Options Bassetlaw Spring 2024

A guide to care and independent living

Leaving hospital

NHS continuing healthcare

Who’s eligible?

SOCIAL CARE tips 10

What’s next? Healthcare services

Wyndthorpe Hall and Gardens Care Home

Situated in the quaint and historic town of Dunsville, in generous private grounds sits Wyndthorpe Hall and Gardens Care Home. Comprising of two buildings, one being a grade two listed 18th century mansion which houses a dome ceiling and has been converted sympathetically. The second being a beautiful red brick purpose-built building with an idyllic walled garden. Both providing a high standard of person centred care in a home from home setting for our clients.

✔ We offer long term residential, dementia and nursing care.

✔ We also provide day care and short term/respite stays to give home carers a well-earned break.

✔ All meals are home cooked and freshly prepared by our cooks. Daily menu choices are available, and all special diets are catered for.

✔ There is a hair salon on site which is visited regularly by a professional hairdresser.

✔ Chiropody, eye testing service and other complementary therapies are also available by arrangement.

✔ We have a full time personal activities leader who provides a varied programme of activities for our clients varying from one to one, group activities, regular outings and frequent fundraising events throughout the year.

Making the most of your healthcare services: avoiding unnecessary Emergency Department visits

Senior doctors at Doncaster and Bassetlaw Teaching Hospitals are encouraging people to choose their health services wisely.

Due to the hot weather we have experienced lately, the number of Emergency Department attendances increased due to heat-related illnesses and injuries and similar rises in attendance are often seen throughout Winter with colder weather bringing about complications with respiratory problems and other weatherrelated illnesses. Clinicians are urging people to stay safe in the heat and make the right choices if they do become unwell.

Your local pharmacist is a highly trained healthcare professional who can give you advice on common illnesses and the medicines you need to treat them.

Dr Nick Mallaband, Emergency Care Group Director and Consultant at the Trust, said: “We’re asking people to put their health first and understand what services are available should they, or a family member, become ill or injured. Please remember to only use the Emergency Department when it’s just that – an emergency.”

If you do feel ill or unwell, and you’re not sure if it’s an emergency, you can seek advice at any time of the day by calling NHS 111. You can also book an appointment at the Doncaster Same Day Health Centre or, if it’s really urgent, call 999.

Here’s some tips to help you choose health services wisely:

• Self-care – A lot of illnesses or symptoms can be treated in your home by using a well-stocked medicine cabinet and by getting plenty of rest.

• NHS 111 – This 24 hour, seven day service offers confidential health advice and information over the

phone. To access the NHS 111 service text-phone, call 18001 111.

• Pharmacist (chemist) – Your local pharmacist is a highly trained healthcare professional who can give you advice on common illnesses and the medicines you need to treat them. Most now have a quiet area away from other customers where you can speak to the pharmacist more privately.

• GP – Your own GP is the best person to speak to about persistent health problems and illnesses that won’t go away. These include persistent coughs, joint pain and long term symptoms that haven’t suddenly deteriorated to a point where you are extremely unwell. Your appointment may be over the telephone.

• Minor Injuries Unit at Montagu Hospital – The unit is open every day from 9.00am to 9.00pm, except on Christmas Day when it is closed. The unit re-opens on Boxing Day. The unit is staffed by experienced emergency nurse practitioners who can assess and treat a wide range of minor injuries and ailments, including sprains, cuts and bruises, and some simple fractures.

• Emergency Department or 999 – Hospital emergency departments provide immediate emergency care for people who show the symptoms of serious illness or are badly injured. If you call 999 for an ambulance the telephone adviser will arrange appropriate assistance for the patient based on information about the illness or injury.

Millbrook redevelopment

Millbrook Mental Health Unit in Sutton-inAshfield provides inpatient services and outpatient clinics to adults including older adults who need specialist mental health services. The Unit comprises of three older adult wards, an ECT suite and an outpatient clinic area.

Each ward will have a low stimulus area and a therapeutic outdoor space.

Redevelopment work is currently taking place at Millbrook as part of Nottinghamshire Healthcare’s programme to eradicate dormitory accommodation to create single ensuite bedrooms for all inpatients.

The programme includes the refurbishment of some of the current building and development of an extension to the current facilities. On completion the unit will provide three wards for over 65s all with single ensuite bedrooms. There will be an 18-bed dementia ward, an 18-bed mental health ward and a 10-bed ward for flexible use (both dementia and/or mental health).

Each ward will have a low stimulus area and a therapeutic outdoor space. There will continue to be a dedicated ECT suite, a new dedicated therapy space, as well as off-ward assessment and tribunal space. In addition, colleagues will have access to a Health and Wellbeing hub, and visitors will have 24-hour access to refreshments. There will also be upgraded CCTV across the site, with a new nurse call system and new key tracker system installed.

Progress is being made on the development of the first two wards. What is currently being called “Ward 1” will become the mental health ward and “Ward 3” will become the dementia ward. They are planned to open in Spring 2024. There are some photographs of some of the early construction works below.

NHS healthcarecontinuing

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 own home or in a 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 cannot be met by existing universal or specialist services alone.

Find out more about the children and young people’s continuing care national framework on GOV.UK

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 for a full assessment for NHS continuing healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.

If you are not eligible for NHS continuing healthcare, you can be referred to your local council 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.

Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition.

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 your needs can be

• how unpredictable they are, including any risks to your health if the right care is not 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.

Information and advice

The process involved in NHS continuing healthcare assessments can be complex. 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.

NHS continuing healthcare assessments

Integrated care boards, known as ICBs (the NHS organisations that commission local health services), must assess you for NHS continuing healthcare if it seems that you may need it.

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.

For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment.

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 what the assessment involves.

Depending on the outcome of the checklist, you’ll either be told that you do not 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 does not 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

Full assessment for NHS continuing healthcare

Full assessments for NHS continuing healthcare are undertaken by a multidisciplinary team (MDT) made up of a minimum of 2 professionals from different healthcare professions. The MDT should usually include both health and social 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:

• breathing

• nutrition (food and drink)

• continence

• skin (including wounds and ulcers)

• mobility

• communication

• psychological and emotional needs

• cognition (understanding)

• behaviour

• drug therapies and medicine

If you’re eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs.

• altered states of consciousness

• other significant care needs

These needs are given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.

If you have at least 1 priority need, or severe needs in at least 2 areas, you can usually expect to be eligible for NHS continuing healthcare.

You may also be eligible if you have a severe need in 1 area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.

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 from GOV.UK

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.

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 1 local care home that’s suitable.

Your ICB 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.

If your needs have changed, the review will also consider whether you’re still eligible for NHS continuing healthcare.

NHS continuing healthcare reviews

If you’re eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within 3 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

ICBs 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 ICB 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 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.

Find out more about NHS continuing healthcare from NHS England.

Frequently asked questions about NHS continuing healthcare

Q

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 ICB 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 1 option being a “direct payment for healthcare”.

Q

Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority?

Consent is not needed for completion of assessments (CHC Checklists, Decision Support Tools (inclusive of FNC by default) and Fast Track), or collation and sharing of information with:

• Care Teams

• Health and Social Care Staff

But consent is needed to share personal information collected for, and as part of, assessments (Checklist, Decision Support Tool (inclusive of FNC by default) and Fast Track) with third parties, such as family, friends or representatives, at the beginning of the process. There is a legal limit to the types of services that a Local Authority can provide. If you have any concerns about being assessed for NHS continuing healthcare, the ICB should explore your reasons for this, and try to address your concerns.

If someone lacks the mental capacity to consent to sharing of information with third parties (other than Care Teams or Health and Social Care Staff), the principles of the Mental Capacity Act will apply and a best interests decision may be needed.

Q

My relative is in a care home and has become eligible for NHS continuing healthcare. The ICB 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 ICB. It will take your concerns into account when considering the most appropriate arrangements.

If the ICB decides to arrange an alternative placement, they should provide a reasonable choice of homes.

Q Is it possible to pay top-up fees for NHS continuing healthcare?

No, it is not 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’re assessed as needing from the NHS. These private services should be provided by different staff and preferably in a different setting.

Paying for your own care (self-funding)

You will not be entitled to help with the cost of care from your local council if:

• you have savings worth more than £23,250 – this is called the upper capital limit, or UCL, and will rise to £100,000 from October 2025

• you own your own property (this only applies if you’re moving into a care home)

You can ask your council for a financial assessment (means test) to check if you qualify for any help with costs.

You can choose to pay for care yourself if you don’t want a financial assessment.

How to arrange your care as a self-funder

You can:

• arrange and pay for care yourself without involving the council

• ask the council to arrange and pay for your care (the council will then bill you, but not all councils offer this service and they may charge a fee)

Having a carer who lives with you costs from around £800 a week. But it can cost as much as £1,600 a week if you need a lot of care.

Paying for a care home

There are 2 types of care home:

• residential homes have staff that help with everyday tasks such as getting dressed and supply all your meals

• nursing homes also offer 24-hour nursing care

A room in a care home costs:

• around £700 a week in a residential home

• over £850 a week in a nursing home

The price will vary according to where you live and the type of care you need.

For example, serious health problems like dementia and chronic obstructive pulmonary disease (COPD) can increase the cost.

Benefits can help with care costs

Even if you choose to pay for your care, your council can do an assessment to check what care you might need. This is called a needs assessment.

Find out what care you need

Even if you choose to pay for your care, your council can do an assessment to check what care you might need. This is called a needs assessment.

For example, it’ll tell you whether you need home help from a paid carer for 2 hours a day or 2 hours a week and precisely what they should help you with.

The needs assessment is free and anyone can ask for one. How

much will care cost?

Social care can be expensive. Knowing how much you’ll have to pay will help you budget.

Paying for carers at home

A typical hourly rate for a carer to come to your home is around £20, but this will vary depending on where you live.

You may be eligible for benefits, like Attendance Allowance and Personal Independence Payment (PIP), which aren’t means-tested.

You can use them to pay towards the cost of your care.

Can I avoid selling my home?

You won’t have to sell your home to pay for help in your own home.

But you may have to sell your home to pay for a care home, unless your partner carries on living in it.

Sometimes selling your home to pay care home fees is the best option.

But there may be other ways to pay care home fees if you don’t want to sell your home straight away.

Contact your local council about 3 months before you think your savings will drop to below the limit and ask them to reassess your finances.

Releasing money from your home (equity release)

Equity release lets you take money that’s tied up in your home without selling it. It’s available if you’re over 55.

But you have to pay interest on the money you take out, which can be expensive.

MoneyHelper has more information on equity release.

Renting out your home

You can rent out your home and use the income to help pay your care home fees.

A deferred payment scheme

A deferred payment scheme can be useful if you have savings less than £23,250 (or £100,000 from October 2025) and all your money is tied up in your property.

The council pays for your care home and you repay it later when you choose to sell your home, or after your death.

Ask your council if you’re eligible for a deferred payment scheme.

You can get more information from:

• MoneyHelper: deferred payment schemes

• Independent Age: do I have to sell my home to pay for residential care?

Get expert financial help

You can get unbiased expert advice from a specialist care fees adviser.

They’ll help you compare all your options before you decide what’s right for you.

Find a specialist care fees adviser in your area with:

• PayingForCare, a free information service for older people

• Society of Later Life Advisers (SOLLA) on 0333 2020 454

Telephone help

Get advice on paying for care from:

• Age UK on freephone 0800 055 6112

• Independent Age on freephone 0800 319 6789

• MoneyHelper on freephone 0800 011 3797

If your savings run out

If your savings fall below the upper capital limit of £23,250 (or £100,000 from October 2025), your council might be able to help with the cost of care.

Contact your local council about 3 months before you think your savings will drop to below the limit and ask them to reassess your finances.

Councils provide funding from the date you contact them. You won’t be reimbursed if your savings are below the limit before you contact them.

What you can get for free

You might be able to get some free help regardless of your income or if you’re paying for your care.

This can include:

• small bits of equipment or home adaptations that each cost less than £1,000

• NHS care, such as NHS continuing healthcare, NHSfunded nursing care and care after illness or hospital discharge (reablement)

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.

2 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)?

3

4

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.

5 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

6

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?

8

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.

7 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.

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CQC’s ratings will identify services as: Outstanding ★ Good ● Requires improvement ● Inadequate ● This will help you make informed choices around your care.

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.

United Against Dementia

Alzheimer’s Society wants everyone affected by dementia to know that whoever you are, whatever you are going through, you can turn to them for support, help and advice.

Dementia Connect

Dementia Connect, from Alzheimer’s Society, is a personalised support service for anyone with dementia, their carers, families and friends.

We understand that dementia affects everyone differently. So whether you, a loved one, a friend or neighbour needs dementia support, we’re here for you.

We’ll connect you to a whole range of dementia support, by phone, online and face to face. Our highlytrained dementia advisers can help people come to terms with their diagnosis and navigate the complicated maze of health and social care services.

It’s free, easy to access, and offers you the support you need. Whether it’s advice on legal documents, help understanding dementia or someone to talk to when things get tough, we’re here to help.

We can keep in touch with you to make sure you keep getting the support you need. And because we know it’s never easy to tell your story, you’ll only ever need to tell it to us once.

Phone support

Our dementia advisers are available to talk to on the phone seven days a week. They will listen and give you the support and advice you need, including connecting you to help in your local area and online. We can offer you the option of regular calls so we can keep in touch, to find out how you are and help when things change.

Online support

Dementia Connect online support is available round the clock through our website. Answer a few simple questions about yourself, or someone you know, to get personalised, relevant information and advice. From guides on dementia to advice on making your home dementia friendly, get the information about the things that matter to you.

‘The Dementia Adviser was lovely and full of information. Without Alzheimer’s Society and the Dementia Adviser we’d have nothing. She is a major networker and knows everything and everyone local. I feel in charge and empowered.’ Katherine, living with dementia

If you need further support, you can request a call from our dementia advisers, who should be in touch with you within a week. Our online support includes Talking Point, our online community where you can connect with others in a similar situation, and our Dementia Directory where you can search for local services.

Face to face support

Where possible, our local dementia support workers can meet you in person to offer further support, advice and information. They will also connect you to other face to face services in your area, including local support groups.

Notes: Dementia Connect phone and online support is available wherever you live. As the service is new, some parts of the service may not be available in your area just yet.