Options Medway - A guide to care and independent living - Spring 2017

OPTIONS A guide to care and independent living

Leaving hospital What’s next?

NHS continuing healthcare Who’s eligible?

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SOCIAL CARE

tips

Healthcare services Choosing the right one

Medway Spring 2017

FREE

guide

CONTRIBUTORS: Age UK Medway Alzheimer’s Society Medway Community Healthcare NHS Choices

Staff are DBS checked Staff are trained to be qualified Out of hours telephone service

DOMICILIARY CARE / PERSONAL CARE Assisting with washing/bathing/ dressing/preparation of foods & assistance with eating. Assistance with continence/toileting/catheter care & stoma care. We also provide domestic assistance assisting with ironing, washing, vacuuming, polishing, general cleaning PALLIATIVE CARE / END OF LIFE CARE At a time that is hard you can turn to staff to offer support and assistance in making life a little easier at such a hard time. Whether it be making comfortable/personal care. Respite or a chat and friendly face ENABLEMENT / MOBILITY SUPPORT Staff assist in regaining mobility and independence & confidence

Support MEDICATION SUPPORT Sometimes we may forget to take our medication, staff are there to support you, prompt you and will help with gentle encouragement DEMENTIA SUPPORT / LEARNING DIFFICULTIES RESPITE / COMPANIONSHIP When a loved one has dementia we worry if they are well and safe, if they have eaten or remembered certain daily tasks. Staff are trained in assisting individuals with dementia and learning difficulties, promoting

healthy safe living and providing support tailored to each individual’s needs. Sometimes it’s nice to have a bit of company too.

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Strood office 01634 739195 ◆ Rainham office 01634 376555

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Contents

Leaving hospital – care in the community............................................................................................ 4 Community Nursing......................................................................................................................... 4-5 The community respiratory team......................................................................................................... 6 Community rehabilitation................................................................................................................ 6-7 Dementia services in Medway............................................................................................................. 8 How to use your health services........................................................................................................ 10 NHS continuing healthcare................................................................................................................ 12 Assessment for NHS continuing healthcare.................................................................................. 12-13 What is NHS-funded nursing care?.................................................................................................... 15 Paying for permanent residential care.......................................................................................... 16-17 Paying for temporary care in a care home......................................................................................... 17 Paying for care if you have a partner................................................................................................. 17 Personal budgets and direct payments - more control over your care................................................. 17 Care services in your home.......................................................................................................... 18-20 Age UK Medway - Providing care and support to the older population..........................................22-23 Alzheimer’s Society – Come along to your local Dementia Café... Information and advice in a relaxed setting for people affected by dementia in Kent & Medway....................................... 24-25 The Motability Scheme.......................................................................................................................26 The Care Quality Commission Social Care, GP and Mental Health top tips.....................................27-29 NHS Hospitals and services in Medway.............................................................................................. 30 Useful contacts................................................................................................................................. 31

WORKING IN PARTNERSHIP

Medway

OCTAGON DESIGN & M ARKE TING LTD

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Leaving hospital – care in the community It’s always nice to leave hospital and get home to your comfort zone, especially if you’ve been in a ward for a long time.

However, just because you’re well enough to leave the hospital, doesn’t always mean you’re completely well; but don’t worry – help is at hand!

There are lots of community services which provide post-hospital discharge support. In Medway, the majority of these are run by Medway Community Healthcare, a social enterprise focussed on patient-centred care, with

values to work in partnership, to deliver care and compassion, and quality and value.

Here we’ll focus on just a few: Our community nursing service, our community respiratory team, community rehabilitation and dementia services.

We call these professionals our unsung heroes – the ones you might not know about, but who work tirelessly to make sure you’re fit, well and back to your old self as soon as possible.

Please note - you should be referred to these services by a medical professional (the consultant in hospital, or your own GP, for example).

Community nursing

Community nurses are expert medical ‘jack of all trades’, nursing the dying, providing general nursing care including personal care, and wound care.

The community nursing service is committed to embedding the 6C’s into its practise: Care: They support people with their chronic disease management to maintain stability, promote independence and reduce avoidable hospital admissions. They also provide medicines management advice and support about medication, chemotherapy disconnection, and 4

Compassion: It isn’t just about the care we give, but the way we give it. It’s about how we listen, what we say, and what we do. We listen to our patients’ feedback, whether positive or highlighting concerns. We investigate and implement lessons learned that can improve our patients’ experience.

Competence: Our staff are trained and skilled practitioners, supported by education and development throughout their careers to enable them to deliver evidence-based and quality care across a range of health needs.

Communication: We work closely with our GPs, other health professionals, social care and voluntary agencies to provide a joined-up approach to our care. We also have designated nurse case managers, for our more complex long term patients.

Courage: We expect our staff to always act in

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n Courag o i t e ca ni

Staff include community staff nurses, district nurses, community practitioners, healthcare assistants, nurse case managers, continence nurses, clinical nurse managers, administrators, a clinical lead and a head of service.

intravenous therapy. All of this care could take place at home or at a clinic. We also provide palliative care, support, management and symptom control for patients living with lifelimiting conditions.

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There are approximately 140 clinical staff within the MCH community nursing service, providing nursing services 24 hours a day, 365 days every year. The community nursing service is we ll-placed to access expert knowledge from other team members and health services.

the best interests of our patients and their families. This might include voicing concerns about any aspect of our patient’s care, even if it has been managed by MCH. Commitment: Our staff are committed to supporting and providing quality care to patients within our community. They seek out and implement new ways of working to improve our patients’ experience and make sure we provide the best care. Patients’ and their families’ interests are paramount when any decisions relating to our service are made.

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ommunity nursing

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e Co tenc pe m

The community

respiratory team The community respiratory team (CRT) is a specialist team of nurses, physiotherapists and a dietician who provide care in the community for patients with the long term conditions chronic obstructive pulmonary disease (COPD), interstitial lung disease and bronchiectasis.

Like the community nursing service, our community respiratory team are integral to making sure those who are discharged from hospital have the right support to manage their conditions, and retain their independence.

Community rehabilitation Community rehabilitation is based at the Walter Brice Centre in Hoo, and comprises five teams that support our patients’ physical and functional recovery and rehabilitation from accident, injury, short term illness or long term conditions such as Multiple Sclerosis (MS), Parkinson’s disease or old stroke.

All five teams work closely with Medway Maritime Hospital and our community nursing teams by supporting elderly and frail patients that have been discharged from hospital.

Community rehabilitation reduces the need for multiple referrals by providing a ‘one stop shop’ for internal colleagues, and external health and social care agencies to request our support for a patient.

Treatment plans are used to help our specialists formulate an appropriate, measurable and meaningful rehabilitation programme that aims to achieve the patient’s goals and objectives.

Rapid response A patient who is unwell at home or being discharged home from hospital and is housebound, will be supported by the rapid response team. Such patients may have a ‘package of care’ to support their recovery and 6

during a six week period the rapid response team will put together an occupational therapy and physiotherapy rehabilitation programme to help the patient to regain their independence and reduce the need for additional services.

If patients are discharged from hospital, but unable to immediately return home, their recovery will be supported at an inpatient rehab unit in Medway. Additionally, Home First, our partnership programme with Medway Council, Medway CCG and Medway Foundation Trust, supports rapid response and focusses on improving patient flow across Medway, and improving hospital discharges to make getting patients home a priority.

Community physiotherapy Once a patient has started to recover from their illness or injuries, rather than be discharged and wait for a referral to other services; patients can be internally transferred to community physiotherapy. Like the rapid response team, this team again facilitates recovery for housebound patients who are unable or not yet ready to leave their home, and who need assessment and treatment that helps them to move safely and independently.

Falls team The falls team assesses and treats patients with a history of falls, fear of falling or with medical conditions that contribute to falls.

The falls team comprises of occupational therapists and physiotherapists who collaborate to enable patients to carry out and complete activities which are part of their daily living, as independently and safely as possible whilst reducing the risk of falls.

Neuro physiotherapy Neuro physiotherapy is a specialist service that supports all the teams within community rehabilitation and across MCH, especially with respect to conditions such as MS, Parkinson’s disease and vestibular (inner ear and brain) conditions.

Walter Brice Rehabilitation Centre Patients who are continuing to recover and beginning to gain enough confidence to leave home or need help to retain function and independence, will be referred or transferred to the care of the Walter Brice Rehabilitation Centre.

The centre offers patients the opportunity to gain confidence and functional independence through group and 1:1 treatments and activities put together by occupational therapists and physiotherapists.

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Dementia services

in Medway

It is estimated that in Medway in 2015 there were 2,898 people living with dementia and 2,727 of those were people over 65 years old. It is estimated that there will be a considerable increase in this number in Medway in future years, largely driven by the growth in the overall older population.

Dementia is a word used to describe a group of symptoms including memory loss, confusion, mood changes and difficulty with day-to-day tasks. These changes may often be small to start with, but for someone with dementia they become severe enough to affect daily life.

A person with dementia may also experience changes in their mood or behaviour.

Alzheimer’s disease is the most common cause of dementia but not all dementia is due to Alzheimer’s. The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.

Dementia services within Medway Community Healthcare (MCH) include Darland House, a specialist nursing home for people with dementia and mental health conditions; and the Dementia support team, a specialist crisis community team set up to support people with dementia and their carers in their homes.

Darland House Darland House is a modern specialist nursing home that provides residential care for older people with mental health problems, including Alzheimers and other forms of dementia. It provides this service for the population of the Medway area who require continuing long-term care. Darland House has 40 permanent beds.

MCH provides 24-hour person centred care at Darland, within a comfortable and caring environment adhering to the ethos of the national service framework for older people, the protection of vulnerable adults scheme, public health guidance and the continuing care criteria.

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Our philosophy of care is to treat all that live here with respect, dignity and warmth, and that, wherever possible, we support residents’ independence and individual choice. This approach to care is extended to the relatives and carers of our residents. We provide a seven day a week activities schedule designed with all of our residents in mind.

Referral to the service is via the NHS continuing care service.

Dementia support MCH’s dementia support team supports people with dementia and their carers who live at home during times of crisis. They enable people to remain in their own homes, ensure that patients and families have the appropriate support and reduce unnecessary admissions into hospital.

The service can provide: • short term support and home treatment for challenging behaviour and physical problems (i.e.: infection, or after a fall where emergency services are not required) • assessments of patient’s current physical and mental health needs • an Admiral Nurse service especially to support carers, enhance their skills and resilience • support for early discharge of patients from hospital or other inpatient care, through managing the patient at home and supporting the carer • signposting to other services when necessary • providing training and support in the management of dementia to community nursing teams and care homes within Medway Referrals are made by GPs, health professionals or carers and can be made for a number of reasons.

These might include carer stress or breakdown; physical problems affecting the dementia that can be managed at home; challenging behaviour; and to prevent unnecessary admissions to hospital or to enable earlier discharges from hospital.

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How to use your health services There are a range of healthcare services available to help you find the right expert care to meet your needs. Choosing the service most appropriate to your symptoms means you get the right treatment in the right place.

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Choking.

Chest pain.

Suspected stroke.

Blacking out.

Severe bleeding.

For symptoms of serious illnesses and major accidents, choose A&E (Accident & Emergency).

Cuts.

Sprains.

Rashes.

Minor fractures.

For trips, falls, skin complaints and minor injuries, choose Walkin Health Centre or Minor Injuries Unit or Urgent Care Centre.

Vomiting.

Ear pain.

Feeling ill.

For infections and persistent symptoms or if your child has a high temperature, choose your GP.

Diarrhoea.

Minor infections.

Headache.

Bites and stings.

For tummy upsets, insect bites and stings, coughs and colds and travel advice, choose a pharmacist.

Unsure?

Confused?

Need help?

For absolutely any questions about your health, choose NHS 111 service.

Grazed knee.

Sore throat.

Cough.

For minor ailments, grazes, bruises and similar problems, choose self-care.

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NHS continuing healthcare NHS continuing healthcare is a free package of care for people who have significant ongoing healthcare needs. It is arranged and funded by the NHS. You can receive NHS continuing healthcare in any setting outside hospital, including in your own home or in a care home.

If you receive care in your own home, the NHS will cover the cost of the support you need from health professionals and the cost of personal care which can include help with washing and getting dressed. If you receive NHS continuing healthcare in a care home, the NHS will also pay your care home fees.

Eligibility for NHS continuing healthcare When assessing your eligibility for NHS continuing healthcare, staff must follow certain processes.

You must be assessed by a team of healthcare professionals as having a ‘primary health need’ for care. This means that you need care primarily because of your health needs.

This is assessed by looking at: • t he type and particular characteristics of your needs • how intense and severe they are • the complexity of your needs •h ow unpredictable your needs are; including any risks to you and others if adequate and timely care is not provided

Eligibility is always based on these needs, rather than any particular diagnosis or condition.

When should I be considered for NHS continuing healthcare?

If you have ongoing health needs, there are times when staff should consider whether you may be eligible.

These include: • when you are ready to be discharged from hospital and your long-term needs are clear • once a period of intermediate care or rehabilitation following a hospital stay have finished and it’s agreed your condition is unlikely to improve • whenever your health or social care needs are being reviewed as part of a community care assessment • if your physical or mental health deteriorates significantly and your current level of care seems inadequate • when your nursing needs are being reviewed. This should happen annually if you live in a nursing home • if you have a rapidly deteriorating condition and may be approaching the end of your life In these circumstances, your discharge staff, staff co-ordinating your intermediate care, GP or a member of the social work team should raise the issue of NHS continuing healthcare and assess your eligibility. If they don’t, make sure you ask for an assessment.

Assessment for

NHS continuing healthcare You should be fully involved in the assessment and have your views taken into account. You can ask a relative or carer to help and support you throughout the process.

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Most people will start by completing a checklist. This assesses your needs and indicates whether or not you should have a full assessment.

If you’re referred for a full assessment, evidence will be collected from all relevant health and social care professionals to give a full picture of your physical, mental health and social care needs.

Then a team of health and social care professionals involved in your care will look at this evidence and recommend whether or not you’re eligible. You and / or your representative can attend and participate at this meeting.

If you are eligible The team will forward their recommendation to the Clinical Commissioning Group (CCG) that is responsible for funding your care. The CCG will then discuss and agree a care and support package with you.

This care and support package will be reviewed after 3 months and then at least every year. If your care needs change, your funding arrangements may also change.

Personal Health Budgets If you’re eligible for NHS continuing healthcare, you have the right to a Personal Health Budget.

Personal Health Budgets allow more choice and control over the services and care you receive and can be used to pay for a wider range of items and services, including therapies, personal care and equipment.

If you choose this, you will develop a care plan with your NHS team that will meet your personal health and wellbeing needs.

See NHS Choices for more information about Personal Health Budgets.

If you’re not eligible If you’re not eligible for NHS continuing healthcare, you’ll be referred to your local authority to decide whether you’re eligible for help to arrange or pay for care.

However, you may be eligible for NHS-funded nursing care.

If you’re not happy with the decision If you’re turned down, you should be sent a letter telling you why. It should also tell you what steps to take and who to contact if you’re unhappy with the decision.

• If you weren’t given a full assessment, you can ask the CCG to reconsider your case. If you are still dissatisfied you can use the NHS complaints system to pursue your case.

• If you’re not happy after a full assessment, you can ask for the CCG to reconsider its decision.

If you are still dissatisfied, you can ask for an independent review of your case.

• If you’re not happy with any help you receive from the NHS, you have a right to complain.

Details of the complaints procedure are available from the relevant organisation.

Fast Track If you are approaching the end of your life, you may be eligible for ‘fast tracking’ which allows you to bypass the full assessment process mentioned above. You must have a rapidly deteriorating condition that may be entering a terminal phase.

If you’re eligible, a care package should be put in place as soon as possible, preferably within 48 hours.

Age UK has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Age UK endorse any of the products or services. All information correct at the time of going to print.

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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?

The increase will be backdated to April 1, 2016 for people who are getting NHS-funded nursing care from that time. This new rate is under review and may change on the January 1, 2017.

You may be eligible for NHS-funded nursing care if: • y ou are not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse • y ou live in a care home registered to provide nursing care

How will my needs be assessed?

You should be assessed for NHS continuing healthcare before a decision is made about whether you are eligible for NHS-funded nursing care.

Most people don’t need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven’t already had one, your clinical commissioning group (CCG) can arrange an assessment for you.

Outcome of the assessment If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the care home.

Services provided by a registered nurse can include planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care.

If you’re not eligible for NHS-funded nursing care and you don’t agree with the decision about your eligibility, you can ask your CCG to review the decision.

NHS-funded nursing care is paid at the same rate across England. For 2016/17, the rate is £156.25 a week (standard rate).

Before October 1, 2007, there were three different levels or bands of payment for NHS-funded nursing care – low, medium and high.

If you moved into a care home before October 1, 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date.

If you moved into a care home before October 1, 2007, and you were on the high band, NHS-funded nursing care is paid at a higher rate. For 2016/17, the higher rate is £215.04 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 £156.25 a week, or • you become entitled to NHS continuing healthcare instead

Content supplied by: NHS Choices has 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.

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Paying for permanent residential care Lots of people worry about paying for care for themselves or for a loved one. Most people will be expected to pay something towards the costs.

If your care is being organised by the local authority, then the main steps of the process are: 1. Your local authority does a care needs assessment to identify what help you need.

2. They make recommendations about your needs and whether or not you need residential care – this is called a Care Plan.

3. They work out a budget to ensure you get what care you need – this is called a Personal Budget.

4. They do a means test, also called a financial assessment, to work out how much you should pay towards your care home fees and how much they will cover.

If your care is arranged by the NHS or social services, you may not have to pay for some or all of the care. For more information, see our page on NHS continuing healthcare.

What does the means test look at?

The means test will look at your income and capital, such as your savings and property. Whether you have to pay, and if so, how much, depends on how much income or capital you have. In certain situations, the local authority may assume that your capital generates an income which can be used towards pay your care home fees.

If you and someone else jointly hold capital, such as a savings account, it’ll be treated as divided equally between the two of you.

In some circumstances your home won’t be included in the means test, for example, if your partner still lives there.

What if I give away some of my money?

You may think about giving away some of your savings, income or property to avoid higher care costs, and to give something to your relatives or charity, for example. If the council thinks that you have done this to avoid paying care fees they may still assess you as if you still had the money or property that you have given away. This is referred to as deprivation of assets.

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How will my capital be treated in the means test?

Amount of your capital How it will be treated (your savings and property) Over £23,250 You must pay full fees (self-funding) Between £14,250 and The local authority £23,250 will assume that this generates an income and this will be taken into account for your care home fee contributions.

Less than £14,250 This will be ignored and won't be included in the means test

How will my income be treated in the means test?

Certain types of income, such as money from certain disability benefits and pensions, may not be counted in the means test. All other income can be taken into account.

As noted above, in some cases, the local authority may also assume that your capital generates an income, which will also be taken into account for your care home fees.

How much will I have to pay?

After the means test the local authority should give you a written record of their decision of what you will have to pay and what they will pay, and how they calculated it.

You should not be left with less than £24.90 a week after any contribution to your fees. This is known as your Personal Expenses Allowance.

What if I prefer a more expensive care home than the local authority will pay for?

If you’d prefer to live in a care home that costs more than the local authority would usually expect to pay, it can arrange this, provided that someone else is willing to meet the difference in cost. This is usually known as a top-up or third-party payment.

You could also choose a care home in another area to be closer to family or friends.

How do I pay my part of the fees?

Generally the local authority pay the full amount to the home and collect from you the amount you need to pay. This may be different if you are paying a ‘top-up’ fee.

What if I run out of money?

If you are paying fees yourself (called self-funding) and your capital goes down to less than £23,250, the local authority may assist with funding. You should request an assessment a few months before that happens. They should arrange one as soon as possible so you don’t have to use up your capital below that amount.

Paying for temporary care in a care home Local authority charging rules differ when a stay in a care home is temporary, rather than permanent.

Some people go into a care home on a temporary basis to give themselves or their carers a break‚ or while they are recuperating from an illness.

Others enter a home temporarily for a ‘trial’ period to decide whether they want to live permanently in that home.

A more detailed account of the charging rules can be found in our factsheet Paying for temporary care in a care home. This factsheet is aimed at individuals who are aged 60 and over.

Personal budgets and direct payments - more control over your care Direct payments When your personal budget is paid directly to you this is called a Direct Payment. Direct Payments allow you to arrange your care as you wish.

There are rules about what you can and can’t use direct payments for. The money must be used to meet the eligible needs identified in your assessment.

You can use direct payments for anything that meets those needs, for example: • employ your own care workers • buy services from a voluntary or private agency • buy equipment or pay for home adaptations • purchase other types of support to meet your assessed needs • get to a café to meet your friends, a place of worship, or other places that are important to you.

Paying for care if you have a partner

You can be personal and creative with your budget. For example, if one of your assessed needs is help with shopping, you could pay for someone to help you go shopping yourself rather than just pay someone to do it for you.

Being part of a couple can affect a care home resident’s eligibility for local authority assistance with care home fees and both partners’ eligibility for social security benefits during the period in care.

We have produced a factsheet that addresses this issue and includes sections on the valuation of jointly owned capital, temporary admissions and where both members of a couple go into a care home.

This factsheet should be read alongside Age UK’s other factsheets on care home charging and benefits.

You can’t use direct payments to: • pay a spouse, civil-partner, live-in partner, or a close relative who lives in the same household as you to care for you (although there may be exceptions to this) • buy services from your local council • pay for permanent care in a care home. You can, however, pay for a short stay of up to four consecutive weeks within any 12-month period if that meets an assessed need.

Age UK has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Age UK endorse any of the products or services. All information and figures correct at the time of going to print.

Content supplied by:

Not everyone will feel comfortable or capable of managing their direct payments themselves, and you don’t have to if you don’t want to. You can always choose the option for the council to arrange care for you, and you can still have a say in what will best meet your needs.

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Care services in 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 • a place to live in a family who will care for you, known as “shared lives services” or adult placement services 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.

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your home

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.

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.

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 record-keeping. 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.

You can find out more from the UK Homecare Association.

>>

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What are the disadvantages of using a care and support agency?

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: • Does the agency check references?

• What training and supervision do they provide?

• What is their complaints policy?

• Who will be responsible for insurance?

• Is there any out-of-hours or emergency contact if needed?

• 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 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.

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.

Questions can be answered by the DBS call centre on 0870 909 0811, or by email.

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.

NHS Choices has 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 correct at the time of going to print.

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Content supplied by:

Holywell Park Nursing & Residential Care

Hodsoll Street, Ash-cum-Ridley, Nr Sevenoaks, Kent, TN15 7LE www.holywellpark.com ■ Telephone: 01732 822 215 ■ Email: holywellpark@aol.com

Family run home for 25 years CQC Quality Rating - “Good” ■ Nursing and Residential ■ Single en-suite rooms ■ Apartments ■ 24 hour care by RGNs and NVQ qualified staff ■ Excellent cuisine ■ Beautiful landscaped gardens ■ Passenger lifts ■ 4 Spacious lounges ■ Conservatories ■ Hairdressing salon ■ Regular entertainment and garden parties ■ Respite care personal needs of our residential care residents but About us Nursing Care also promote their social being and independence.

We provide comprehensive individualised nursing Holywell Park has been a family run home for 25 As with our nursing clients, we will also carry out care delivered by our experienced team of fully years. We provide 24 hr care in a caring and homely a full assessment prior to admission and create an trained Nurses and Care Assistants. We cater for those environment and we are proud to be rated ‘Good’ individualised care plan to ensure that all assessed requiring general nursing care and also for those who

by CQC. needs are met including religious, social and require some specialist nursing care.

Residents at Holywell Park can enjoy tastefully cultural needs.

Each resident will receive an assessment prior decorated en-suite bedrooms with stunning views of Respite Care to admission to ensure that we are able to meet the countryside, as well as four lounges, including a their needs. This assessment will be carried We understand the considerable pressures of looking well-stocked library. Bedrooms can be decorated and out by one of our Managers and will be used to after a very dependent elderly person and are aware furnished to your taste if enough notice is given. form the basis of the residents care plan. This that at times you may appreciate a break. Should you In addition to this, residents can benefit from: personalised care plan will detail each and every need to arrange care for a short period to as long as ■ Daily activities and outings assessed need and contain a plan of action for you wish then please contact us and we will carry out a ■ Excellent cuisine those needs to ensure that the resident receives full assessment of needs.

■ Regular entertainment and garden parties the highest quality of care.

If you have arranged a holiday then your loved one ■ Hairdressing Salon Residential Care can also enjoy a holiday at Holywell Park where they ■ On-Site laundry service will meet new friends and participate in all the daily We provide residential care in luxury and homely activities of a vibrant community. surroundings. We will not only look after all the ■ Beautiful surroundings ■

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Medway Age UK Medway has been providing care and support services to our community for over four decades. In recent years we have extended the range of services we are able to offer.

During the last year Age UK Medway has rapidly expanded its dementia services, offering a variety of different levels of service to support people living with dementia, their carers and families.

Dementia day centres The Capstone Centre in Chatham was our first specialist dementia day care centre, and opened its doors in 2013. Capstone can accommodate up to 32 people a day, and offers a full day based around cognitive stimulation activities. The sister centre to Capstone is the Pat Warner Suite, which is housed in the rear of the Mackenney Centre in Gillingham, and uses the same model of care as Capstone for up to 12 people a day. The Pat Warner Suite will celebrate its second anniversary at the end of June.

COGS clubs Augmenting the support of the two centres we are now offering COGS clubs in four different locations around Medway. These clubs aim to encourage members to participate in purposeful activity in order to develop or maintain active minds. The day is from 10am to 3pm and includes a light lunch / snack, tea or coffee and we have clubs running Monday – Friday.

Flexible Dementia Outreach The flexible dementia outreach service offers flexible activity based support for people with dementia and memory concerns living in their own home. Trained support workers will spend quality time with each person on a weekly or fortnightly basis, helping reduce social isolation and retain or regain links with their local community.

Dementia Friends Our dementia marketing co-ordinator is able to offer dementia friends training to interested parties.

Currently all Age UK Medway staff are dementia friends, and we are in the process of delivering this training to our volunteer team.

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Social clubs We operate two social clubs, based in Strood and Gillingham, which provide a full range of trips and activities, including arts & crafts, cooking, quizzes and chair based exercise for over 50’s living in Medway. A freshly cooked two course meal is prepared, using ingredients sourced from local independent suppliers. Transport is available if required via our fleet of minibuses.

Home care services Our Home Care Service provides a full range of personal care and domestic services, including breakfast, lunch and tea calls, as well as assisting to bed and prompting medication. We are also able to offer bathing assistance as well as shopping and domestic calls. We treat each person as an individual by offering a personalised service, to support people with the same respect you would want for yourself or a member of your family. The most recent inspection by CQC rated the service as good.

Membership scheme The membership scheme allows members access to organised trips and outings, as well as a 10% discount on some services, and a meals delivery service. Members are kept up to date with regular mailings, newsletters and information.

Shop Sales of goods in our shop help to support our work, and we rely on donations to maintain stock levels. All donations, no matter how big or small, are welcome. If you are unable to make it down to the shop to donate your items this isn’t a problem as we can arrange to collect them from you.

Foot care We provide a foot care service in our centres in Strood and Gillingham, as well as a community based service. The service is able to provide toenail cutting and filing, smoothing and moisturising dry and rough skin, checking for cracks and breaks in the skin, and inflammation such as blisters. It also helps highlight signs of infection like nail fungus or other problems, and signpost to appropriate professionals.

Harvest time, pea picking at The Mackenney Centre

Handy van The Handy Van service launched in 2014, and provides a vetted handyman to undertake small maintenance jobs in and around the house. We assist with a wide range of jobs, including • Key safes • Handrails • Decorating • Garden clearance The cost of the service is £23 per hour, plus the price of any materials used, with initial home visits and quotations being free of charge.

Volunteer opportunities Age UK Medway has a large team of volunteers who provide vital support to the organisation in delivering a wide variety of services. We have volunteering opportunities in a number of areas:

•B efrienders – offering companionship to people in their homes • ‘ Call In Time’ – occasional friendly phone calls to the lonely and the isolated •H ome From Hospital Service - Supporting clients who have recently been discharged from hospital For more information about any of our services contact us on 01634 572616 or visit our website at www.ageuk.org.uk/medway. You can also find us on Facebook and Twitter

For more information about any of our services contact us on 01634 572616 or visit our website at www.ageuk.org.uk/medway

• Social Clubs – assisting with serving snacks/meals and delivering activities • Minibus Escorts – Acting as a passenger assistant on our minibuses • Minibus drivers – pick up and drop off customers to Social Clubs • Charity shop assistant – serving customers and carrying out small office administration tasks • Information and Advice workers – help the advising officer with entitlements to State Benefits 23

Come along to your local Dementia Café Information and advice in a relaxed setting for people affected by dementia in Kent & Medway Get support in an informal setting A cup of tea with someone who understands. Ideas about local support. A chat with a health professional who has the time to answer your questions.

These things can make a massive difference when you or someone you know has dementia.

Your local Dementia Café provides a safe and supportive place for you to: ■

■

■

iscuss your own dementia diagnosis, or someone else’s, and think about d what it means for the future et answers from health professionals and meet and learn from other people in g similar situations keep active, make new friends and feel more confident.

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.

‘‘The people are so friendly and helpful.

It stopped me bottling everything up and going into a downwards spiral,”

Judith, who has dementia

T d t 24

Taking on dementia together

Find out more

Get in touch today to find out more about how your local Dementia CafĂŠ can support you: 01622 747181 kentandmedway@ alzheimers.org.uk

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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.

NHS Choices has 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 correct at the time of going to print.

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 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.

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The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care.

We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one.

You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia.

We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided.

You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care.

You can also call us to share an experience of care on 03000 61 61 61.

Here are some tips to help you choose your care.

Social care Top tips 1

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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.

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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/

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Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police.

You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.

The Care Quality Commission has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.

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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.

GP Top tips

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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

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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 ●

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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.

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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.

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Mental health Top tips

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If you are concerned about your mental health you should first visit your GP.

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Outstanding Good ● Requires improvement ● Inadequate ●

Your GP will assess you and offer appropriate advice or treatment. They can refer you to a psychological treatment service or a specialist mental health service for further advice or treatment.

Mental health services are free on the NHS but you will usually need a GP referral. If you don’t want to go to your GP you may also have the option of self-referral. This means you can go directly to a professional therapist. The NHS Choices website has a searchable directory of services which you can use to find a service near you.

If you are referred to a specialist mental health service, you can ask which other providers offer the same service in your local area and make a choice.

CQC rates mental health providers to help people make choices about where they get treatment.

They will use a four-point scale:

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CQC uses information from the public and holds listening events across the country where people can talk with inspectors about their experience of services.

You can look at our inspection reports and ratings for mental health services or share your experiences of care (good or bad) by visiting www.cqc.org.uk

Telephone: 03000 616161 • Web: www.cqc.org.uk /CareQualityCommission

@CareQualityComm

In April CQC launched its new-style inspection reports for mental health providers – looking at five key areas of Safe, Effective, Caring, Responsive and Well-Led – you can compare reports on CQC’s website to help choose a provider.

The Care Quality Commission has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.

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NHS Hospitals and services in Medway Walter Brice Day Centre, Tilley Close, Hoo, Rochester, Kent, ME3 9AE

Medway The Admirals Offices, Historic Dockyard, Chatham ME4 4TZ

Allhallows Cliffe

Tel: (01634) 572616

St Mary Hoo

MEDWAY St Mary’s Island

Wisdom Hospice, High Bank, St Williams Way, Rochester, Kent, ME1 2NU

Tel: (01634) 253611

Upper Stoke

Isle of Grain

Sunlight Centre GP Surgery, 105 Richmond Road, Gillingham, Kent ME7 1LX Tel: (01634) 283847

Rochester

Tel: (01634) 830456 Chatham

MCH Pentagon 30 - 34 Pentagon Centre, Military Road, Chatham, Kent, ME4 4BB

Gillingham

ourZone, Pattens Lane, Rochester, ME1 2RB

Hempstead

Tel: (01634) 335580 Darland House Nursing Home, 29 Darland Avenue, Gillingham, Kent, ME7 3AL Amherst Court, Palmerston Road, Chatham, Kent ME4 6LU

Tel: (01634) 852323

MAIDSTONE

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1 Dairy Court, Fairview Farm, Linton Road, Loose, Maidstone, Kent ME15 0AL

MCH House Bailey Drive, Gillingham, Kent ME8 0PZ

Tel: (01622) 747181

Tel: (01634) 337593

Useful contacts A

M

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

Medway Citizens Advice Bureau 3rd Floor Kingsley House, 37-39 Balmoral Road, Gillingham, Kent ME7 4PF I www.medwayadvice.org.uk/

Admiral Nursing DIRECT 0845 257 9406 This helpline has been set up to provide people with an opportunity to talk through their worries and concerns about themselves, friends or relatives with dementia.

The lines are open on Tuesdays and Thursdays between 11am and 9pm. Callers can leave messages any time and request a call back I direct@dementiauk.org

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

Age UK Medway 01634 572616 The Admirals Offices, Historic Dockyard, Chatham ME4 4TZ I www.ageuk.org.uk/medway

National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis.

I www.nos.org.uk

Alzheimer’s Society 01622 747181 1 Dairy Court, Fairview Farm, Linton Road, Loose, Maidstone, Kent ME15 0AL I www.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 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

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 DIAL North West Kent 01474 356962 DIAL provides free confidential information and advice on all aspects of disability to the residents of North West Kent (Dartford, Swanley and Gravesham).

DIAL NWK c/o KASBAH 7 The Hive, Northfleet, Kent DA11 9DE I www.dialnwk.org.uk I info@dialnwk.org.uk 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

I Integrated Care Council 01379 678243 (Formerly the National Homecare Council) The Integrated Care Council is a body which brings together British public and independent sector organisations who commission or directly provide support for people living at home.

01634 383760

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NHS 111

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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

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 Medway is published by Octagon Design and Marketing Ltd with editorial contributions from Medway Community Healthcare, 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.

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