OPTIONS A guide to care and independent living
NHS continuing healthcare Who’s eligible?
CONTRIBUTORS: Age UK Berkshire Berkshire Healthcare NHS FT Bracknell Forest Council NHS Choices
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Contents Inside this guide n Choose Berkshire Healthcareâ€™s Adult Hearing Service.................................................4 n Looking after your health this winter..................5 n NHS continuing healthcare............................ 6-8 n Care Quality Commission...................................9 n Personalised care...................................... 10-11 n What is NHS-funded nursing care?..................11 n Paying for your own care and support........ 12-13 n Get out and about...................................... 14-15 n NHS 111..........................................................15 n Care at Home Services (Domiciliary Care).. 16-17 n Age UK Berkshire Services......................... 18-19 n Useful contacts.......................................... 22-23
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Options Berkshire is published by Octagon Design & Marketing Ltd with editorial contributions from the Berkshire Healthcare FT, Royal Berkshire NHS FT, the CQC, Age UK Berkshire, and NHS Choices. The editorial contributors have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor do the editorial contributors endorse any of the products or services.
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NHS continuing healthcare Free care package Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.
Where can NHS continuing healthcare be provided? NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your home or in a registered care home.
Am I eligible for NHS continuing healthcare? NHS continuing healthcare is for adults. Children and young people may receive a “continuing care package” if they have needs arising from disability, accident or illness that can’t be met by existing universal or specialist services alone. To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a “multidisciplinary team”). The team will look at all your care needs and relate them to: • what help you need • how complex your needs are • how intense or severe your needs can be • how unpredictable they are, including any risks to your health if the right care isn’t provided at the right time Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change. You should be fully involved in the assessment process and kept informed, and have your views about your needs and support taken into account. Carers and family members should also be consulted where appropriate. A decision about eligibility should usually be made within 28 days of it being decided that the person needs a full assessment for NHS continuing healthcare. If you aren’t eligible for NHS continuing healthcare, you can be referred to your local authority who can discuss with you whether you may be eligible for support from them. If you still have some health needs then the NHS may pay for part of the package of support. This is sometimes known as a “joint package” of care.
NHS continuing healthcare assessments Clinical commissioning groups, known as CCGs (the NHS organisations that commission local health services), must assess you for NHS continuing healthcare if it seems that you may need it. 6 | Options Berkshire
For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment. However, if you need care urgently – for example, if you’re terminally ill – your assessment may be fast-tracked.
Initial assessment for NHS continuing healthcare The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed, and be asked for your consent. Depending on the outcome of the checklist, you’ll either be told that you don’t meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility. Being referred for a full assessment doesn’t necessarily mean you’ll be eligible for NHS continuing healthcare. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment.
The professional(s) completing the checklist should record in writing the reasons for their decision, and sign and date it. You should be given a copy of the completed checklist. You can download a blank copy of the NHS continuing healthcare checklist from GOV.UK.
• symptom control through drug therapies and medication • altered states of consciousness • other significant needs
Full assessment for NHS continuing healthcare
If you have at least one priority need, or severe needs in at least two areas, you should be eligible for NHS continuing healthcare. You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.
Full assessments for NHS continuing healthcare are undertaken by a “multidisciplinary team” made up of a minimum of two health or care professionals who are already involved in your care. You should be informed who is co-ordinating the NHS continuing healthcare assessment. The team’s assessment will consider your needs under the following headings: • behaviour • cognition (understanding) • communication • psychological/emotional needs • mobility • nutrition (food and drink) • continence • skin (including wounds and ulcers) • breathing
These needs are given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.
In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS continuing healthcare should be provided. The assessment should take into account your views and the views of any carers you have. You should be given a copy of the decision documents, along with clear reasons for the decision. You can download a blank copy of the NHS continuing healthcare decision support tool.
Fast-track assessment for NHS continuing healthcare If your health is deteriorating quickly and you’re nearing the end of your life, you should be considered for the NHS continuing healthcare fast track pathway, so that an appropriate care and support package can be put in place as soon as possible – usually within 48 hours. An organisation called Beacon gives free independent advice on NHS continuing healthcare. Visit the Beacon website or call the free helpline on 0345 548 0300.
Care and support planning If you’re eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs. Depending on your situation, different options could be suitable, including support in your own home and the option of a personal health budget. If it’s agreed that a care home is the best option for you, there could be more than one local care home that’s suitable. Your CCG should work collaboratively with you and consider your views when agreeing your care and support package and the setting where it will be provided. However, they can also take other factors into account, such as the cost and value for money of different options. >> Options Berkshire | 7
NHS continuing healthcare continued Free care package
NHS continuing healthcare reviews If you’re eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within three months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs. If your needs have changed, the review will also consider whether you’re still eligible for NHS continuing healthcare.
Refunds for delays in NHS continuing healthcare funding CCGs will normally make a decision about eligibility for NHS continuing healthcare within 28 days of getting a completed checklist or request for a full assessment, unless there are circumstances beyond its control. If the CCG decides you’re eligible, but takes longer than 28 days to decide this and the delay is unjustifiable, they should refund any care costs from the 29th day until the date of their decision. If your CCG decided that you weren’t eligible for NHS continuing healthcare, but then revised this decision after a dispute, it should refund your care costs for the period between their original decision and their revised decision.
If you’re not eligible for NHS continuing healthcare If you’re not eligible for NHS continuing healthcare, but you’re assessed as requiring nursing care in a care home (in other words, a care home that’s registered to provide nursing care) you’ll be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the cost of your registered nursing care. NHS-funded nursing care is available irrespective of who is funding the rest of the care home fees. Read more information from NHS England about NHS continuing healthcare.
Frequently asked questions about NHS continuing healthcare
Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority? An assessment for NHS continuing healthcare can’t be carried out without your consent, so it’s possible to refuse. However, if you refuse, although you’ll still be entitled to an assessment by the local authority there’s no guarantee that you’ll be provided with services. There’s a legal limit on the type of services that a local authority can provide. If you refuse to be assessed for NHS continuing healthcare, the CCG should explore your reasons for refusing, and try to address your concerns. If someone lacks the mental capacity to consent to or refuse an assessment, the principles of the Mental Capacity Act will apply and in most circumstances an assessment will be provided in the person’s best interest. My relative is in a care home and has become eligible for NHS continuing healthcare. The CCG says the fees charged by this care home are more than they would usually pay, and has proposed a move to a different care home. I think a move will have a negative effect on my relative. What can we do? If there’s evidence that a move is likely to have a detrimental effect on your relative’s health or wellbeing, discuss this with the CCG. It will take your concerns into account when considering the most appropriate arrangements. If the CCG decides to arrange an alternative placement, they should provide a reasonable choice of homes. Is it possible to pay top-up fees for NHS continuing healthcare? No, it isn’t possible to top up NHS continuing healthcare packages, like you can with local authority care packages. The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you get from the NHS. These private services should be provided by different staff and preferably in a different setting.
I have a local authority support package that works well. I’m now eligible for NHS continuing healthcare – will my support package change? If you’re concerned about changes to your care package because of a move to NHS continuing healthcare, your CCG should talk to you about ways that it can give you as much choice and control as possible. This could include the use of a personal health budget, with one option being a “direct payment for healthcare”. Content supplied by:
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The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care. We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one. You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia. We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided. You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care. You can also call us to share an experience of care on 03000 61 61 61. Here are some tips to help you choose your care.
Social care Top tips 1
The Care Quality Commission (CQC) registers all care homes and home care agencies. You can find out which ones support specific groups of people, such as people with a learning disability or those living with dementia. CQC’s Chief Inspector for Adult Social Care, Andrea Sutcliffe always uses ‘The Mum Test’: is a care home safe, caring, effective, responsive to people’s needs and well-led? In other words, is it good enough for my Mum (or anyone else I love and care for)? Look for care homes and home care agencies where the staff involve people who use services and their families and carers, and treat individuals with compassion, kindness, dignity and respect.
Whether you are being cared for in your own home or in a residential setting, the staff looking after you need to be skilled, kind and supportive. They should also be capable and confident in dealing with your particular needs. You should always feel that their support is helping you to live the life you want to. A care home will be a home for you or your loved one. Residents should be treated as individuals with their likes and dislikes taken into account. Think about whether a home is close enough to family, friends, and community facilities. Look at how well-led and managed a home is. What does it have in place to ensure that it delivers high quality care? Does it promote meaningful activity and connect the home with the community?
If you or a loved one needs help with day-today care, you can contact your local council’s social services department. They will ‘make an assessment of your needs’ and depending on circumstances, may be able to help you access financial help. For more advice visit Age UK’s website www.ageuk.org.uk /home-and-care.
If you would like to organise your care yourself, you can find a care worker or personal assistant through an agency. Your local social services department should be able to provide details of approved agencies.
CQC’s ratings will identify services as:
Outstanding Good ● Requires improvement ● Inadequate ● This will help you make informed choices around your care. There’s also useful advice on the Social Care Institute for Excellence’s Find me good care website www.scie.org.uk/findmegoodcare/
Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police. You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.
The Care Quality Commission has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.
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Personalised care Meeting your needs If your local authority agrees to pay for some or all of your home care needs, it must offer you choice and control over how your needs are met. This is known as personalised care. You’ll be given a personal budget, and can choose to receive it as a direct payment.
Read more about how to choose care services.
How does personalised care work? You and your social worker or care manager need to work together to create a care plan. This plan details your care and support needs, and can be used to work out the value of your personal budget. Your care plan should include:
A personal budget is the amount of money the local authority allocates for your care, based on its assessment of your needs.
• what’s important to you, including your interests, lifestyle, personal tastes and the people in your life
You can be put in charge of this budget either by telling the local authority how you would like it spent, or by the council giving you the money so you can directly pay for your own care (a direct payment).
• your hopes for the future, such as whether you’d like to study or take on more hobbies outside the home
It can also be given to a separate organisation (such as a user-controlled trust) that will spend the money on your care as you see fit, if you prefer. These are known as Individual Service Funds.
• what you want to achieve by managing your own support
You can choose a combination of the above (for example, a direct payment with some council-arranged care and support), often called a mixed package. Find out how personal budgets work.
Direct payments Direct payments give you the most control over your care. If you’re unhappy with the services you’re getting, you can decide to change who gives you the care services without having to go through the local authority. But you have to be able to account for how you spend the budget. And you have responsibilities as an employer if you hire a personal assistant with your direct payment. The Money Advice Service has a guide to using direct payments.
The pros and cons of personalised care Personalised care means you have to spend some time and effort thinking about your care and support needs and the outcomes you want. There may be extra responsibilities. For example, if you decide to request a direct payment to cover the cost of homecare, you could use the payment to hire an individual, giving you the responsibilities of an employer. Alternatively, you could hire care workers through an agency. This removes the legal obligations of being an employer, but may cost more and may remove some of the benefits of having the same person provide your care. 10 | Options Berkshire
• what limitations you currently have and how you want to change Make sure you include information about how you’ll manage your money and what you’ll spend the money on (including personal assistants, transport, housing adaptations, therapists and respite services). Clarify how you’ll receive your money. If you choose to receive your personal budget as a direct payment, the local authority may pay the money straight into a bank account that you control (you must set up a new bank account to do this) or they may give you a pre-paid card. Alternatively, you may prefer your personal budget to be managed by the local authority or by someone else, such as: • a friend or family member (the local authority must agree to this) • a broker, independent social worker or an advocate • your care manager or social worker Discuss these options with your social worker or carer to work out which option is best for you. If someone else will be looking after your money, you may need to create a decision-making agreement. This should state how they’ll look after your money and what decisions they can and can’t make on your behalf. The local authority may want to check what you do with your money to make sure you’re spending your budget appropriately, and your care and support needs are being met. You may need to keep receipts (especially for large purchases) so you can show them you have spent your money responsibly. If you choose a direct payment, the council will give you a direct payment agreement that sets out the terms and conditions. If you’re struggling to manage your money, the local authority can advise you on how to make your money work best for you.
Check your care plan is working Meet with your local authority at least once a year to discuss whether your care plan is working. This is an opportunity to discuss whether your needs are being met in the best way, and it’s also your chance to talk about changes you want to make for the future. You don’t have to wait for a review meeting to change the way you spend your budget. You can change things as you go along.
Disagreements about care plans and personal budgets If you have been told that you’re not eligible for services or you don’t agree with the amount allocated to you in your personal budget, you can ask for a reassessment. Speak to your social worker or care manager about being reassessed, or phone your local authority social services department and request a complaints form.
If you want to make a big change, consult your care manager or social worker, who may arrange a review. You can ask for a review meeting about your care plan at any time. To prepare for a review, provide any receipts you have kept since you were awarded a personal budget. If someone is managing your funds for you, get them to join the review meeting.
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What is NHS-funded nursing care? The facts NHS-funded nursing care is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this registered nursing care.
Who is eligible for NHS-funded nursing care? You may be eligible for NHS-funded nursing care if: • you are not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse • you live in a care home registered to provide nursing care
How will my needs be assessed? You should be assessed for NHS continuing healthcare before a decision is made about whether you are eligible for NHS-funded nursing care. Most people don’t need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven’t already had one, your clinical commissioning group (CCG) can arrange an assessment for you.
Outcome of the assessment If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the care home. Services provided by a registered nurse can include planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care.
If you’re not eligible for NHS-funded nursing care and you don’t agree with the decision about your eligibility, you can ask your CCG to review the decision.
What is the rate of payment for NHS-funded nursing care? NHS-funded nursing care is paid at the same rate across England. In April 2017, the rate was set at £155.05 a week (standard rate). Before October 1 2007, there were three different levels or bands of payment for NHS-funded nursing care – low, medium and high. If you moved into a care home before October 1 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date. If you moved into a care home before October 1 2007, and you were on the high band, NHS-funded nursing care is paid at a higher rate. In April 2017, the higher rate was set at £213.32 a week. You’re entitled to continue on this rate unless: • you no longer have nursing needs • you no longer live in a care home that provides nursing • your nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £155.05 a week, or • you become entitled to NHS continuing healthcare instead.
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Paying for your own care and support Making the right decision Many people who use care and support services will pay for all of the costs. This is known as being a “self-funder”.
idea of how the cap will work for you, but actual costs will vary to reflect your individual circumstances and needs and how they change over time.
The cost of your care will vary depending on its type, intensity, specialisation, location and duration. For example, a place in a residential care home will cost hundreds of pounds a week.
For more information on how paying for care is changing from 2020, read about the changes in the Care Act.
To make decisions that have such major financial implications, you may want to seek independent financial advice and it’s always worth researching the costs of alternatives first. For example, if you are considering a care home place, the cost should be weighed against the cost of care and support that may help you remain in your current home, such as homecare.
How much will care cost? If you are thinking about your future care needs or are facing immediate decisions about care options, it can be helpful to get an idea how much care can cost. Inevitably, the price you would pay will depend on your particular circumstances and needs. The costs also vary depending on where you live. Unfortunately, care homes and homecare agencies tend not to provide this information publicly but you may find it helpful to search for and contact care services in your area to get some idea of likely costs.
The ‘cap on care costs’ Currently, it is not easy to plan for your future care needs, as it’s hard to estimate how long you will need care for and how your circumstances may change. From April 2020, a “cap” on the costs of meeting your eligible care needs (but not accommodation associated with care or nursing costs) is being introduced. The cap means that, once reached, the local authority will take over paying the cost of their eligible care needs. The cap will not cover your daily living costs. These costs include expenses such as rent, food and utilities and the costs you would face even if you did not have care needs. It is important to note that daily living costs will be a nationally set figure. This figure will be a “notional” amount rather than the actual costs. This is designed to support consistency and enable people to plan. To benefit from the cap once it comes in, you will need to contact your local authority to see if your needs are eligible. If you are seen to have eligible care needs, the local authority will open a “care account” for you. This account records your progress (the amount of costs you have incurred) towards the cap. The cap does not begin until April 2020 and any costs incurred before this will not count towards the cap. The BBC’s care calculator can estimate how much you may have to pay for care services depending on where you live in England, once the new rules are in place. This will give you an 12 | Options Berkshire
Ask for help from your local authority It’s worth checking whether you’re eligible for means-tested support from your local authority or other financial support – for example, through a care needs assessment and a financial assessment. Few of us will have the income or ready access to the cash to pay for our ongoing care needs, and you may need to look at selling or remortgaging any property you may own. The new Care Act means more people may be able to benefit from “deferred payments”. Deferred payments can help people avoid being forced to sell their home in a crisis in order to pay for their care by having the council temporarily cover the cost – usually until you sell your property. Following the Care Act, every local authority in England has to make deferred payment agreements available. As an alternative, you may be able to enter an “equity release scheme” with a financial organisation. Equity release can pay for the fees from the value of property you own. However, you should consider which of these options best meets your needs, and what the overall costs to you will be. Before taking such significant financial steps as equity release, you might want to get independent financial advice. You can find information on equity release for care at home from Which? Elderly Care or the Money Advice Service’s equity release information. If you’re planning ahead, you may consider arranging an investment or insurance plan to fund your care. Again, it may be worth taking independent advice on financial arrangements before making major changes. Because of the new rules, there are likely to be more financial products emerging that are designed to help people pay for care. You may also want to explore whether the NHS would meet some or all of your care and support costs, or you may have entitlement to benefits that may help you meet costs. Read about other ways of funding care.
Advice on paying for care Even if your local authority is not able to help fund your care, it will be able to make an assessment of your care and support needs. From this, the local authority can provide you with access to a range of information and advice available locally. You can also get independent advice from: • The Money Advice Service website: offers information on paying for care or the option to speak to an online adviser. You can call the Money Advice Service on 0300 500 5000. • The Society of Later Life Advisers: the society can also help you find advice on how to make financial plans for care in your old age. • Find Me Good Care: a website of the Social Care Institute for Excellence. It has advice on all aspects of planning and funding social care. • Age UK: has great advice for older people and those planning for their later years. • Carers UK: an excellent resource of advice for carers who need to help someone else. • Which? Elderly Care has a guide to financing care.
Deferred payments if you are unable to pay for care services Care home fees are a big financial commitment, and the decision to go into a care home is often made at a moment of crisis or urgency, such as when being discharged from hospital. This can make finding the money to pay for fees (usually several hundred pounds a week) challenging for people funding their own care. In particular, if you own property outright but have little in the way of savings, you may be expected to fund your own care but have little immediately available money to pay for it. Some people going to stay in a care home for a long time find that they have no option but to sell their property to pay the care home fees. Your council may be able to help you if you are at risk of having to sell your home. Where there is a delay in selling the property, or you don’t want to sell the property immediately, you may be eligible to have your care fee payment “deferred”. This is where the local authority helps you to pay your care fees temporarily, and you repay the costs to the local authority at a later date.
If the local authority agrees to the deferred payment and pays the care home fees, it will take payment from the money raised once the property is sold. This can be: • during your lifetime if you choose to sell your home • once you die, the local authority can be repaid from your estate All councils must offer people the chance to defer payment if they meet a set of eligibility criteria. A deferred payment scheme is only available if you don’t have enough income to cover your care home fees, and you have less in savings than £23,250. In these circumstances, the savings don’t include the value of your property, but does include money in bank accounts. The local authority will put a “legal charge” (similar to a mortgage) on the property and will then pay the remaining care fees in full. You will then be assessed to see whether they are able to pay a weekly charge to the authority. Your ability to pay is based on your income less a set “disposable income allowance” (currently £144 per week). Before considering deferred payments, you should look into whether the property will or won’t be counted in how your capital is calculated. For instance, it may be disregarded because your partner still lives there, and if it is a deferred payment agreement wouldn’t be necessary. It’s wise to get independent financial advice before agreeing to a deferred payment, and it’s worth bearing in mind that choosing deferred payments can impact on some welfare benefits.
Protection for self-funders While you may have the savings in place to afford care services, if you lack the capacity to make the arrangements, the local authority can step in to help. The local authority can also help people who lack capacity by negotiating fees with a care provider and paying them directly. The local authority will need to be reimbursed. Anyone entering into a contract for care services should be given adequate information about the fees. Care providers should supply: • information about the fees charged for various services provided • arrangements for paying the fees • the fees charged for any additional services If your capital falls below the set levels for local authority funding (currently £23,250), you will be eligible for reassessment for help with funding your care.
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Getting out and about Get mobile Although mobility problems make it harder to get around, transport has been getting more accessible for disabled and elderly people over the years. You can get help: • using public transport • getting discounts on public transport • from the NHS with travel costs • finding community transport schemes If you have mobility problems and you need a car to get around, you may be able to get help with costs through: • discounted or free road tax • a Blue Badge parking permit • help with the cost of buying or hiring a vehicle through the Motability scheme
Using public transport with a disability All public transport vehicles have to be “accessible” so disabled passengers can use them. Public transport also has to accept guide dogs or assistance dogs. But if you’re using public transport, it’s worth contacting the transport operator before you travel to make sure they’re able to offer the assistance you require. Buses and trains usually have priority seating for older people and people with disabilities. They also usually have space and wide doors for wheelchairs. Some buses, trains and trams are fitted with automatic ramps.
Check the criteria to see if you’re eligible. Children aged 5 to 16 with disabilities are eligible for a Disabled Person’s Railcard. This lets an adult to travel with them for a third of the cost of an adult fare, while the child pays the normal child fare. Taxi and private hire companies can provide wheelchairaccessible vehicles if you ask for one when you book a vehicle. Some councils also give free taxi vouchers to people who find it difficult to use public transport because they’re frail or disabled.
NHS help with travel and transport costs If you pay to travel to a hospital or other NHS premises for NHSfunded treatment or diagnostic tests, you may be able to claim a refund of reasonable travel costs.
The London Underground is being upgraded to improve stepfree access.
Find out more about the Healthcare Travel Costs Scheme and who’s eligible.
Staff at Underground stations are also trained to help people move around the underground system – for example, by helping you avoid escalators and calling ahead to arrange for assistance at your destination.
Community transport schemes
Discounts on public transport for older people and disabled people
Many areas offer a free “Dial-a-Ride” service, offering door-todoor transport for people unable to use normal buses.
Older people and people with disabilities can travel free on local buses anywhere in England between 9.30am and 11pm Monday to Friday, and at any time during the weekend and on bank holidays. Some authorities offer free travel for longer, and some allow a companion to travel with the pass holder for free. You may have to apply through your local authority, but in most areas you can apply online for an older person’s bus pass or for a disabled person’s bus pass. If you often travel by train, it’s probably worth getting a Disabled Railcard Card. This gives you a third off the price of rail tickets. 14 | Options Berkshire
These schemes provide transport to and from hospitals, doctors’ and dentists’ surgeries, and opticians and chiropodists.
Some schemes require you to register and may charge a fee. Carers may be able to travel with you for an additional charge. Check with your local council whether your area has a community transport scheme. The British Red Cross runs a similar transport service in some areas. Contact your local Red Cross branch for information.
Cars and parking Road tax reductions If you’re disabled or have a serious long-term condition, you might be eligible for a reduction in your road tax, or even be exempt from it altogether.
Find out more on GOV.UK about vehicle tax exemption and vehicle tax reduction. Blue Badge disabled parking scheme If you have severe mobility problems that make using public transport difficult, you may be able to get a Blue Badge parking permit for your car. This lets you park closer to places you wish to visit, such as in marked disabled parking bays. You may also be able to: • park for free within certain time limits in some places • park on single and double yellow lines • stay longer in on-street time-limited parking bays Blue Badge schemes are run by councils. Most councils will let you apply for a Blue Badge online. Central London is exempt from the national Blue Badge regulations and the central London boroughs of Kensington and Chelsea, Camden, Westminster and City of London don’t fully operate the Blue Badge scheme. But if you’re exempt from road tax or have a Blue Badge permit, you may be able to get an exemption from paying the central London congestion charge.
Motability scheme The Motability scheme allows some disabled people receiving a mobility allowance to get a car, powered wheelchair or scooter. The scheme uses some or all of your mobility benefit payments to cover the cost of contract hire or hire purchase of an appropriate vehicle. You can also pay an extra amount of money if you want a more expensive vehicle. Find out more about how the scheme works and who can join. Editorial content for pages 6-8 and 10-15 supplied by:
NHS Choices have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does NHS Choices endorse any of the products or services. All information and figures correct at the time of going to print.
If you need medical help fast, but it is not life threatening – call What is
If you need medical help fast but it’s not a life-threatening situation, you can now call the new NHS 111 number. When you call 111, a trained adviser will ask you questions to find out what’s wrong, give you medical advice and direct you to someone who can help you, like an out-of-hour doctor or a community nurse. If the adviser thinks your condition is more serious, they will direct you to hospital or send an ambulance. If you don’t speak English, tell the adviser what language you want to speak and they will get you an interpreter. You can call 111 any time of the day. The call is free, from landlines and mobiles.
When do I use it? You should only call 999 in an emergency – for example, when someone’s life is at risk or someone is seriously injured or critically ill. Call 111 if you need medical help fast, but it’s not lifethreatening – for example, if you: • think you need to go to hospital • don’t know who to call for medical help • don’t have a GP to call • need medical advice or reassurance about what to do next For health needs that are not urgent, you should call your GP. If a health professional has given you a number to call for a particular condition, you should continue to use that number.
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Options Berkshire | 15
Care at Home Services (Domiciliary Care) Providing care and support in your own home
What is Care at Home?
What do you need?
Care at Home Services assist in enabling people to live as independently as possible in their own home, (including sheltered or Extra Care housing).
Care at Home is all about helping you to continue living comfortably, safely and independently in the way you have always done. Care and support is available for as short or as long a period as you need.
The Social Services Departments of each of the Berkshire Unitary Authorities seek to give individuals a greater say in how they live their lives and in the services they require to meet their everyday needs. The Care at Home Service is designed to provide care and support to people living in their own home. It doesn’t matter whether your home is owner-occupied, rented, sheltered housing or supported living. Whilst considering the different care and support services available it may sometimes appear that a residential care home is the only option. It is possible, however, with the right assistance at the right time, to continue living independently in your home. Care at Home (also referred to as Domiciliary Care or Home Care) aims to promote independence in as many aspects of daily living as possible for people who require personal care and support in their home. Independent sector organisations and the Local Authorities’ Adult Social Care Services offer care and support to enable people to remain in their own homes as independently as possible. Specialist care staff work with frail and elderly adults, those with physical or sensory impairments, disabled children, and families, in their own homes. They help people to regain skills and independence following illness or a hospital admission, and may also help prevent the need for residential home care. Care staff are also trained in the use of hoists, manual handling, food hygiene and first aid, where these form part of the care required. A range of specialist training is also required to provide care to some user groups, such as people with a learning disability or dementia. Care at Home should be considered if you require assistance with aspects of personal care, including getting up in the morning and going to bed at night, dressing, washing and maintenance of personal hygiene, and preparing drinks and meals. Care assistants also offer emotional support and encouragement. All Care at Home organisations providing personal care are required to be registered with the Care Quality Commission. Inspection reports on each organisation are available from Care Quality Commission (including the Care Quality Commission website: www.cqc.org.uk) or from the Care at Home organisation itself and account should be taken of the report in making your choice. 16 | Options Berkshire
Services may include: • Some housework and help to do chores around the home (and even in the garden), doing the washing and cleaning • Cooking, shopping, collecting prescriptions and other tasks • Providing a Community Meals Service (i.e. Meals-on-Wheels) • Helping you to get out and about, or being company for you while your family go out • Staying overnight if this would be helpful • Helping you to get up in the morning, and get ready for bed in the evening, help with washing and bathing (we call this personal care) • Help to settle back in when you come home from hospital, or if you need to get ready to go on holiday • Providing equipment and adaptations to help with daily living for disabled people • Help with exercises your doctor or another health professional has recommended • Support with your medication • Attending a Day Care Centre (i.e. Social and Personal Care, Rehabilitation and/or recreation in a Centre) • Short-term (respite) care at home or in a care home (residential or nursing) (i.e. providing a break for carers) Help can be an hour a week, or several times a day, or someone living in your home all the time (we call this a live-in service). Some elements of care and support listed above may be limited by each Local Authority’s eligibility criteria if your service is provided or purchased from an independent sector provider by the Council.
How can you find someone to help you? The Berkshire Care Directory is a good way to find which organisations might be able to help you. We have endeavoured to list all the care agencies registered with the Care Quality Commission who provide care services within the Berkshire area. Some Berkshire Councils will only work with care agencies that have been accredited by their own Accreditation and Monitoring Team. They work closely with the providers in a supportive and open way, providing advice and suggestions to help them provide better care services.
These accreditation and monitoring teams assess the quality of local care services against local and national standards. Those who meet the standards are published on accredited lists on each authority’s website. Normally a search for ‘Accreditation’ will produce the results. The individual Council’s lists are updated regularly and contain details of care service providers for: • Older People • People with a Learning Disability • People with a Physical Disability • Domiciliary agencies (Care at Home) • Employment agencies / businesses (for supplying staff to residential homes). There are various different types of service depending on what you need and want. • Personal care providers. They are listed in the Care Directory, and will provide you with some or all of the services above. You can contact them to ask more about this, and they will be happy to come and discuss your needs with you. • Live-in care providers. Some of the home care agencies listed specialise in this type of care service. They are indicated in the directory’s list of home care agencies and, they will be able to explain what they can do to help you, if you need someone living in your home to provide • Care and support. • Personal Budgets are an amount of money which the Council can allocate to help an adult with eligible social care needs to get the support they need in the form they choose. They give you more choice and control over how you want to receive your support. There are lots of different options for managing your Personal Budget. You can choose to have the money in the form of a cash payment, or the local authority can arrange services on your behalf. Other sources of information are advisory bodies like the Citizens Advice Bureau or Age Concern. Often the best source of information is someone who has used a provider before, and can recommend them personally. Checks on care services can be made with the Care Quality Commission (see section in the Care Directory), as all personal care services must, by law, be registered and inspected by this Government body.
How much will it cost? Care at Home Services vary depending on what you want and the level of skill that your care worker may need. Standards and regulations have recently been introduced to ensure that people working in Care at Home services are selected, trained and supervised to make sure that you are looked after by someone who is competent, trustworthy and reliable. The cost of these safeguards is included in the fees charged by Care at Home providers. In general, personal care is likely to cost between £16.50-£25 per hour and live-in care from around £700-£900 per week. If you are purchasing care privately you should contact the various providers to get precise information about their charges. It is quite possible that fees vary across Berkshire depending on the availability of good carers and other factors.
What do you do next? There is a wide range of services to help you continue living comfortably, independently and safely in your own home. It will be helpful, when you are choosing a service to have some idea about what you want, and it may be helpful to have someone else with you (a relative or a friend) to ensure that everything you need to know is covered. It may be that as you discuss this with the Care at Home provider, they can suggest ways to help you that you had not considered. Most providers are very experienced in helping to look after people, and they may give you good advice about things to help you in your home, that you did not know about. It is part of their job to make things easier for you, which will mean that their care workers can help to look after you better. If you choose a particular Care at Home provider, they will supply you with their customer (or service user) pack, which will include details of what you and they have agreed, and what to do if you are dissatisfied with their service. It is a statutory requirement that you have this information. The provider will also need to check with you at least twice annually in person, that you are satisfied with what you are receiving and to review your service with you.
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WINDSOR AND MAIDENHEAD
Options Berkshire | 17
Age UK Berkshire Services Independence, wellbeing and enjoyment are the keys to help you love later life Age UK Berkshire is your trusted local charity to help you continue to live independently at home for as long as you want. We can also assist when you're out of the house, providing information, services and products to fit your needs.
Memory Loss Support
Information & Advice
We’re your first contact for a complete range of confidential, free information and advice, face-to-face, by phone or email. Age UK Berkshire helps with benefits, staying independent at home, housing enquiries and information about groups and activities in your locality. Age UK also provides many free useful guides and factsheets on a range of issues that are relevant to older people. We cover the whole of Berkshire, as well as providing information to friends and families anywhere in the world.
Keeping mentally and physically fit improves your quality of life and makes older age a much more enjoyable time. Qualified instructors run a wide range of popular activity sessions which promote well-being and give participants health and social benefits, as well as a chance to meet other like-minded people.
Handyperson For when you need small jobs completed around your house, such as tap washers, fitting curtain rails, handrails or replacing light bulbs. We also fit security devices, for example, keysafes, smoke detectors and CO detectors.
Easy Shop We offer a regular shopping service over the telephone. We will call you at a prearranged time, take your order and place it with the supermarket of your choice. We arrange for the shopping to be delivered at a convenient time for you.
Home Help Plus Our home help plus service is to help with keeping you independent at home and covers cleaning, shopping and going with you to appointments, for example, hairdressers, hospital or the library.
Companionship If you’re feeling a bit lonely or isolated, we offer long-term friendship and support from our dedicated volunteers who visit regularly or make regular contact by telephone. If you’re new to the area or you’ve lost touch with your local community we offer introduction and support, accompanying you if you need, for a short time. 18 | Options Berkshire
We can support you or your family member that is living with memory loss or dementia. We provide a wide range of specialist, tailored stimulating support and encouragement, for example, cookery, gardening, accompanied trips, music and games.
Silver Surfers Our one-to-one booked sessions cover what you need to know about the internet, social media, digital photography and even the basics of modern computers, smartphones and internet tablets. The sessions are individually-tailored and planned to the correct pace and you can use your own computer/laptop/tablet.
Money Management When handling your financial affairs becomes a worry Age UK Berkshire is able to help. With your permission we will sort out and take over managing your day-to-day finances, keeping you informed and alleviating any stresses or strains. Please note there is a charge for some of our services. We can only provide these quality services through the efforts and dedication of our many volunteers. If you’d like to give something back or learn new skills, try volunteering with Age UK Berkshire. To find out more about any of our services contact us: Huntley House 119 London Street Reading Berkshire RG1 4QA 0118 959 4242 Info@ageukberkshire.org.uk www.ageukberkshire.org.uk
No one should have no one, in Berkshire
Age UK Berkshire is your trusted local charity to help you continue to live independently
Options Berkshire | 19
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OPTIONS A guide to care and independent
Leaving hospital What’s next?
NHS continuing healthcare
CONTRIBUTORS: Age UK Berkshire Berkshire Healthcare NHS FT Bracknell Forest Council NHS Choices
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• Live-in Care • Personal Care • Companionships • Shopping • Bathing • Dressing • Meal Preparations and more • Private Nursing • Healthcare workers supplied to care & nursing homes 21 Pembroke Centre, Cheney Industrial Estate, Swindon SN2 2PQ Landline: 017932
721538 Mobile: 07429 763775 firstname.lastname@example.org www.trioplushealthallcare.com
20 | Options Berkshire
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Options Berkshire | 21
Useful contacts Important numbers A Action on Elder Abuse 080 880 88141 We work to protect, and prevent the abuse of, vulnerable older adults Action on Elder Abuse, PO Box 60001, Streatham SW16 9BY I www.elderabuse.org.uk I firstname.lastname@example.org Admiral Nursing DIRECT 0845 257 9406 This helpline has been set up to provide people with an opportunity to talk through their worries and concerns about themselves, friends or relatives with dementia. The lines are open on Tuesdays and Thursdays between 11am and 9pm. Callers can leave messages any time and request a call back I email@example.com Age UK Berkshire 0118 959 4242 Providing practical services and support to make later lifer better. Huntley House, 119 London St, Reading, RG1 4QA I www.ageuk.org.uk/berkshire Alzheimer's Society 0118 959 6482 The UK's leading support and research charity for people with dementia, their families and carers. I www.alzheimers.org.uk I firstname.lastname@example.org Arthritis Care 0808 800 4050 Working with and for all people with arthritis to put them in control of their arthritis and their lives. Arthritis Care, Saffron House, 6-10 Kirby Street, London EC1N 8TS. I www.arthritiscare.org.uk I email@example.com C CareAware 0161 707 1107 A one stop shop for free advice on care fee funding for older people. I www.careaware.co.uk I firstname.lastname@example.org Care Quality Commission (CQC) 03000 616161 National Correspondence, Citygate, Gallowgate, Newcastle upon Tyne NE1 4PA I www.cqc.org.uk I email@example.com Carers UK 0808 808 7777 Prevents carers from becoming emotionally drained, and from forgetting to take care of themselves. 20 Great Dover Street, London SE1 4LX I General enquiries: 0207 378 4999 I Advice line: 0808 808 7777 www.carersuk.org I firstname.lastname@example.org
22 | Options Berkshire
Cruse Bereavement Care 0808 808 1677 Cruse Bereavement Care is here to support you after the death of someone close. I www.cruse.org.uk I email@example.com D Disability Benefits Helpline â€“ 0845 712 3456 for Disability Living Allowance and Attendance Allowance I Textphone: 0845 722 4433 I w ww.direct.gov.uk/en/Dl1/Directories DG_10011169 E Elderly Accommodation Counsel 020 7820 1343 The Counsel's aim is to help older people make informed choices about meeting their housing and care needs. It was founded in 1984 and became registered as a charity in 1985. It is now more commonly known as EAC. I www.eac.org.uk ENRYCH Berkshire 0844 412 7501 At ENRYCH Berkshire we believe that someone with a disability should not be prevented from living the life they want to live. Room G1 TOB1, Earley Gate, University of Reading, Whiteknights, Reading RG6 6AT I http://www.enrychberkshire.org.uk I Integrated Care Council 01379 678243 (Formerly the National Homecare Council) The Integrated Care Council is a body which brings together British public and independent sector organisations who commission or directly provide support for people living at home. M Mind (National Association 0300 123 3393 for Mental Health) The leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. www.mind.org.uk I firstname.lastname@example.org N National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis. I www.nos.org.uk NHS 111
N NHS Choices I www.nhs.uk P Parkinson's Disease Society I www.parkinsons.org.uk
0800 800 0303
Physiotherapy (Boathouse) 0118 984 2234 I www.boathousephysiotherapy.co.uk R Royal Voluntary Service 0845 608 0122 A volunteer organisation that enriches the lives of older people and their families across Britain. We support older people by giving time and practical help to help them get the best from life. Royal Voluntary Service, Cardiff Gate, Beck Court, Cardiff Gate Business Park, Cardiff CF23 8RP I www.royalvoluntaryservice.org.uk
Stroke Association 0845 3033 100 Advice and information for stroke patients and their families. I www.stroke.org.uk T The Department of Work and Pensions I w ww.dwp.gov.uk The Pension Service 0845 606 0265 I w ww.dwp.gov.uk/about-dwp/customerdelivery/ the-pension-service W West Berkshire Citizens Advice Bureau 0300 222 5941 2nd Floor, Broadway House, 4-8 The Broadway, Northbrook Street, Newbury, Berkshire RG14 1BA I www.citizensadvicewestberkshire.org.uk
Beech House is a residential dementia care home ideally located between Wokingham and Bracknell in Berkshire. It is been owned since 2008 by a small independent care group who have invested heavily to create a beautifully furnished care home for 31 people aged 65 or over, living with dementia. The home provides high quality 24 hour care in comfortable and friendly surroundings, with diet and nutrition, and a variety of activities (both in the home, and outdoors), top priorities. Beech House care home has 25 single, and 3 shared rooms, 9 of which have ensuite facilities. For our communal areas we have two beautifully furnished lounges and two elegant dining rooms. All the rooms are fully furnished, but residents are encouraged to bring some of their own possessions to create a familiar and homely feel.
Beech House Dementia Care Home London Road, Binfield, Bracknell, Berkshire RG42 4AB
Tel: 01344 451 949 email@example.com www. beechhouse-dementiacarehome.co.uk Part of Haven Care Home Management Group
Options Berkshire | 23
www.excellentcarehomes.co.uk Northcourt Lodge Nursing Home 65 Northcourt Avenue, Reading, RG2 7HF Tel: 0118 9875062 Fax: 0118 9755007 Email: firstname.lastname@example.org www.northcourtlodge nursinghome.co.uk Northcourt Lodge Nursing home provides residential care to 22 service users over the age of 65 years old who require 24 hrs care. Our goal is to promote and protect physical, mental, spiritual and social well being of service users through assuring that quality services are provided by trained and responsible health care professional whereby service user’s dignity, respect, freedom of choice, privacy, confidentiality and equality are maintained at all times. There are two communal lounges in the home. One is a large lounge for those who enjoy sitting and chatting or watching television, the sun lounge is for those who prefer quiet recreation and reading. There is a separate dinning room where we
encourage all service users to have their meals together and use this opportunity for socializing but those who prefer having their meals in their rooms are given the choice to do so. At the rear of the home there is a spacious garden, where service users usually do planting and have their coffee in the summer months. We plan and implement occupational therapy involving service users that enable them to continue hobbies, develop new interests, and participate in events and outings as desired. These activities are run indoors as well as outdoors. The following are examples of some of the activities that we run: • Quizzes, puzzles & bingo • Story telling & music • Playing cards, board games such as reminiscence
•K nitting, gardening, nail painting • Physical exercise Specialist Dementia Care
24 Huntercombe Lane North, Maidenhead SL6 0LG Tel: 01628 663287 Fax: 01628 663987 Email: email@example.com www.applegarthcarehome.co.uk Applegarth care home is a small friendly 20 bed care home situated between the boroughs of Maidenhead/Windsor and Slough. A fully trained and dedicated care team provide 24 hour care allowing the home to provide a high quality standard of care and a real sense of security to its residents & families. Our focus is on caring for the individual - always treating them with dignity, and promoting independence. With this in mind, individual care plans are in place ensuring that all care provided is very much person centred. We also understand the importance of keeping hold of pets - and so Applegarth care home is a pet friendly home; a
member of the Cinnamon Trust with a five star rating. We also provide long term care, and respite care is available for those in need. The accommodation includes 20 rooms, all with ensuite facilities. The building has a TV lounge, a light and airy dining room, and a communal shower and bathroom, as well as a beautiful enclosed garden. The home also has a sun lounge, which provides access out into the homes garden. We also have a key-worker system in place, allowing each resident their own dedicated Keyworker. With this, personalised care plans are in place which are reviewed monthly by the allocated Key-worker. This ensures a continuing high level of care for each individual.
Two fully trained cooks prepare lovely home cooked meals to cater for all tastes & dietary needs. Menus are monitored regularly with residents & families completing feedback sheets into what meals they would like to see on the menus. Specialist Dementia Care
Wild Acres Care Home 440 Finchampstead Road, Wokingham RG40 3RB Tel: 0118 9733670 Fax: 0118 9734581 Email: firstname.lastname@example.org www.wildacrescarehome.co.uk Wild Acres is a spacious detached bungalow set in 1 acre of grounds, in a secluded semirural setting, with superb views of the surrounding countryside. Established for over 28 years, we provide a high standard of personalised care for 26 residents. We value each and every individual that comes to live at Wild Acres. All residents can be assured that they will be treated with respect and dignity according to their individual needs and wishes. We welcome applications from all cultures and religions and are able to cater for those with physical, sensory and cognitive impairments. Our aim is to provide a family atmosphere whilst endeavouring to maintain privacy and quality of life. All of the rooms are on
ground level. Wild Acres currently has 26 single rooms. 13 rooms have a wash basin with an adjacent bathroom, the remaining 13 rooms have en-suite facilities. We are able to offer long-term care and respite care if we have a room available. Monitoring of all aspects of the care is the responsibility of the Homes Manager, and the team of qualified staff, who adhere to very rigorous standards of care. Our standards are monitored by internal audits and checks. A designated G.P. from the local practice visits weekly or on request. We employ two cooks to provide varied and nutritious meals for the residents, reflecting their
individual dietary needs. Each person’s plan includes a description of their preferred daily routine, their likes and dislikes in relation to food and any specific dietary requirements. Most of the residents choose to eat their meals in the dining room but meals may be served in the resident’s room if preferred. Specialist Dementia Care
ADMIN OFFICE FOR BOTH ABOVE HOMES, 1 THE DRIVE, EARLEY, READING. RG6 1EG TEL: 0118 9698870 FAX: 0118 9698824
24 | Options Berkshire
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Applegarth Care Home
Published on Mar 12, 2018