OPTIONS A guide to care and independent living
Cambridgeshire Autumn 2017
Leaving hospital What’s next?
10
SOCIAL CARE
tips
NHS continuing healthcare Who’s eligible?
Healthcare services Choosing the right one
FREE
guide CONTRIBUTORS: Age UK Cambridgeshire & Peterborough Alzheimer’s Society Cambridgeshire and Peterborough NHS FT North West Anglia NHS FT NHS Choices
2
Contents How do you get help if you or a loved one is struggling with a mental health illness?....4 What to do in a mental health crisis?................................................................................ 5 Top tips for looking after your mental health.................................................................. 6 Integrated community and mental health services....................................................... 7-8 If you need medical help fast, but it is not life threatening – call 111............................... 9 Hinchingbrooke Hospital – planning your discharge from hospital............................ 10-11 NHS continuing healthcare............................................................................................. 12-14 Personalised care............................................................................................................. 14-15 What is NHS-funded nursing care?..................................................................................... 16 Paying for your own care and support.......................................................................... 17-18 The Motability Scheme........................................................................................................ 19 Care services in your home............................................................................................. 20-21 Age UK Cambridgeshire & Peterborough Services....................................................... 22-23 Alzheimer’s Society Cambridgeshire – When a loved one with dementia leaves hospital................................................................................................................. 24-25 The Care Quality Commission Social Care and GP top tips........................................... 26-27 NHS Hospitals and services in Cambridgeshire................................................................... 30 Useful contacts..................................................................................................................... 31
Welcome and
introduction
This guide is intended to help you, your carer and your relatives understand how your local health services can help you after discharge from hospital. Also information to help you to live independently or access support and care services in your area.
Cambridgeshire and Peterborough
NHS Foundation Trust
OCTAGON DESIG N & M A R K E T I NG LT D
3
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) provides mental health, community, learning disability, substance misuse and social care services across Cambridgeshire and Peterborough along with children’s community services in Peterborough. Every year, one in four of us will experience a mental health illness. The experience will be different for each of us, as will the type of support we need. But what mental health services are there? And how do they fit in with other health and public services? CPFT sees about 40,000 patients a year and employs more than 3,000 staff. We provide services from more than 90 sites across the county – our biggest bases are at Fulbourn in Cambridge and The Cavell Centre in Peterborough. CPFT’s services include: •C hildren’s mental health and community services • Adult mental health services •O lder people’s and adult community services • Forensic and specialist mental health services • Primary care and liaison psychiatry services • Substance misuse services • Specialist learning disability services • Learning disability services Our core purpose is to provide excellent community and mental health services to people of all ages across Cambridgeshire and Peterborough and beyond this geographical boundary. We also provide some specialist services on a regional and national basis. 4
How do you get help if you or a loved one is struggling with a mental health illness? The help and support you receive will depend on what illness you have. Depression and anxiety are two of the most common mental health illnesses and this can be treated in primary care (your GP). If your illness is more severe, your GP may refer you on to one of CPFT’s mental health services. If you are suffering from anxiety or depression and feel you need help, you can contact our Psychological Wellbeing Service. This service allows patients to refer themselves (or your GP can refer you) and put you in direct contact with mental health professionals. Treatments include individual therapy, guided self-help, group sessions including training in Mindfulness, a range of psychotherapy courses and online options. Anyone registered with a GP in the Cambridgeshire and Peterborough area can access the Psychological Wellbeing Service by completing an online form that can be found on the Trust’s website www.cpft.nhs. uk. They will be then be contacted by someone from the Trust and talked through the options available to them. Alternatively, the service can be contacted by calling 0300 300 0055. The lines are open from 9am to 5pm, Monday to Friday, excluding Bank Holidays.
What to do in a mental health crisis? You might be in crisis if: •Y ou are thinking of hurting yourself or suicide seems the only option • S omeone you know has made threats to hurt you or someone else. •Y ou are experiencing extreme distress that seems overwhelming. If you believe you or a person you care for is in a mental health crisis and is in immediate need of help, there are several different avenues you can take. If you are already receiving support from mental health services, the first point of contact should be your care co-ordinator. Your care plan will contain information on how to contact them. If they are not available, ask to speak to the clinician on duty. If you are in crisis and need immediate help, then please contact The First Response Service (FRS). This is a service which puts your mental health first. It provides 24-hour access, seven days a week, 365 days a year, to mental health care, advice and support. If you are experiencing something that makes you feel unsafe, distressed or worried about your mental health you can now contact the FRS by dialling 111 and selecting option 2. The
phone will be answered by a trained mental health professional who will be able to listen to your concerns and help you get the support you need. With your permission, they can also access your medical records to better meet your needs and to avoid you repeatedly having to tell us your situation. They can offer advice over the phone, put you in contact with our crisis services or even refer you to a Sanctuary - safe places run by mental health charity, Mind in Cambridgeshire. The Sanctuaries offer shortterm practical and emotional support between 6pm and 1am, seven days a week. CPFT out-of-hours service is a phoneline available for CPFT’s service users who are experiencing a crisis in their mental health. The service is also available for carers who are concerned about the mental health of a service user. The out-of-hours telephone number is 0808 808 2121. This is available 7pm-11pm, 365 days a year. If you are feeling unwell and need a telephone health assessment, please call the NHS 111 service free of charge from any phone by dialling 111. If you are not able to obtain the support you need through the methods above, you can call 999 or go to your nearest A&E department. They will be able to assess your needs and contact mental health services to arrange an assessment or hospitalisation if necessary.
5
Top tips for looking after your mental health It is important to take care of yourself – both physically and mentally. Below are some tips to help you. •K eep active and get regular exercise – this helps you sleep, concentrate, look and feel better. Regular exercise is good for your mind and body. •D eal with practical problems when they arise – this prevents them from being overwhelming and unmanageable. •B uild and maintain friendships – friends and family give us support and comfort. •C are for and help others – this helps us to feel good about ourselves.
• Recognise the signs of poor mental health and ask for help – ignoring problems only makes them worse. None of us are superhuman. If things get too much, family, friends or health professionals can offer help. • Talk about your feelings – this helps us digest and process what’s going on so that we can begin to find solutions. Bottling up worries just makes things worse. • Accept who you are – this is an important part of valuing and taking care of yourself. • Take time to relax and unwind – this helps our resilience and helps us to get a good night’s sleep. • Do something you’re good at – enjoying yourself can help you fight stress and boost your self-esteem. • Eat and drink healthily – our brains and bodies need a mix of nutrients to stay healthy. A good, balanced diet is good for your physical and mental health. Drinking too much alcohol is not a good way to manage difficult feelings – once the drink wears off you’ll feel worse.
Useful contacts If you would like more information or support with a mental health issue, here are some useful contacts. •C ambridgeshire and Peterborough Psychological Wellbeing Service: 0300 300 0055 •C PFT out-of-hours line for mental health service users: 0808 808 2121. This is available 7pm-11pm, 365 days a year. • CPFT website: www.cpft.nhs.uk • NHS 111 service: Dial 111 if you urgently need medical help or advice but it’s not a life-threatening situation. • Samaritans: Call 116 123 • Mind infoline: 0300 123 3393 (weekdays 9am - 6pm) • Saneline: 0845 767 8000 (everyday 6pm - 11pm) • Childline: 0800 1111
6
Integrated community and mental health services The wide range of health and social care services available to help people can sometimes be hard to navigate - partly because these are provided by lots of different NHS Trusts and organisations, depending on the type of help that people need, such as health, social care and housing. Most people’s first point of contact with the NHS is when they either visit their GP or have to go to hospital if they become very unwell. However, in many ways, the ‘glue’ that holds these services together are the integrated community services provided by Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). These provide care in people’s homes and focus on keeping them out of hospital, or supporting them to return home when they are leave hospital, but need extra support. CPFT brings together community and mental health services for adults and older people in Cambridgeshire and Peterborough. These are organised into 14 neighbourhood teams which are designed to improve joined-up working between primary care, community staff and mental health. This new way of working makes it easier to keep people safe and well in their homes by joining up community resources for over 65 year olds and adults with long-term conditions requiring community services (does not include mental health services for people aged 18-64 years old).
• community matrons • occupational therapists • physiotherapists • multi-disciplinary team (MDT) co-ordinators • team manager. The Trust also provides a number of specialist services that support the neighbourhood teams with expert assessment, treatment and advice. These include: • Diabetes • Respiratory • Tuberculosis (TB) • Heart Failure • Cardiac rehabilitation • Parkinson’s disease • Multiple sclerosis • CFS / ME • Epilepsy • Tissue viability • Continence • Dietetics • Podiatry • Neuro rehabilitation • Speech and language therapy • JET and out of hours (OOH) services. The aim is to provide multi-disciplinary, community health and social care, working with clusters of GP practices in Cambridgeshire and Peterborough.
The multi-disciplinary teams include:
It’s vital we put patients at the centre of services, not only those provided by CPFT, but also hospital and ambulance services, GPs, councils, care homes and the voluntary sector. Only by improving co-ordination, co-location and co-operation between different services and organisations can we make the best use of limited resources for a rapidly expanding, ageing population.
• integrated care workers • district nurses • mental health nurses
So the next phase is to build on these neighbourhood teams to fill in gaps in existing services by providing joined up health, social care
They work closely with GPs, primary care, social care and the third and independent sector to provide joined-up, responsive, expert care and treatment. They operate 365 days a year. Most referrals into these services come from GPs, hospitals and other health professionals.
7
and therapy to people in their own homes. There has also been a lot of work to agree how we best identify and support those who have complex needs and are most at risk of being admitted to hospital. So we’ve been working closely with all these organisations to develop a case management model which means that everyone uses the same criteria to spot those most at risk to ensure they get the help they need, when they need it.
JET continues to support patients More people will be supported by the Joint Emergency Team (JET) following a £3.5 million investment. The additional funding from the Sustainability and Transformation (STP) fund for Cambridgeshire and Peterborough will be spent on extra practitioners, triage staff and 40 integrated care workers to look after people at home. JET is an urgent two or four hour response service that supports people over the age of 65 or those with long-term conditions in their home environment when they become very unwell and need urgent care, but do not need to go to hospital. JET is an urgent community service which operates from 7.30am to 8pm. It comprises a
paramedic or nurse who will visit the person at home to assess and arrange care for them if they are unwell and need urgent care, but do not need to go hospital. It also links to more services, such as district nurses or occupational therapists.
Contact PALS The Patient Advice and Liaison Service (PALS) provides service users, their carers and families with help, information and support to resolve concerns quickly and efficiently. PALS achieves this by liaising with staff and managers, other PALS services and health-related organisations. We provide information about the Trust’s services and other health-related issues and we act as a gateway to independent advice and advocacy support from local and national sources, including Independent Complaints Advocacy Services. Your feedback is really important to us, and we also like to hear when our services are good. If you would like to compliment any of our staff please contact PALS and we will pass on your comments. Details about PALS information and complaints leaflets in languages including Bengali, Lithuanian, Mandarin, Polish, Russian, Urdu, Portuguese and Slovakian, are available below. If you need information in a language not listed, please contact us. For more information contact: Suzanne Williams – Patient Experience Officer Telephone: 01223 726774 (Office hours Monday to Friday) Freephone: 0800 376 0775 (Office hours Monday to Friday) Confidential email: pals@cpft.nhs.uk Postal address: PALS, Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, CB21 5EF
More information about CPFT Web: www.cpft.nhs.uk Twitter: @CPFT_NHS Facebook: cpftnhs/ YouTube: CPFTvideo LinkedIn: CPFT 8
Content supplied by:
9
Hinchingbrooke Hospital is part of the North West Anglia NHS Foundation Trust, which also runs Peterborough City and Stamford Hospitals. All our hospitals provide hospital care for patients who require emergency, medical or surgical services. Hospitals are the right place to be when you are in need of specific surgical or medical treatment. However, when your treatment is completed, it is important your stay is not delayed for the following reasons: • S taying in hospital increases your risk of infection, your muscles wasting and could result in loss of independence • S ome people find it harder to return home the longer they stay in hospital due to loss of confidence and worry about being able to manage •B eds are always needed for people who are very unwell and who may be waiting in the
10
Emergency Department for a bed on a ward to become available • People awaiting surgery, both urgent and nonurgent, may have their operations cancelled if a bed on a ward is not available For all the reasons above, our teams will start to plan your discharge from our hospital almost as soon as you come in. The considerations made in planning your discharge include: • Assessing what your needs might be when you are ready to leave hospital • Talking to relevant colleagues who can help in meeting any additional needs you have (such
as social workers, occupational therapists, physiotherapists or district nurses) • Making arrangements for any equipment or services which need to be in place when you are medically fit to leave hospital • Making sure that your carer is given any information, help or advice that may be needed to aid your recovery. Our staff will work with you, your relatives or your carer, to discuss your discharge with you. It is helpful if we can discuss any concerns you may have at the earliest opportunity. For example, you might be worried about your safety at home, or managing your personal care or domestic arrangements. You may have concerns about your ability to move around at home and need equipment to make this easier. By talking about this sooner rather than later, we can ensure you will have everything you need in place as soon as you are ready to leave hospital. You will be given a predicted date for your discharge, based upon when it is expected your treatment will be completed. All those involved in your care will be aware of this date and will be working towards it with you. Having this date will help us ensure all necessary arrangements for your discharge from hospital are made in time for you being ready to leave. Such arrangements may include: • Having suitable clothing ready to leave hospital, such as sturdy shoes and a coat • Having the key to your property available for you • Making sure there is adequate heating in your home • Making sure there is support in place if you need it from your family members or carer • Ensuring you have transport home. Patients will be expected to arrange their own transport when leaving hospital. Relatives, friends or carers coming to collect you are
welcome to meet you on the ward, or a nurse can escort you to our main reception area to await your lift home. A supply of your current medication will be ordered from the hospital pharmacy and delivered to you in time for you leaving hospital. If you have any questions or concerns about your medication, please ask to speak to the pharmacist who works on your ward, or to a member of the nursing team. We understand that any hospital stay can be stressful, which is why we support you and your relatives/carer as much as we can during your hospital stay. For most patients, being discharged from hospital back to their home is straightforward. Some may need information or advice or may need support from social care or the local council. Some people have ongoing health, care and support needs which require a more detailed assessment. Staff from health and social care will work together to plan and deliver services that support people after their hospital discharge. Sometimes it is necessary to move to an interim care setting while awaiting a home care package or a care home of your choice. It is not possible to stay in hospital until such arrangements are made. The hospital discharge team will arrange any interim care destination for you. If you, or your family or carer, have any questions or worries – or if you don’t understand what is happening at any stage of your hospital stay, please speak to your nurse, doctor or ward manager. They will be happy to discuss any aspects of your care to ensure that you are fully prepared for discharge. After you discharge, if you have any concerns about your condition, please contact your GP Surgery in the first instance. If you have any concerns about your medication, please speak to your local pharmacist. 11
NHS continuing healthcare NHS continuing healthcare, also known as “fully funded NHS care”, is free care outside of hospital that is arranged and funded by the NHS. This means that you will receive care and support to meet your assessed needs at no cost to you.
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.
Eligibility 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”) as having a “primary health need”. Whether or not someone has a primary health need is assessed by looking at all their care needs and relating them to: • what help is needed • how complex these needs are • how intense or severe these needs can be •h ow unpredictable they are, including any risks to the person’s 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 still pay for part of the package of support. This is sometimes known as a “joint package” of care. 12
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. For most people, there is 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 will 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 will be referred for a full assessment of eligibility. Being referred for a full assessment doesn’t necessarily mean that you will 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 written reasons for their decision, and sign and date the checklist. 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 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 • symptom control through drug therapies and medication • altered states of consciousness • other significant needs These needs are then given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”. The multidisciplinary team will consider: • what help is needed • how complex these needs are • how intense or severe these needs can be • how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time 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. 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 someone’s condition is deteriorating quickly and they are nearing the end of their life, they 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 are 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 is agreed that a care home is the best option for you, there could be more than one local care home that is 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.
NHS continuing healthcare reviews If you are eligible for NHS continuing healthcare, your needs and support package should 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 are still eligible for NHS continuing healthcare.
Refunds for delays in NHS continuing healthcare funding CCGs should 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 that you are 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 are not eligible for NHS continuing healthcare If you are not eligible for NHS continuing healthcare, but you are assessed as requiring nursing care in a care >> 13
home (in other words, a care home that is registered to provide nursing care) you will be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the cost of your registered nursing care. This is known as NHS-funding nursing care and is available irrespective of who is funding the rest of the care home fees. NHS England has issued guidance on how people can be compensated following eligibility disputes and delays in receiving NHS continuing healthcare.
Frequently asked questions about NHS continuing healthcare I have a local authority support package that works well. I am now eligible for NHS continuing healthcare – will my support package change? If you are 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”. If you’re still not satisfied, you may want to complain. Can someone refuse an assessment for NHS continuing healthcare? If they do refuse, will they be able to get services from their local authority? An assessment for NHS continuing healthcare can’t be carried out without someone’s consent, so it is possible to refuse. However, if they do refuse, although they will still be entitled to an assessment by the local authority there is no guarantee that they will be provided with services. This is because there is 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 is evidence that a move is likely to have a significantly detrimental effect on your relative’s health or wellbeing, you should discuss this with the CCG who will take your concerns into account when considering the most appropriate arrangements. If the CCG decides to arrange an alternative placement, they should make efforts to provide a reasonable choice of homes. 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 get from the NHS. These private services should be provided by different staff and preferably in a different setting.
Content supplied by:
14
Personalis If your local authority agrees to pay for some or all of your home care needs, it must offer you choice over how to meet your needs – this is known as personalisation of your care and support. A good assessment of your needs will help you begin to think about the kinds of things you may want to do to meet you care and support needs. Following this, you will be involved in planning out how you would like to meet your needs, and be given a personal budget, and can choose to take a direct payment. Self-directed support through good planning, personal budgets and direct payments is often called “personalised support” or “personalisation”. It gives you choice and control over how your needs are met, and enables you to do the things you value the most.
Personal budgets A personal budget is the amount of money the local authority allocates for your care, based on its assessment of your needs. 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 that you can directly pay for your own care (a direct payment). It could 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 commonly known as Individual Service Funds. Additionally, you can choose a combination of the above (for example, a direct payment with some councilarranged care and support), often called a mixed package.
Direct payments Direct payments give you the most control over your care, and mean that if you are unhappy with the services you’re getting, you can decide to change who gives you the care services without the process of going through the local authority. However, with this freedom comes
sed care the responsibility of accounting for how the budget is spent to ensure it is meeting your needs, and additional responsibilities if you decide to become an employer and hire a personal assistant with your direct payment. The Money Advice Service has a guide to using direct payments.
What does personalised support mean for me? Personalisation means that you will have to spend some time and effort thinking about your care and support needs, the outcomes you wish to achieve, and how you may want to meet your needs. Depending on the choices you make, there may be some additional 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 careworkers through an agency, which removes the legal obligations of being employer, but may potentially add costs and may remove some of the benefits of having the same person provide your care. Read more about how to choose care services.
How does personalised care and support work? You and your social worker or care manager will work together to create a care and support plan. This plan details your care and support needs, and will be used to work out the value of your “personal budget”. Your support plan should consider: • what’s important to you, including your interests, lifestyle, personal tastes and the people in your life • your hopes for the future, such as whether you’d like to study or take on more hobbies outside the home • what limitations you currently have and how you want to change • what you want to achieve by managing your own support Ensure that 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). You will need to clarify how you will manage 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 and consider which option is best for you. If someone else will be looking after your money, you may need to create a “decision-making agreement”. A decision-making agreement should state how they will 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 that your care and support needs are being met. You may need to keep receipts where possible (especially for large purchases), so that you can show them you’ve spent your money responsibly. If you choose a direct payment, the council will give you a direct payment agreement that will set out the terms and conditions. If you’re struggling to manage your money, the local authority should advise you on how to make your money work best for you.
Checking your care plan is meeting your care and support needs You should 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 in which you spend your budget. You can change things as you go along. 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, you should provide any receipts you’ve kept since you were awarded a personal budget. If someone is managing your funds for you, get them to join the review meeting. Disagreements about care plans and personal budgets If you’ve been informed that you’re not eligible for services, or you don’t agree with the amount allocated to you in your personal budget, you can request 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. Find out how direct payments and personal budgets work.
Content supplied by:
15
What is NHS-funded nursing care? 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.
What is the rate of payment for NHS-funded nursing care?
Who is eligible 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).
You may be eligible for NHS-funded nursing care if:
Before October 1 2007, there were three different levels or bands of payment for NHS-funded nursing care – low, medium and high.
• 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 16
decision about your eligibility, you can ask your CCG to review the decision.
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.
Content supplied by:
Paying for your own care and support Many people who use care and support services will pay for all of the costs. This is known as being a “self-funder”.
incurred) towards the cap.
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.
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 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.
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
The cap does not begin until April 2020 and any costs incurred before this will not count towards the cap.
For more information on how paying for care is changing from 2020, read about the changes in the Care Act.
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. >> 17
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.
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:
Advice on paying for care
• once you die, the local authority can be repaid from your estate
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. 18
• during your lifetime if you choose to sell your home
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.
Content supplied by:
The Motability Scheme The Motability scheme allows some disabled people getting DLA, PIP or War Pensioners’ Mobility Supplement to obtain 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. With hire purchase, the price of the car will be agreed directly with the Motability dealer, and you will own the vehicle outright at the end of the agreement. With contract hire, you won’t own a vehicle, but you will
get a new car every three years, full insurance for the driver and passengers, servicing, maintenance and repairs, vehicle excise duty, replacement tyres and breakdown cover. Adaptations to the car can be made if needed, although there may be an extra charge for some adaptations. Under the Motability scheme, cars can also be adapted for people in wheelchairs. If you don’t need or want a car, you can transfer your allowance to lease a scooter or powered wheelchair. Content supplied by:
Contact and Support We are here to answer any questions you may have about the Mobility Scheme. You can contact our Customer Services team directly or one of our Scheme partners depending on the nature on your enquiry. Tel: 0300 456 4566. Opening times: 8am-7pm Monday to Friday, 9am-1pm Saturday, Monday 9am-11am is our busiest period. You may find it easier to call outside these times.
If you have specialist Minicom equipment, call our textphone number on 0300 037 0100 or speak to us through a British Sign Language (BSL) interpreter for Deaf customers who have an enquiry about the Motability Scheme. 19
Care services in your home If you need help around the home, a good option is to have a care worker come in to your home to help you.
Types of care and support Care and support comes in many forms and has many names used to describe it, including home help, care attendants and “carers” (not to be confused with unpaid family or friends who care for you). Care and support can suit you if you need: • personal care, such as washing or dressing • housekeeping or domestic work, such as vacuuming • cooking or preparing meals • nursing and health care • companionship Care and support can be very flexible, in order to meet your needs, and the same person or agency may be able to provide some or all of these options for the duration of your care: • long-term 24-hour care • short breaks for an unpaid family carer • emergency care • day care • sessions ranging from 15-minute visits to 24-hour assistance and everything in between If you already know what you want, you can search NHS Choices directories for: • local care and support services and agencies • a list of national care and support organisations • services that can help you stay safe and well in your home on a long-term basis; these services, often known as “supported living services”, can include financial, help with medication, advocacy, social and practical support
Independent care and support agencies If you use an independent care and support agency, you or the person you’re looking after has to find the care agency and pay them. The agency will provide a service through a trained team of care workers, which means you may not always have the same person visiting your home, although the agency will do its best to take your choices into account. Independent care and support providers are regulated by the Care Quality Commission (CQC). Care and support agencies must meet CQC’s national minimum standards and regulations in areas such as training and recordkeeping. The CQC has the power to inspect agencies and enforce standards. Care and support agencies must vet care and support workers before engaging them by taking up references and carrying out Disclosure and Barring Service (DBS) checks on potential employees. Care and support agencies can also: • take over the burden of being an employer – for example, payroll, training, disciplinary issues and insurance • train their care and support workers through national qualifications and service-specific training • replace workers when they are ill, on holiday or resign • put things right when they go wrong An agency will want to see you and the person you’re looking after so that they can assess your needs. This also means that a joint decision can be made about the most appropriate type of care and support.
• a place to live in a family who will care for you, known as “shared lives services” or adult placement services
You can find out more from the UK Homecare Association.
If you believe that you might benefit from some help at home, the first thing to do is to contact your social services department to ask for an assessment of your care and support needs. To contact social services, go to GOV.UK: find your local authority.
What are the disadvantages of using a care and support agency?
If you are eligible for care and support services, the local authority may provide or arrange the help themselves. Alternatively, you can arrange your own care, funded by the local authority, through direct payments or a personal budget. 20
If you have chosen direct payments or a personal budget, or you aren’t eligible for local authority help and want to get care privately, you can arrange it in several different ways.
The main disadvantage is the cost of using an agency. The agency will charge a fee on top of the payment made to the care worker to cover their running costs and profit. You normally have to make a regular payment to the agency, which includes both the worker’s earnings and the agency’s fee.
Questions to ask when using a care and support agency The fees some agencies charge can be quite high. Before deciding to go ahead with an agency, you should ask questions about the fee and what it covers, including:
employees or volunteers to work with vulnerable adults or children. This includes a check of the barred lists. If an organisation fails to make the relevant checks, they can be penalised.
• Who will be responsible for insurance?
If an organisation dismisses an employee or volunteer for harming a child or vulnerable adult, they must tell the DBS. The DBS must also be notified if any employee or volunteer harms a child or vulnerable adult, but isn’t dismissed because they leave voluntarily. If their organisation does not tell DBS, they will be acting illegally.
• Is there any out-of-hours or emergency contact if needed?
Questions can be answered by the DBS call centre on 0870 909 0811, or by email.
• Does the agency check references? • What training and supervision do they provide? • What is their complaints policy?
• Will they be able to provide staff if your own care worker is ill or away? (If an agency contracts to provide care every day, it must ensure that it does.)
Hiring a personal assistant You can hire a “personal assistant” to act as a care and support worker for you. Personal assistants can offer you all that you’ll get from an agency worker, but you’ll also get the continuity, familiarity and ongoing relationship with your assistant. However, if you employ a personal assistant, you will then have the legal responsibility of an employer. This will include arranging cover for their illness and holidays. GOV.UK has more information on becoming an employer, while Which? Elderly Care also has advice on employing private individuals.
Care and support from charities Charities such as Age UK and Carers Trust can provide home help and domestic assistance services. The Carers Trust supports carers by giving them a break from their caring responsibilities through care and support services. Marie Curie Nurses can provide practical and emotional support for people near the end of their lives in their own homes.
Safeguarding vulnerable groups The DBS makes decisions about who is unsuitable to work or volunteer with vulnerable adults or children. It makes this decision based on information held by various agencies and government departments. The service decides who is unsuitable to work or volunteer with vulnerable adults or children. If someone who is barred from working with children or vulnerable adults is working, volunteering or trying to work or volunteer with these groups, they are breaking the law. They could face a fine and up to five years in prison. Employers must apply for an enhanced DBS check (formerly known as a CRB check) when taking on new
Employing a care worker on a private basis If you employ a care worker privately, you will not be obliged to use the DBS scheme, but you can use it if you choose to. You need to ask social services or the police to make the checks on your behalf. The care worker must have already applied to be vetted, and must consent to the check. If you have concerns about the suitability of someone you employ privately to work with a vulnerable adult or child, you can ask social services to investigate the matter. They can refer the worker to the ISA on your behalf.
Manual handling If you need help to move, or you need someone to lift you (such as getting out of bed or getting on to the toilet), this can put the person doing the lifting at risk of injury. This “manual handling” can result in back pain and in the most serious cases, permanent disability if not done correctly. The law says that employers must take reasonable precautions to ensure their employees don’t do any manual handling that carries a risk of them being injured. This applies to you if you directly employ a personal assistant to care for you (but most likely will not if you hire someone through an agency). It is particularly important to consider insurance in this situation. This would cover any risk of the care worker injuring themselves, as well as any risk of them causing an injury. There are rules around the risk assessments you need to carry out, and the Health and Safety Executive produces advice on safe manual handling. Editorial content for pages 9, 12-21 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.
21
Age UK Cambridgeshire & Peterborough Services Age UK Cambridgeshire and Peterborough is your local independent charity working with and for older people across Cambridgeshire and Peterborough. Our objectives are to help older people to maintain their independence, health and well being by providing support and services that meet individual needs. We recognise that you want a choice in how you are supported and we provide a variety of services to help you keep your independence.
Information & Advice We provide rights based information, which can be used with confidence to make informed decisions and choices, on a range of issues including: income and benefits, housing, health and social care.
Social Connections We aim to reduce social isolation by bringing people together, providing opportunities to meet people and develop friendships. Day Services: We have 6 social clubs located in Cambridge, Huntingdon, March, Chatteris and 2 in Wisbech, providing an opportunity to meet friends and participate in various activities. A hot meal and beverages are provided. Visiting Scheme: We visit older people in their own homes for one hour per week for company and conversation to help prevent feelings of loneliness. You will be assigned a one to one volunteer to visit you on a regular basis to build friendship and companionship. Volunteering: We have a whole range of volunteering opportunities, from befriending to administration. Our volunteers range in age from 17yrs to 94yrs. Please get in touch to find out more. To find out more about any of our services – call us on: 22
Practical Services Our services offer support to help you remain independent and safe in your own home. Home Help: We can assist with housework including, cleaning, laundry, ironing. Gardening: We can support you with regular garden maintenance to help keep your garden neat and tidy. Handyperson Service: Our aim is to prevent falls and accidents in the home by offering a free Personal Assessment and Home Safety Check. For a charge we can arrange for aids and adaptations to be installed and small jobs to be carried out. There is no obligation to order work through Age UK. Examples of the types of jobs we can do are: • Installing keysafes • Fitting grab rails • Putting up shelves • Fitting blinds/curtains • Tacking down fraying carpets • Changing lightbulbs • Small repairs (gates; locks; changing fuses etc) Community Wardens: Our wardens help people to live in their own homes with support, providing daily contact, reassurance and general help such as small amounts of shopping, collect prescriptions, help to complete forms, liaise with other services on your behalf. NB There is a charge for some of our services.
0300 666 9860
E: infoandadvice@ageukcap.org.uk or visit: www.ageukcap.org.uk
Love later life Insurance, Products and Services Most of us want to remain independent and to keep doing things in life we love most. Age UK Enterprises offers a wide range of products and services designed for the over 50s. Home Insurance – Cover for Buildings, Contents or both is available with no hidden admin fees and the choice to pay by monthly instalments at no extra cost (0% APR Representative) Car Insurance – Cover with no upper age limit and the choice to pay by monthly instalments at no extra cost (0% APR Representative) Motor Breakdown – Cover wherever you are in the UK including Roadside, Recovery and Home Services^. Travel Insurance – Choice of Single Trip or Annual Multi-trip cover with no upper age limit and cover for existing medical conditions wherever possible*. Funeral Plan – Your family will be spared the worry of having to make all the arrangements, and the financial strain of paying for them will be eased. Acceptance is guaranteed if you are over 50 and there are easy payment options. Personal Alarms – If you want to remain independent and have peace of mind, Personal Alarms could be the service for you. Professional and friendly help in an emergency,
any time of the day and night. No obligation home demonstration available upon request or order online and connect the unit yourself with Easy-Connect. Wills and Legal Services – In association with leading law firm Irwin Mitchell, we offer a range of legal services providing advice in relation to Wills, family and relationships, personal injury, buying or selling a home and rights at work. Age UK Home, Car and Travel Insurance are administered by Ageas Retail Limited. Age UK Motor Breakdown Insurance is provided by Intana Assistance. The Age UK Funeral Plan is provided by Dignity. Personal Alarms are provided by Aid-Call Limited. Brought to you by Age UK Enterprises Ltd. ^ Only available in Mainland Great Britain. * Subject to medical screening and acceptance by the underwriters. Personal Alarms are provided by Aid-Call Limited, which is authorised and regulated by the Financial Conduct Authority for Consumer Credit. Financial Services Register number 707455. Age UK Cambridgeshire and Peterborough is an appointed representative of Age UK Enterprises Ltd which is authorised and regulated by the Financial Conduct Authority for insurance mediation and introducing potential annuity customers. ACOEE2666V4NOV16
To find out about insurance, products and services – call us on
01354 700 113
23
Alzheimer’s Society Cambridgeshire When a loved one with dementia leaves hospital Discharge is the term used when a person leaves hospital. This should only happen once a doctor at the hospital decides that the person is ‘medically fit’. A person with dementia may have complex needs that should be considered before they can be safely discharged. For example, they may need to move into a care home or need adaptations made to their existing home, such as a stair-lift. Others may need support in their own home or in the home of a relative or friend. Every hospital has a hospital discharge policy. This is a public document that anyone can ask to see. It should include details of how the hospital staff will arrange the discharge. Plans about the date and time of discharge should be discussed with the person and their carer, if they have one. Ideally these plans will start to be discussed a reasonable period of time before discharge, and will include details about where the person will be living and the care that they will need. Hospital staff must ensure that transport to the person’s home or care home has been arranged. They should also take extra care when making plans to discharge someone on a Friday or during a weekend or a public holiday as it may be difficult to contact homecare workers and GPs on these days. The hospital discharge process should include: ■ an assessment of the person’s needs and living environment, with consideration given to the people involved in supporting them – often referred to as their ‘support network’ ■ a written care plan that records these needs ■ a system for monitoring and, if necessary, adjusting the care plan to meet any changes in needs ■ confirmation that any required services are in place in time for the discharge – for example, home visits needed to help with personal care, or grab rails in the home to help with support and stability ■ an assessment to see if the person qualifies for NHS continuing healthcare More information can be found in the Alzheimer’s Society Fact Sheet No 477, Hospital Care. To download go to alzheimers.org.uk/hospitalcare or call 0300 303 5933 Alzheimer’s Society is the UK’s leading dementia charity. We provide information and support, improve care, fund research, and create lasting change for people affected by dementia. In Cambridgeshire, we offer the following support and services. Our Dementia Adviser Service offers information about all aspects of living with dementia and supports people to access services. People with 24
dementia and their carers can contact our Dementia Advisers whenever they need further information or support to find other services. Our Dementia Support Workers offer information and practical guidance to help people understand dementia, cope with day-to-day challenges and prepare for the future. They offer support face to face, over the phone or in writing. Our Carer Information and Support Programme (CrISP) is a series of sessions for carers that provide information about all dementia related topics to support carers in their caring role. These range from information regarding dementia, it’s progression, legal and benefits and relevant support services. Our Activity groups give people affected by dementia the opportunity to take part in structured activities. Our facilitator will encourage and support people to take part and our groups provide an opportunity to relax and socialise. We run Dementia Cafés where people can just pop in and receive information about living with dementia. Available locally, cafes are an informal and comfortable environment where people with dementia and their carers can relax, socialise and meet other people in a similar situation. Our Dementia Friends Programme is our national initiative to improve people’s understanding of dementia and its effects. In our hour long information session, a Dementia Friend will learn a little bit more about what it is like to live with dementia and will be encouraged to turn that understanding into action. To book your place on a local information session, visit www.dementiafriends.org.uk. Dementia Action Alliance (DAA) is our movement that aims to bring about society-wide response to dementia. We encourage organisations to create a dementia friendly community, whether it be a city, town or village, where people with dementia will feel included and involved, and have choice and control over their day-to-day lives. For more information about joining the DAA, email: dementiaactionalliance@alzheimers.org.uk. Volunteering with the Alzheimer’s Society provides a wealth of benefits including meeting new people and learning new skills. By volunteering, you can get involved in the Society’s wide range of work such as research, campaigning, fundraising and local services. For more information on current volunteering opportunities in Cambridgeshire, email volscambridgeshire@alzheimers.org.uk or visit www.alzheimers.org.uk/volunteer.
Alzheimer’s Society Dementia Cafés in Cambridges
Dementia Café in W
First Monday of the mo (except Bank Holidays at the Robert Hall Cen St Augustines Road, Wisbech PE13 3AH fro 10am to 12noon.
Dementia Café in M
First Tuesday of the m St Peter’s Church Hall Street, March PE15 9J 10am to12.00noon.
Dementia Café in R
First Wednesday of the month at the Rainbow Surgery, Stocking Fen Ramsey PE26 1SA fro 10am to 12.00noon.
Dementia Café in S
Third Tuesday of the m at St Ives Free Church Reformed), Market Hill St Ives PE27 5AL from 10am to 12.00noon.
Dementia Café in South Cambridge (Great Shelford)
Third Thursday of the m at the David Rayner C Scotsdales Garden Ce Great Shelford, Cambr CB22 5JT from 10am to 12.00noon.
Dementia Café in E Fourth Tuesday of the the Cathedral Centre, Green, Ely CB7 4AW 10am to 12.00noon.
If you would like more information about any our Dementia Cafés in Cambridgeshire, pleas local office on 01954 2 or email cambridgesh alzheimers.org.uk.
s
shire
Wisbech
onth s) ntre,
rom
March
month at l, 36 High JR from
Ramsey
e w n Road, om
St Ives
month h (United ll, m
month Centre, entre, bridge
Ely
month at Palace from
of n se call our 250322 hire@
You can find out more information about our support services in Cambridgeshire, by calling 01954 250322, emailing cambridgeshire@alzheimers.org.uk or by visiting www.alzheimers.org.uk.
Taking on dementia together 25
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
2
3
4
5
6
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.
7
8
9
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/
10
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.
26
GP Top tips
1
If you are new to an area you can find details of local GP services such as doctors’ practices, out-of-hours services and walkin centres in our online directory of care services www.cqc.org.uk/content/doctorsgps
6
7 2
3
4
5
You can search any of these services by the name of the service, a place name or your postcode at www.cqc.org.uk
After an inspection, CQC publishes its findings in a report on its website. You can use these reports to check and compare services in your area.
Telephone: 03000 616161 • Web: www.cqc.org.uk
CQC rates all GPs to help people make choices about where they get treatment. This will be on a four-point scale:
Outstanding Good ● Requires improvement ● Inadequate ●
8
There are already over 1,000 reports about GP practices published on the CQC website.
Last year, CQC launched its new-style inspection reports for GPs – looking at the five key areas SAFE, EFFECTIVE, CARING, RESPONSIVE and WELL-LED – you can use the reports to compare local GPs and choose services.
You can also use these new style inspection reports to find out more about local services and choose the one that is best for your needs.
9
CQC will also look at how specific population groups are treated and give a rating. For instance how well they serve: Mothers, children and young people, vulnerable older people (over 75s) and people with long-term conditions. People will be able to choose a GP service that rates highly on the areas that matter to them.
We welcome your feedback (good and bad) on the services you, or a loved one, receives from your GP. You can share information with us online at http://www.cqc.org.uk/share-yourexperience-finder or call us on 03000 61 61 61.
/CareQualityCommission
@CareQualityComm
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.
27
BENTLEY
✆ 01733 555 838 OPEN
Nursing Supplies
SHOP OPEN TO THE PUBLIC
Mon - Fri 0800 - 1630 (excl. Bank Holidays) Closed Saturday and Sunday
NEW WEBSITE: SHOP ONLINE www.bentleynursing.com
Being discharged...? Where do we go from here...? Caring comes home at Bentley Nursing Supplies Profiling Nursing Bed
NEW LOWER PRICES ✓ Infinitely adjustable for ultimate comfort ✓ Electric raise and lower and profiling, 4 section base ✓ As supplied to Care Homes, fully portable on castors ✓ Free Local Area Delivery and Installation by a Bentley Technician ✓ Pressure relieving mattresses available from stock
BUY OR HIRE
Wheelchairs
DOMESTIC PROFILING BEDS
Continence Pads & Fixation Pants
RISE & RECLINE CHAIRS/FIRESIDE CHAIRS
Bath Lifts
Commodes
On Display in Store
Northgate House, Dukesmead, Werrington, Peterborough PE4 6ZN Email: sales@bentleynursing.com Web: www.bentleynursing.com
Notes
28
RECOMMENDED LOCAL PROVIDER OF CONTINENCE CONSUMABLES We deliver to:
Bourne; Crowland; Deepings; Oundle; Peterborough area; Stamford area; Whittlesey
Cambridge Manor and Cherry Hinton TLC Care Homes in Cambridgeshire Step inside Cambridge Manor and you’ll know you’ve arrived somewhere special. Our exclusive home, set on the outskirts of the City Centre, is a home from home where you can live life to the full. Offering residential, nursing and specialist dementia care, our teams are highly trained to provide care that allows you or your loved one to live life independently, with freedom of choice and dignity. Cherry Hinton Care Home is an exceptionally friendly home set in the suburb of Cambridge, offering nursing care and specialist dementia care Call now to arrange a personal tour and let us show you why Cambridge Manor, or Cherry Hinton, is the place for you.
CAMBRIDGE MANOR
33 Milton Road, Cambridge, CB4 1UZ 01223 363904 www.cambridgemanor.co.uk
CHERRY HINTON
369 Cherry Hinton Road, Cambridge CB1 8DB 01223 210070 www.cherryhintoncarehome.co.uk
29
NHS Hospitals and services in Cambridgeshire The Lindens, 86 Lincoln Road, Peterborough PE1 2SN
Wisbech
Stamford
Downham Market
Peterborough
March
Chatteris
2 Victoria Street, Chatteris, Cambridgeshire PE16 6AP
113A King Street, Rampton, Cambridgeshire CB24 8QD
Tel: 0300 666 9860
Ely
Mildenhall
Hinchingbrooke Hospital, Parkway, Hinchingbrooke, Huntingdon PE29 6NT Tel: (01480) 416416
Cambridgeshire and Peterborough
Tel: (01954) 250322
St Neots
NHS Foundation Trust
Milton
Cambridge
Newmarket Cambridgeshire and Peterborough
NHS Foundation Trust
Union House, 37 Union Lane, Chesterton, Cambridge CB4 1PR
Elizabeth House, Fulbourn Hospital, Fulbourn, Cambridge CB21 5EF
Tel: (01223) 533300
Tel: (01223) 726789
Biggleswade
Haverhill Saffron Walden Cambridgeshire and Peterborough
Cambridgeshire and Peterborough
Brookfields Hospital, Mill Road, Cambridge CB1 3DF
Ida Darwin Site, Fulbourn, Cambridge CB1 5EE
Tel: (01223) 723194
Tel: (01223) 726789
NHS Foundation Trust
Cherry Trees Centre St Matthews Street, Cambridge, CB1 2LT
NHS Foundation Trust
The locations on the map indicate where services operate out of.
30
Useful contacts A
I
Action on Elder Abuse 020 8835 9280 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 enquiries@elderabuse.org.uk
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.
Admiral Nursing DIRECT 0800 888 6678 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 www.dementiauk.org I direct@dementiauk.org Age UK Cambridgeshire & Peterborough 0300 666 9860 2 Victoria Street, Chatteris, Cambs, PE16 6AP I www.ageuk.org.uk/cambridgeshireandpeterborough/ Alzheimer’s Society – Cambridgeshire 01954 250322 113A King Street, Rampton, Cambridgeshire CB24 8QD I www.alzheimers.org.uk I cambridgeshire@alzheimers.org.uk Arthritis - National Rheumatoid 0800 298 7650 Arthritis Society (NRAS) or 0845 458 3969 Provide information, support and advice for people living with Rheumatoid Arthritis. I www.nras.org.uk
C Cambridge & District Citizens Advice 01223 222660 66 Devonshire Road, Cambridge CB1 2BL I www.cambridgecab.org.uk I caba@cambridgecab.org.uk Cambridge Dial-a-Ride 01223 506335 A non-profit organisation which provides local transport services that are safe, affordable, and accessible to community groups and to individuals who have difficulty in accessing public transport. Unit B, Rene Court, 1 Coldhams Road, Cambridge CB1 3EW I www.cambridgedialaride.org.uk I camdar05@hotmail.co.uk CareAware 0161 707 1107 A one stop shop for free advice on care fee funding for older people. I www.careaware.co.uk I enquiries@careaware.co.uk Care Quality Commission (CQC) National Correspondence, Citygate, Gallowgate, Newcastle upon Tyne NE1 4PA I www.cqc.org.uk I enquiries@cqc.org.uk
M Mind (National Association 020 8519 2122 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. I www.mind.org.uk I contact@mind.org.uk
N National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis. I www.nos.org.uk NHS 111
111
P Parkinson's Disease Society I www.parkinsons.org.uk
0800 800 0303
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
S 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 www.dwp.gov.uk The Pension Service 0845 606 0265 I w ww.dwp.gov.uk/about-dwp/customerdelivery/thepension-service
03000 616161
Cruse Bereavement Care 0844 477 9400 Cruse Bereavement Care is here to support you after the death of someone close. I www.cruse.org.uk I helpline@cruse.org.uk
D Disability Benefits – for Disability 0845 712 3456 Living Allowance and Attendance Allowance I Textphone: 0845 722 4433 I www.direct.gov.uk/en/Dl1/Directories DG_10011169
E Elderly Accommodation Counsel 0800 377 7070 A national charity that aims to help older people make informed choices about meeting their housing and care needs. It is now more commonly known as EAC. I www.eac.org.uk I info@firststopadvice.org.uk
OCTAGON DE S IG N & M A R K E T I NG LT D
Every possible care has been taken to ensure that the information given in this publication is correct at the time of going to print. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. No reproduction by any method whatsoever of any part of this publication is permitted without prior written consent of the copyright owners. Octagon Design & Marketing Ltd. ©2017. Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire, DN10 6AB. Telephone: 01302 714528 Options Cambridgeshire is published by Octagon Design and Marketing Ltd with editorial contributions from Cambridgeshire and Peterborough NHS Foundation Trust, North West Anglia NHS Foundation Trust, the CQC, Age UK, the Alzheimer’s Society 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.
31
Designed & Compiled by Octagon Design and Marketing Ltd., Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire, DN10 6AB. Tel: 01302 714528