The Five Step Guide to Choosing and Paying Care

Transcription

1 The Practical Guide to Care Information to help you to find and pay for your care and support

2 Welcome to the Practical Guide to Care Choosing care is a big decision. The right services should give you the support that you need and let you stay in charge of how you live your life. Paying for care can be expensive. If you have assets of 14,250 or more you will usually need to pay for at least some of your care costs. This guide aims to help older people in Birmingham, Shropshire, Staffordshire and Stoke-on-Trent to find and pay for the care and support that they need. Are you aged 55 or over? Do you live in Birmingham, Shropshire, Staffordshire or Stoke-on-Trent? Do you need help to remain independent, or to carry out day-to-day activities? Do you want more information about the options that you have? Are you wondering how you might pay for your care? If your answer to these questions is yes, then this guide is for you.

3 Did you know Social care is not free in England? Did you know? You can ask the council to assess your needs and tell you about useful services, even if you are paying for your own care Did you know? You may not need care: local and community services could help you to live independently If you need more information or help on any of the topics in this guide, contact your council. You can find contact details at the back of this guide.

4 Contents SECTION 1: THE FIVE STEP GUIDE TO CHOOSING AND PAYING FOR CARE... Page 7 The first section of this guide sets out five practical steps you can take to help you to find and pay for the support that you need. STEP 1: IDENTIFY THE SUPPORT I NEED... STEP 2: DECIDE HOW MUCH I CAN AFFORD TO PAY... STEP 3: EXPLORE OTHER OPTIONS TO HELP ME STAY INDEPENDENT... Page 8 Page 10 Page 18 STEP 4: FIND CARE WHICH IS RIGHT FOR ME... Page 24 STEP 5: START USING CARE... Page 32 SECTION 2: SELF-HELP SHEETS... Page 35 Section 2 is a series of self-help sheets. You can use these to help you choose the care and support that is right for you. CHOOSING CARE HELP SHEETS... BUDGET HELP SHEET... FINDING A CARER HELP SHEETS... FINDING A CARE HOME HELP SHEETS... OVERALL CHECKLIST... Page 36 Page 42 Page 44 Page 51 Page 56

5 SECTION 3: USEFUL INFORMATION... Page 61 This section of the guide sets out practical reference information. WHAT DO ALL THESE WORDS MEAN?... Page 62 FREQUENTLY ASKED QUESTIONS... Page 64 TEN USEFUL ORGANISATIONS AND WEBSITES... Page 66 This guide aims to help you to find and pay for care. You can use it to find out information for yourself or for someone else, such as a family member, neighbour or friend. If you are looking after someone, there is also other information which you might find useful to support you in your caring role. Contact your council, using the numbers at the back of this guide, to find out more.

6 6

7 7 Section 1: The Five Step Guide to Choosing and Paying for Care This section gives you practical information to help you understand your options, and find the support that is right for you. It is set out as five steps: Step 1: Identify the support I need Step 2: Decide how much I can afford to pay: - Can I get help with costs? - Where will I find the money to fund my care? - How can I make my money last? - Specialist financial advice Step 3: Explore other options to help me stay independent: - Local and community services - Equipment and adaptations - Supported housing Step 4: Find care which is right for me: - What type of care should I use? - Choosing a carer - Choosing a care home Step 5: Start using care You can read these steps in order from the beginning. Alternatively, you can turn straight to the step that is most relevant to you.

8 8 STEP 1 Identify the support I need If you are finding it difficult to carry out day-to-day activities, there is help available. You may not need formal care. Depending on your circumstances, there are other options which could help you to stay independent. The table below sets out types of support you could consider. My needs I am lonely I need help maintaining my house and garden I would like to have meals cooked for me sometimes I find it difficult to get out to appointments and social activities I should consider Support from local and community services I find it difficult to do practical tasks in my house, such as: Getting into my bath / shower Going up and down stairs Turning on switches Reading Using the phone Installing equipment or adapting my home Moving into supported housing I want to know that someone will help me if I have an emergency Installing an alarm in my home Moving into supported housing I need help with personal care, such as: Washing Dressing Eating Formal care I need medical support as well as help with personal care Formal care with nursing

9 Local and community services There are a number of services which can help you to live more easily at home or get out and about to appointments and social events. Support services: Befriending groups, lunch clubs and drop-in centres offer services designed to help older people access support and make new friends. Wider community services: Local colleges, libraries, community groups and volunteering opportunities let you meet people and learn new skills. Transport: Community transport, bus passes and good neighbour schemes can help you to get to the places you need to go. Domestic services: You can pay for practical assistance around the house, such as cleaners, handyperson services, gardeners and food delivery services. Equipment and adaptations Installing equipment, or adapting your home, can help you to remain independent. Equipment: There is a wide range of equipment available to help with day-to-day tasks such as cooking, eating, reading and turning on switches. Adaptations: Adaptations, such as widening doorways, lowering worktops or installing a chair-lift can make it easier for you to get around your home. Alarms: Alarms can connect you to 24-hour emergency support, or remind you about important activities, such as taking pills. Supported housing Supported housing schemes are groups of properties specifically designed for older people or those with mobility difficulties. They offer an on-call warden, and often have social and leisure facilities close by. Sheltered housing schemes: These are generally groups of properties. Retirements villages: Retirement villages are bigger schemes with over a hundred properties. Extra-care housing: Similar to sheltered housing, extra-care housing also offers support with personal care. Formal care There are two main options for care. Personal care assistants: You can employ a personal care assistant (often called a carer ) to provide you with care in your home. You can choose how often you need care. This could be on a part-time basis for a short period of time right through to permanent, full-time care during the day and night. Residential care homes: Care homes provide you with accommodation and access to personal care when you need it. Many also have on-site social and leisure activities. Nursing Nursing support can be delivered in your own home or in a care home. Nursing support in your home: Nurses can visit you in your own home. This may be paid for by the NHS or you can employ a nurse privately. Care homes with nursing: Care home with nursing is the term now used for a residential home which offers nursing. In addition to the general facilities provided by care homes, there will be a qualified nurse on duty throughout the day and night. as Find out more on page 18 Find out more on page 22 Find out more on page 23 Find out more on page 24 Find out more on page 24 9 Section 1: The Five Step Guide to Choosing and Paying for Care

10 10 STEP 2 Decide how much I can afford to pay Social care and support is not free in England. Paying for care can be expensive. It is important that you use your money wisely, so that it can support you throughout your life. Can I get any help with costs? Depending on your circumstances, you may be able to get some financial support. This could come from the council, the NHS or through benefits. 1 Will the council pay for my care? You will only receive help from the council if you cannot afford to pay for care yourself. Is the total of your savings and capital worth 14,250 or less? Is the total of your savings and capital worth between 14,250 and 23,250? The council may pay for your care The council may pay for some of your care Ask your council for a financial needs assessment Is the total of your savings and capital worth 23,250 or more? You will probably need to pay for your own care costs. However, if you are close to the threshold, it can be useful to ask for a financial needs assessment from your council.? Did you know If you are moving into residential care, you will usually need to include the value of your home as part of your total savings and capital. Find out more Contact your council, using the numbers at the back of this guide, to ask for a financial assessment or to find out more.

11 11 You can ask your council for a financial needs assessment. This will look at: In a nutshell Financial Needs Assessment Your savings and capital (which could include investments, money which you have been given or inherited and the value of your home) How much money you get in as a regular income, for example from your pension, benefits or earnings. The council will use this information, alongside an assessment of your needs, to decide if they will pay for some or all of your care costs. The amount that they will pay will depend on the type and level of care that you need. Section 1: The Five Step Guide to Choosing and Paying for Care Did you know? Thresholds can vary between authorities. The figures given in this guide are the national guidelines. If you are close to a threshold, it is worth checking with your council for the figure in your area.

12 12 2 Will the NHS pay for my care? Healthcare is free in England, regardless of how much money you have. If you need care or nursing support due to medical reasons, the NHS may pay for some or all of your costs. The table below sets out support which is currently on offer. Name What is it? Is it for me? NHS Continuing Healthcare Care or support, which can be delivered in a range of places such as a hospital, care home or your own house. You must have a high level of health-related needs. Your needs must be mainly health related, rather than for social care or accommodation. Funded Nursing Care Nursing care which is funded by the NHS. You must: Get care from a registered nurse in a nursing home Have been assessed as needing care from a registered nurse Not qualify for NHS Continuing Healthcare. Intermediate Care A stay of up to 6 weeks in a care home for rehabilitation or recuperation which is paid for by the NHS. To qualify you must need: A short stay in a nursing or residential home for rehabilitation or recuperation To stay for 6 weeks or less. Registered Nursing Care Contribution A benefit paid by the NHS to cover nursing or medical care. You could qualify if you: Need nursing care Stay in a care home that can provide nursing care. Find out more If you do have long term health needs, speak to your GP or hospital to ask for an assessment.

13 13 3 My age 60 (or older) I can get Free prescriptions and eye tests Can I get any benefits? Everyone aged 60 or over is entitled to some help. The table below sets out support which is currently available. 65 (or older) Free bus pass 75 (or older) Free TV licence 80 (or older) Higher level of winter fuel payment If you have a disability: you may be able to get help with the extra costs for your house or carer. If you have a low income: you may be able to get a range of support such as: Help with health, eye and dental costs Grants to improve the heating in your house Cold weather payments Pension credit to top up your income. Free passport *for British citizens born on or before 2 September 1929 Depending on your circumstances, you may be able to get other benefits. 85 (or older)* Section 1: The Five Step Guide to Choosing and Paying for Care Remember: The financial support available, including benefits, frequently changes. Please do check for the latest information before making any decisions. Find out more To find out more about the benefits you can get, look at or contact your council using the details at the back of this guide.

14 14 Where will I find the money to fund my care? You are strongly advised to speak to an expert financial advisor to help make the best use of your savings, capital and income. Remember: your needs may change over time, so you should plan for the future as well as the present. There are a number of sources of money that you might use to pay for your care: Your savings and investments If you have funds that you have saved, been given or inherited, you can use these to fund your care. Insurance policies Check if you have any insurance policies which could help cover the costs of your care. For example, care costs may be included in a critical illness policy, or an over-50s plan. Remember to check policies from your work or taken out by your partner as well as those set up solely in your name. Your ongoing income Income from pensions, work or benefits can be used to fund all, or part, of your care. 4 5 Downsizing Selling your home and moving to a cheaper property will release money which you could put towards your care. This could also enable you to move to a property or location which is more suitable for your needs. Selling your home If you are moving into residential care, you could sell your house to raise funds. 6 Using your home to raise money If you own your own home and don t want to sell it, you can still use it to raise money, for example through: Renting out the whole property, or rooms within it Releasing equity against the value of your property. Also consider if you have any other sources of money. For example, can any friends or relatives help? Do you have any valuable items which you could sell? The approach you take will depend on your individual circumstances.

15 15 In a nutshell... Releasing equity There are two main ways in which you can generate money from the value of your house, whilst still living in it: Lifetime mortgage: You either receive a lump sum or monthly payments as a loan against the value of the house. The loan will usually have to be paid back when the house is eventually sold. Home reversion plan: You sell all or part of your house at below market value in exchange for a lump sum or regular payments. You can then stay on as a tenant paying little or no rent. Products change regularly. Do get expert financial advice to decide if releasing equity is suitable for you. Section 1: The Five Step Guide to Choosing and Paying for Care

16 16 How can I make my money last? Once you have worked out where you will get money from, you need to decide how best to use it to meet your care needs. The three main options are set out below. What? How does it work? Good if you... Not so good if you Annuity / payment plan A type of insurance policy. You invest a lump sum in the plan. The insurance company then pays a set amount of money to cover your care costs for the rest of your life. You can choose a plan where payments start straight away, or one where they will start after an agreed period of time. Need ongoing care Want a regular income for care costs for the rest of your life Have a lump sum of money to invest Want to cap the cost of your care Expect your care costs to stay at roughly the same level Only have short-term care needs Want the flexibility to use your money in different ways Are unlikely to live long enough to get the benefit of the regular payments Expect your care costs to rise by more than the amount allowed in your plan Regular income You use income you have coming in on a regular basis to pay for your ongoing care costs. For example, you may have income from pensions, work, renting out your house, interest on savings or other sources. Have a regular income, which is more than the cost of your care fees Don t want to use savings and investments for your care fees Don t have a lump sum to invest Only have short term care needs Expect your care fees to stay at roughly the same level or less Your care fees, plus your personal expenses, are higher than your income Your care fees are likely to go up to a higher level than your income Savings and investments You use savings and/or investments which you have built up to pay for your care costs. You may receive enough from dividends or interest, or you may decide to draw on the capital in order to pay for your care fees. Only have short term care needs Expect your total care fees to be less than the amount you would need to pay for a payment plan Have savings or investments which you can easily access to pay for your care fees Have long term care needs (you may be better with a payment plan) Want to have a cap on the amount you will pay Think your savings are likely to run out

17 17 Specialist financial advice Unless you have very straightforward requirements, you are strongly advised to get expert financial advice before making a decision. An independent financial advisor that specialises in long-term care funding is often called a specialist care fees adviser. What will they do? A financial advisor will explore your: Care needs Financial circumstances Relevant personal circumstances (eg whether you have a partner or dependents) Attitude towards risk. The financial advisor will then provide you with written recommendations about financial products and services which are suitable for you. The financial advisor will explain all the costs and risks involved with each option, to help you decide the best way forward. Finding a Financial Advisor Birmingham: Contact your council for details of local advisors, or look at: Shropshire: Shropshire Council has a list of approved local advisors who have confirmed that they meet a set of criteria, including training, CRB checks and references. Contact the council to request the most up-to-date list of advisors using the numbers at the back of this guide. Section 1: The Five Step Guide to Choosing and Paying for Care Staffordshire: Mint Wealth Management is working in Staffordshire to provide people with access to care funding information and advice. Call or look at their website at Stoke-on-Trent: Stoke-on-Trent Council does not provide recommendations for financial advisors. You can also search for a local advisor on the Society of Later Life Advisers website at: Checklist for finding a financial advisor Does he / she: Specialise in care funding advice? Have qualifications in advising on long term care? Have either the Chartered Insurance Institute (CII) CF8 or the Institute of Financial Services (IFS) Certificate in Long Term Care Insurance (CeLTCI) Offer advice on products from across the whole market? Give you their Key Facts document, setting out how much you will need to pay?

18 STEP 3 Explore other options to help me stay independent Needing help with practicalities may not mean that you need to move into a residential care home or employ a personal care assistant. Using local and community services, installing equipment, or moving to supported housing are all options which may help you to live more easily and independently. Local and community services I need: To keep my mind active To meet people To feel involved with the local community I should think about: Local support services, such as drop-in centres, lunch clubs and befriending services Classes at local colleges or community groups Volunteering or work To get out and about Support to get to the places I want to go Applying for a free bus pass Community transport Help with the house or garden Employing a cleaner, gardener or handyperson Support with practical tasks, such as ironing and washing clothes Help looking after my pets Mobile services such as for ironing and washing clothes Local pet / dog-walking services Asking friends and neighbours if they can help To sometimes have meals cooked for me Local meals-on-wheels services Private catering firms, who can deliver meals to my house Asking family and friends to help out 18

19 19? Did you know Your council has information to help you stay safe and warm in your own home. For example, they can give you practical advice to help you to avoid falls and accidents as well as fires in your home. In a nutshell: Services in your home Having services delivered in your own home can make life easier. Think about help with: Domestic activities, such as cleaners, ironing / washing services that pick up direct from your home, and catering companies, which can deliver home-cooked meals to your house Maintaining your home, such as handyperson services and gardeners Section 1: The Five Step Guide to Choosing and Paying for Care Looking after your pet, such as dog-walkers. If you find it difficult to get out and about, also consider mobile services such as hairdressing and pet-sitting services. To find a suitable service: Ask friends and neighbours for recommendations Look in the Yellow Pages / Thomson Directory, check for adverts in local shops or consider placing your advert Confirm references and CRB checks before letting someone into your own home Agree costs and services in writing. Did you know Shopmobility lends wheelchairs to members of the public who need them to shop or visit local facilities within a shopping centre or town.?

20 20 In a nutshell: Local activities and support Taking part in activities can help you to meet people, learn new skills and find out about the support which is available locally. Some services are designed specifically for older people, such as drop-in centres, day centres, lunch clubs and befriending services. Other activities are open to all in the community, such as education and learning, or volunteering opportunities.? Did you know Good Neighbour Schemes can organise volunteers in your local neighbourhood to provide you with practical support, such as giving you a lift to the hospital or doing your shopping. Find out more Birmingham: Shropshire: Staffordshire and Stoke-on-Trent: Use your council s community directory to search for local support services: Speak to charity shops to find out about Ask your library for brochures for your local college or community classes volunteering opportunities, or look at the national online database

21 21 In a nutshell: Getting out and about If you are over 65 you are entitled to a concessionary travel pass*. This will let you travel on local buses for free during off-peak hours. If you have mobility difficulties, you may also be able to use community transport, such as taxi card schemes and specially designated buses. Most public transport can now support people who have trouble walking. This includes: taxis with ramps, low floor buses, ramps and support to get on and off trains, and help at airports. *The age threshold is gradually moving from 60 to 65. Contact your council to check eligibility in your local area. Top Tips If you are over 60, and like to travel by train, apply for a senior person s railcard which gives you a third off rail travel. Look into car share schemes if you drive, but don t need to use your car that often. Ask local friends and family for help. Find out more Support on public transport Bus passes For information about the support you can expect on public transport look at: To apply for your bus pass: Birmingham: Call or look at: Shropshire: Apply in person at any of the council s customer service points, or online via the council website Staffordshire: Call or apply in person at your local library or online via the council website Stoke-on-Trent: Call or look at Section 1: The Five Step Guide to Choosing and Paying for Care

22 Equipment and adaptations Living in a property which is suitable for your needs can make it easier for you to stay independent. There is a wide range of equipment that you can buy to help you with day-to-day living. You can also adapt your house to make it easier for you to get around. 1 Day-to-day living 2 Getting around your house There is equipment to help you with most aspects of day-to-day living, including: Washing and toileting: shower stools, bath seats, hand rails and adapted toilet seats Going to bed: hoists, specially designed mattresses and reading poles Getting up and down stairs: lifts and handrails Eating and drinking: adapted cutlery, plates and trays General living: equipment to help with tasks such as shopping, picking things up and opening jars and bottles. If you use a wheelchair, or are having difficulty getting around the house, you may need to consider bigger adaptations for your home. This could include: Widening doorways Adding ramps Installing chair-lifts Changing the heights of surfaces and equipment. 3 Communications 4 There is a range of technology which can help you with day-to-day communications, such as reading, answering the phone, hearing, writing and using a computer. This includes: Switches to help turn equipment on Voice amplifiers Magnifiers for reading Telephones for people who are blind and partially sighted Adapted clocks and watches. Personal care and safety There are a number of devices which can be used to help ensure your safety. This includes: Devices which warn you that there is a risk (eg with smoke, gas or flooding) Movement sensors, which can raise an alarm if you don t appear to be moving around your house Alarms you can wear to enable you to call for help if you have fallen or are in trouble Equipment to remind you to take your pills. You can also install a telecare system. This will link you up to a help centre, which is contacted automatically if your alarm goes off. Find out more Go to: or call for impartial information and advice from the Disabled Living Foundation about equipment for daily living, plus links to suppliers. 22

23 Supported housing Supported housing provides an alternative option to living by yourself or moving into a residential care home. It can offer you the security of knowing that help is close by, whilst allowing you to live independently. There are a number of different types of supported housing: Retirement Villages are bigger schemes, with over a hundred properties brought together. The houses are designed for older people, and usually have a range of social and leisure facilities close by. Sheltered Housing Schemes are groups of between properties, specifically designed for people with mobility difficulties. They have an on-call warden, and often have other facilities close by. Extra-care Housing is similar to sheltered housing, but also offers support with personal care. Each scheme is slightly different, so it is important to look at the individual property when choosing where to live. Section 1: The Five Step Guide to Choosing and Paying for Care Checklist Is the property suitable for your needs? How many other houses are in the scheme? What type of support will you have? Does this match your needs? How close are the shops and other facilities? How close is the housing to your family and friends? Is there transport close by? Top Tip If you only need equipment for a short time (eg whilst recovering from an operation), then consider borrowing or renting rather than buying. Find out more Contact your council, using the details at the back of this guide, for a list of schemes in your area. 23

24 24 STEP 4 Find care which is right for me If you are paying for your own care, you can choose where you want to live and how you will get the support that you need. There is no right or wrong solution. However some forms of care will be more suitable for you than others. What type of care should I use? The care that is right for you will depend on your needs, your individual preferences and your budget. The table below provides an overview of the three main options. Care in your own home Residential care home Care home with nursing In a nutshell A personal care assistant (often called a carer ) provides help with personal care and day-to-day activities. You can have live-in carers delivering full-time care on a rotating basis, or a part-time carer who comes in at set hours. You can employ a carer direct, or to go through a care agency. Care homes will provide you with personal care and support when you need it throughout the day and night. They usually also offer a range of social activities. Care homes with nursing provide all the features of a care home, plus nursing support. This means that there will be a qualified nurse on duty at all times. Good if you Don t want the upheaval of moving house Want to stay living independently Want to keep all your personal belongings around you Have a good network of local friends and activities Need care and support throughout the day and night Want company and social activities where you live Want easy access to facilities Have medical or nursing needs Need care and support throughout the day and night Want company and easy access to facilities where you live Not so good if you Need 24-hour nursing or care Don t want the responsibility of maintaining your home Don t want people coming into your house Want to know all your care and support is regulated and inspected Feel lonely or isolated in your own home Don t want to move Need nursing support Want to live by yourself Don t need nursing support (as you will be paying more than you need to) Don t want to move Want to live by yourself

25 25 Did you know Short Term Care? There may be times when you want to have care for a short period of time, for example, after a stay in hospital, or when your regular carer is away. Many care homes set aside a number of places for short term care placements, even if they are full for new permanent residents. You can also arrange for a care agency to provide you with a carer in your own home for a short period of time. In a nutshell: Needs Assessment Your council can help you think about the support you need, by carrying out a Needs Assessment. What is a Needs Assessment? A Needs Assessment looks at: Section 1: The Five Step Guide to Choosing and Paying for Care What care and support you need What support (if any) you already have in place What services could be provided to help you live as full and independent a life as possible. Who will be involved? The assessment will be carried out by a health or social care professional. You can ask other people such as carers and family members to be part of it, if you like. Where does it happen? The assessment will usually take place in your own home. What happens after the assessment? The council will give you a copy of their assessment and tell you about local services and support. You can use this to help identify the best care for you. If they are going to be paying for any of your care, the council will also create a Care Plan for you. Who can have a Needs Assessment? You can ask your council for a Needs Assessment, regardless of how much money you have. You don t have to have a Needs Assessment if the council isn t going to pay for any of your care. Should I have a Needs Assessment if I m going to pay for my own care? A Needs Assessment gives you a chance to discuss your needs with a qualified professional, and find out about the services and support available. This can be useful, even if you don t expect the council to pay for any of your care. How do I ask for a Needs Assessment? Contact your council, using the details at the back of this guide.

26 26 To help you decide what type of care is right for you, consider: 1 How often do I need support? Four times a day or more Three times a day or less Personal Care Day-to-day activities in the house General domestic activities Getting out and about Residential care may be more practical and could work out cheaper for you A carer could provide the support you need in your own home 2 Nursing support What else is important to me? You are likely to need a care home with nursing if you have ongoing nursing needs You might be able to organise nursing in your home Not moving house Being in control of how I structure my day Living by myself Care in your own home will allow you to remain as independent as possible, and avoid a house move Having only my own possessions around me Not worrying about maintaining my house Meeting new people and having company Having support available at all times where I live Moving into residential care will mean that you can have company when you want it, and know that there is support available if you need it Easy access to activities

27 3 Where do my family and friends live? Moving into a care home can mean that you move away from friends and places which matter to you. However, it can also allow you to move closer to people who are important. Consider: How easy is it for family and friends to visit? Is there good parking and/or public transport links? What facilities are close by? In a nutshell: The Care Quality Commission The Care Quality Commission (CQC) regulates and inspects all care services in England. This includes: Registered care homes Registered care homes with nursing Agencies which provide care services. However, it does not usually include individuals who deliver care services or act as personal assistants. You can find out more about the CQC, and search for individual care services, on their website at: Section 1: The Five Step Guide to Choosing and Paying for Care Find out more Me, Myself & I This is an interactive game from Staffordshire Cares to help you identify your needs and priorities, and direct you to the information, advice and products that you need. My Care in Birmingham The Birmingham website guides you to look at your goals and priorities, and identify approaches which are right for you. 27

28 28 Choosing a carer / personal care assistant A personal care assistant (or carer ) will help you carry out day-to-day activities in your home. All carers offer support with personal care, such as washing, dressing and eating. Many carers can also provide additional services, such as cooking, cleaning, shopping and help for you to get out and about. How can I find a carer? You can recruit a carer direct yourself, or you can go through a care agency to find one. How does it work? What should I know? Employ a carer direct You are responsible for the whole process from recruitment to ongoing management of your carer You will be responsible for: Finding and recruiting your carer (or set of carers) Providing appropriate training, support and management Legal responsibilities for being an employer (eg pensions, insurance, health and safety, holiday pay) Paying your carer(s) and keeping required records Contract with a care agency You set up a contract with the care agency to provide you with a carer at agreed times The agency should ensure that a suitable carer is available at the times you have agreed. This includes providing cover over holiday periods Your contract is with the agency rather than the carer, so you may not always get the same person looking after you Good if you Want to have full control over who delivers your care Want to be able to negotiate rates and hours direct with your carer Enjoy the responsibility of managing an employee Don t want the responsibility of being an employer Want to know that there will be back-up if your usual carer is off sick or on holiday Not so good if you Don t want to be an employer Want to know that there will be back-up if your usual carer is off sick or on holiday Want to have full control over who delivers your care Want to be able to negotiate rates and hours direct with your carer To ensure you get the support you want, clearly set out what you are looking for. For example: What do you want the carer to do? How often do you want to have care? Do you want a carer to live in your house, or one who comes in at specified times? Do you have any personal requirements, for example someone who likes pets, a non-smoker, or someone who can drive?

29 29 Give your general location in a job advert rather than exact details. Make sure you include costs for recruitment, holiday cover, training, insurance and pensions in your calculations when comparing costs of using an agency versus direct employment. Always take up references, and ask for a copy of a CRB check before letting someone into your home as a carer. Did you know Care agencies are regulated by the Care Quality Commission. However, there is currently no regulation of individual carers or personal care assistants.? In a nutshell: Carers and Personal Care Assistants The terms carer and personal care assistant (or personal assistant ) are both used to describe someone who will provide care for you in your own home. You may see either of these terms used when you are looking for care, as there is no agreed definition. This guide uses both terms. However, councils generally use the term carer to describe someone who is unpaid, such as a family member, neighbour or friend who provides you with help. On the other hand a personal assistant may be used to talk about someone who provides care and practical assistance that you pay for. There is support available for unpaid carers. If you are a carer, or have someone caring for you, contact your council, using the numbers at the back of this guide. Top Tips Find out more Section 1: The Five Step Guide to Choosing and Paying for Care The Skills for Care Toolkit provides practical information and templates to guide you through the process of recruiting and managing a carer: CareMatch: Staffordshire s recruitment service to match up people looking for and delivering care:

30 30 Choosing a Care Home A residential care home will provide you with accommodation and personal care. All residential care homes: Are regulated and inspected by the Care Quality Commission for quality and safety Offer personal care and support for you Will provide an individual space for you in the care home Have access to shared rooms and facilities. However, care homes can differ in a number of ways, such as: Type of care provided: Some care homes offer nursing, whilst others only deliver general care and support. Size: Care homes can vary in size, from only a couple of rooms up to large buildings with rooms across several floors. Personal accommodation: You may have your own room and bathroom or need to share with other residents. Communal space: There will generally be a dining room, and a shared room for TV and social activities. You may also find a garden, kitchen area and other shared spaces around the home. Social activities: Care homes can provide activities and facilities on site. They may also offer outings for residents. Ethos: All care homes should be non-discriminatory. However, you can find care homes which have been based on a particular set of values, such as those set up by the Quakers. Costs: Generally you will get what you pay for. Care homes which offer individual rooms will usually cost more than those with shared facilities. Costs can also vary depending on where they are located. The right care home for you will depend on your own personal needs, circumstances and preferences. Care Homes with Nursing If you need regular medical support or a high level of help with personal care, you should look for a care home with nursing (the name now used for Nursing Homes). In these homes, there will be a qualified nurse on duty throughout the day and night. This means that there will always be someone available to administer medical support or assess whether you need a doctor. Not all care homes will offer nursing, so check before you decide to move in. You can choose to live in a care home with nursing, even if you don t currently need this type of support. However, you may need to pay more.

31 To find a care home that meets your needs: Decide what support and facilities you want (including whether you need a home which offers nursing) Search for local care homes at or ask your council for a list Shortlist a few that meet your requirements, and arrange a visit. If possible: Take a friend or family member with you Speak to residents and their families to find out what they think about the home Check costs, look at the contract and ask the manager of the care home any questions. Checklist: Visiting a Care Home Before you visit a care home, think about what questions you would like to ask. For example: What personal space will I have? Can I bring my own possessions with me? Can I make food and drink outside of regular meal times? What training and qualifications do the staff have? Can I bring my pet? Can visitors stay overnight? What is included in the price? What activities / social event do you offer? Top Tip Start your search as early as possible, as care homes can have waiting lists. If your preferred home doesn t have any availability, you can move into another home temporarily, until a place comes up. Section 1: The Five Step Guide to Choosing and Paying for Care? Did you know... If you are paying for your own care, you can choose a home which offers a higher level of care than you need. However, you are likely to have to pay more for this. If your money runs out, and you need the council s help, you may have to move into a different home which matches your needs more closely. Find out more The Find Me Good Care website includes a search facility and reviews as well as information about care homes: The Care Home Handbook provides more detailed information about finding and paying for care: 31

32 32 STEP 5 Start using care After you have chosen your care, you need to arrange to start using it. 1 Agree a contract A contract should clearly set out what will be provided. This helps you understand the services you will be paying for, and gives you something to refer to if there are any problems in the future. Contracts Checklist Carer in your home Care Home Ensure your contract includes: The services that the carer will be delivering The days and hours that the support will be delivered How much you will pay for the care Any additional costs you will be expected to pay (eg transport for the carer) Any agreed points about the carer (eg whether this is always the same person / group of people) Any requirements from your side (eg if you need to provide any equipment, insurance, or training) Arrangements for if your carer is off sick, or on holiday What happens if you need to cancel a care visit How to cancel or make changes to the care Ensure your contract includes: What will be provided by the care home How much you will have to pay, including: - How often fees can go up - What you will pay if you go on holiday or have to stay in hospital Terms and conditions, including the amount of notice you or the provider has to give if you want to make changes to the contract or move out Any special requirements, such as bringing pets, smoking policy, insurance requirements What to do if you have a complaint An annual review, to reflect on how the care is going and make any changes 2 Confirm your start date, and arrange a trial or settling-in period Once you are happy with the contract, you should confirm the date that you want to move into the home, or start your care. You should agree to have an initial trial period, during which it is easy for you to stop or change the contract. This will give you a chance to check that you are happy with the services and support. At the end of the trial period, you should review the service with the care provider and agree whether it is working as you had hoped and/or make any changes.

33 33 3 Arrange a service review Once the trial period is over, and you are happy with the services, you can settle down with your care. However, it is useful to set up a regular review, to ensure that the services continue to meet your needs. For example, you could review your care on a six-monthly or annual basis. This will give you the opportunity to formally discuss any suggestions or changes you would like to make. If you are moving into a care home, remember to change your address details with all key contacts including your GP, TV licence and the electoral register. Keep talking to the people who are caring for you, to ensure you are getting the support that you need. Top Tips Section 1: The Five Step Guide to Choosing and Paying for Care

34 34

35 35 Section 2 Self-Help Sheets This section provides a series of self-help sheets. They aim to help you think about the support and care that is right for you. You can use the sheets in any order. You may find that some are more relevant to your circumstances than others. You may find it useful to go through these sheets with a carer, friend or support worker.

36 36 Choosing Care Help Sheets

37 Choosing Care Sheet 1: What help do I need? To choose care which is right for you, you need to be clear about what help you need. Use this sheet to help think about what types of support would be useful. I need to: Essential Nice to have Keep my mind active Meet people Feel useful I need help to stay active and meet people Section 2: Self-help Sheets I need help with: Essential Nice to have Walking Getting on / off public transport Going to social activities and appointments I need help with getting out and about I need help with: Essential Nice to have Cleaning Gardening Jobs around the house such as changing a lightbulb I need help with maintaining the house I want to know that: Essential Nice to have Someone will help me if I fall or need urgent support I need 24-hour emergency support I need help with: Essential Nice to have Getting up / down stairs Cooking meals Getting in / out of the bath Answering the door Using the telephone Reading / writing Turning on switches I need help with day-to-day activities around the house 37

38 38 I need help with: Essential Nice to have Having a bath / shower Washing Getting dressed Eating Taking medicines I need help with personal care I need: Essential Nice to have Significant help with personal support Nursing Help for ongoing medical needs I need nursing support If you need: Help to stay active, to get out and about or to maintain the house Look at local and community services To know that you have access to 24-hour emergency support Think about installing an alarm or moving into supported housing Help with day-to-day activities around the house Consider installing equipment or moving into supported housing Help with personal care Employ a carer to look after you in your own home, or think about moving into a residential care home Nursing Speak to your GP or hospital about nursing support You can find out more about all of these options in Section 1 of this guide.

39 39 Choosing Care Sheet 2: How often do I need help? Being clear about the amount of support you need can help you to decide what type of care is right for you. Use the table below to think about how often you will need help: Type of support Day-to-day activities in the house All the time All day All night At least 4 times a day 1 to 3 times a day Less often Section 2: Self-help Sheets Personal care Nursing support Did you... Tick anything in the shaded areas? If so, think about moving into residential care. This will ensure that you have support available when you need it. You may also find it cheaper to move into a care home, rather than paying for the level of care that you need to be provided in your current house. Only tick white boxes? If so, you may find it easier and cheaper to stay in your own home. Alternatively, you could think about moving to a supported housing scheme, so that you have extra support and facilities near by, if you need them. Remember to also consider what else is important to you, when making a decision about where to live. Choosing Care Sheet 3 can help you with this.

40 40 Choosing Care Sheet 3: What is important to me? When you are choosing care, you should think about how you want to live your life. Use the table below to think about what is important to you. How important is it that I... Essential Nice to have Not important Don t have to move house Choose when to go out Live by myself Don t have to worry about maintaining my house Live with other people Have support available at all times in the place where I live Have company where I live Meet new people Have easy access to activities Live close to friends and family Stay in the area I currently live in Use your answers to think about where you would like to live. What did you say was essential? Points mainly in the blue section: consider care in your home. Points mainly in the orange section: consider residential care. Points mainly in the green section: consider residential care or supported housing plus find out about local and community services. Points in the pink section will depend on your current circumstances for example, moving could help you to be either closer to, or further away from, friends and family. There is no right or wrong answer it is up to you to choose where and how you would like to live.

41 41 Choosing Care Sheet 4: Adapting my house Adapting your home can help you live safely and independently. However, it can also be expensive. Use this sheet to help think about whether it will be worthwhile making adaptations to your home. Points to consider Could I use the space in my house differently, rather than buying equipment or making structural changes? My options and thoughts Section 2: Self-help Sheets For example, could I have my bedroom downstairs, rather than installing a chair-lift to help me go upstairs? What other support will I have? Who or what could provide the help that I need, without making changes to the house? For example, rather than lowering my work surfaces, can my carer / family / friends help with the cooking? How important is it that I can use every part of the house? For example, could I leave one of my rooms for my carer, rather than widening all the doorways in my house? Is there anything else I could do to make it easier to live in my house?