wellbeing and quality of life, and to reduce the risk of falls.
Alcohol and drug misuse – an easy-access service may be available for people whose drug or alcohol use is a problem. It aims to promote health and minimise harm to the individual, their families and the community.
Stopping smoking – use the NHS stop smoking tool to get daily tips for success to stop smoking, visit the NHS Choices website www.nhs.uk
Leisure centres offer many opportunities for getting active and healthy. For details of what’s on, visit your local leisure centre’s website. Exercise does not have to be in a leisure centre and you may prefer to go on walks, either on your own or organised with a group.
Libraries and community hubs
Libraries can provide much more than just books and are often a valuable source of resources for people of all ages. Some regions will have community hubs which include a network of well-connected community buildings that will provide spaces, services and activities for people in their local area. It is intended that community hubs are designed and led by the community. Some areas also operate a ‘books on prescription’ service.
Day care centres
Many older people can feel lonely or isolated without an opportunity to fill their days with meaningful activities. Research has shown that one way to reduce loneliness and promote
wellbeing and independence is regular social contact and activities.
Day care centres give people the chance to have a change to their routine, meet new people, take up an activity or receive specialist services such as chiropody or hairdressing. There is a wide variety around the country, supporting older people, people with mental health conditions, learning disabilities and dementia. Day opportunities can be as important for carers as those attending as they allow for a regular break from caring. Attendance may be free or chargeable, transport and meals must usually be paid for.
Meals on wheels
Meals on wheels are ready meals delivered to your home. There are frozen meal services and freshly-cooked hot meal services. Frozen meals can be delivered in bulk and kept in your freezer until required, whereas hot meals should be eaten immediately. Councils may be able to arrange meals delivered to your door, though you would need to be assessed as eligible for meals on wheels and it wouldn’t necessarily be free. National and local commercial companies also provide meals on wheels or home delivery meals at a charge.
To find out about meals on wheels in your area, look at your region’s page on this website, contact your local Adult Social Care department or search the internet.
Blue Badge Scheme
The Blue Badge Scheme is a national arrangement of parking concessions that allows badge holders to park close to their destination, either as the driver or passenger. The Blue Badge Scheme is also open to organisations that care for disabled people meeting the qualifying criteria.
Occupational therapy
Occupational therapy provides advice, assessments and solutions for people who are living in their own home and require physical assistance. They provide advice and solutions such as equipment and adaptations. You may be referred to these services following an assessment by your local adult social care or health professional.
Special equipment
There is a range of equipment, daily living aids or home aids available to make life easier and to improve safety and independence, such as stair rails, raised toilet seats, shower stools etc. These simple items are often referred to as ‘simple aids for daily living’.
Advocacy
Advocates can give advice, support and information to people of any age, helping you to voice your concerns and guiding you through difficult or challenging times. Consider using the services of an advocate if you feel unsure or concerned when you are faced with making an important decision about your care choices.
Advocates are not there to tell you what to do or to make decisions for you, but to help you express your views and make your own decisions.
If you contact the local authority for any reason such as for an assessment, the council has a duty to arrange an advocate to support you if it appears that you need one. They usually work with independent advocacy organisations.
How solicitors can help
A solicitor can give you impartial advice about wills, making gifts, estate planning and Powers of Attorney. Some can also offer guidance on immediate and long-term care plans, ensuring (if applicable) the NHS has made the correct contribution to your fees.
Lasting Powers of Attorney (LPA) allow you to appoint someone you trust to make decisions about your personal welfare, including healthcare and consent to medical treatment, and/or your property and financial affairs. An LPA is only valid once registered with the Office of the Public Guardian. It allows for a person of your choice to make decisions on your behalf at a time when you may be unable to.
The Court of Protection can issue Orders directing the management of a person’s property and financial affairs if they are incapable of managing their own affairs should they not have a LPA. The Court procedure is presently very slow and the fees are quite expensive so preparing a LPA is always advisable, providing you have somebody sufficiently trustworthy to appoint as
your attorney.
An ‘advance directive’ allows you to communicate your wishes in respect of future medical treatment but it is not legally binding. You may instead wish to make a living will, known as an ‘advance decision’ setting out treatment that you do not want to receive in specified circumstances, which would legally have to be followed, even if you die as a result.
Any proposed Gift out of your estate needs careful consideration of the benefits, risks and implications, particularly on any future liability for care costs or tax liability.
If you don’t have your own solicitor, ask family or friends for their recommendations. Contact
several firms, explain your situation and ask for an estimate of cost and an idea of timescales
involved. Many firms will make home visits if necessary and will adapt their communications
to meet your needs. It’s important to find a solicitor who specialises in this area of the law. The
Citizen’s Advice Bureau offer an advice service and will be able to recommend solicitors in your area. Alternatively, contact Solicitors for the Elderly www.solicitorsfortheelderly.com
Regulating and inspecting care services
All care providers must be registered under a system which brings adult social care, independent healthcare and the NHS under a single set of essential standards of quality and safety.
The Care Quality Commission (CQC) registers, inspects and reviews all adult social care and healthcare services in England in the public, private and voluntary sectors. This includes care homes, care homes with nursing, home care agencies and NHS services, amongst others.
Inspectors carry out a mixture of announced and unannounced inspections looking at the quality and safety of the care provided. They look at whether the service is: Safe; Effective; Caring; Responsive to people’s needs; and Well-led.
Inspection teams are led by an experienced CQC manager and often include experts in their field. The team may also include professional or clinical staff; Experts by Experience; people who use services and carers.
Following an inspection, each care home and home care agency is given a report of how it rates against national essential standards of quality and safety. CQC has also started rating services as ‘Outstanding’, ‘Good’, ‘Requires Improvement’ and ‘Inadequate’. By March 2016, CQC expects to have rated every adult social care service in England.
Healthwatch
This is the consumer champion for health and social care who gather knowledge, information and opinion to influence policy and commissioning decisions, monitoring quality of services and reporting to regulators.
Comments, compliments and complaints
If you use a home care agency or move into a care home or nursing home you should feel able to comment on any aspect of your life which affects your happiness or comfort. This might be anything from the way you are treated by staff to the quality of the food you are served. You should also feel free to make comments and suggestions about possible improvements to your surroundings and the services provided.
Making a comment, whether complimentary or a complaint, should not be made difficult for you and should not affect the standard of care that you receive whether in your own home, a care home or care home with nursing. Care services are required to have a simple and easy to use complaints procedure.
If you are concerned about the care that you, a friend or a relative are receiving, it makes sense to speak to the manager of the service about your concerns before you take any further action.
The problem may be resolved quite easily once they are made aware of it. However, if you need
to make a formal complaint, you should initially contact the registered owners of the service. They have a duty to respond to any complaints made.
If your complaint is about a breach of regulations, contact your local office of the Care Quality Commission.
If your local authority has arranged or contributed to the cost of your service and support, another option is to raise your complaint with your social worker/care manager or the department’s designated complaints manager.
If you have been unable to resolve your complaint you can contact the Local Government Ombudsman to assist you. The Local Government Ombudsman looks at complaints about councils and some other authorities and organisations, including Adult Social Care providers (such as care homes and home care providers). It is a free service and its job is to investigate complaints in a fair and independent way.
Protecting vulnerable adults
A vulnerable adult is a person aged 18 years or over who may be unable to take care of themselves, or protect themselves from harm or from being exploited.
Abuse is mistreatment by any other person or persons that violates a person’s human and civil rights. The abuse can vary from treating someone with disrespect in a way which significantly affects the person’s quality of life, to causing actual physical suffering.
It can happen anywhere – at home, in a care home or a care home with nursing, a hospital, in the workplace, at a day centre or educational establishment, in supported housing or in the street.
Forms of abuse could be physical, sexual, psychological, emotional or financial. It could also cover the issues of neglect and institutional abuse – where the abuse affects more than one person within an organisation and is not addressed by the service’s management.
The person who is responsible for the abuse may be known to the person abused and could be:
- a paid carer or volunteer;
- a health worker, social care or other worker;
- a relative, friend or neighbour;
- another resident or service user;
- an occasional visitor or someone who is providing a service; or
- someone who deliberately exploits vulnerable people.
If you think someone is being abused call Adult Social Care. Your concerns will be taken seriously and will receive prompt attention, advice and support. Adult Social Care will also arrange for an advocate to support you if needed. If you believe somebody is in immediate harm, contact the police on 999.
You can also:
- Contact the Care Quality Commission (CQC) if the vulnerable adult is living in a registered care home, care home with nursing or receiving home care services.
- Let a public service professional, such as a social worker, community nurse, GP, probation officer or district nurse know your concerns. They have responsibilities under the county’s adult protection procedure and can advise you about what to do next.
The Disclosure and Barring Service
There is a barring system for all those intending to work, or are working with children and vulnerable adults.
The Criminal Records Bureau (CRB) and the Independent Safeguarding Authority (ISA) merged into the Disclosure and Barring Service (DBS). CRB checks are now called DBS checks.
The DBS provides a joined up, seamless service combining the criminal records checking and barring functions. These details will be published on the DBS website. For disclosure information and services, visit the DBS homepage www.gov.uk/dbs
Care home owners, home care agencies and employment agencies which supply care workers are required to request checks as part of a range of pre-employment checks.
Care providers and suppliers of care workers are also required to refer workers to the DBS where, in their view, the individual has been guilty of misconduct. It is an offence for an employer or voluntary organisation knowingly to employ a barred person in a regulated activity role.
Frequently Asked Questions
Will I get the same carer for each call?
We always try to make sure you get the same carer as much as possible. Unfortunately due to days off and holiday that can’t always happen, we will provide you with a team of three regular carers so that you’ll always know the person coming to see you.
Do you send out a schedule of calls?
We send out a schedule every two weeks with the following fortnights visits on. If you have access to the Internet you can also log on to the portal and see all your up coming calls.
Do the carers always arrive on time?
Due to the nature of the work we do there is always the possibility of hold ups with previous clients, so we always advise to allow your carer 30 minutes leeway either side of the time scheduled. If the carer is going to be more the 30 minutes late either the carer or a member of the office team will ring to let you know. Having said that late calls don’t happen very often over 90% of the calls we do are on time.
When do I pay my bill?
We send out our bills on the 1st of each month for the previous months care. You can make payment, via cheque in the stamped address envelope included with the bill, by BACS or online via the credit/debit card payment tab on our website.
What if I want to cancel a call?
We understand that from time to time you will need to cancel a call. Just give the office team a call and they will let the carer know and cancel the call off of our system. The only thing we do ask for is a minimum of 24hrs notice as we need time to find the carer work to replace the cancelled call, if less then 24hrs notice is given the call will have to be charged for.
Can I add an extra call if needed?
Absolutely, just give the office team a call and they’ll get an extra visits booked in. The more notice you can give us the better, as it will allow us to change the carers schedules and provide you with the time you require.
What happens if I go into hospital or respite?
We will put your calls on hold while you are away. When you are due back we will reinstate the calls and schedule you back on to the carers visit list. We can not always guarantee the same call times on your return, but will endeavour to get things back to normal as quickly as possible. If your care needs have changed we will do another assessment and make the necessary amendment to your care plan.
Do you do shopping trips?
We are happy to either take you shopping or you can supply us with a list of the items you need and we’ll go out and buy them on your behalf.
Do you charge mileage?
We only charge mileage on trips out for example going to the shops or doctors. On regular visits we only charge a visit allowance, which we pay directly to the carers at the end of each month to cover their travel costs.
Do you do live in care?
We do provide live in care, for more information please contact a member of the office team.
How do you monitor the carers on a daily basis?
We use a system called CM2000, this system allows us to monitor the carers in real time. We can see when they login at the start of each call and when the logout at the end, this allows us to track where they are and make sure they are staying the full length of time. Being able to track the carers also enables us to make sure that all the calls are covered as any late calls are flagged up to us. We also speak to all the carers on a daily basis and do regular supervisions.
Do you do cleaning?
We are happy to do light domestic work and will keep the hygiene areas clean. If you require a deep clean for example cookers cleaned etc, then we can put you in touch with competent companies who can help.
Do you supply mobility aids?
I’m afraid we don’t but we can put you in touch with companies that do.
What is your availability?
Due to the nature of the work we do, our availability changes on a daily basis. For our up to date availability it’s best to ring the office team.
How quickly can you put care in place?
A week is our preferred timescale as it gives us time to do the care needs assessment, get the care plan in place and schedule cares. We do understand that sometimes peoples care needs are urgent, so we can put care in place on short notice if required.
How much will my care cost?
The cost of your care package will depend on the amount of visits you need. Please see our cost calculator for an overview of the cost of care.
What is the minimum amount of care you can provide?
Our minimum call time in 30 minutes, so the minimum we can provide is one 30 minute visit per week.
Do you do pop in's?
Our minimum call length is 30 minutes, we are happy to do a pop in but it would be charged at the 30 minute rate.