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THE HANDBOOK FOR RELATIVES 2017 YOUR COMPANION THROUGH THE EMOTIONAL AND PRACTICAL ASPECTS OF CHOOSING AND FUNDING CARE FOR AN AGEING RELATIVE.

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FOREWORD BY DAME ESTHER RANTZEN

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Heatherwood NURSING HOME

Tel: 020 8660 6646 47 Foxley Lane, Purley CR8 3EH

A beautiful, small, family-run home Situated in Purley, south east London, Heatherwood Nursing Home provides high quality nursing, residential and palliative care to 22 residents. We are a family-run home that focuses on individual care and attention. As a small home we have the time and resources to ensure each resident receives the very best in care and facilities.

www.heatherwood.org l info@lloydparknursing.org l 47 Foxley Lane, Purley, Surrey CR8 3EH

Lloyd Park NURSING HOME

Tel: 020 8688 7022 84 Coombe Road CR0 5RA

A Home away from Home Lloyd Park is a modern and highly-skilled care facility, that can show a proven record in functioning as satisfying elderly care accommodation for a wide range of individual health requirements. This facility’s dedicated team are not idle or unimaginative in the care solutions they bring to their residents.

www.lloydparknursing.org l info@lloydparknursing.org l 84 Coombe Road, South Croydon CR0 5RA

Willow Lodge NURSING HOME

Tel: 0208 642 4117 59 Burdon Lane SM2 7BY

Live your life and believe in your ideas! At the heart of what we do is a desire to provide everyone we support with the opportunity to continue to live life to the full. This means much more than just providing good care; it is about working with each resident to understand their life story to-date, as well as their dreams and aspirations for the future. Armed with this understanding, we can achieve these dreams together.

www.willowlodge.org l info@willowlodge.org l 59 Burdon Lane, Cheam Village, Sutton SM2 7BY


Contributors Dame Esther Rantzen Les Bright, BCD Care Associates Samantha Bandak, Independent Age

Contents 6

Foreword by Dame Esther Rantzen

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Having the conversation

10

Understanding their needs

Howard Masters, Care Home Finder Fiona Gilbert, Care Home Finder Chris Hay, Bupa

Dealing with family pressures

14

Support to live independently at home

17 23

Making life easier at home

Tom White, Helping Hands

27

Choosing care

George McNamara, Alzheimer’s Society

Care and support at home

James Ashwell, Unforgettable

Specialist housing with care schemes

Toby Scott, National Council for Palliative Care Chloe Wright, Carers UK

34 44

Residential care options

48

Was it the right decision?

58

Dementia and dementia care

Andrew Farley, Farlely Dwek Solicitors Limited

62

Thinking of end of life care

70

Rebecca Sharp, RJR Legal Limited

Are you a family carer? 

77

Paying for care

81

Legal considerations

87

Useful contacts

90

Region-by-region care homes

93

Advertisers’ index 

105

Useful checklists Publications

www.careselect.co.uk

@careselectmag

Alternative formats

Home care agency Residential care homes Residential dementia care

42 57 69

This Handbook is available electronically at www.careselect.co.uk. There is also a Browsealoud option for those requiring the information in the spoken word.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Foreword

by Dame Esther Rantzen My wish for 2017 is that we tackle the epidemic of loneliness in Britain today. I know from my own personal experience the stigma attached to admitting you are lonely. But the only way we can ever solve this problem is by discussing it and working together. We know from the 1,600 calls we receive daily at The Silver Line that the simple act of talking, and feeling listened to in return, is transforming lives. One comment from a gentleman which stays in my memory was that when he put the phone down he felt like he had joined the human race.

“The aim of this handbook is to guide older people and their families through the emotional and practical aspects of finding the right help at the right time.”

Foreword Having the conversation Understanding their needs Dealing with family pressures

People being honest about how they feel and what they need gets more important as they grow older and this is particularly true of choosing the right care and support. The aim of this handbook is to guide older people and their families through the emotional and practical aspects of finding the right help at the right time. I have visited older people in many different types of settings. On one particular visit to a care home, where I

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was invited to have tea with the residents, a care worker took me to one side to ask if I could do something to counteract the myth that all care homes are bad and that to ‘put Mum into a home’ should not be seen as a callous act. ‘Look at our residents,’ she said. ‘If they were trying to survive in their own homes, they would never have this standard of food or care, and the company and the activities. We try to make sure they have a real quality of life here, that they are happy. And we love our work. Yet nobody ever talks about the difference we make, you only ever hear about the horror stories.’ I know from my recent hosting of the 3rd Sector Care Awards, the importance of not only recognising but also celebrating the outstanding work that goes on behind the scenes. If things aren’t right, that needs to be uncovered, but recognising a care home or a similar support service when they are providing excellent care and support can inspire and promote positivity for the sector and those who rely on it. Everybody has a responsibility to spread the message that ‘living in the right home’ can be positive and transformative. By doing this, we will be one step closer to ensuring that the silver generation doesn’t feel invisible or inaudible, rather, they feel listened to and, with the help of family and friends and information such as this handbook, able to choose the right kind of care for them.

Visit www.careselect.co.uk for further assistance with your search for care


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Having the conversation No matter how many difficult decisions you may have made over the past few years – whether that’s choosing a pension provider, moving house, changing jobs, or selecting a university with your children – you are likely to find broaching the topic of care and support for a loved one a formidable task.

Seeing through the fog Nothing prepares you for the wave of possibly conflicting emotions that are likely to envelop you as you face up to some big challenges; chief among them being to persuade someone you love and care about to be realistic about their changing situation. You may see the need for big changes to ensure the safety and welfare of a parent or other loved one long before they acknowledge or accept the difficulty of their situation. Alongside this, there are likely to be practical and logistical issues, financial concerns and the unpredictability of you and your loved one’s other relationships – within and outside of the close family. Even if you are considered to be a ‘clear thinker’, this rich mix of issues is likely to be coming at a time when your judgement – and that of other family members – may be skewed by personal responses to illness, accident, bereavement or evidence of a long and gradual decline suddenly speeding up. At times like this, the information provided here on the steps to take, and the order to take them in, will be invaluable.

Choosing the right time Timing is crucial if you are to avoid encountering delays arising from understandable resistance to raising sensitive matters. Get it wrong and an already tricky situation could become

more painful. Recognition of the need to do something may emerge in different ways for each of those affected, with competing opinions on what is necessary. People are likely to be influenced by the closeness of relationships or physical proximity. Living nearby doesn’t necessarily mean you can find time to speak to your loved one about important matters, and if you live in another part of the country, managing the time and stress of travel may also feature. It’s not easy to keep everyone happy and feeling that their views are understood and respected. The person whose future will be most intimately affected, and who is likely to experience anxiety or helplessness most acutely, could react angrily and irrationally. Harsh things can be said – on all sides. At such a time, it is hard for the person requiring support to escape from a feeling of failure. They may be relying on others for a whole range of tasks, perhaps initially with maintaining the house, but then extending to requiring support with more intimate personal care, such as bathing or getting in or out of bed. There’s a number of ways to meet each of these needs, but when a combination of failing physical health, fading mental capacity and/or restricted mobility suggests assistance of various kinds is required, the need to act will become more compelling and even the most spirited resistance to the loss of

For assistance with finding care and support, call Care Select on 0800 389 2077

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independence will diminish. Recognising that the time has come to seek help will not make it easier for them to manage their own feelings, or to readily accept and understand your worries about their safety and security. You may also chide yourself for not being able to do more due to other calls on your time – work or family and the practicalities of managing things at a distance from your home.

Staying focused on the issues Forgetting things is perfectly normal. But forgetting things that may compromise personal safety – such as locking doors and windows, or that the cooker is on – is usually a sign that ‘something must be done’. However, you should still be careful how you discuss these concerns.

“It is essential that you take time to involve your parent/s and any siblings as fully as possible.” Drawing attention to other indications that all is not well, such as growing difficulty climbing the stairs and getting to the toilet on time, can help, but conversations should not focus on the indignity of being too late, rather on what can be done to change the situation. Fitting grab rails, banisters or a stair lift, or moving to accommodation with a ground floor toilet could be what is needed – at least in the early stages. See page 19 for ideas of adaptations that can help maintain independence.

Working it out – together Regardless of your view on the urgency of finding suitable solutions for the

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concerns that you have identified, it is essential that you take time to involve your parent/s and any siblings as fully as possible. It may sound overly formal to suggest a ‘family conference’ but the opportunity for everyone to sit down and talk about the situation, the options, and their feelings on what will be best is well worth trying, even if it feels like you don’t have much time. If it’s not possible for the whole family to come together, consider asking those who can’t be there for their thoughts over the phone and bringing these to the conversation when you talk to your loved one. This will give you all the chance to talk about your hopes and concerns and to think through the financial implications. The family home, in particular, is a topic which can evoke strong emotions, conflicting opinions, and block progress towards the goal of ensuring that your loved one is well cared for; it can be much easier to have these tricky conversations face-to-face where possible.

Feeling confident Many of us – perhaps the overwhelming majority – may have limited or no experience of care services, so it will be no surprise if discussions, already fraught with family sensitivities, may be framed by what you have learned from ‘undercover reporting’ in the media. Reports of care services that have fallen short of expected standards attract attention – and it’s good that they do, otherwise it might seem that society is prepared to accept the unacceptable. However, shocking occurrences depicted in these reports are not the norm and are not representative of the whole picture. There are thousands of care homes that provide a highlypersonalised service, often to people with complex needs.

Visit www.careselect.co.uk for further assistance with your search for care


Regular visitors to care homes frequently comment on the kindness and dedication of the staff looking after their relative, expressing gratitude for the way in which they

‘go the extra mile’ to make life enjoyable, and giving them confidence that they have made the right decision and that their loved one is safe and properly looked after.

Enid’s choice Bob and Len’s mother had been just about managing since the death of her husband of more than 60 years. She cooked, because she needed to – and never ‘trusted microwave ovens’ – and did all her own shopping, albeit without a list and so seemed to be permanently over-stocked with tea bags and short of milk! But as time went by, she began to display other signs of memory loss and vagueness about everyday events. This then grew into concern about her habit of switching on the gas cooker without igniting the rings, and struggling to get her gas fire to ignite. She protested that nothing was wrong, but her sons persuaded her to get the fire serviced so that an engineer could give her a ‘tutorial’ – it was clear that the fire was in no way faulty, but Enid needed a bit of coaching. Enid insisted that the small problems – offering visitors cups of tea and then finding no milk, cobwebs forming – ‘they’re just out of my reach’ – and malfunctioning appliances were not an issue. On one occasion, after a few months of ‘near misses’, when they were all together, and there was no

milk for the tea she had made, her sons seized the opportunity to talk about the little things that needed attention and what each of the brothers could do to make her life easier. She talked about how helpful their father had been, acknowledging for the first time, the extent to which he had been managing many of the household routines for a number years. What started as a discussion about cooking and cleaning became a wider discussion about managing everyday life. Together, Enid and her sons agreed that there were things that needed addressing and she accepted their suggestion that they should ask a home help agency to come and quote for assisting her – after Bob and Len had reassured her that she had sufficient income to be able to afford this ‘luxury’. After a few months, she became quite attached to the woman who popped in twice a week, and accepted her views on other help she seemed to need. ‘It started with the cobwebs, but has led to her accepting the need for more care. She’s grateful and we’re much less anxious now,’ said Len.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Understanding their needs Having arrived at an understanding that your loved one would benefit from more help, and identified some activities with which assistance is needed, you should consider third party advice on the range and variety of help available. Reaching agreement that assistance is needed, with the fullest possible involvement of all parties, especially your relative who should be central to conversations, means that you can move on to the next stage where you can make more detailed plans. This should be done sensitively, with respect for your relative’s personal preferences, rather than only thinking of the most efficient way of dealing with the situation as you see it.

Take stock of abilities It is likely that you will all want to start by focusing on where assistance is required, for example, simple household tasks that are going undone, or feelings of isolation and loneliness. These may be the most obvious signs of decline but it may be good to also take stock of those things that are not presently a concern. If your loved one wants to go food shopping, but no longer finds it easy to get there, it is far better to take them to the supermarket, or book a taxi if they want to go alone. This will allow them to carry on choosing what they eat. Issues with mobility should not prevent them from having the pleasure of continuing to buy their own food, exploring the offers and enjoying being out with other people.

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The alternative of a supermarket home delivery service is now very much part of the mainstream and may be less likely to provoke feelings of defeat or failure – just don’t opt for it because it is more convenient for you.

Small changes – big impact Your comprehensive knowledge of your loved one’s past and observations of some of the difficulties that have emerged will be invaluable, but you may still be too close to see things clearly, and are unlikely to have detailed knowledge of the possible solutions. Until you become familiar with the range of options, you should resist the temptation to be ‘efficient’ and organise lots of changes that could be very unsettling. Instead, consider whether there are small changes that could make a big difference. For example, installing grab rails into the house or in the bathroom will give confidence back, at the same time as reassuring you too. It is also wise not to take on apparently simple jobs for which you possess the necessary practical skills. An understanding of what works for people with mobility issues or any other impairment is important – putting a grab rail in the bathroom without risk assessing whether this might cause more

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issues than it solves is clearly counterproductive. You may like to contact an occupational therapist before making any changes, as they will be able to help you identify the best adaptations for your loved one. Your loved one’s local council should be able to put you in touch with an occupational therapist in their area.

Again, resist the temptation to speed things up – unless there is a serious and imminent threat to your loved one’s health and wellbeing. This will give you all adequate time to think through the implications of such a major decision. Remember – time spent planning and consulting is rarely wasted.

Dealing with loneliness

Calling on the professionals

Living alone for the first time in many years may be at the root of some issues. Loneliness may become a constant companion and can have a debilitating effect on morale. Explore options such as groups or clubs organised by local churches or charities like Age UK, or perhaps a local pub or club has a more informal arrangement that you could visit together. These informal settings can often prove to be pivotal in changing perceptions of loneliness, because other older people who have travelled the same path and are facing life on their own can share their ‘top tips’ and provide some much-needed stability. No matter how old you are, it can be a very big step to go out alone for the first time so try to find someone to act as a companion/support.

If your loved one's condition has deteriorated to the extent that they might require a care home, or at least much more intensive support to help them remain living at home, you should contact the local authority for an assessment of their care and support needs. This will assist in ensuring sound decisions can be made on the best way of meeting current and future needs. Local authorities have a duty to assess the needs of those who may need care or support. Family members acting as carers for a loved one, offering support and assistance on a daily basis, may also need support. You should contact your loved one’s local adult social care department for an assessment of their care needs, and your local adult social care department for a carer’s assessment.

Making a move? Most of us are clear that we want to carry on living at home for the rest of our life, and services are increasingly being arranged to make that possible. However, it may not always be possible for your loved one to carry on living in the family home as their health or mental capacity deteriorates. This doesn’t mean they will have to move to a care home. You can also explore the various levels of support offered by housing with care – discussed in more detail on page 44. Thinking about selling up and moving on may bring back all the emotions you thought that you had dealt with earlier.

“Local authorities have a duty to assess the needs of those who may need care or support.” The right to an assessment and the authority’s duty to conduct it should in no way be influenced by financial considerations. You should not allow questions about financial standing to get in the way of, or delay fixing, an appointment for an assessment. An assessment of care and support needs, conducted by a professional assessor, provides an opportunity to take a view

For assistance with finding care and support, call Care Select on 0800 389 2077

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on your loved one’s overall capacity to carry on undertaking the normal activities of daily life. It helps to identify the steps that can be taken to improve the situation, and to establish personal preferences and the views of significant others – including you and other family members. Even if they need help to do so, your relative should be the one expressing their thoughts and wishes during the assessment. Ask your council for details of local advocacy services if your relative could benefit from someone independent to help them to communicate their wishes. You could find that your relative's views about the type of support they need differ from what you or other family members think is best. This can be frustrating, but always bear in mind that if your relative has mental capacity – the ability to make and communicate their decisions – then they have the final say on the support they get, even if you (or others) think their decisions are unwise.

“Even if they need help to do so, your relative should be the one expressing their thoughts and wishes during the assessment.” The assessor will also want to explore the extent of current help from family and friends, the scope for stepping that up, and the impact increased demands could have on you and any others involved in providing support. If it seems that the process is being delayed, you should consider asking your loved one’s GP to

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make a referral to the local authority.

A plan for care An assessment leads to a care and support plan being produced. This plan will outline your loved one’s needs and wishes in detail. Regardless of whether the authority organises and/or contributes to the cost of the services required, you will be left with a key document to assist you in setting up the right kind of services independently. It will be invaluable, equipping you with a fuller understanding of the options, and will provide any possible supplier of services with a clearer picture of the extent and complexity of your loved one’s needs. If the local authority is involved in providing services, they will make a separate assessment of your loved one’s financial means to determine whether, and to what level, any charges will be made. The plan should be reviewed regularly to take account of the impact it has made, and to modify either the duration or type of service in light of what works well and meets the needs of your loved one most effectively.

Leaving hospital If you are thinking through these issues while your loved one is in hospital, you may feel some pressure to get them discharged. However, this should not happen without a comprehensive assessment of their health and care needs – not simply a doctor’s opinion that medical treatment on that site is no longer required. If it is decided that your loved one should leave a medical ward, while continuing to need further

Visit www.careselect.co.uk for further assistance with your search for care


rehabilitation support to return to the community, they may be offered a short stay in a ‘community hospital’ or care home that is registered to provide care that is variously known as ‘reablement’, or ‘step down’; it might also be offered in their own home to help them adjust to familiar surroundings while they get back on their feet. Again, there should be a detailed plan of the steps to be taken, the outcomes of this approach, and any key timescales. In some cases, your loved one may be discharged to a care home while other support services are set up so that they can move back to their home. An assessment will be undertaken by one of the team of professionals involved in your loved one’s care, or by the local adult social care team, and will take

the same approach as outlined when your parent is living in the community. Ideally, the person undertaking the assessment should visit your loved one’s house, accompanied by them if their health permits, to ensure the fullest understanding of the environment to which they will be returning. As with a community-based assessment, key people should be involved, so make sure that you and your siblings or any significant others are consulted. In some cases, your loved one may qualify for NHS Continuing Healthcare (NHS CHC) funding; for more information on this, see page 82. Health trusts have designated NHS CHC assessors who you should speak to if the assessment points towards this as a possibility.

www.carechoices.co.uk

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily search by location and care need information on care quality links to inspection reports

• additional care provider information, photos and direct website links • brochure requests

Developed by the publisher of this Handbook Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

For assistance with finding care and support, call Care Select on 0800 389 2077

13


Dealing with family pressures When a loved one starts to need more support, it can be stressful for the whole family. Having open and honest conversations can help everyone to come to terms with the situation and find a solution that your loved one feels is right for them.

Help from others We’ve already talked about understanding the needs of your relative, but what if the rest of the family sees those needs differently? If you spend the most time with your relative, you may clearly see the need for them to have more help, but other members of the family might disagree – either because they don’t see it for themselves or because your relative insists that they are coping. A busy family life, living a long way away or being unsure about how to deal with the situation can make family members reluctant to talk, but openly discussing a situation like this is important. Family members can make assumptions about what other people’s roles should be in organising care and making plans with, or for, an older relative. Talking early on can help to challenge these assumptions – so that you can share the responsibility, plan ahead and avoid future conflict. If other family members don’t accept that your relative needs more support, it could help to give them specific examples of things you have seen that show that your relative’s quality of life is deteriorating. Perhaps they struggle to change their clothes or wash their hair. You also need to be honest about what you can and are prepared to do to help in the future. Don’t feel guilty if you don’t feel able to continue giving the level of support you have been.

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Professional care workers might be the best option. This may need to be approached sensitively, as conversations which could be interpreted as blaming the other family member (for not being around more, for example), could be counter-productive. In highly emotional situations, old conflicts can easily resurface. If things do get heated, you might want to consider using Relate’s family counselling service, or just contacting them for advice (0300 100 1234, www.relate.org.uk). When you’re talking, it’s helpful to be specific about what you want from others – if someone can’t help with support, ask them to do some research instead, for example. Make sure that you listen as well as talk, and don’t assume that they don’t want to help. Regardless of how successful conversations like this are, keep the lines of communication open so that everyone is informed about your relative’s health and care needs (hospital appointments, medication, current care arrangements, etc). That way, the whole family can get a clear picture of your relative’s support needs.

“Don’t feel guilty if you don’t feel able to continue giving the level of support you have been.” If you aren’t living near to your loved one, but have a sibling or other family

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member who is closer or has more time, it’s important not to assume that they will be happy to take on the caring role. If they do look after your loved one, be aware that they are likely to need support from time to time, and if there comes a time when they don’t feel they can carry on, you must be respectful of this. In this instance, try to do what you can to help them and your loved one to find an alternative.

Broaching the subject of support Once it’s clear that they need some additional support, you need to sit down with your loved one to discuss it as soon as possible. Having this kind of conversation can be difficult, but it’s important to act early and not wait until things are at crisis point. See page 7 for ideas on how to broach the subject.

Preparation is key Talk to your family about who the right person is to have this conversation with your relative – don’t feel pressured to have to do this yourself just because you are nearest or have the most free time. It can be hard for a parent to hear advice from their children and emotions may cloud the advice. They might feel more comfortable talking to someone else. You may want to do some research so you can explain and discuss your relative’s choices with them. It is worth asking family members to help you with this as you may all approach it differently and discover different things. This also avoids one person feeling as though they are the only one trying to help. You can get advice on what support options might be

suitable from organisations such as Independent Age (0800 319 6789, www.independentage.org).

Decisions, decisions After all the effort you’ve put in to raising the issues, you may find that other family members will have different opinions on what type of support your relative should receive. Try to understand the reasons why one member of the family might be putting pressure on Mum to stay at home, for example. Are they finding it difficult to come to terms with the fact that Mum needs a high level of care? Are they worried about how a place in a care home would be paid for? Or do they think that it’s the family’s duty to care for her? If the family cannot see eye to eye or you want to address someone’s concerns, you could suggest involving a third party, someone impartial who your relative trusts, such as a GP, priest or good friend to talk it through with you all. Working through these issues will make it easier to focus on what’s most important: that your loved one gets the right support for them. Arranging a free care needs assessment (as mentioned in the previous chapter) for your relative sooner rather than later is a good way to get professional help in exploring all your relative’s needs and what support might meet them – it might be that there are options that you’ve not thought of. Contact their local council’s adult social services department to arrange one. Make sure that key members of the family are involved in this assessment, or see a copy of it afterwards.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Jane’s story Jane reached breaking point last year when her caring responsibilities got too much for her. She works part-time and cares for her elderly Mum, Gladys, who lives an hour away. Jane’s two brothers live much further away and can only visit every other month or so due to other demands on their time. Gladys had always been adamant that she didn’t want ‘strange people’ coming into her home, and insisted that Jane help her with cleaning and making meals every day. The demands of caring, as well as working, meant that Jane was spending less and less time with her husband and two children, and she was always irritable and tired. Eventually, Jane realised that she couldn’t continue as she had been and she spoke to her brothers about the situation. They felt guilty for not realising the impact that caring for

their mum was having on Jane. They researched local support options and spoke to an advice agency, who told them to arrange a care needs assessment for Gladys and a carer’s assessment for Jane too. Jane tried to broach this subject with Gladys but she wouldn’t listen to Jane, telling her that she was happy with the way things were. Jane asked her eldest brother to speak to their mum instead. He chatted with her about why Jane needed a break from caring, and persuaded her that a care needs assessment was a good idea. The result was a compromise – Jane still visits Gladys three times a week and on a Sunday, but social services provides care for the rest of the week, allowing Jane to spend more time with her family.

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily • search by location and care need information on care quality • links to inspection reports additional care provider information, photos and direct website links brochure requests

www.carechoices.co.uk

Developed by the publisher of this Handbook

Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

16

Visit www.careselect.co.uk for further assistance with your search for care


Support to live independently at home

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The time may have come when your relative is starting to need a little extra support with tasks around the home. When this happens, you’re likely to question what the next step should be. Do they need to go into residential care? Should you be supporting them more often? What if something happens and you’re not around to help? These are all common concerns when a relative’s needs start to increase, especially if they don’t want to admit that they need help themselves.

The good news is that there are plenty of steps you can take to ensure that your loved one can be supported at home independently, in a safe environment, and the first signs of declining independence may not necessarily point to the need for formal care.

A little goes a long way Taking regular exercise can improve mobility and wellbeing, as well as helping to reduce the risk of developing certain long-term health conditions such as high blood pressure, heart disease, stroke and osteoporosis.

“Light housework or gardening is a great way to get exercise.” Aches and pains aren’t always a sign that someone should be resting more. Often, joints ache and get stiff as a result of not moving about enough. If your loved one is able to, it might be worth encouraging

them to get out and about more than they are. Walking to the local shop for a daily paper or going for a gentle swim might make it easier for them to move around. If leaving their home is difficult for them, light housework or gardening is a great way to get exercise. If your relative has a health condition, they should contact their GP before starting any exercise. For more information on physical activity guidelines for older people, visit the NHS website: www.nhs.uk

Support to live independently at home Making life easier at home

Staying safe at home

Choosing care

Your loved one may be finding it more challenging to live independently at home. Their own concerns for their health may be causing them to keep this to themselves, or they may not see the issues at all. Keep an eye on what they seem to be struggling with and see if any small amount of help you give them makes an impact. If you notice that a lightbulb has been out for longer than usual, or the cobwebs are building up in the corners, consider why this may be

For assistance with finding care and support, call Care Select on 0800 389 2077

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Care and support at home Choosing a home care agency checklist Specialist housing with care schemes Residential care options Choosing a residential care home checklist


rather than assuming your relative hasn’t got around to dealing with it. Most people prefer to remain living in their own homes for as long as possible. Often, this is the family home and it is natural for everyone to feel attached to it for its comfort and memories. However, it’s important to consider whether the house is contributing to your loved one’s increasing dependence. Are they struggling on the stairs? Is getting in and out of the bath tougher than it used to be? Can they reach all the cupboards in the kitchen? Would they be able to call for help if they fell? These are common concerns and many people assume their relative will need to move, but there’s a multitude of options for adapting the home to make it safer and to enable your loved one to stay living there for as long as possible. Whatever solutions might work, consider that your loved one might not be receptive to the idea of home adaptations at first. It may be hard for them to admit that they need assistance. Be patient and give them a chance to adapt to the idea that there are items available to help them live well.

Aids and equipment There are many options for simple equipment to help with daily life. If you’re not sure where to start, an occupational therapist may be able to suggest items, aids or adaptations to make independent living easier. If your relative is having an assessment by the local authority, an occupational therapist should be involved in this. Alternatively, you could contact a private occupational therapist directly or your local independent living centre

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may have someone you can speak with. You should check whether you need to make an appointment before visiting an independent living centre. Some are run by the local authority, so you may have to go through them in the first instance. A quick internet search should show you if there is a centre nearby. If you need support to access the internet, your local library should be able to help.

“It’s important to consider whether the house is contributing to your loved one’s increasing dependence.” The Living Made Easy website offers help and advice on daily living as well as details on equipment that could help your loved one in the home, these include kettle tippers or bath chairs, stair lifts, grab rails and accessible clothing. For more information, visit: www.livingmadeeasy.org.uk The website is run by the Disabled Living Foundation and works in conjunction with AskSARA. AskSARA can also help you find useful advice and products that make daily living easier. For more information, visit: www.asksara.org.uk If you are looking after someone who is living with dementia, Unforgettable has a host of equipment and daily living aids that you can purchase from the website, visit: www.unforgettable.org See page 23 for other solutions to make life easier in the home.

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Simple but effective changes When Penny’s husband passed away, her son, Malcolm started coming around a lot to help with the sorts of things his father would have done – he secured the loose stair rail so his mum was safe going up and down stairs and performed little checks to make sure fire alarms and lightbulbs worked. He made sure he went around once a week to have a cup of tea or supper so that Penny wasn’t so lonely. After a few months, Malcolm noticed his mother was withdrawn and seemed depressed. He worried that, despite his visits, she was feeling alone, but when he broached this with her, she said she was fine and that she still saw a lot of her friends. The next time he visited, Malcolm noticed that the garden had become a bit overgrown. Penny always enjoyed her garden – she would pick flowers and arrange them in vases, and on a warm day she would sit outside and enjoy a cup of tea and a book. Malcolm mowed the lawn and trimmed back some hedges and his mum was over the moon. She

Adapting the home Large adaptations like installing a downstairs bathroom or stair lift, or refitting the kitchen to make it more accessible are great ways of maintaining your loved one’s independence. However, these jobs are likely to require specialist advice or information. Home Improvement Agency (HIA) services may be able to assist you in improving, repairing, maintaining or

explained to Malcolm that his father had been the one who looked after the garden so that she could enjoy it, and that it brought her so much joy to see it looking nice again. Malcolm talked to his mum about getting a gardener to look after the garden for her – Penny thought this was a great idea. She admitted that the steps down to her garden table were becoming difficult so Malcolm sought advice from a local tradesperson and had a rail installed next to the steps. She was also concerned that she might fall in the garden and wouldn’t be able to get help. Together, they looked into telecare and got Penny a personal alarm. This gave them both peace of mind – Penny knew she was safe in her home, and Malcolm felt relieved that she would be OK if there was an issue. The gardener comes in once a fortnight to tend the garden and even checks in on Penny to make sure she’s alright. Now, Penny can enjoy her garden again and she and Malcolm often have their weekly cup of tea outside!

adapting your loved one’s home. They can guide homeowners and private tenants on what may be possible as well as undertaking a benefits check to see if your loved one is entitled to any support from the Government. HIAs help vulnerable people to ensure their home is comfortable and safe and can help to identify reputable tradespeople if small repairs or adaptations are needed around the home. They can also oversee the work. You can find your

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19


local HIA at www.findmyhia.org.uk This website also has an option for you to find a handyperson. Handypeople can undertake small jobs around the home, including safety and security checks and minor adaptations. Some homeowners may be eligible for a Disabled Facilities Grant to help with the cost of larger adaptations. Your local HIA may be able to help with the grant application, but make sure you look into the grant before starting any work. More information is available at: www.gov.uk/disabled-facilities-grants

Assistive technology Telecare and assistive technology can help support people in their homes for longer. The most familiar piece of assistive technology is likely to be a personal alarm. These can be worn as a pendant or wrist button, or pull cords could be placed around the home. In an emergency, your relative activates the alarm and it either contacts you or a nominated person directly. Alternatively, it can go through to a central call centre which calls you, a nominated person or the emergency services if necessary. Telecare is equipment that can detect falls, inactivity, smoke, flooding, gas or extreme temperatures in the home. Sensors, when activated, may raise a voice alert in the home, or connect to a response centre where trained operators can contact your relative through a home unit. They will take the most appropriate action, such as contacting you, a nominated responder, a doctor or the emergency services. Some devices, known as telehealth, can help monitor particular health conditions and reduce the need for hospital admission. Tablet computers can also make a huge difference. They allow you to set automatic calendar reminders, video call and access

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the internet with ease. Local groups may offer training on getting to grips with a tablet or may offer advice on the best kind of tablet for your relative’s requirements. These items can all add to peace of mind if you’re concerned about your loved one being alone at home, as well as giving them the opportunity to regain confidence in their home.

Equipment hire If your loved one is becoming less mobile, they may feel isolated or concerned that they are becoming dependent on others. To help address this, you may want to consider hiring equipment to help them get around. The British Red Cross, for example, offers short-term loan of wheelchairs and other equipment including crutches, backrests, bath seats and walking sticks and frames. You can search its website for your nearest service, visit: www.redcross.org.uk Alternatively, a wide range of private providers hire out similar equipment. A quick search of the internet will help you find what’s on offer nearby. Again, your local independent living centre might be able to help too.

Getting out and about Mobility If your relative still drives but has a disability which means that they receive particular benefits, they may be eligible for the Motability Scheme. Motability enables people to use their mobility allowance to lease a new car, scooter or powered wheelchair. To find out more, visit: www.motability.co.uk

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Blue badge scheme A blue badge enables the holder to park closer to where they need to go, making it easier for them to shop and access local amenities. For more information, visit: www.gov.uk/apply-blue-badge

Community transport Community transport can help people to get to appointments if they can’t use existing transport. To find local community transport, visit the Community Transport Association’s website: www.ctonline.org.uk/search/england

Free bus pass Those living in England may be entitled to a bus pass giving free, off-peak travel on local buses. Men and women both become eligible at the State Pension age for women. You can find out more about eligibility by searching ‘Free bus pass’ on: www.gov.uk A bus pass can be applied for from the local council and: www.gov.uk can link you through to the correct page on your relative’s local authority’s website via a simple postcode search. The free bus pass can help people to get out into the community, see friends and family and stay socially active – without the worry of driving or the cost of keeping a car.

Staying social As people get older, they can find themselves becoming more lonely or isolated. Where once there was a wide social group, there may now only be one or two friends. These friends may struggle with mobility or live at a

distance, making social activities more difficult to organise. This can lead to loved ones going out less, or feeling less inclined to try new activities without friends to accompany them. Often, people turn to family for support – perhaps your relative frequently asks when you are next visiting, suggests days out you could go on together or asks for lifts to or from events. If you’re willing and able to do this, that’s great. However, the sudden responsibility of being a person’s main source of companionship can take its toll on you and your family. Local befriending services may be a solution. They offer companionship and support and can accompany your loved one on appointments or outings. They may even pop by for a cup of tea and a chat. Companions may be volunteers or employed by private companies such as home care agencies. For peace of mind and your loved one’s safety, it is important to ask whether the befriender has the necessary background checks, including a Disclosure and Barring Service check. To find befriending organisations, contact your relative’s local Age UK or search online for small local organisations. The Silver Line, set up by Dame Esther Rantzen, offers a free, 24hour helpline providing information, friendship and advice for older people. Volunteers can be on the end of the phone at any time and the organisation can match people to volunteers for weekly calls and catch-ups over the phone. Such a simple gesture can go a long way to making someone’s day if they’re feeling lonely. Day opportunities should also be

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available in the area. These offer your relative a great opportunity to get out and about, possibly have lunch, meet new people, make friends and enjoy themselves. Some even arrange transport. It is likely that you’ll need to pay for these services, but it may not cost much and they offer the chance of regular social activities and something to look forward to each week. Look around the local council website, community centres or ask Age UK or similar organisations if they know of any day opportunities in the area. Some local care homes also offer day opportunities which is a great way to become familiar with the setting and the community feel it can bring. There are also day services

specifically for people with certain conditions, such as dementia or mental health issues.

Small steps Knowing what’s available for inside the home and in the wider community can make a big difference to your relative’s life. Small changes can go a long way to keeping them independent and safe in their own home for longer. If you find that your parent isn’t as open to change as you’d like, don’t be disheartened. Take things slowly and don’t overwhelm them. Remember it may not be not easy for them to adapt to these changes and they may be resistant to admitting they need assistance.

www.carechoices.co.uk

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily search by location and care need information on care quality links to inspection reports

• additional care provider information, photos and direct website links • brochure requests

Developed by the publisher of this Handbook Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

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Visit www.careselect.co.uk for further assistance with your search for care


Making life easier at home In the living room

Plug with handle

Easi-reach YB NOR

Chair raisers WHAT IS DIFFICULT?

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

GETTING IN/OUT OF CHAIRS

• Block of foam in chair base • Buy ready-made chair raisers • Buy a chair at the right height • Take regular, gentle exercise

• Buy an electric riser chair

OPENING/CLOSING WINDOWS

• Move furniture out of the way • Install/purchase a fan • Buy a tool to open/close windows

• Remove the window opener • Install environmental controls or air-conditioning • Install new windows

CONTROLLING THE HEATING

• Change the switches for ease of use • Fit a timer switch • Purchase a standalone heater

• Move the heating controls • Install new or additional heating system

KEEPING WARM

• Use a trolley to transport the fuel for your fire • Replace the fire with a heater • Apply for a winter fuel payment

• Insulate your house • Swap to a cheaper heating system • Change to a simpler heating system

TURNING LIGHTS ON/OFF

• Install a light switch toggle • Purchase a socket extension • Purchase handi-plugs

• Move the light switches • Replace the light switches • Install environmental controls

HEARING THE TV

• Use subtitles • Purchase wireless headphones

• Request an assessment for a hearing aid • Install a room loop

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In the bedroom

Pillow raisers

Easy grip scissors

M T W T F S S

Bed raisers

Pill dispenser

WHAT IS DIFFICULT?

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

GETTING IN AND OUT OF BED

• Learn new ways of moving safely • Purchase a leg lifter • Raise the bed • Fit grab rails

•U  se a transfer board •B  uy an electric adjustable bed • Install a hospital bed •U  se a hoist

SITTING UP IN BED, TURNING OR ROLLING OVER

• Change to less heavy bedding • Learn new ways of moving safely • Purchase a pillow raiser • Change the mattress

•B  uy a bed cradle/bed ladder •U  se a bed lever •B  uy a specialised mattress • Install a drop-down rail • Install an over-bed pole

KEEPING WARM IN BED

• Buy a heavier duvet • Buy thermal clothing

• IBuy an electric blanket (make sure it’s tested regularly)

GETTING DRESSED

• Learn new ways of dressing • Buy alternative/adaptive clothing • Buy simple gadgets: long-handled shoe horn; dressing stick; button hook • Contact the local authority regarding an assessment of needs

• Consider home support

CUTTING YOUR NAILS

• Buy easy grip scissors

• See a podiatrist

TAKING YOUR TABLETS

• Ask for an easy-open bottle • Keep a note of when you take a tablet • Get a pill dispenser

•G  et an automatic pill dispenser •A  sk someone to prompt you

READING THE TIME

• Buy a clock with larger numbers

• Buy a clock that ‘speaks’

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In the kitchen

Teapot tipper

Large handled cutlery

Liquid level indicator

Pan handle holder

Chopping board with spikes

Perching stool

WHAT IS DIFFICULT?

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

REACHING CUPBOARDS

•R  earrange your cupboards/ surfaces •B  uy an Easi-Reacher or HandiReacher

• Alter the spring in the doors • Lower or raise the cupboards

USING TAPS AND SWITCHES

• Fit tap turners • Purchase Handi-Plugs

• Change switches • Raise or reposition taps • Fit lever taps or new taps • Alter the kitchen

PREPARING/COOKING FOOD

•S  it at a table •C  onsider kitchen gadgets including: knife with a thick handle; chopping board with spikes; pan handle holder; teapot tipper; lid gripper

• Use a food processor • Purchase a perching/high stool • Buy a trolley • Raise/lower work surface • Make space under worktop for your knees when sitting

MOVING AROUND THE KITCHEN

• Re-organise the furniture

• Review mobility equipment used • Adapt the kitchen

EATING AND DRINKING

•U  se large handled cutlery •U  se a non-slip mat •U  se a lightweight cup/mug •U  se a cup with two handles • Contact the local authority regarding an assessment of needs

• Buy a trolley • Consider home support for meal times

LAUNDRY/IRONING

• Install a wall-fixed ironing board

• Raise/lower the washing machine

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In the bathroom

Grab rail

Shower board

Tap turners

Toilet seat and support frame

Long-handled sponges

Raised toilet seat

WHAT IS DIFFICULT?

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

WASHING HANDS, FACE AND BODY

• Install tap turners • Buy a long-handled sponge • Purchase a flannel strap • Contact the local authority regarding an assessment of needs

• Install lever taps or new taps • Purchase a stool • Raise or lower basin • Consider home support

HAVING A BATH

• Purchase a non-slip mat • Buy a long-handled sponge • Use a half-step • Install grab rails • Use a bath board or bath seat

• Install a bath lift • Use a hoist • Replace the bath with a shower • Convert to a wet room • Consider home support

DRYING YOURSELF

• Use a non-slip mat • Purchase a towelling gown

• Change the floor covering • Purchase a hot air body dryer

USING THE TOILET

• Install a raised toilet seat • Use a combined toilet seat and support frame • Install a flush lever extension • Contact the local authority regarding an assessment of needs

• Review mobility equipment • Consider home support

CLEANING TEETH

• Purchase a toothbrush gripper • Buy an electric toothbrush • Use a stool

HAVING A SHOWER

• Have a strip wash • Use non-slip mats • Purchase a half-step • Contact the local authority regarding an assessment of needs

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• Use a shower board • Use a shower chair or stool • Replace shower controls • Consider home support

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Choosing care Making the right choice about the future care of anyone is rarely straightforward and is likely to be even more challenging when the person in question is dear to your heart. An already difficult process may become more complicated by the fact that the work of finding out what is needed, and then exploring the options available, often happens at a time of crisis – after illness or a stay in hospital, or during a period of bereavement.

Whatever the catalyst for the need for care, emotions may be running high with sorrow, guilt, anger or resentment coming to the fore because of recent – possibly sudden and dramatic – changes. You may find that your family also has competing opinions on what is needed, or is seen to be most convenient. Even if your loved one has accepted that they can no longer manage without some help, this does not mean that the process of selecting and engaging a service will be plain sailing. They may perceive different benefits and drawbacks to any plans that you – or others concerned for their wellbeing – put before them. Time spent responding to worries expressed at that time may appear to slow things down, but in the interest of making good and sustainable decisions you should resist the temptation to rush this stage.

Planning ahead Most big things you do in life work out so much better if you plan ahead. Most of us are quite good at doing this – whether it’s saving for a pension, moving house or even just planning our next holiday. We go into research mode, ask a lot of people for advice, and finally make a choice based on sound evidence. But somehow, planning ahead for our health and care as we become older

seems to be a different matter. While we’re good at talking about money, holidays and houses, few of us are as good at thinking about the implications of getting older. Our loved ones don’t want to admit to their mortality – nor do we – and none of us want to talk about it. We all just hope that if we ignore it, the problem will go away.

“Most big things you do in life work out so much better if you plan ahead.” As we move into our 50s and 60s, our thoughts may turn more frequently to our, by now, elderly and increasingly vulnerable parents. Maybe one of them has been seriously ill, or has passed away, leaving their partner suddenly alone and vulnerable. Or perhaps it’s your partner who is requiring more and more support from you, which you’re finding difficult to provide yourself. For some, it will come as a sudden change, a heart attack or stroke perhaps, and you’re forced into a caring position without having time to consider your options. For others, it can be a long process that goes unnoticed until you speak up or reach crisis point. This is all the more reason to put

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27


appropriate plans in place. For example, making sure your loved one has an upto-date will is a good start. Also strongly recommended is looking into a lasting power of attorney. These are both covered in more detail in the chapter starting on page 87. It is always a good idea to sit down, have a proper conversation and address some key questions together, whether this is between you and your loved one or the whole family. For example: • Where is the best and most appropriate environment for your loved one to live? •  How will they be cared for in due

course, as and when the need arises? •  How will it all be paid for? •  Does your loved one have sufficient

income and assets to cover all eventualities? •  Will they need financial support – either

from family or the state? Emotionally, these are all difficult subjects to broach, and most people will feel some guilt at raising them. This is normal, but you may be surprised by how much better both you and your loved one feel after you’ve discussed matters fully and openly.

So where to begin? Let’s assume you are able to start the whole planning and preparation process at an early stage. Your loved one may still be moderately fit, but is noticing age-related symptoms, such as arthritis, sore knees or impaired eyesight. Maybe they’re still living in the family home, a big house with a sizable garden. This alone can be a stimulus to think about putting services in place or moving to somewhere more manageable, either of which could help them maintain their independence for longer.

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Home care For many people, remaining in their own home is a key priority and home care, or ‘domiciliary care’, is a good option here. The reasons for choosing to have care at home can vary significantly. If your loved one has been in hospital, they may find they need some extra help at home while they recuperate, or a longterm condition or disability may mean that they are no longer able to manage without some support. The level of home care can be tailored to meet individual needs – from, say, two visits per week, to several visits a day, through to 24-hour live-in care. Services available include: • Help getting in and out of bed. • Meal preparation. • Help with taking medicines. • Assistance with bathing and dressing. • Help doing the shopping. • Keeping your loved one company. Home care can be sourced privately or via your loved one’s local adult social care department, if their income and assets are sufficiently low to qualify (see page 81 for information on paying for care). Home care providers can range from a single self-employed person through to national chains with local centres, employing a number of care workers. All providers of home care, however big or small, are subject to inspection and regulation by the Care Quality Commission and you are strongly advised to look at the reports and ratings of agencies before making your choice. All registered providers, their reports and ratings can be found at: www.cqc.org.uk

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Moving out of the family home If you and your loved one have decided that a move is the best option, the first question is usually whether it should be in the same general location or somewhere new. If your loved one has friends in the area, it often makes sense not to move too far away. But if they are starting to need a significant amount of care and/or regular visits from close relatives, who may live some distance away, it may just be more practical to move closer to family. Remember to keep in mind what your relative wants, and don’t just choose the option that is most convenient for you. Once you’ve discussed with them where they would like to move to, there’s a variety of options as to the type of accommodation and the level of support they may need. For help with establishing what sort of support might be best for your loved one, ask your local authority for an assessment of their needs, as mentioned on page 11. This is free and is often an extremely useful exercise, even if you know that you will be funding the care yourselves. The assessment may help you all to identify the areas your loved one most needs help with, and give you a general idea of what level of support they may need.

Housing with care There are different types of housing with care, offering different levels of support. These range from retirement villages, offering somewhere to live, with communal areas and maybe lowlevel support, to sheltered and extra care housing, which offer the same community living concept as retirement

housing, but with domiciliary care available too. Schemes may have local shops and restaurants and sometimes leisure facilities such as swimming pools. Properties are generally sold on a leasehold basis, although some schemes may offer the opportunity to buy the property. Housing with care schemes can offer a better quality of life than staying in the family home, as they give residents a network of people they can see and socialise with every day, whilst providing access to care services if required. ‘Close care’ schemes are built to contain all levels of care and support on one site, from home care to residential care. This type of accommodation can be particularly suitable for couples, where one person has a higher level of support need than the other.

Care homes with or without nursing care A care home will provide personal care, including help getting in and out of bed, help with washing and dressing, and support at mealtimes if required. They are staffed by care workers who are trained in moving and handling amongst other things. Care homes with nursing, on the other hand, have trained nurses on-site, who are qualified to provide medical support. While it’s perfectly possible to receive nursing care at home, it may be more difficult to provide in practice, or your loved one’s needs may mean they require more attention than can be given at home. Care homes provide people with their own room, often with an en-suite bathroom and maybe a small kitchen

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29


area, so they can have as much privacy as they like. When they feel like it, they can move around the home, chatting to people, relaxing in the sitting room or garden, or partake in activities that may be provided each day. Some care homes also specialise in the support of people who are living with dementia or other conditions. There are some 20,000 care homes to choose from across the UK. The majority are privately owned and range from a single home managed by the owner, to national operators that own several hundred homes all over the county. Others are owned and operated by voluntary or not-for-profit organisations, as well as local authorities. Their décor varies, from converted older buildings through to brand new, state of the art, purpose-built properties. The following things are important when considering a care home: • First impressions as you approach the entrance. • First impressions when you enter the building. • Is there a good atmosphere or feeling about the place? • Do you and your loved one like the home’s manager? • Are the staff friendly and welcoming? • Do residents look like they’re being treated well and with dignity? Ultimately, what matters is the quality of care and whether it can fulfil your loved one’s needs.

Care plans An important question to ask any care provider is: does every individual have a care plan? Everyone receiving care at home or in a care home should have an individual plan outlining how those

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providing the service will go about meeting their needs. The plan should be reviewed regularly by all parties and be updated to take account of any changes in circumstance. Care plans must take into account your relative's personal likes and dislikes, not just their specific needs.

Quality standards All care providers must be registered with the Care Quality Commission (CQC), the regulatory body which is responsible for checking that essential standards of quality and safety are being met. All services are inspected regularly by the CQC, which reports on its findings and gives each provider a quality rating. Following an inspection, the CQC’s report provides ratings of: Outstanding, Good, Requires Improvement, or Inadequate for each of the following categories: Safe – from abuse and avoidable harm. Effective – for care, treatment and support to maintain quality of life. Caring – being treated with compassion, kindness, dignity and respect. Responsive to people’s needs – in terms of organisation of services to meet people’s needs. Well-led – to ensure provision of high quality care based on individual needs. You can view the reports and ratings of every provider in the country at: www.cqc.org.uk It is commonly reported that Good and Outstanding care providers have Good or Outstanding managers. Asking how long the manager has been in post and their approach to managing the home or agency will give you a feeling of how the organisation is run.

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CARE HOMES FOR LOVED ONES Excellence in residential, day, respite, nursing, dementia & younger disabled care With over 30 years experience we have continued to grow with our dedicated team in understanding the needs of our residents. We ensure that you can begin a new chapter in your life. We also take care of your wellbeing, and help you feel part of something special. Contact us: Derbyshire Tel: 0845 602 2059 Nottinghamshire Tel: 01623 441 130 Web: www.ashmere.co.uk

DEMENTIA STANDARDS

AWARD DERBYSHIRE County Council

Improving life for local people

Codnor Park: 88 Glass House Hill, Codnor, DE5 9QT The Firs: 90 Glass House Hill, Codnor, DE5 9QT Smalley Hall: Main Road, Smalley, DE7 6DS King William: Lowes Hill, Ripley, DE5 3DW

Valley Lodge: Bakewell Road, Matlock, DE4 3BN Kidsley Grange: 160 Heanor Road, Smalley, DE7 6DX West Hallam: Newdigate Street, West Hallam, Ilkeston DE7 6GZ Sutton Court, Lodge & Manor: Sutton-in-Ashfield NG17 2AH

Bupa care homes

For a choice of elderly care options If you’re considering long or short term care for an elderly loved one, a warm, welcoming place close to family and friends means a lot. That’s why our choice of care homes across the UK could be something for you to think about. And, you don’t need to be a Bupa customer to stay with us. To find out more, call our free Elderly Care Support Line seven days a week on

0808 252 7969 For training and quality purposes, we may record or monitor calls.

For Living

Q217579 MAY17 BPR 02131

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10 top tips for choosing care 1. Start talking to your loved one now, if possible – before their needs increase. 2. P  lan ahead. Learn as much as you can about all the options. 3. S  peak to organisations like Age UK and Alzheimer’s Society and ask their advice – they are extremely knowledgeable and helpful. 4. S  peak to people who have already found care for a loved one. 5. F  ind out who will have to pay for the care – your loved one, the state or both. 6. If your loved one needs to pay, arrange to see a financial adviser – it may be easier to afford than you think. 7. If you’re thinking of using a home care agency, find out which ones are in your area, check their inspection reports and speak to

each one, using the checklist on page 42. 8. Do the same if you’re considering a care home; make a shortlist, check their inspection reports and arrange to visit them. You may even want to contact an agency that specialises in finding a suitable care home, like Care Home Finder: www.carehomefinder.org 9. If you are planning to visit an accommodation option such as independent living or a care home, use a checklist (see page 57) and don’t forget to take into account ‘gut feelings’ such as the manager’s attitude, general ambience, friendliness etc. 10. Finally, perhaps the best way to find out whether a care provider will be suitable, is to try one out for a few days. Most care homes will encourage you to do this. Check if home care agencies offer this too, either as a trial or with a cooling off period in the contract.

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily • search by location and care need information on care quality • links to inspection reports additional care provider information, photos and direct website links brochure requests

www.carechoices.co.uk

Developed by the publisher of this Handbook

Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

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Visit www.careselect.co.uk for further assistance with your search for care


Care home or YOUR home? You do have a choice... We are Europe’s largest live-in care provider. Our expert care workers live in your home with you, 24-7 as a companion, a carer and a friend. Get the care you need, want and deserve, in the comfort of your own home. We offer a genuine alternative to residential care homes. Our mission is to give elderly and vulnerable people the opportunity to remain safely in their own homes by providing 24 hour, live-in care. Each carer is recommended based on personality, interests and your overall care needs. Video profiles of our carers provide a personal reflection of their character and experience, ensuring a familiarity from day one, where genuine friendships can blossom. Our carers can give friends and family a break, help you to get back on your feet after a hospital stay or simply be a kind companion to help with day-to-day tasks such as cooking, cleaning and shopping. We also offer care packages for more advanced care needs such as Dementia, Stroke, Parkinson’s and Palliative Care. Our bespoke care packages ensure you retain independence and dignity for as long as possible.

Your one-to-one live-in companion/care package starts from just £695pw For more information about our tailored care packages in West Sussex please call Chris on 07836 256 639 or 01243 684 085 Or visit www.promedica24.co.uk/west-sussex

For more information about our tailored care packages in Brighton and Mid Sussex please call Lesley on 07388 326 686 or 01273 257 465 or visit www.promedica24.co.uk/brighton

The Home Care Specialists

If you are looking for extra support at home or an alternative to residential care homes, then we’re here to help. Helping Hands has been providing award-winning quality home care since 1989.

Do you need a Helping Hand? To find out how we can help Freephone: 0808 223 0975 Visit: www.helpinghands.co.uk

We are a family run company with over 28 years’ of experience to offer. Our one to one home care enables you or your loved one to remain at home with compassion and dignity. We can provide help around the home, assistance with shopping, support with personal care, a hospital discharge or even a break for an existing carer. Our local carers are here to help.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Care and support at home With so many negative stories in the press surrounding care, it’s no surprise that families can be uncertain about the practice of finding safe care. Whilst the realisation that your loved one needs extra help may feel hard for them to accept, receiving care and support in their own home can actually be a positive step towards more confident living, all whilst still being surrounded by the comforts of their own home.

It may feel like there is a lot of information to digest when you start to look into the different types of care and support available at home. This is because there is a lot to consider initially. However, once you have sat down with your relative and pinpointed the exact things they need help with, this should help steer you in the direction of the right choice. Placing the impetus on companionship and flexibility should be a key aspect of a provider’s approach to support. For example, it is important that the care worker themselves know everything there is to know about your loved one. What do they like to eat for breakfast? What are their hobbies? When do they like to go to bed? These are the seemingly small details which make the biggest difference to the wellbeing and comfort of the person receiving care.

What types of home support are there? Home help If your loved one just needs some extra support around the home, home help could be a good option. Home help typically provides assistance with things such as: • C  ooking, shopping or light gardening. • H  elp with pet care, such as taking the

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dog for a walk. • C  ompanionship and help with getting to and from social activities or doctors’ appointments. • S  mall DIY jobs such as changing light bulbs or putting up shelves. Home help doesn’t include personal care or help with moving around, as these are more specialist tasks. If this is what your loved one requires, you may want to consider home care.

Home care Also known as domiciliary care or care at home, home care involves trained staff going into your loved one’s home and assisting them with personal care tasks. These can include: • H  elp with morning and evening routines; showering or bathing and getting dressed or ready for bed. • P  reparation of meals and help with eating these meals, if needed. • H  elp to remember important tasks, such as taking medicine. • H  elp moving around the home – this will usually involve the use of hoists and specialist handling. Home care workers will not usually provide the same ‘housework’ type services as home help.

Visit www.careselect.co.uk for further assistance with your search for care


“I truly do not know what I would have done without your caring support and assistance and wish you all the best for the future.� Mrs R, Customer, Bluebird Care

Bluebird Care Care & support in your home Bluebird Care is your alternative to residential care. We can help you remain in your own home while enjoying a fulfilling life with dignity and enjoyment. We can help you with personal care, shopping, cleaning, social visits and round the clock live in care. Our care assistants are supported and trained to exceptional standards, we are experts at providing compassionate care. Elmbridge & Runnymede 01932 567 593 elmbridge@bluebirdcare.co.uk Guildford & Waverley 01483 761 000 guildford@bluebirdcare.co.uk

Epsom & Kingston 01372 822 875 epsom@bluebirdcare.co.uk

Reigate 01737 247 111 reigate@bluebirdcare.co.uk For assistance with finding care and support, call Care Select on 0800 389 2077 35 Rushmoor & Surrey Heath 01276 683 577 rushmoor@bluebirdcare.co.uk


Depending on their needs, trained care workers can visit your loved one a few times a week or come every day. The length of their visits can vary depending on what they need to do. However much, or little, help your loved one decides they need, it is important to establish a routine. Visits should be arranged between the agency, your loved one, you and anybody else who can advise on their care needs. These conversations will lead to a care plan being drafted so that everyone involved is clear on what will happen on a daily basis. Home care can also be arranged to provide short breaks for you. You can arrange this for a regular weekly basis or as and when you feel you need to. Commonly, home care services are available from 7am until 10pm; outside these times, services may be available by special arrangement. There is also the option of night-sitting, which can be helpful if your loved one has difficulty sleeping or needs to get up multiple times in the night.

The costs of these services vary depending on the type of support your relative needs, the time of the visits and the location of your loved one’s home. Remember to ask for a written breakdown of all costs and ask if these are reviewed annually before signing any contracts.

“Trained care workers can visit your loved one a few times a week or come every day.” Home care agencies have a responsibility to vet their staff by checking their references and carrying out Disclosure and Barring Service (DBS) checks before they are employed. These have replaced CRB checks. You should also look at the Care Quality Commission’s report and rating of the agency and see if you can speak to the service’s other clients.

Employing your own staff Whilst home care agencies can take away the burden of being an employer, you or your relative may prefer to be directly responsible for the staff coming in and out of their home. Care assistants or personal assistants (PAs) can be a great option to helping someone live independently in their own home, but, depending on how you find your PA, you may become an employer

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and take on all the responsibilities that come with it. If you are looking at employing staff, there is a number of factors to consider. First off, you can choose to use an agency or recruit a PA directly. You may also consider taking on a selfemployed PA. However, be aware that few PAs are legitimately considered self-employed and if you get this wrong you could be liable for fines and paying tax retrospectively.

Visit www.careselect.co.uk for further assistance with your search for care


Employing your own staff continued Although it may sound daunting, the benefits of having domestic assistance in the home can far outweigh any initial fears or uncertainty. Everyone has the option of employing their own staff if this is what they would prefer.

Advantages of employing directly An advantage of employing directly is that it gives you the option to choose somebody who is a good fit for your parent, perhaps even somebody they know personally. You will also have direct control over their hours and duties, whereas agency staff may need to fit your loved one around other customers if they do not need somebody full-time. Furthermore, you can negotiate salary with your employee rather than paying an agency’s set fee.

Responsibilities of being an employer Employing a care assistant or PA directly involves taking on various responsibilities. Employers have a duty of care towards employee(s) and a host of legal obligations. • T  he employee must be provided with a Contract of Employment. • W  hoever is the employer, you or your relative, you must register as an employer with HM Revenue and Customs (HMRC) and pay the National Minimum Wage or National Living Wage, depending on the employee’s age. You must provide your employee with

payslips and pay any liabilities to HMRC. All of this is encompassed in Payroll. • Y  ou must make a pension scheme available to them. This is the law for all employers, even if you only employ one person. • You will need to have Employer’s Liability Insurance, which may be included in your home insurance or available as an add-on from your home insurance provider.  s a safeguard, it is recommended • A that any potential employees have a current Disclosure and Barring Service (DBS) check before being employed in the home.

Help available to employers If recruiting staff is the best option, you may want to use a payroll company. A good, specialist domestic payroll company will do the following: • Issue a Contract of Employment. • R  egister you as an employer with HMRC. • C  alculate how much the employee should be paid. • Provide payslips. • T  ell you how much tax and National Insurance needs to be paid and how to pay it. • Help with getting DBS checks.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Live-in care If your loved one has complex needs, requiring care at all times, but would like to remain living in their own home, 24hour live-in care may be suitable. Live-in care can be a useful service to offer short-term respite if you want to have a holiday or just need a break. Live-in care can also be considered if, for example, hospital discharge relies

on having the right care and support in place in your loved one’s home. In this regard, a live-in carer would help with recuperation and rehabilitation whilst working alongside professionals in the community, but this may only be for a limited period. Live-in care can also be arranged on a permanent basis, although you may also want to consider a care home if this is required.

The right care for Joan After Joan experienced a fall, her daughter Amanda arranged for her to recover in a care home, though she felt that her mother would be much happier at home. After approaching home care agency, Helping Hands and explaining what her mother required, the agency worked closely with Amanda and Joan to find a live-in carer who would make a significant difference to Joan’s life. They looked to implement a tailored care programme that would allow Joan to have the lifestyle she wanted, including days out with her live-in carer. ‘Mum had been struggling at home for a couple of years,’ Amanda said. ‘Her health was deteriorating and she wasn’t eating or drinking properly. Care workers came in during the day and for a night-time tuck-in and she had an emergency button to press should she need help. It was a

Choosing the right service A good home care provider will be on hand from the start, to arm families with as much information as possible about what home care involves. It will

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constant worry to all the family as to whether she was OK. I often tried to call her during the evening and the phone would be engaged – she had forgotten to put it back on the hook properly. My stress levels spiked. ‘Mum’s and our family’s lives were transformed when she came home from the care home and her first live-in carer joined her. It wasn’t an easy decision opting for live-in care – we didn’t know whether it would work, however Mum knew that if she didn’t have full-time home care she couldn’t return home. We now no longer worry. She’s eating better than she has in years and has put on weight. It’s a relief that’s for sure. In reality what first felt like an impossibility for my mum has now resulted in her having a better life than we could have possibly hoped for.’

do everything it can to put your mind at ease, whilst looking to arrange the solution which suits the individual. It should be about ensuring that the care is tailored perfectly to your loved one. Make sure you contact several

Visit www.careselect.co.uk for further assistance with your search for care


enquiries@harlestonehomecare.co.uk Main Office : 01604 419600 Fax : 01604 419604

An exclusive family run business, catering for private clients across Northamptonshire. At Harlestone Home Care our key purpose is to deliver reassuring, compassionate and supportive care and companionship. Harlestone Home Care enables the people we work with to maintain individuality and independence in their own home. All services are tailored to suit the wants and needs of each person that we work with providing an individual package bespoke to their needs. We are able to provide home care to anyone over the age of 18 though most of our clients are over 65. We specialise in Dementia care. Our staff are hand-picked and receive thorough in-depth training in order to provide the highest quality service. No matter how small or complex your needs, we have a service that suits you. l

Our services include: Personal Care l Dementia Care l Friendship l Home Help l Medication Assistance

www.harlestonehomecare.co.uk

Monthly A lzheimer’s Support Evenings

Cheriton H o m e c a r e

The Staffordshire Charity making ☎ 01273 273 277 a difference to local people

Cheriton H o m e c a r e

www.cheritonhomecare.co.uk info@cheritonhomecare.co.uk

Specialist Live-in care warm welcome awaits Carers and their cared for provider Afor at any of the following MASE Groups Sussex and Cannock-Drop In • Haughton • Rugeley Surrey Stafford • Hednesford

Choose to maintain your independence Friendly at home Volunteers • Advice & Support Carers Forming Friendships • Information Leaflets Buffet & Refreshments • Entertainment Project Co-ordinators

Daphne: 01785 211140 • Elaine: 01785 823110

www.themasegroup.com Registered Charity No: 1137193 The Monthly Alzheimer’s Support Evening Limited (MASE)

Maintaining your independence at home is an affordable alternative to a care home. We will support you so you can continue living in your own home, surrounded by your family and friends. For free, confidential and professional advice, contact us:

☎ 01273 273 277 www.cheritonhomecare.co.uk info@cheritonhomecare.co.uk

For assistance with finding care and support, call Care Select on 0800 389 2077

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different providers that could help support your relative. Don’t just go for the first company you come across. Though it may feel like a lot of work, doing your research will help to ensure that the settling in period feels smoother and eventually confirm to you that the type of support you have chosen is the right one. Speak to your relative about what they feel the right fit for them would be. Always consider that the role care staff take on is a very personal and sometimes intimate one, so make sure your relative plays a central role in the decision and feels comfortable with the people supporting them. There is no one-size-fits-all approach to care. Everyone has unique needs and their own daily routine and the care they receive should be tailored to their characteristics. This even includes finding a care worker who has the right combination of experience and personality, so that your loved one has a companion as well as someone to help care for them. A clear care plan is essential to set out your loved one’s specific needs and ensure they are fully supported. If your relative doesn’t agree that they need support, this may prove difficult. It may be that you’ll need to have a couple of meetings with the agency’s manager to discuss needs or look to an external adviser to help with the process. If your relative has had a care needs assessment from their local authority, this will form a good starting point for conversations with any care agencies. When you do speak with agencies, you should request a ‘Service User’s Guide’, which you can take away and read in your own time; ask to see a copy of their most recent inspection report and quality rating. This information is also available from the Care Quality Commission at: www.cqc.org.uk or via

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the care search option linked to the Care Select website: www.careselect.co.uk

Finding care options in your area Care Select’s publisher offers a telephone and website service allowing you to search by postcode or region for care providers that meet your requirements across the country. Your search can be sent to you by post or email, or discussed with you over the telephone. If you are searching online, the results can be saved and emailed to others. Visit: www.carechoices.co.uk You can also view an electronic version of Care Select on the dedicated website and have it read to you by using the ‘Browsealoud’ function. Visit: www.careselect. co.uk or call 0800 389 2077 to start your search for care and support.

Careful consideration Support at home is a natural first step when someone starts to need formal support from trained care workers. However, it’s important you consider that your loved one’s needs are likely to change and develop over time. They might currently require assistance with getting out of bed, but they could later need support with washing or dressing. Their care plan should be reviewed to ensure all their needs are met, but be aware that you may need to think about increasing the amount of in-home care or look into a housing with care scheme or care home in the future.

Visit www.careselect.co.uk for further assistance with your search for care


Loud and clear

Hearing loss doesn’t have to be a problem with the right advice and hearing aid

THE ABILITY to hear is something we can take for granted, so when it gets worse it can affect our confidence. Quite often hearing loss is gradual and it might take years before it is an issue. This was the case with Richard Phillips. “It was four or five years before I thought about a hearing aid,” he says. “I was missing parts of sentences, clarity of sound and I had trouble with background noise. I felt very isolated.

“The hearing aids have made a huge difference to my life. I didn’t realise how much my hearing loss was limiting me. “My advice to someone experiencing hearing loss and considering getting an Age UK hearing aid is, stop thinking about it and just do it!”

“I contacted UK Hearing Care, the provider of Age UK Hearing Aids because I didn’t have much success with my first hearing aid. I made an enquiry and Mumtaz, an audiologist, arrived within a week. She carried out lots of tests and showed me the hearing aids I could buy.

“ I can now go into a shop and hold a conversation.”

“After another week, she came back with my new hearing aids. The first thing I noticed when I put them on was how different and amazing the sound was.

Richard Phillips’ new hearing aids have made a huge difference to his daily life

All you need for better hearing The service from UK Hearing Care provides a clear and effective approach to testing for hearing difficulties, which helps make choosing a suitable hearing aid easier. The free, no-obligation hearing assessment can take place in the comfort of your own home or at a location close to you.

Buying this product supports Age UK’s charitable work.

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Freephone 0808 252 7691 or visit www.ageukhearingaids.co.uk Age UK Hearing Aids is provided by UK Hearing Care working in association with Age UK Trading CIC Age UK Hearing Aids is a trading name of UK Hearing Care Management Services Ltd (UKHCMS) working in association with Age UK Trading CIC. Age UK Trading CIC is a trading subsidiary of Age UK which donates its net profits to Age UK. UKHCMS will aim to raise a minimum of £420,000 during 2016/17 for Age UK (charity number 1128267) through the promotion and sale of hearing aids. Age UK Trading is registered in England and Wales, number 01102972. Registered office: Tavis House, 1-6 Tavistock Square, London, WC1H 9NA.

Send this coupon Freepost to: FREEPOST RTXH-BGAZ-SCGR, UK Hearing Care, 103 Dalton Avenue, Birchwood Park, Birchwood, Warrington, WA3 6YF Send me a hearing advice guide

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Keep in touch with Age UK: Age UK would like to let you know about the vital work they do for older people, their fundraising appeals and opportunities to support them, as well as products and services you can buy. They will never sell your data and promise to keep your details safe and secure. Tick the boxes if you’d like to hear from Age UK by: telephone SMS/text. Tick this box if you do not wish to receive post You can change your mind at any time by contacting Age UK by email: contact@ageuk.org.uk or telephone on 0800 169 87 87. “Age UK”, includes the charity, its charitable and trading subsidiaries, and national charities (Age Cymru, Age Scotland and Age NI). For further details on how your data is used and stored: www.ageuk.org.uk/help/privacy-policy. UK Hearing Care will only use your details to provide you with the service or information you have requested. CC0517


Choosing a home care agency checklist Quality rating*

Agency 1 

£

p/w



Agency 2 

£

p/w



Agency 3 

£

p/w



We suggest that you have paper with you when speaking with home care agencies so you can make notes.

Accommodating your needs

About the agency How long has the agency been operating?



How long are staff allocated  per visit?

Does the agency have a training scheme in place? 



Can you contact the agency in an emergency or outside  office hours?

Are all staff trained to a certain level?



Does the agency have experience with your specific needs?

Are staff able to help with administering medication if required?





Staff Are you likely to be visited by different staff each day?  Are all staff checked with the Disclosure and Barring Service?

Is there a way for staff to communicate with each other about the support they provide when they  visit you? How?

Regulation



Will you be notified in advance if your care worker is on  holiday or sick? Are staff matched to you specifically, based on your needs and  preferences? © Care Choices Ltd 2017

Can the agency accommodate your needs if they increase? Ask about the process for this. 

Can you meet your care worker(s) before they start?  Does the agency have both  male and female staff?

Can you see the agency’s contract terms?



Can you lodge a complaint easily?



Are complaints dealt with quickly?



Will your support plan be reviewed at regular intervals?



Can you see a copy of the agency’s CQC registration certificate  and quality rating? *See page 30.

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Visit www.careselect.co.uk for further assistance with your search for care


We provide care at home and support your loved one in the place they love. Elderly care • Dementia care • Post-discharge care • Private nursing • Palliative care • Respite care Household help • Personal care and hygiene • Medication prompting • Companionship and personal assistance

Our experienced carers undergo a rigorous vetting and training process to ensure you receive the best quality care

Our real-time, digitalised reports offer complete transparency on the care delivered

Call us on 020

To handle any queries, each client has a dedicated Cera care manager available all day, every day

We can coordinate home services, ranging from healthcare professionals to meal delivery to transport assistance

3034 4737, we are available 7 days a week. www.ceracare.co.uk info@joincera.com


Specialist housing with care schemes Housing with care schemes are on the rise in the UK and there’s good reason for this. If your loved one is lonely or isolated at home but doesn’t necessarily require the level of support that a care home might offer, a housing with care scheme could be the solution. These offer a mid-ground for people with care and support needs, with a combination of support services and independent living. This can promote wellbeing, giving people back an independence they may have feared lost.

Who would use housing with care? There are so many different types of housing with care, offering all levels of support for various needs. Some schemes will be more suited to people with lower care and support needs while others can cater for people with more complex needs requiring high levels of support. Usually, schemes are aimed at people over the age of 55, but some will accommodate younger people with support needs as well.

“Housing with care schemes offer a midground for people with care and support needs.” Typically, your loved one will rent a property on the site (although some schemes offer the properties for sale, too) and will have their care and support services provided by a contracted company. A scheme manager may be based on- or off-site and a 24-hour emergency response service could be available through a community alarm system. Your loved one will have their

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own home but can access services such as meals on wheels and domiciliary care. Most schemes will have communal areas, for example a lounge, and many will also have other facilities. These can vary, from a laundry service to a hairdresser. The amount of support your loved one receives in a housing with care scheme can change, depending on their level of needs. For example, if your loved one’s needs increase, they can arrange to have more support.

Different forms of housing with care Housing with care is a catch-all term. Usually, one type of scheme is not considered ‘better’ than another, as the best one for you and your family will be influenced by your loved one’s needs, plus the options available in the local area. Listed here are the most common types of housing with care.

Sheltered housing Sheltered housing schemes, sometimes referred to as retirement housing or assisted living, are generally owned, run and maintained by local authorities or housing associations. Properties are self-contained and easy to manage,

Visit www.careselect.co.uk for further assistance with your search for care


ranging from simple bedsits to flats and small houses, and are paid for on a rental basis. Many schemes have communal areas, such as a lounge and garden, where tenants can socialise. Residents are usually expected to be able to look after themselves. A scheme manager is either based at the site or visits regularly. Many sheltered housing schemes also have communal lounges, laundry facilities, lifts, door entry systems and speciallyadapted facilities. There may also be a communal garden.

Extra care housing Extra care housing schemes typically provide a greater level of access for older people, with a home care service and personal care element being available. In addition, meals may

be provided and a communal dining room may provide an opportunity for social interaction. Some schemes may also have restaurants or hairdressers on-site. Extra care housing allows your loved one to live independently, in their own self-contained accommodation whilst still having their care and support needs met by a designated team of workers. This may include a night time on-site member of staff who can be available in an emergency. This makes it popular with people who are unable to live independently in traditional housing but still don’t want or need to move into a care home. ‘Very sheltered housing’ is another term used for this type of housing.

www.carechoices.co.uk

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily search by location and care need information on care quality links to inspection reports

• additional care provider information, photos and direct website links • brochure requests

Developed by the publisher of this Handbook Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Retirement villages Retirement villages tend to be larger developments than other schemes. This means that there can be a wider range of services, catering for a larger variety of needs. Your loved one may be able to buy or rent their property or have it on a shared ownership basis. Retirement villages can offer your loved one a combination of independence and security, as well as an active social life, even if they have a higher level of support needs.

do you like the scheme because of the facilities it offers or because of the style of the housing? Consider the following when you are looking at choosing a scheme:

Location – It’s really important to consider the location of any scheme that you are looking at. You may want to make sure that your loved one is close enough to local amenities – if they regularly attend church, is there one nearby? What is the local public transport like?

Close care Close care schemes are built to contain all levels of care and support. They are usually built around, or linked to, a care home. The idea is to move to close care when you or your loved one requires a bit of support, and then as symptoms progress or needs increase, more care is available within the same scheme. If the time comes when a care home is needed, your loved one can move into the care home on-site, which they may already be familiar with from attending day services there, for example. This type of accommodation can be particularly suitable for couples, where one person has a higher level of support need than the other; it allows couples to remain near to each other and can make visiting easier. It’s important to check how much support is available on the site, as this can differ from scheme to scheme.

Cost – Make sure that you weigh up the cost against the suitability of the services on offer. The cost is likely to be determined by the level of support that your loved one requires. Tenure – If your loved one would like to buy their home, is this available as an option? Are they able to rent or part-buy it? If they are renting, it is important to consider the terms of the contract and what you might do if your loved one suddenly needs to move into residential care. Size – The size of a scheme will vary. Make sure your loved one considers the number of other people who are likely to be around – would they prefer to be in a large scheme, which is likely to have more amenities, or would they prefer a smaller atmosphere?

Making the right choice There are so many considerations when choosing a housing with care scheme, as they are all so different. It may be useful to think about what you do and don’t like about particular schemes, for example,

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“Consider asking the manager whether your loved one would be able to come for a trial stay.”

Visit www.careselect.co.uk for further assistance with your search for care


If you find a scheme that you and your loved one both like and think would be suitable, you may like to consider asking the manager whether your loved one would be able to come for a trial stay. This would give your loved one a

good idea of whether they might like to live there for the foreseeable future and whether the scheme is appropriate for their needs. It will also give you the opportunity to see whether it would be a viable solution for you too.

To purchase or rent? Purchase

Market rent

If the chosen scheme offers the option to purchase a home, your loved one may want to use the money from the sale of their house to buy a property on the scheme.

Your loved one would rent their property from its owner at a fixed price.

Shared ownership This is where your loved one purchases part of the property and the rest is owned by the developer, housing association, local authority or managing company. You will need to speak to the scheme manager if you are considering this as an option as it will work differently at different schemes.

One size doesn’t fit all Whilst housing with care can be the perfect solution for many, it is important to ensure that it is the right fit for your loved one. You will need to carefully consider their needs and whether these can be met by the services available in the scheme. Think about the long-term too – what needs will your loved one have in a

Social rent This is generally only offered to ex-tenants of local authority or social housing who do not have sufficient funds to purchase, part-purchase or rent their property themselves. In this instance, the rent is subsidised by benefits. Options vary from site to site, so it is important to ask about what may be available at the sites you are considering. You should also get specialist advice to help you with the decision.

year or two years’ time? It goes without saying that you and your loved one should visit more than one scheme so that you can make an informed decision. You should also carefully consider other options as well as housing with care. This way, you can be sure that your loved one will be safe in an environment they like and where their needs will be met.

For assistance with finding care and support, call Care Select on 0800 389 2077

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Residential care options The move from a person’s own home to the shared environment of a care home is a major life transition and, while it can come with a range of emotions, it can be a positive move that brings great benefits: helping people to enjoy more independent and fulfilling lives, whilst making sure help is at hand when needed.

Care homes can offer a real community spirit, where people can interact with fellow residents, family and friends and enjoy an active social life based on their interests and hobbies.

Role reversal Finding a care home for your loved one can be a very challenging time. It may be that your parent, who has always looked after you, now needs you to look after them. That, in itself, requires adjustment, as it may seem like a complete role reversal. Alternatively, you may be looking for care for your partner, which can feel strange and intrusive when they have always looked after themselves. You may feel that your loved one should move in with you so that you can care for them yourself. For many, this just isn’t feasible; your property may not be suitable, the family semantics may make it impractical, you may be working full-time, or lead such busy lives that you do not feel equipped to become a full-time carer. You may have already tried offering care to your loved one and have been rejected. They may be too proud or embarrassed to accept care from a family member or consider themselves too independent. Many of us may feel guilty if we reach the conclusion that our parents can’t continue to be looked after in their own home, especially if long distances are involved and you can’t keep an eye on the care provided at home.

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Sometimes, the best thing you can do for your loved one is help to find an appropriate care setting when the time arrives. My Home Life supports good care in care homes, and contains lots of useful information: www.myhomelife.org.uk

What’s available? Care homes are generally split into those offering personal care only and those offering nursing care.

Personal care only Care homes that provide personal care only are a good option for people who need someone to look after them 24-hours a day, but don’t need nursing care. Personal care includes bathing, eating, dressing and help with moving.

Care homes with nursing A care home with nursing provides the same support as a care home, but with 24-hour nursing staff on hand. The staff can dispense medication, carry out treatments and can care for people with complex nursing needs. Care homes with nursing are generally more expensive than care homes because the residents’ needs are usually more complex.

Care complexes It is not unusual for larger homes to offer a range of different care, so that if someone moves to a care home for support with

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personal care and later develops dementia or a condition which requires nursing care, they can remain in the same home, but perhaps move from one unit or wing to another as their needs change. This is worth bearing in mind if your loved one needs personal care now but may need nursing care in the future, as it would mean they could remain in the same home. Most care homes and many care homes with nursing will have activities for the residents to take part in. These can vary based on the needs and interests of the residents and may include games, TV or film shows, concerts, sing songs, or excursions to local places of interest, depending on the home. Many homes also have gardens and patios where you can sit out in the sun. You may find homes that offer their residents the opportunity to join in with housework if they want to, like laying the table for a meal, or folding laundry. Within the home, there will be many different members of staff with different roles, some employed full-time, some part-time and maybe some sub-contracted. There should always be a registered manager who is responsible for the overall running of the home. This is the person you can go to if you have any concerns about your loved one’s care or if you want to discuss any changes that may need to be made to the care plan. There may also be: • A deputy manager. • N  ursing staff (if the home offers nursing care). • Care workers. • Staff trained in dementia care. • Activity co-ordinators. • Staff involved in administration, catering, housekeeping and maintenance. • S  upport staff dealing with HR, IT and health and safety issues.

Respite care Some care homes and care homes with nursing will offer short-term care, usually called respite care or a short break, which is a good way of ‘trying before you buy’. This is useful if, for example, someone is uncertain about or resistant to moving into a care home. If a respite stay proves successful, it may be a good opportunity for you and your loved one to re-evaluate their perspective of being in a place where they can be looked after. They may feel that they have become a little isolated at home if they haven’t been able to get out much and mix with other people; a stay in a care home provides readymade company and stimulation.

Time to choose The choice of care environment is down to your loved one’s needs. A particular care home or care home with nursing may be perfect for one person but totally unsuitable for another. It is important to focus on your loved one’s needs and preferences when choosing the right care home. You may favour a modern purpose-built care home with the feel of a 4- or 5-star hotel, because you may be more used to that sort of environment or feel that it is grander. However, your loved one may prefer a smaller, homelier environment with fewer residents and surroundings more like their own home. Prices will vary enormously depending on where you live in the country and the type of care your loved one requires. A newly-built home providing nursing care in the south east of England can cost well over £1,000 per week, whereas a care home in the same area could be as little as £600.

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Respite to the rescue Rosy’s mum, Lesley has complicated health needs, as well as some social care needs. Lesley lived with her husband, Sam, who was looking after her and helping her to wash, go to the toilet and eat. A community nurse was also coming in twice a day to administer Lesley’s medication. Rosy lives two hours away and couldn’t always be there to help her dad look after her mum. She had tried to get her dad to employ a home care worker but he refused, saying he could look after Lesley himself. One evening, Rosy received a call from her dad saying that he couldn’t get her mum out of the bath. Rosy got in the car immediately and rushed to help. When she arrived, she found her dad was seriously unwell with flu. Together, they got Lesley from the bath and comfortably into bed. Rosy sat down with her dad and told

him things couldn’t carry on the way they were. It was evident that caring for Lesley meant that Sam couldn’t take care of himself. In the morning, Rosy made arrangements with a local care home for her mum to spend a week there while her dad recovered. Rosy took a week off work and stayed with her father to help him find a more permanent arrangement. Together they decided that, although it would be hard, it would be best for Lesley to go into a care home permanently. They anticipated Lesley being resistant to this, but the respite care proved to them all that it was what was needed and she agreed. They found a lovely care home nearby with qualified nurses on the staff. Sam visits every day to help Lesley with her lunch and Rosy is much happier knowing that they are both safer and well.

www.carechoices.co.uk

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily search by location and care need information on care quality links to inspection reports

• additional care provider information, photos and direct website links • brochure requests

Developed by the publisher of this Directory Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

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THE ANGELA GRACE NORTHAMPTON’S LUXURY CARE CENTRE We understand how difficult choosing the right care home either for yourself or a loved one can be. Our individual-based approach gives complete peace of mind.

The Angela Grace is a family run care provider located right in the heart of Northampton, opposite the Hospital. The Home is close to shops, amenities and public transport. Providing residential, nursing, specialist dementia care as well as respite and end of life care, it is the latest home from care providers A. G. E. Nursing Homes Ltd, a group who draws on 30 years of experience to provide top quality care.

Facilities include a cinema, hair & beauty salon, reminiscence kitchen, en-suite rooms, conservatory, activities centre and patio garden.

Tel: 01604 633282 l Email: admin@theangelagrace.co.uk Web: www.theangelagrace.co.uk 4-5 Cheyne Walk, Northampton, NN1 5PT Now offering both town centre and village locations. Our sister home Brockfield House – a delightful home in the picturesque village of Stanwick. Specialising in the care of people living with the after effects of long-term mental health problems and those living with dementia.

Brockfield House Nursing Homes Limited Caring Since 1984

Villa Lane, Stanwick, Wellingborough NN9 6QQ Tel: 01933 625555


The dotted line

of the following:

Before making a final decision about a care home, ask to see a copy of the contract. If your relative is funding their own care, offer to go through the contract with them – two pairs of eyes are better than one. Read the contract very carefully, and ask the care provider to explain any clauses that you don’t understand. If you are still unsure about what an element of the contract means, you should consider consulting a solicitor.

• The cost of care, including the notice period for any increases.

“If your relative is funding their own care, offer to go through the contract with them – two pairs of eyes are better than one.” The contract should be written in clear, simple language so that it’s easy to understand. It should avoid the use of complicated legal jargon or confusing, ambiguous terms. Important information should be explained in full up-front, not hidden in the small print. The contract will be between the care home provider and whoever is paying for the care; for example, if your loved one is paying for their own care, the contract will be between them and the care home. Alternatively, if the local authority is paying the full cost of the care, the contract will be between the home and the local authority. If someone pays a top-up fee to the care home (if there is a difference between what the local authority contributes and what the family may pay), there may be two contracts, one with the local authority and one with the person paying the difference. More on top-ups can be found on page 85. A care home contract should cover all

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• Any deposits or advance payments required. • Details of any trial period offered. • W  hat is and isn’t covered by the care home’s insurance. • The type of accommodation provided. • The level of care to be provided. • Any additional fees and charges that may be incurred. • The cost and details of any extra services, such as meals, laundry, personal care (e.g. hairdressing, chiropody), television and phone bills. • What happens if residents are temporarily absent from the care home (e.g. in hospital). • The terms of cancellation of the contract, both on your part and on that of the care home, including the required notice period. • The complaints procedure. You should also look out for information on the following points: • If a resident is away from the home for an extended period (for example, in hospital), the contract should make it clear what fees are payable during that time. • S  ome care homes might pass on savings – for example if they’re not having to provide meals or care during that time – whereas others may not. Residents have the right to expect that they, and their possessions, will be looked after with reasonable care and skill. A good contract should not try to limit or take away the care

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Cooksons Court, Yeovil

Somerset Care has care homes throughout Somerset and on the Isle of Wight. For more details of your nearest homes, visit: www.somersetcare.co.uk or call us on: 0800 9884 337

Our community teams deliver care and support to people living in their own homes across the south of England. We can also provide specialist support from our Petals dementia care team and Realise, our learning disabilities service. Realise

For assistance with finding care and support, call Care Select on 0800 389 2077

www.somersetcare.co.uk | 0800 9884 337

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home provider’s liability if it is at fault when things go wrong – for example, if unsatisfactory care leads to injury, or if a staff member loses or damages a resident’s possessions. A good contract should clearly explain a resident’s rights to cancel, and what procedure to follow if they want to leave the care home. Both parties should be able to cancel with a reasonable amount of notice.

restraint, or inappropriate limits on their freedom.

Expecting high standards

Display of ratings – the CQC rating must be displayed where you can see it in person, on their website and you must be offered their latest inspection report.

It is important to remember that, in care, we all have the right to expect high standards. The Care Quality Commission (CQC) has ‘Fundamental Standards’, below which a person’s care must never fall. These apply to home care and care home providers. It is so important that, when you are searching for care, you ensure that the providers you are considering fully commit to these fundamental standards.

Some of the fundamental standards include: Person-centred care – tailored to your loved one’s needs and preferences. Dignity and respect – making sure your relative has privacy, is treated as an equal, and is supported to remain independent. Consent – your loved one must give consent before care or treatment is given. Safeguarding from abuse – ensuring your relative doesn’t suffer neglect, degrading treatment, unnecessary

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Complaints – a robust system must be in place to handle and respond to any complaints and take action where necessary. Staffing – enough suitably qualified, competent and experienced staff. Relevant checks must be carried out, such as DBS and work history.

Mixed emotions It is normal to have a mixture of emotions when your loved one moves into a care home. However, the move need not be perceived as negative. In fact, in most cases, it can be a truly positive move for everyone, including your loved one. In a good care home, people should be safe, well looked after and stimulated. They should be encouraged to join in with activities, whatever their abilities. Their environment should enable them to flourish. Many people see a marked improvement in their loved ones when they adapt to life in a care home. You may also see that they are freer to make decisions and choices, as they are no longer limited by what shelf they can reach, or whether they can get up the stairs. You can take comfort in the fact that they are in a safe place, looked after and treated with the respect they deserve, particularly if their mental capacity declines.

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Welcome home... We care for you as we would our own mums, dads, brothers and sisters. • Residential, nursing & respite care • Sheltered housing • Day centre • Compassionate and stable team

• Light and airy rooms • 3 acres of beautiful grounds • Immaculate interiors • Vibrant community

“I was bowled over by the wonderful community that you have at Peterhouse. So warm, friendly and vibrant.” Charlie Parkin

✔ ‘Good’ CQC Rating

Double Award-Winning Care Home in Bexhill-on-Sea CALL NOW OR COME TO VISIT US. WE ARE IN THE OLD TOWN AREA OF BEXHILL-ON-SEA. 01424 730809 or email info@peterhousecare.com

A caring way of life, where you come first

www.peterhousecare.com

Enabling the best in time of need Our Westerley Christian Care Homes aim to provide the best in time of need for people looking for actively Christian residential care in their retirement.

• A caring environment with permanent, respite or day care. • A Christian ‘family’ with daily acts of worship. High quality en-suite rooms with comfortable lounges, homely atmosphere • and a wide range of activities. • The warmest of welcomes for you and your family and friends. Call us now for a brochure or to arrange a visit Phone: 01702 342059 Email: homesadmin@lwpt.org.uk

Active Christian Care for the Elderly Minehead

Westcliff-on-Sea

Woodhall Spa

www.lwphomes.org.uk

For assistance with finding care and support, call Care Select on 0800 389 2077

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FAR FILLIMORE CARE HOME • Accommodation for 26 residents • 2 double rooms for couple sharing • Long and short term respite care • Large landscaped gardens

“Home away from home”

• For elderly people and people with Dementia • Group activities • Palliative care • Local GP visits

Wood Lane, Hanbury, Burton-on-Trent DE13 8TG Telephone: 01283 812 180 • Email: ffch.admin@ffchltd.com • Web: www.farfillimore.co.uk

NIGHTINGALE COURT CARE HOME • Accommodation for 43 residents • Long and short term respite care • Regular group activities • Sensory room

“Offers a sense of togetherness”

• For elderly people and people with Dementia • Palliative care • Sensory gardens • Local GP visits

11/14 Comberton Road, Kidderminster DY10 1UA Telephone: 01562 824 980 • Email: ncch.admin@ffchltd.com • Web: www.nightingalecourtcarehome.co.uk

LITTLEOVER NURSING HOME

“Premier nursing home”

• Accommodation for 40 residents • Specialise in palliative care with unrestricted visits • Regular group activities and entertainment • Within walking distance of shops and post office • Local GP visits • On-site nurse 149 Stenson Road, Littleover, Derby DE23 1JJ Telephone: 01332 760 140 • Email: lnh.admin@ffchltd.com • Web: www.littleovernursinghome.co.uk

“Warm, friendly and professional care homes”

NEW CARE HOME

NOW OPEN! in Blackheath

We are the difference between quality and excellence and between caring at work and caring like family.

RESPITE BREAKS Our flexible, short-term care can provide a well-earned break. Call us to see how we could help.

If you need help finding care, we will do whatever we can to be the difference you need. Call our team on 020 8318 2272, visit cinnamoncc.com/leah or email leah@cinnamoncc.com Blessington Road, Blackheath, London, SE13 5EB

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Choosing a residential care home checklist Quality rating*

Home 1 

£

p/w



Home 2 

£

p/w



Home 3 

£

p/w



We suggest that you have paper with you when visiting care homes so you can make notes.

Activities Is there an Activities Co-ordinator? Can you get involved in activities you enjoy? Does the home organise any outings? Are residents escorted to appointments? Do the residents seem entertained? Does the home have a varied activities schedule? Life in the home Is the home adapted to suit your needs? Can you bring your own furniture?  Are there enough plug sockets in the rooms? Are there restrictions on going out? Is there public transport nearby? Does the home provide any transport? Can you make/receive calls privately? Can you decide when to get up and go to bed? Does the home allow pets?

     

        

Personal preferences Is the home too hot/cold? Can you control the heating in  your room? Is the décor to your tastes?  Are there restricted visiting  hours? Is there somewhere you  can go to be alone? Does the home feel  welcoming? Catering Does the menu change regularly? Can the home cater for any dietary requirements you may have? Can you eat when you like, even at night? Can you have food in your room? Is there a choice of food at mealtimes? Is alcohol available/allowed if you want it? Can visitors join you for meals?

      

Fees Do your fees cover all of the services and activities? Are fees likely to change regularly? Is the notice period for cancellation of the contract reasonable? Could you have a trial period? Can you keep your room if you go into hospital? Can you handle your own money?

   © Care Choices Ltd 2017

Staff What is the minimum number of staff that are available at  any time? Are staff respectful, friendly  and polite? Do staff have formal  training? Are the staff engaging with  residents?

  

*See page 30. For assistance with finding care and support, call Care Select on 0800 389 2077

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Was it the right decision? Making the decision to arrange support in your loved one’s home, or to move a loved one into a care home, can have a huge emotional impact on all those involved, even if everyone agrees it’s absolutely the right thing to do.

Making sure that a care home or home care arrangement is successful is often the result of several individuals all working collaboratively. It is not always an easy process; it is usually emotional and overwhelming, particularly for you and your family, with so many different factors to consider, from finding the right care agency or home to deciding how much care is required – you may feel that in your bid to give them a better quality of life, you are stripping them of their last independence. As long as you’ve had open discussions, as far as possible, with your loved one, you should feel reassured that the decision you’ve made together is the right one. However, the transition to this new situation is likely to be difficult on everyone. How do you differentiate between teething problems and more serious concerns?

The first few weeks Home care Naturally, families and the person receiving care will feel wary or anxious about having a stranger come into the home. Some of the concerns you might have include: • Can I trust the care worker? • D  oes the care worker understand my loved one’s condition? • Am I working with a quality provider? Was it the right decision?

• What if our needs change?

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Though care providers should make every effort to make the transition into care as smooth as possible, there will inevitably be a settling-in period. Typically, the first week of home care can be the most difficult; you and your loved one will need some time to get used to having a care worker coming in and offering support, especially if you have been managing the care yourself or if your loved one is returning home from hospital. As with any new job or house move, the care worker will also need some time to adjust to their new surroundings; in these first few days of a new placement, working collaboratively with your loved one’s care agency is key. Great care should always be a flexible and adaptable process, with your loved one’s wellbeing at the centre.

“As long as you’ve had open discussions, as far as possible, with your loved one, you should feel reassured that the decision you’ve made together is the right one.” Care homes If your loved one has moved into a care home, you’ll want to feel reassured that the decision was the right one and that they are happy and settling in. However, change can be challenging for anyone

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and the first few weeks are likely to be the most difficult as your loved one adjusts to their new environment. For your loved one to feel anxious and overwhelmed is quite normal, even if the move has been much anticipated, but these feelings are generally temporary and disappear once they have settled in and developed their own routine.

Susan Sowden, home manager at Bupa’s Southlands Care Home, believes getting to know the resident and developing a personalised care plan is key to helping new residents settle in quickly. ‘The first few weeks are really important for the resident and their family and a good care home will take the time to get to know the resident – their likes, dislikes and preferred routines – from day one. If a resident and their family has a say in their care plans, it can make a real difference to their settling in period.’

After a few months, your loved one should have settled into a routine and be familiar with the staff. That’s not to say there won’t be some emotional days, but they should generally be their old self and feel comfortable and happy in their new home.

Talking to your loved one’s care workers The care staff play an important role in engaging with and supporting you and your loved one, helping you to all come to terms with the new situation or surroundings and allaying any fears you may have. Give your loved one time to adjust to their new surroundings, but if you feel

it’s taking longer than you expected, you might want to have a conversation with the care staff. The provider should work closely with you and your loved one to spot any signs of change or unrest; you know how your loved one usually behaves. If you notice something that concerns you, talk to the care worker and try to find out if they have experienced this before. They may be able to offer solutions to settle your loved one, suggest a change to the care plan based on your loved one’s needs, or suggest ways of talking to your loved one about issues they are having with the support.

Susan Sowden suggests it may be useful to ask the carers about how your loved one is when you’re not there as it maybe that they are settling in better than they are portraying to you. ‘Sometimes, negative comments are used to voice uncertainty or fear and your loved one may just want you to listen and offer support and comfort at a time of change,’ she says.

This behaviour won’t be unusual to care staff and they should be able to give you advice on how to handle it in the short term and what to do if things don’t improve in the long term.

“If you notice something that concerns you, talk to the care worker and try to find out if they have experienced this before.” A high level of communication is essential when you are new to a

For assistance with finding care and support, call Care Select on 0800 389 2077

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care provider, and throughout your relationship with them. If they communicate with you and you feel as though they are being open and honest, it is likely that any issues you hear of are just teething problems. Remember that it will be strange for your loved one to be in new surroundings with new people, or to have someone coming into their house to help them, even if they have agreed that they need this support.

Ongoing concerns Not every care package goes smoothly and it is important to know this. Occasionally, families may find that they or their loved one don’t connect with their care workers, or don’t settle in their home, and you need to be realistic about this if it is the case. When issues with care arise, there can be a great deal of stress, anxiety, and even anger or frustration. Understanding any issues can help ease the situation and the right solution can be worked on together with your care provider, whether this is finding an alternative care worker or giving your loved one some additional support. There is also a need for managing expectations, from you, your loved one and the care provider, understanding exactly what everyone needs from one another and being flexible where possible – it is ultimately a partnership; everyone needs to listen to each other to make it work. When this happens, and the care workers become supportive companions, the relationship between them and the person they are caring for is healthy and the wellbeing of the individual improves. However, if your loved one’s personality

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or mood is uncharacteristic for an extended period of time, you need to address these concerns with a member of staff.

Should I complain? If you have any concerns, however small they might seem, they should be addressed with a member of staff. Waiting and hoping that small niggles will take care of themselves will only give issues time to get bigger. If the problem is a small one that should be easy to fix – for example, if your loved one is in a care home and is unhappy with their meals or thinks their room should be cleaned more often – start by asking to speak to someone in charge, as an informal chat can usually address these concerns. If not, you can make a formal complaint using the provider’s complaints procedure. Your relative may worry that complaining will affect the care workers’ attitude towards them. This shouldn’t happen as staff should want your loved one to be comfortable with them and happy with their support. Instances of abuse are rare but it’s important to know what to do if it occurs. Listen to your relative if they are telling you something is wrong and be alert to changes in their mood or behaviour. Look out for worrying signs: your relative wearing dirty clothes, appearing withdrawn or scared, or unexplained bruising. Write down your concerns and keep a log of what you saw and when. Don’t be afraid to ask staff or managers whether they’ve noticed changes in the behaviour or attitude of your relative and seek their views as to why this has happened and how they’re dealing with it.

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What next?

wellbeing and, more often than not, these things are impossible to predict. Even though it’s difficult, you are doing what is in their best interest overall. Difficulties with life transitions are normal, but almost always temporary. With more people living for longer, care is something thousands of people have to consider. The important thing is to remember that you are not alone; there is lots of support and advice available. Bupa has an Elderly Care Support Line which offers a free advice and support service on all aspects of elderly care, call 0333 331 5096. Alternatively, see the useful contacts section on page 90 for organisations that offer similar services.

If your loved one still doesn’t settle after an extended period and displays unhappiness or dissatisfaction in the form of verbal expression, depression, anxiety, withdrawal or unresponsiveness, you may consider changing the care agency or moving them to an alternative care home. While there are risks that come with this option, especially with a care home move, it might be the best decision all around. At this stage, you may be struggling with or regretting the decision to move your loved one into a care home but don't beat yourself up. Remember, you did what was necessary for their

Crossways Nursing Home Our Nursing Home provides a friendly environment caring for older people and adults with physical disabilities. We strive to promote independent living, preserve dignity and maintain privacy at all times. We provide:

• Person-centred nursing • Palliative care • Respite and re-ablement • Dementia care • Fully vetted and trained staff

Contemplation Homes 86 Hookhams Lane, Renhold, Bedford MK41 0JX

01234 771694

www.thecontemplationgroup.co.uk

For assistance with finding care and support, call Care Select on 0800 389 2077

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Dementia and dementia care Dementia affects an estimated 850,000 people in the UK today – this number is set to rise to one million by 2021. The term ‘dementia’ describes a set of symptoms that may include memory loss, mood changes and problems with communicating and reasoning.

The symptoms of dementia occur when the brain is damaged by certain diseases. Alzheimer’s disease is the most common form of dementia; other types include: vascular dementia, frontotemporal dementia and dementia with Lewy bodies. The condition has a wide impact, affecting not only the person who is living with it, but families, friends and carers too.

Spotting the signs

Dementia and dementia care Residential dementia care checklist

In the first instance, spotting the signs of dementia isn’t always clear cut. Memory lapses happen to most people from time to time – forgetting a name, popping upstairs and forgetting what you went for or struggling to find the right word. This could be down to stress, depression, certain physical illnesses, or medication, but sometimes memory loss can be an early sign of dementia. Talking about dementia can seem frightening, but seeking help early offers the best chance of getting the right support, advice and treatment. Dementia is not a natural part of ageing and when memory and thinking problems begin to affect day-to-day activities; it’s time to visit the GP. The GP will talk about any concerns and arrange further investigations. They

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may make a referral to a local memory clinic or hospital specialist where further assessments will be performed and a formal diagnosis can be made. Having a dementia diagnosis can be a huge shock but information and support is available, which allows many people who have the condition to continue to lead fulfilling lives.

“Talking about dementia can seem frightening, but seeking help early offers the best chance of getting the right support.” Key signs and symptoms to look out for in your relative include: • Struggling to remember recent events, although they can easily recall things that happened a long time ago. • Finding it hard to follow conversations or programmes on TV. • Forgetting the names of friends or everyday objects. • Regularly losing the thread of what they are saying. • Leaving objects in unusual places.

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• Having problems thinking and reasoning. • Feeling confused, even when in a familiar environment or getting lost on familiar journeys. • Finding that people are starting to comment on their forgetfulness. Each person experiences dementia in their own way, and the way the condition progresses can be seen as a series of stages known as early, middle and late stage. When considering the future and planning ahead it is useful to be aware of the likely progression of a person’s dementia. However, it is important to realise that everyone’s experience and dementia symptoms are likely to be different. The focus of any care and support should be on meeting the individual needs of the person at that time.

Supporting dementia at home Two thirds of people with dementia live in the community and people with dementia express that they want to remain independent, living in their own home for as long as they are able. Generally, in the early stages of the condition, people can be supported through simple changes, for example, memory aids around the house. However, as their symptoms develop, people often need increasing amounts of support, like help with washing, preparing and eating meals, or going to the toilet. This could be delivered via help from family and friends, or professional home care workers.

There is a wealth of community-based initiatives and services provided by the voluntary sector that can help people with dementia to live well at home – these include Dementia Cafés, Singing for the Brain groups and dementia advisers. There are also courses for family carers to help them to better understand dementia, cope day-to-day and learn more about legal and money matters, like the Alzheimer’s Society Carer Information and Support Programme (CrISP).

“There is a wealth of community-based initiatives and services provided by the voluntary sector that can help people with dementia to live well at home” Extra support may also be available from adult social care. As with other conditions and care needs, a local authority assessment will establish the person's needs whether or not adult social care has a role in arranging or contributing towards any support. For a person with dementia, a needs assessment could indicate, for example, the need for someone to come into the home to help in the morning or the need for support at mealtimes. Carers, family members or others who offer informal support should also be assessed, enabling them to access invaluable respite care (more information on support for carers starts on page 77).

For assistance with finding care and support, call Care Select on 0800 389 2077

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Adapting Wendy’s home Wendy, 61, has young onset Alzheimer’s disease. She lives independently and moved from York to a smaller village when she was diagnosed. On her blog, she talked about how the move was much more difficult to adjust to than she first thought and how she has overcome it. ’I hadn’t appreciated how difficult it would be to get used to new surroundings and a new layout in the house. When I first moved in, the kitchen – which is very compact, had two doors. For days, I’d get confused and forget where each door led and I’d end up going around in circles – out of one and in the other. So my remedy for this confusion was to remove the

doors. Now I can clearly see where each archway leads and there’s no confusion. ’I had trouble remembering that new kitchen cupboards existed and would be oblivious as to what was inside each. Many people have suggested see through doors, but that would have cost too much, and more importantly, I find them too busy. So instead I took photos of the contents and now have a picture on each cupboard telling me what’s inside. ’I haven’t made many adaptations yet as I see these as necessary when something becomes an issue.’ Read more about Wendy at: https:// whichmeamitoday.wordpress.com

Coate Water Care, expert care for people with dementia — Coate Water Care is a family-run business that provides a high quality care service in all our Nursing, Residential and Dementia care homes. We provide 24-hour nursing, residential and specialist dementia care, as well as specialist care for clients with end of life and palliative needs. Respite and day care services are also available. All these services are provided by our friendly and fully qualified care staff.

Let us help you find the right care for your loved ones. Please contact our ‘Welcome Team’ to arrange a visit to your local Coate Water Care home. Call: 01793 821200 or Email: info@coatewatercare.co.uk to order a home brochure.

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Dementia Friends Alzheimer’s Society research has found that nearly two thirds of people with dementia experience loneliness and almost half report losing friends after their diagnosis. It can be a difficult subject to talk about, and stigma can create a huge, very isolating, barrier for people to live well in the community. Alzheimer’s Society’s Dementia Friends initiative has already got over 1.7 million people on board to help address the stigma and lack of understanding of dementia amongst communities. The initiative encourages a spectrum of social action, from changes in everyday behaviour and how people respond to dementia, to people taking sustained action, working to make their communities dementia-friendly. From Scouts to Cabinet Ministers, Dementia Friends is the biggest ever social action movement to change perceptions of a condition. The initiative combines face-to-face Information Sessions and online videos to help people learn more about dementia and the small things they can do to make a difference. To get involved, visit: www.dementiafriends.org.uk

Changes in behaviour When a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support. People with dementia may experience changes in behaviour. For example, they may go for walks, seemingly without purpose; this is often referred to as ‘wandering’. However, they may want to walk and be walking with purpose – the key is to find out why they are doing it and how they can do it safely. As a close relative or carer, you may find yourself having to explain things

to your loved one that you hadn’t had to explain previously, or help them with tasks that they used to do unaided. Patience and calmness are important qualities in these situations, and you may want to call upon coping strategies like silent counting in your head or deep breathing techniques, to keep your cool if you need to. Also, consider if there is anyone you can call upon if you need to, whether that‘s to come over for a chat or to offer practical support. There is no shame in calling for assistance. It is vital, whenever you support a person with dementia, to ensure that you don’t find yourself taking over from them. It can often seem easier, and quicker, to simply do things for a person. However, in reality, by doing this, you may be contributing to them becoming more disempowered; losing skills and, ultimately, relying on you more than they might otherwise need to. People may grow concerned that their loved one could be mistreated, and people with dementia can be particularly vulnerable to abuse and mistreatment. However, both financial and physical abuse can be reduced with greater training for carers and the right support and information. Contact Alzheimer’s Society for more support. To find out more, read Alzheimer’s Society’s ‘Top Tips for Carers’ or join the online forum ‘Talking Point’ for peer support. Visit: https://forum.alzheimers.org.uk

Looking after you Many people find that they have taken on the role of a ‘carer’ without making any conscious decision to do so. Supporting someone with dementia can be stressful and, at times, upsetting but it can also be very rewarding. It’s important that you look after your own health and wellbeing, and turn to others

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for help when needed. It’s likely you will experience a wide range of emotions at different times. These may range from positive feelings – satisfaction from supporting the person – to other feelings of loss, grief, guilt, embarrassment and anger – and it may feel awkward to reverse previous roles. Try to take time to reflect on your feelings, and talk to someone you trust. Getting practical support, too, will make it easier to cope. This could be through adult social care and a carer’s assessment, benefits and flexible working options from an employer, support workers and local support groups, friends and family, online forums like Talking Point or the Alzheimer’s Society National Dementia Helpline (0300 222 1122).

When home care isn’t enough As a person’s dementia symptoms progress, they will need more support and care, and there may come a time where full-time residential care is needed, perhaps with nursing care. If the person cannot make this decision for themselves, it often comes down to their carer or the wider family. Being prepared for this eventuality early on, and having discussions as early as possible, can help to make this decision slightly easier when the time comes. Prior to making this decision, consider whether housing with care would be appropriate. Respite care is another option. It offers a chance to experience residential care on a shortterm basis and gives you a break and some important time to yourself. It may also help to discuss the decision with a

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health or social care professional, such as a social worker, GP or consultant. Often, they can give their professional opinion on the type of care that a person needs. A social worker can review the needs assessment, which can help with deciding the level of care required and the right care setting to meet those needs.

Considering care homes Good quality care that preserves dignity, treats people with respect and promotes independence can improve the lives of people living with dementia. The majority of care home residents, 70% in fact, are thought to be living with dementia. While the condition can be confusing and debilitating, excellent dementia care can support older people to live dignified and fulfilling lives throughout their condition. This is not always the case however, and some care homes are not suitable for people with dementia, as they may be difficult to navigate, for example. Well-trained staff with experience of dementia care is essential. It is important to note whether staff are friendly and caring towards residents and whether they treat residents with respect. A good care home will focus on the individual rather than their dementia – an approach known as ‘person-centred care’. This approach rightly takes into account the individual’s unique qualities, personality, life history, interests and needs. This can be achieved through small but significant actions, like finding out what they like to be called, or what their preferred daily routine is.

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Using technology when caring for someone with dementia Technology is everywhere, so it’s no surprise that it can be used to help support someone living with dementia.

Walking or wandering One area where dementia technology is making leaps and bounds is supporting people who like to walk around. This might be called wandering. Devices have been developed which can be worn by the person with dementia, so if they get lost you can locate them. Some trackers (such as the Pebbell) also have fall monitors. Other devices use Bluetooth technology, so if your loved one is wearing a special button that gives off a Bluetooth signal and walks off while you’re with them, your mobile phone will warn you that the Bluetooth link is broken. These items can help keep people safe and allow them independence and freedom to come and go. However, there are ethical considerations around tracking someone’s movements and these need to be taken into account. Other gadgets include movementoperated audio reminders. Place one by the front door and, as someone goes to leave the house, it plays a message reminding them to take their keys, wear a coat, or tell you where they’re going.

Time orientation Dementia may affect a person’s body clock, causing confusion about whether it’s morning or evening and what the day or date is; this

often leads to repetitive questions, anxiety, agitation and night-time wandering. A popular piece of technology for this is a day clock. These are like digital photo frames, but clearly display the day, date and time. Some varieties show both an exact time and a phrase like ‘Now it’s Thursday morning’, which may help ease confusion. Some also have options to programme in reminders to take medications, whether to expect visitors that day and even personalised audio messages.

Incontinence and UTIs Dementia can cause issues with continence and urinary tract infections (UTIs), particularly in the middle to later stages. Maintaining comfort and dignity are the key objectives where these issues are concerned. To help, special sensors can be placed under chair cushions and bedsheets which will sound an alarm if your loved one has an incidence of incontinence, so a person can be alerted and check on them to ensure they stay comfortable. UTIs can be hard to detect in someone with dementia, as they can cause delirium; it can be difficult to know if your loved one has an infection, or if it’s a sudden change in their symptoms. Special incontinence pads have been created that detect whether the person’s urine contains high levels of a bacteria that causes UTIs. If it does, it can alert someone so your loved one can visit their doctor.

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Using technology when caring for someone with dementia continued

Falls For someone with dementia, the risk of falling can be higher because dementia can cause problems with vision and depth perception. While you can’t always prevent a fall at home, you could use telecare so your loved one can get assistance if it happens, see page 20. For example, a sensor outside a bedroom door will check when a person leaves their bedroom. If they haven’t got up at their normal time, and no movement has been detected for a while, or they haven’t returned to their room within expected timeframes, it can alert you or a nominated person, so you can check they’re OK. Motion sensor lighting can also be useful if your loved one gets up at night. Plugging the lights into hallways, near the stairs, and en-route to the bathroom means the person can find their way without fumbling for a light switch.

Boredom Dementia technology can also be useful for providing enjoyable activities. It’s about making it easier for someone with dementia to enjoy activities, by simplifying technology. This could include music players that work by lifting a flap, radios that start playing with one button, and remote controls with only five buttons, so that turning on the TV and changing channel are less confusing.

Dementia technology in care homes Whilst all of these products can be useful in care homes, there is some

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technology that can be particularly valuable when a person has moved away from their own home. In a recent study by researchers connected to Harvard Medical School, tablet computers were found to be an effective tool for easing agitation or upset in people with dementia, as they enable quick and easy access to a range of therapies such as music, art and games. Another useful item for care homes is a talking photo album. You insert photos that are meaningful to your loved one, and then record messages, descriptions and music to help trigger memories and aid reminiscence.

Using technology appropriately It’s important to remember where technology stands alongside other methods of care. It shouldn’t be a replacement for person-to-person care, but rather sit alongside it. It can be a useful tool, but care for someone with dementia should still be as personalised as possible. Technology has the power to support carers, help their loved ones stay at home for longer, and allow them to cope with their dementia as best they can. It also has useful applications in more formal care settings, such as care homes. James Ashwell is the founder of www.unforgettable.org a website that brings together life-changing products and services to help people with dementia do the things we take for granted.

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Residential dementia care checklist Quality rating*

Home 1 

£

p/w



Home 2 

£

p/w



Home 3 

£

p/w



We suggest that you take paper with you when visiting care homes so that you can make notes. Please use this checklist in conjunction with the care home checklist on page 57.

Design



Can residents get help with  eating and drinking?

Has the home been designed or adapted for people with  dementia?

How often does the home review residents’ medication?

Are the home and grounds secure?

Does the home offer help if a resident needs assistance  taking medication?



Are there prompts outside the residents’ rooms to help people identify their own?  Is the décor familiar to your loved one?



Choices Do residents get choice in terms of what they wear each day?



Are residents encouraged to be independent?



Can residents decide what to do each day?



Can residents have a say in the décor of their room?



Do GPs visit the home regularly?





Staff Are staff trained to identify when a resident might be  unwell? Are staff trained to spot when someone needs to go  to the toilet? Do the staff have any dementia specific training/experience?



Will your loved one have a member of staff specifically responsible for their care? 

Activities

Approach to care

Are residents able to join in with household tasks like  folding washing?

Does the home follow a specific approach to dementia therapy, for example, validation  therapy?

Are there activities on each day? 



Can residents walk around outside on their own?



Are residents sitting in front of the TV or are they active  and engaged? Are there rummage boxes around?



Will the home keep you informed about changes to your loved one’s care?



Does the home have a specific approach to end of life care?



Does the home keep up to date with best practice in dementia care?



© Care Choices Ltd 2017

Are there clear signs throughout the home?

Health

*See page 30. For assistance with finding care and support, call Care Select on 0800 389 2077

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Thinking of end of life care About 1% of the population dies every year, and each death affects many more people who knew, cared for or loved the person who passed away. Yet according to an opinion poll by ComRes for Dying Matters, people would rather discuss politics, money, religion or immigration with family or friends than death.

Only 25% of people have discussed their end of life wishes, the same percentage that have asked a family member about their end of life wishes. Yet 78% of people in the same poll agreed that it would be easier to have our end of life wishes met if people were more comfortable discussing death and dying. Talking about death and dying is something we understand we should do, and see the benefits of doing, yet don’t do. We are all going to die one day. It’s understandable that people don’t generally dwell on this, but avoiding the conversation won’t make death or dying any easier, and in many situations, can make things worse. Talking about end of life, and doing it early on, gives people the opportunity to share their hopes, fears and wishes for the end of life. This control over the process can be very powerful and help to deal with any fears your loved one may be experiencing. There can also be a sense, once the work is done and all necessary plans are in place, of being able to leave the topic behind and getting on with living life to the full for however long we have left.

Thinking of end of life care

whether or not someone has ‘capacity’ to make decisions on their own behalf. This is especially true if someone is living with dementia. The Mental Capacity Act sets out the rules for how ‘capacity’ is determined, and people will always be assumed to be capable of making their own choices unless there is clear evidence to the contrary. However, it is important to aim to get all end of life care and other plans in place before there is any risk of losing capacity, whether this is due to a lasting condition like dementia or temporary circumstances. When planning for the end of life, there are some important considerations. The need for care and support and discussing getting older and end of life may prompt conversations around: • Making a will. • Planning and sharing funeral wishes. • Writing down preferences for care and support at the end of life – including their preferred places to die.

Mental capacity

• Creating lasting power of attorney documents to cover financial or healthcare decisions, or both.

A phrase you might hear is about

• Making a decision on organ donation.

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• Making financial plans. • Thinking about ‘digital legacy’ and access to online accounts. • Sharing wishes with partners and close relatives.

We need to talk about dying Talking about dying may not always be easy but it can help people to make the most of life. There are many reasons why we hesitate to talk about death, including fear of bad timing, poor taste, causing upset or a fear that talking about it will make it happen. Some people, especially those caring for someone with a terminal condition, can feel that talking about death, and making plans, is a sign of giving up, or of wishing for the end.

“Talking about dying may not always be easy but it can help people to make the most of life.” Emotionally, avoiding the topic can isolate people facing death, or who have fears or concerns. And practically, not talking about it prevents plans from being made and shared which can lead to unwanted end of life care or arguments by the bedside. Without communication and understanding, terminal illness or approaching the end of life can be a painfully lonely and stressful experience for the person dying and for their friends and family. Addressing the subject of dying, whether the likelihood

is still years off or more imminent, can help the whole family plan and hopefully see through as many of their wishes as possible. This can make the whole experience better for everyone.

Broaching the subject Few of us want to be the first person to start a conversation about death and dying, but many people find it a relief to talk openly about the subject, and starting the conversation gives other people space to do this. Try to choose the right place and the right time to start the conversation. Avoid stressful situations and gauge how comfortable the person is talking about their future. Maybe use discussions about care and support needs to bring up their final wishes too. There’s no right or wrong way to address the topic of dying but here are a few sensitive suggestions:

Starting the conversation • Starting the conversation with a question rather than a statement, ‘Have you ever wondered what would happen…?’; ‘Do you think we should talk about…?’ • Other starting points can be conversations about recent experiences of other people’s deaths or funerals, whether these are friends, celebrities or fictional characters. • Talking about one element of a funeral – what song you’d want, what kind of flowers – can be a place to start, as this is more about your personal memories and tastes.

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• Sometimes it helps to start with something direct but reassuring, like, ‘I know that talking about these things is never easy…’ or ‘We’ve never talked about this before but…’ • It may be easiest to ask people about what they definitely wouldn’t want – as a way of getting the conversation started. • Encourage everyone to be totally honest about how they feel from the start. If you’re all open, there may be both laughter and tears – don’t be afraid of either. • Accept that it will be upsetting to some degree, but don’t let that put you off. Death is upsetting because it means losing someone we love, but one of the ways we can show that love is by supporting open and honest conversations about it.

Consider • Everyone approaches this subject differently, so if one opening gambit doesn’t work, try another later. • Talking about dying can be emotionally tiring, and a touch of humour can bring relief. • Some people would rather write

things down alone, or talk to someone they don’t know well. There may also be other opportunities for them to have conversations around death and dying. For instance, a local ‘Death Café’ might be taking place where people can meet to discuss death over tea and cake. For more information, visit: www.deathcafe.org • Don’t be so worried about saying the wrong thing that you don’t say anything.

Planning ahead Don’t leave it too late to have important conversations about life and death. Thinking and talking about wishes for how your relative is cared for in the final few months of life can make things easier for partners or family members. It could include where a loved one would like to die, if they wish to be resuscitated or if they want to refuse any kinds of treatment (Advanced Decision to refuse treatment). Knowing that someone had the end of life care they wanted can help the grieving process later. By discussing these questions with the person, you are ensuring that you don’t have to make the difficult decisions on your own later on.

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily • search by location and care need information on care quality • links to inspection reports additional care provider information, photos and direct website links brochure requests

www.carechoices.co.uk

Developed by the publisher of this Handbook

Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

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Planning dying well In the checklist below are some of the areas that people often leave too late to discuss. Because it may not be easy to talk about, you could leave this with your relative for their consideration. When planning ahead for yourself, it is important to think about all the things you want well in advance, talk to your family, write it down and keep it safe. Remember, you can always change or update these plans later.

1. C  onsider legal and financial matters • Write a will, setting out your wishes for your personal effects and financial affairs to avoid difficult legal issues for your family – and make sure you take legal advice if needed. • If you need to, make financial plans to ensure the people you care about are protected. • Write down your funeral wishes so your family knows what you would like, and consider how funeral costs would be met. • Plan for your future care and support, for example by setting up a lasting power of attorney (LPA) for health and welfare as well as an LPA for property and financial affairs, in case there comes a time that you are unable to make health, wellbeing or financial decisions for yourself. • Consider writing an advance care plan setting out your wishes for care and support at the end of life or an advanced decision to refuse

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treatment stating what you do not want.

2. M  ake a plan for what you want when you die. Here are some things to consider. • The type of care you would like towards the end of your life. • Where you would like to die. • Whether you have any worries you would like to discuss about being ill and dying. • Whether you want to be resuscitated. • Whether there are treatments you want to refuse.

3. S  ave other lives – through organ donation • If you want to be considered as an organ donor, it’s essential you register and share your wishes with those close to you. Or you may want to make arrangements to leave your brain or body to medical research, for example to help with dementia research.

4. C  onsider how you would like to be remembered • What would you like people to know before you die? • Think about messages, memory boxes, or videos for loved ones. • Consider your digital legacy – would you like to be remembered online, and what do you wish to happen to any social media accounts? Visit www.dyingmatters.org for more guidance on planning dying well.

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As the end approaches Wherever your loved one is being cared for, in their own home or a care home, you should be confident that the people responsible for caring for them will have the necessary training to help make their end of life as comfortable as possible. A good understanding of someone’s wishes can help to avoid unnecessary admission to hospital. Most people would prefer not to die in a hospital and with good planning and support, the care staff should be able to ensure this happens. Care staff should assess the person and be familiar with their specific wishes. Each organisation should have its own end of life care policy – ask your loved one’s care provider for their policy and training on the subject. Whilst being professional, staff should also be sympathetic and understanding of the situation and the emotions surrounding it.

Palliative care continued made with the help of the members of a multidisciplinary team and in line with your loved one’s personal preferences. Team members usually include doctors, nurses and social workers. Occupational therapists or physiotherapists, chaplains, pharmacists, nutritionists and others might also form part of the team.

Myths about dying Many of the preconceptions of dying stem from our childhood and images we see on television and in films. Don’t let the myths get in the way of planning properly for what you want for yourself or the person you love at the end of their lives.

The most common myths

Palliative care Palliative care focuses on the relief of pain and other symptoms and issues experienced in serious illness. The goal of palliative care is not to extend life or hasten death, but to improve quality of life, by increasing comfort, promoting dignity and providing a support system to the person who is ill and those close to them. It makes the most of life, even when time is limited. It regards dying as a normal process. Palliative care can be delivered in any care setting, including at home, in care homes, hospitals and hospices. In palliative care, decisions about treatment and care should be

Myth 1: There’s no point in thinking about dying Thinking about death does not bring it any closer; or, in the words of the Dying Matters coalition, ‘Talking about dying won’t make it happen’. If we think about it in advance, we can plan for the kind of death we’d actually wish for. Encouraging your loved one to make a will, decide what kind of care they’d like, or just practical things to help those left behind, can make the last days easier and help reduce feelings of regret. Myth 2: Most of us will die in hospital – it’s inevitable In the UK, currently, about half of deaths occur in hospital, but increasing numbers of people are getting the support they need to be able to die in a place of their choosing, often their

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own homes. Others will prefer to die in hospices, care homes or supported housing. Planning ahead and talking to the health or social care team and encouraging the person to write down their wishes may make it more likely that they will die where they want to. Myth 3: It’s better to keep family in the dark to protect their feelings Being honest with those you love about illness or dying can be hard, as no-one likes causing avoidable upset. Facing illness together can bring people closer, take away unanswered questions and make the situation easier for all to cope with, particularly for those who are left behind. It can also make the financial and practical impacts easier to deal with. Myth 4: Death is generally very quick or very painful TV and films often portray deaths that happen in a romantic, violent or very quick way but everyone’s death is different and often the dying process is gradual. If people are given good care, there is no need for them to be in pain, and you don’t have to be in hospital to receive pain or symptom control. There are many different medications available to doctors and nurses to help manage symptoms, including morphine which is often prescribed when pain is severe, and the dosage and delivery of these can be set to allow as active and full a lifestyle as possible. Myth 5: Everyone is vulnerable and powerless at the end of their life Whilst there are always aspects of death that cannot be controlled, many people remain in control of lots of aspects because they’ve prepared for a time

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when decision-making won’t be as easy. It is possible for people to leave instructions for where and how they’d like to be cared for, when they would like treatment to stop and who they would like to make decisions for them.

“Don’t let the myths get in the way of planning properly for what you want for yourself or the person you love at the end of their lives.” Practical help There is a range of organisations that can help you and your loved one to plan the support and care they need towards the end of life, advise on writing wills and advance care plans, and provide advice on the emotional issues surrounding dying. Dying Matters (www.dyingmatters.org) and the NHS Choices website (www.nhs.uk/Planners/end-of-life-care) are useful starting points. You can also find information about a range of practical services to support people approaching the end of life, their family and their carers through the ‘Find Me Help’ directory at: www.help. dyingmatters.org To find out more about the dying process and the care available in the last days of life, see ‘What to expect when someone important to you is dying’ published by The National Council for Palliative Care, Hospice UK and Sue Ryder. It can be downloaded from: www.ncpc.org.uk

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Are you a family carer?

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Every day 6,000 people become carers, looking after family or friends who are older, disabled or seriously ill. Carers regularly look after, help or support someone who wouldn’t be able to manage everyday life without their help. A carer doesn’t have to be living with the person they care for, and the help they give doesn’t have to be physical. The carer may be caring for a partner, another relative, a friend or a neighbour.

At times, caring can be profoundly joyful. There’s nothing more natural and human than helping our loved ones get the most out of life. However, focusing on someone else’s need often means that carers neglect their own needs and caring can have an impact on your health and wellbeing, your relationships, finances, ability to work and have a life of your own alongside caring. A caring role can come on suddenly as a result of an accident or sudden deterioration in health and it can be hard to think of yourself when a crisis hits, or it can build up more slowly – making it hard to realise when you can’t carry on without support.

Breaking the barrier – getting support Identifying yourself as a carer can be one of the biggest barriers to getting information, advice and support early. It’s natural to see yourself as a daughter, son, sibling or friend rather than as a carer but recognising that providing care and support to someone makes you a carer is important to accessing the support available. One way to get help and support is through an assessment by the local authority adult social care department. Both you and the person you care for can get an assessment. This may result in help and support being provided to

you as a carer and/or to the person you are looking after. You could decide to buy in additional help and support for the person you are looking after. You could decide to employ an individual or use a care provider such as a care agency.

“Recognising that providing care and support to someone makes you a carer is important to accessing the support available.” Caring can be hard work – physically and emotionally. It’s important to find out about the different ways you can get help and support with caring. You can also find out about equipment and technology that could help make your home safer, your life easier and provide independence for the person you are looking after. See page 18 for more information, or page 67 for information on technology specifically for people with dementia. Caring inevitably means adapting to changing circumstances, so it’s important to think about the future. You may need to look into different ways of managing someone’s affairs, either now or for the future. You could find out if

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Are you a family carer?


you have a local carers organisation, and if so, what support they offer to carers in the area. To find your local carers organisation visit: carersuk.org/ localsupport Finding support in what is a complex system can feel bewildering. Carers UK’s ‘Upfront’ tool provides some quick tailored information that can help: www.carersuk.org/upfront

Looking after your health Caring for someone can be rewarding but it can also be very tiring, putting a lot of demand on your physical and emotional energy. When you are simply coping day-to-day and responding to the needs of others, it's easy to forget your own health needs. It’s important to take breaks from caring. There are different ways in which you may take a break as a carer. Only you will know what type of break is best for you. You may need an hour each week, a day here and there, a week or two for a holiday, or a combination of all of these. Think about the kind of break that you need as a carer and what kind of alternative care the person you are looking after needs. There are different options for getting alternative care (often called respite care) for the person you are looking after whilst you take a break: • Getting an assessment from the local authority adult social care department. • Arranging care yourself. • Support from friends or family. • Some organisations provide short

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break services for carers or for the person being looked after (or both) if you want to go on holiday, either alone or with the person you are looking after. You may be able to get some help towards the cost.

Accessing practical support If you have not already been offered a carer’s assessment, you should contact the local authority and ask for one. You can have an assessment no matter what your level of need, the amount of care you provide or your financial means. You can have an assessment even if the person you care for doesn't want their needs assessed. Your carer’s assessment should cover: • Your caring role and how it affects your life and wellbeing. • Your feelings and choices about caring. • Your health. • Work, study, training, leisure. • Relationships, social activities and your goals. • Housing. • Planning for emergencies (such as carer emergency card schemes). Following the assessment, the local authority will decide if you are eligible for support. If eligible, this can be provided either to you, or to the person you are looking after to reduce the impact caring has on you. Support might be provided by the local authority, or in the form of a direct payment (an allocation of money) if

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you are eligible. Some examples of the kind of support you could get include driving lessons, taxi fares, a laptop, help with housework or gardening or a gym membership. Your support will depend on what needs have been identified in your assessment and what services will help you to carry on in your caring role.

“It is your choice whether or not to tell your employer about your caring role.” Whether the local authority will contribute towards the costs of any support you are identified as requiring will depend on your financial situation (if the local authority is one which charges for carer support – not all do), or the financial situation of the person you are looking after (if services are provided to them). Even if you are not considered to be eligible for support, the local authority must provide you with information and advice on local services to prevent your needs from developing further.

for any intermediate or reablement care, NHS continuing healthcare or NHS funded nursing care, other NHS services and/or community care services from the local authority. You should also be offered a carer’s assessment to see whether you, as a carer, need support once the person you are looking after is discharged.

Managing caring alongside work Juggling work and caring can be very challenging. It’s important to find out about your rights and about any support that is available. It is your choice whether or not to tell your employer about your caring role. There might be extra support for carers in your workplace; even if you haven’t told your employer about your caring role, it would still be worth finding out what extra support, if any, might be available. Your rights at work come from two sources: • The law gives you ‘statutory rights’ which everyone has.

Coming out of hospital

• Your contract of employment gives you ‘contractual rights’, which can be more generous than statutory rights.

Deciding to care, or continue caring, for someone who is coming out of hospital can be very difficult. It is important to remember that it is your choice whether or not to take on a caring role. Before the person you are looking after comes home from hospital, a discharge assessment should be carried out to see whether they need any support once they are discharged. This discharge assessment should look at whether the person you are looking after is eligible

The following information is about statutory rights. However, it is always worth checking your contract of employment, staff handbook or letter of appointment to see if you have any contractual rights on top of your statutory rights. All employees have the right to request flexible working after they have worked for the same employer for 26 weeks (six months), as long as they haven’t already made a flexible working request within the last

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12 months. Employers can only refuse requests for certain specified reasons. Examples of flexible working include: • Home working. • Part-time working. • Term-time working. • Flexitime.

The Carers UK Adviceline can also carry out a benefit check for you – email advice@carersuk.org or call 0808 808 7777. You can get a benefit check online, too. It will take about 20 minutes to complete. Visit: www.entitledto.co.uk/benefitscalculator or www.turn2us.org.uk/ find-benefits-grants

• Working compressed hours. • Job sharing. • Shift work. The Equality Act 2010 provides carers with protection from some forms of discrimination. For example, employers and providers of goods and services must not treat carers less favourably than those without caring responsibilities. All employees have the right to take a ‘reasonable’ amount of time off work to deal with an emergency or an unforeseen matter involving a dependent (which includes your partner, child or parent, or someone living with you as part of your family – others who rely on you for help in an emergency may also qualify). The time off is unpaid unless your employer is willing to give paid time off as a contractual right.

Looking after your finances Getting information on benefits The benefits system is complicated. It is a good idea to get a benefit check to make sure you and the person you are looking after are claiming all the benefits you are entitled to. As well as increasing your household income, benefits can sometimes help protect your State Pension entitlement in the future. The Carers UK website covers the main conditions for each benefit. Visit: carersuk.org/benefits

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“It is a good idea to get a benefit check to make sure you and the person you are looking after are claiming all the benefits you are entitled to.” You may be able to get a face-to-face benefit check from a local advice centre such as your local Citizens Advice Bureau, Age UK, carers organisation or disability charity or your local authority.

Carer’s Allowance You could get £62.10 a week if you care for someone at least 35 hours a week and they get certain benefits. You don’t have to be related to, or live with, the person you care for. If you are getting certain other benefits, including a State Pension, then you might not be able to be paid Carer’s Allowance at the same time. However, it might still be useful to make a claim and receive what is called the ‘underlying entitlement’ to Carer’s Allowance, even though you won’t be paid the benefit itself as it can help to increase any means-tested benefits you might be getting (such as Pension Credit, Housing Benefit and Council Tax Reduction), or it could mean that you become entitled to means-tested benefits for the first time.

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Paying for care

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Understanding the way care is financed can be difficult. Social care is not free at the point of delivery, like NHS services. Most people are likely to have to contribute something towards the cost of their care. In these cases, it’s important to know some key facts about what might be available to help support your loved one if they need to pay towards their support.

As mentioned on page 11, the starting point for someone with perceived social care needs is a care needs assessment. This will be conducted by the local council. If this assessment shows that your relative is eligible for social care services, the council will then conduct a financial assessment to look at what, if anything, your loved one can afford to pay towards these services.

Financial assessment The financial assessment will look at your relative’s capital, savings and income. If your loved one chooses not to have a financial assessment, they will be responsible for paying the full cost of their care and support. If your loved one is moving into a care home or care home with nursing, the value of their home is included as part of their capital in this assessment, except in limited circumstances. See page 83 for more information on when the value of your relative’s home might be considered. Their home is not included if they are receiving care in their own home. If your relative has capital and savings of less than £14,250, they may

be asked to contribute part of their income and the local authority may meet the shortfall.

“The starting point for someone with perceived social care needs is a care needs assessment.” If they have capital and savings between £14,250 and £23,250, your loved one is likely to have to contribute towards the cost of their care. They may need to contribute part of their income, and a sliding scale operates whereby they contribute £1 for each £250 they have in capital and savings above the lower figure. If their capital and savings amount to more than £23,250, they will likely have to pay the full cost of their care themselves. However, they are still entitled to an assessment of their needs by the council and they may be able to get some support with funding their care, see page 83. These figures may change during the lifetime of this publication. It is important to note that the local authority can only consider the capital of your relative who is assessed as

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Paying for care Legal Considerations


needing care and not the capital of their spouse, and there are special rules surrounding joint assets. Even if the local authority is contributing towards the cost of your loved one’s support, they should still be given a choice in terms of the service they receive – for example, they should be allowed to choose their own home care agency or care home, as long as it meets their assessed needs and falls within the money that has been allocated to meet these needs.

Running out of money If your relative’s capital and savings are likely to reduce to £23,250 through payment of care fees, the council must be made aware well in advance. It must undertake an assessment of your loved one’s circumstances before deciding if it will make a contribution. If your relative becomes eligible for the council’s support with funding their care, and the care home they are living in charges more than the council’s fee levels, someone must help pay the difference. This is known as a ‘top-up’ or ‘third party payment’, see page 85 for more information. If funds for a top-up are not available, your relative will need to move to accommodation which can meet their needs at the local authority fee level. Understanding your loved one’s rights before moving into care is essential. There are a number of financial products and specialist companies that may be able to help. It is important to seek independent financial and legal advice before committing to anything. See page 86 for more information.

Non-means-tested support Some support may be available to your relative without the council needing to

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look into their finances. These include:

Benefits Attendance Allowance, Disability Living Allowance and Personal Independence Payments are non-means-tested, nontaxable benefits from the Department for Work and Pensions. There are different rates depending on the level of your loved one’s needs. Everyone who needs care should consider finding out if they are eligible for these benefits, however, they will not be paid to anyone who is, or becomes, a permanent resident in a care home. If your relative is entitled to the mobility component of Disability Living Allowance or Personal Independence Payment, this payment will not stop once they are in a care home and is not included in their financial assessment. Your loved one may also want to consider applying for Universal Credit (if they are under pension age) or Pension Credit (if they are over pension age).

NHS Continuing Healthcare NHS Continuing Healthcare (NHS CHC) is fully-funded care and support, provided and paid for by the NHS. If your relative has a primary healthcare need, the NHS should provide and pay for their care – all of it, including their care home fees – through NHS CHC. Getting NHS CHC can be a difficult process as the criteria your relative must meet are strict. If your relative is eligible, they are likely to have severe issues surrounding their health. The term ‘primary healthcare need’ can be misleading – your relative won’t be automatically entitled to this funding just because they are living with dementia, or have an ongoing illness. Eligibility for NHS CHC depends on an assessment of the nature, intensity, complexity and unpredictability of the

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actual care that is required to manage your loved one’s needs. It is worth consulting someone who specialises in this field, see page 90 for useful contacts. It’s important to note that not everyone who requires care has a primary healthcare need – your relative’s needs may be incidental to their social care needs. If this is the case, their needs will be assessed and means-tested by their local authority. However, everyone who is discharged from hospital into a care setting should be offered an NHS CHC assessment. If they are eligible for NHS CHC, your loved one can receive the services in any setting, including their own home or in a care home. The NHS will pay if your relative needs healthcare from a community nurse or a therapist as well as personal care to help at home.

Self-funding your care Paying for care can be an expensive and longterm commitment, so seeking specialist information and advice before entering into any arrangements is strongly recommended. It is important that this advice comes from appropriately qualified and regulated financial advisers, see page 86 for suggested contacts. It is important to know that the local authority cannot force your relative to sell their home, or take the value of their home into consideration as capital, if: • Your relative’s partner still lives there. • A dependent under 16 lives there. • A relative over 60 lives there. • A relative who is incapacitated lives there.

• Someone else owns a proportion of the property, for example their spouse (although your portion may still be taken into account).

Twelve-week property disregard If your relative’s former home is included in their financial assessment but their other capital and savings are less than £23,250, and their income is not enough to meet the care home fees, the council may share the cost of the first twelve weeks of permanent care, provided it agrees that care is needed. This is known as the twelve-week property disregard period.

Deferred Payment Agreements After the twelve-week property disregard period, your relative may be offered a Deferred Payment Agreement. Under this type of arrangement, the local authority will pay for your relative’s care but will defer your relative’s payment to the local authority until their property is sold, or after they have passed away. Any fees paid by the council will be charged against the value of your relative’s home, and must be repaid once the house is sold or from your relative’s estate. Interest is payable throughout the period of the loan and there is also a one-off fee to join the scheme which covers all legal and administrative costs for the lifetime of the loan. The council may limit the amount of the loan, depending on the equity in the property.

NHS Nursing Care Contribution Whether your relative is a temporary or permanent resident, if they live in a care home that provides nursing care, they may be entitled to a non-means-tested

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Helping you to understand: •

The care system and how it works

The benefits that you may be entitled to and ensuring that you claim them

Duties of a Power of Attorney

Your options with regard to your family home, and guidance on the 12 week property disregard

The financial choices you have in relation to paying for care

Care fees annuities explained

“Our dealings with Sasha and her team, throughout the past few years have been nothing but professional, with everyone that comes into contact with the staff and residents being caring, thoughtful and fun. ”

A. Hardman, Manager, Hunters Lodge Care Home

01489 555180 www.eightwealthmanagement.co.uk

“Alan has a most professional and relaxed style which made this whole process easy to understand. We could not be any happier with the advice that we have been given which will ensure that our Aunt will not have any financial worries concerning her care.” Client

Eight Wealth Management represents only St. James’s Place Wealth Management plc (which is authorised and regulated by the Financial Conduct Authority) for Visit www.careselect.co.uk for further assistance with your search for care 84 the purpose of advising solely on the Group’s wealth management products and services, more details of which are set out on the Group’s website www.sjp.co.uk/products.


Registered Nursing Care Contribution (sometimes referred to as Funded Nursing Care) towards the cost of their nursing care. This is paid directly to the home.

Third party payments If your relative is eligible for the council’s support, they will be offered a choice of homes that meet the local authority’s funding rates. If your loved one decides to live in a more expensive home and someone is able to make an additional payment, that person will have to pay the difference between the local authority rate and the amount the home charges. This additional payment is called a ‘topup’ or ‘third party payment’.

“Councils have a duty to offer a place at a home that accepts their funding rates.” Your relative is not allowed to make this additional payment themselves, except in limited circumstances, so the responsibility usually falls to a family member, friend or charity. Before anyone agrees to pay a top-up, they should be aware that the amount may increase, usually once a year, and they need to be confident that they can sustain the payments for as long as they are required. They will need to sign a contract to confirm that they are able to do this. If the additional payments stop being paid, your relative may have to move to a cheaper home within the local authority’s funding levels. It is important to note that councils have a duty to offer a place at a home that accepts their funding rates. If no such place is available, a top-up should not be charged.

Mitigating your relative’s care costs If your relative has capital above the maximum threshold of £23,250, they may seriously want to consider effective legal ways to mitigate their liability to pay for their care costs in the future. However, it is important to be aware that there are strict rules in terms of what your relative can and can’t do with their capital to mitigate the future costs of care. Local authorities will look at your relative’s financial circumstances as part of the financial assessment and will look closely at their historic capital. This is to identify whether they believe they have tried to dispose of their capital to avoid the cost of paying for their care. This is known as deprivation of capital. Examples of where the local authority might consider that your relative has disposed of capital in order to reduce their assessment for care costs include: • Where a lump sum has been paid to someone else as a gift, or to repay a debt on their behalf. • Where substantial expenditure has been incurred, i.e. an expensive holiday or buying a new car. • Where the title deeds to a property have been transferred to someone else. • Where money has been transferred into another form, i.e. into personal possessions, jewellery etc. • Where capital has been reduced by extravagant living, i.e. gambling. • Where capital has been used to purchase an Investment Bond with Life Assurance (depending on the circumstance and timing of the purchase).

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If it is determined that your relative has deliberately deprived themselves of capital or assets, they will be treated as though they still have this money. The general rule of thumb is that, if your relative has undertaken any of these measures before they could have reasonably foreseen that they had an impending need for care, then the local authority may have to disregard what’s happened and consider their capital based on what they had when they entered the care assessment process. There are no hard and fast rules, but if your relative had not had any interaction with the NHS or local authority in terms of care before they reduced their capital, they may have a strong argument that they were not seeking to deprive themselves of capital. There are a number of ways in which your relative can effectively dispose of capital without breaching the local authority guidelines, including: • Setting up a Trust. • Repaying legitimate debts. • Producing receipts for legitimate expenditure. • Purchasing an Investment Bond with Life Cover (depending on the circumstances and timing of the investment). The local authority has the right to scrutinise any arrangements which it considers may have caused the deprivation of capital, and no arrangement is guaranteed to prevent deprivation of capital rules being applied. Before making any major financial decisions, you and your relative should speak to a qualified adviser.

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Seeking financial advice Planning for care and support needs can be complicated and funding care can be expensive. Professional advice may be helpful in enabling you and your loved one to identify the most suitable and cost-effective solution. Everyone is encouraged to seek unbiased, expert advice from independent financial advisers to help work out how to pay for long-term care. Independent financial advisers are regulated by the Financial Conduct Authority (FCA) and must take shared responsibility for the suitability of any product they recommend. Unlike advisers who are tied to particular providers, specialist care-fees advisers can offer advice on products from across the whole market. A list of independent financial advisers who are accredited by the Society of Later Life Advisers can be found at: www.societyoflaterlifeadvisers.co.uk or you can call 0333 202 0454. There is also a number of organisations that will provide free advice about funding care and support. These are a good place to start if you are looking for information and want to see what sort of options are available.

Age UK Tel: 0800 678 1174 Web: www.ageuk.org.uk/ moneymatters

Citizens Advice Bureau Web: www.adviceguide.org.uk

Money Advice Service Tel: 0800 138 7777 Web: www.moneyadviceservice. org.uk

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Legal considerations When considering your loved one’s affairs, there are a number of aspects which are important to look at to ensure that their assets are managed effectively. Your loved one may already have a will in place – or may be considering making one – but it’s equally as important to consider lasting powers of attorney, and where you would stand if your loved one loses mental capacity.

Lasting powers of attorney When someone makes a lasting power of attorney (LPA), they give another person or persons (known as ‘attorney(s)’) the authority to act for them if they are unable to do so themselves. That authority continues even if the person’s mental capacity declines and they are unable to make decisions for themselves. You can’t make an LPA on behalf of someone else, so it is worth making sure that your loved one has one before they are unable to make decisions for themselves.

There are two types of attorney – what are they? Financial affairs This allows your loved one’s attorneys to deal with their financial affairs, for example to pay their bills, sell their property or investments and operate their bank accounts. Unless your relative specifies otherwise, their attorneys can use the LPA to make decisions before they have lost mental capacity. This can be helpful if your relative is unwell or on holiday for an extended period. Health and care This allows attorneys to make decisions about matters such as medical treatment, diet, where your loved one lives and how they spend their time. Attorneys can also make decisions about

life sustaining treatment. Unlike the LPA for financial affairs, attorneys can only use it if your relative no longer has the mental capacity to make decisions themselves.

How do I make an LPA? An LPA must be made using a specific form. Your relative does not need to use a solicitor but may find it helpful if they find that the forms are a bit daunting. Who will be the attorneys? Your loved one must only appoint people that they can trust to act as their attorneys. They should also consider the time, skill and expertise that each attorney has in relation to what they may need to do. If they choose to appoint professional attorneys, they will need to pay them. Can I control what the attorneys do? The law limits what attorneys can do and how they must act. The most important rule is that an attorney is only allowed to act in the person’s best interests. Your relative can also include additional restrictions or guidance in the LPA itself.

Making a will Why should you make a will? Making a will is the only guaranteed way that your loved one can ensure that

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their estate passes to who they want. It is vital for your relative to have a will if they are unmarried, have been married before, have children, have a business, or are concerned about inheritance tax or care home fees.

expenses, any cash or specific legacies and the costs of administering the estate. Your loved one can leave their residuary estate:

What is the estate?

• To charity.

The estate is everything that your relative owns, whether jointly with another person or in their sole name. This can include a house, cash, investments, shares, a car and personal items like jewellery.

• On trust.

What should be included in the will? There are certain important aspects to a person’s will which include: • Who the Executors and Trustees are. • Who your relative wants to receive their estate. • How your relative’s inheritors should receive their estate.

What are Executors and Trustees? Executors must deal with the assets of the estate and distribute them in accordance with the terms of the will. This role can involve closing bank accounts, selling shares/investments and selling your relative’s house. Executors are also responsible for paying any debts. If there is a trust in the will, then at the end of the administration the Executors will become Trustees.

Residuary estate This is usually the largest part of a person’s estate for distribution and is calculated as the balance remaining after deduction of debts, funeral

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• To one or more than one person.

Your relative should also think about where their estate would go should their first beneficiary die before them and what would happen if all the beneficiaries didn’t survive (this is called the ultimate default clause).

Why do we recommend trusts in wills? A trust is a way of protecting assets by placing those assets under the control of chosen trustees. Trusts are extremely useful in the following situations: 1. Delaying someone’s inheritance until they are older (and/or more responsible). 2. Protecting capital for vulnerable beneficiaries. 3. Generational tax planning. 4. Business succession. 5. P  rotecting the estate for children where your loved one has been married before.

Inheritance and the family home The family home is often the asset which causes the most concerns. Your relative may wish to gift their home

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to their children but, if your loved one requires formal care and support, there is the danger that they may be accused of deliberately depriving themselves of assets, or indeed it may leave them financially vulnerable. There are genuine reasons why someone may wish to gift their home which may include: • Moral obligations to certain members of the family. • Financial obligations where someone has contributed to the property, lifestyle or helping with personal choices. • Avoiding family issues or disputes by making the gift of the family home during their lifetime. • Passing on the burden of owning property to the family. For example, they may agree to then keep the property maintained, repaired and insured at their own expense. Making a gift of a home should not be entered into lightly or without the benefit of professional advice. Aside from the concerns for your loved one regarding deliberate deprivation, they need to consider that: • The recipient of the gift could suffer from financial difficulties. If they are made bankrupt, the property may be lost to creditors. • The recipient of the gift could divorce and the property would be included when determining the divorce settlement. • The recipient must be aware of and accept the responsibility of property ownership.

• The family could fall out. • If the recipient dies, the property passes under their will or intestacy.

Mental capacity Mental capacity is fundamental when considering making a will, lasting power of attorney or indeed when undertaking lifetime planning. Capacity is not black and white; it is very much shades of grey and even if someone has been diagnosed with dementia it does not automatically preclude them from making decisions themselves. It is important not to simply dismiss someone’s ability to make a decision based on their age, appearance, a medical condition or their behaviour which may lead you to an unjustified preconception as to their capacity. Capacity is decision and time specific and your relative must have the required capacity to make the decision in question (for example, making a will or gifting an asset) at that particular time, even if this is just between 10.00am and 12.00pm. If your loved one is not lucid or does not have capacity at the time of an appointment, you may be able to reschedule for another time.

Specialist advice Exploring legal considerations before your loved one requires care and support is important. If there hasn’t been a chance, consider seeking advice at the time that care needs are identified. It’s never too late to get sound advice and it is important that your relative’s wishes are adhered to and their best interests are at the heart of all decisions. A specialist solicitor can advise on many aspects of the law around ageing, care and support.

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Useful contacts Action on Elder Abuse (AEA) Works to protect, and prevent the abuse of, vulnerable older adults. Tel: 0808 808 8141 Web: www.elderabuse.org.uk Age UK Information on issues affecting older people and their carers. Tel: 0800 678 1174 Web: www.ageuk.org.uk Alzheimer’s Society Confidential advice, information and support helpline, open seven days a week, with trained advisers who understand the needs of people affected by dementia. Tel: 0300 222 1122 Web: www.alzheimers.org.uk Ask SARA Guided advice about daily living. Web: www.asksara.org.uk Care Home Finder Provides tailor-made support to help you find the right care solution. Listens to your requirements and compiles reports of the best care options based on your loved one’s needs and personal interests. Tel: 0345 853 0300 Web: www.carehomefinder.org

Useful contacts

Care Select The online version of this handbook with many more features, plus a link to online care search and telephone service to help you find care providers in your area. Tel: 0800 389 2077 Web: www.careselect.co.uk

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Care Quality Commission National organisation responsible for inspecting and regulating care services. Tel: 03000 616161 Web: www.cqc.org.uk Carers Trust The largest provider of comprehensive carers’ support services in the UK. Tel: 0844 800 4361 Web: www.carers.org Carers UK Provides support to anyone who is a carer. Tel: 0808 808 7777 Web: www.carersuk.org Disabled Living Foundation (DLF) A national charity that provides impartial advice, information and training on daily living aids. Tel: 0300 999 0004 Web: www.dlf.org.uk Dying Matters Aims to change public knowledge, attitudes and behaviours towards dying, death and bereavement. Tel: 0800 021 4466 Web: www.dyingmatters.org Elderly Accommodation Counsel Helps people make decisions about where to live and any support or care they need. Web: www.housingcare.org Farley Dwek Solicitors A specialist provider of legal services in relation to issues around care funding, with a specific knowledge

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of NHS Continuing Healthcare funding. Tel: 0161 272 5222 Email: enquiries@farleydwek.com Web: www.farleydwek.com FirstStop Advice Advice and information on finance and rights for older people. Tel: 0800 377 7070 Web: www.firststopadvice.org.uk Friends of the Elderly Committed to enhancing the quality of life for older people by providing a range of high standard services. Tel: 0207 730 8263 Web: www.fote.org.uk Gov.uk Information portal for Government services and information. Web: www.gov.uk Housing Options for Older People Online Online questionnaire to help consider the most suitable housing for your parent’s needs. Web: hoop.eac.org.uk Independent Age Helps older people on very low incomes to live independently in their own homes and when this is no longer possible, they

can help with care home fees. Tel: 0800 319 6789 Web: www.independentage.org.uk National Activity Providers Association (NAPA) Works to create new opportunities for community involvement and activity in care settings. Tel: 0207 078 9375 Web: www.napa-activities.com National Care Forum (NCF) Represents the interests of the not-forprofit care sector. Tel: 0247 624 3619 Web: www.nationalcareforum.org.uk National Council for Palliative Care (NCPC) Umbrella organisation for all those who are involved in providing, commissioning and using hospice and palliative care services in the UK. Tel: 0207 697 1520 Web: www.ncpc.org.uk Relatives and Residents’ Association, The Offers support and information to families, friends and relatives about issues affecting care homes. Tel: 0207 359 8136 Web: www.relres.org

SEARCHING FOR CARE OPTIONS IN YOUR AREA? With so many providers to choose from, where do you start? • • • •

find care providers quickly and easily • search by location and care need information on care quality • links to inspection reports additional care provider information, photos and direct website links brochure requests

www.carechoices.co.uk

Developed by the publisher of this Handbook

Alternatively, call our friendly team on 0800 389 2077 to talk to someone directly.

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RJR Legal Ltd Specialising in wills, estate administration and planning, and trusts. Tel: 0161 613 5091 Web: www.rjrlegal.co.uk

Solicitors for the Elderly A national association of solicitors, barristers and legal executives providing and promoting a range of legal services for older people. Tel: 0844 567 6173 Web: www.sfe.legal

Silver Line, The Free 24-hour helpline providing information, friendship and advice for older people. Tel: 0800 470 8090 Web: www.thesilverline.org.uk Society of Later Life Advisers A not-for-profit organisation aiming to ensure that consumers are better informed about the financial issues of later life and can help you find an accredited adviser. Tel: 0333 202 0454 Web: www.societyoflaterlifeadvisers. co.uk

Unforgettable Dedicated website to support people living with dementia and their carers. Contains useful information about equipment and technology specifically designed for people with dementia. Web: www.unforgettable.org United Kingdom Homecare Association Promotes high standards of homecare and takes an active role in liaising with local and central government on all homecare and related issues. Tel: 0208 661 8188 Web: www.ukhca.co.uk

The lifestyle site for parents and carers of children with additional needs and those who support them.

Birth to Adulthood • Directory • Guidance • Real Life • Ask the Experts www.myfamilyourneeds.co.uk To join the family call 01223 207770 or email hello@myfamilyourneeds.co.uk @WeAreMFON

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Region-by-region care homes

North West

Yorkshire and the Humber

East Midlands

East of England

West Midlands

London

South West

South East

> East Midlands

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Derbyshire, Leicestershire, Lincolnshire and Northamptonshire.

> East of England

100

Bristol, Gloucestershire, Poole, Somerset and Wiltshire.

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> London

103

All areas, Central, North, East, South East, South, South West and North West.

Bedfordshire and Cambridgeshire.

> North West

> South West

96

Cheshire East, Manchester and Merseyside.

> West Midlands

104

Warwickshire and Worcestershire.

> South East

97

Buckinghamshire, East Sussex, Hampshire, Kent, Surrey and West Sussex.

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Region-byregion care homes Advertisers’ index

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East Midlands Derbyshire CODNOR PARK

a shmere

88 Glass House Hill, Codnor, DE5 9QT Tel: 01773 741111 Web: www.ashmere.co.uk

A purpose built care home Codnor Park Aispurpose built careroad home, Codnor Park is set off the main through Codnor setand off we the benefit main road through Codnor, from extremely goodand webus benefit extremely good links to links from to nearby Ripley andbus Heanor nearby and and Heanor as well as Derby as wellRipley as Derby Nottingham. and Nottingham.

CARE HOMES FOR LOVED ONES

THE FIRS

a shmere

90 Glass House Hill, Codnor, DE5 9QT Tel: 01773 743810 Web: www.ashmere.co.uk

KIDSLEY GRANGE

A purpose built care home Codnor Park The home hasmain retained original warmth is set off the roadits through Codnor and whilst having been developed andcharm we benefit from extremely good to the that all bushighest links tospecifications, nearby Ripleyensuring and Heanor residents have the amenities necessary to as well as Derby and Nottingham. enjoy our high quality care.

A purpose built care home Codnor Park We provide hourroad personalised care along is set off the24main through Codnor with wide range from of services and facilities and a we benefit extremely good tailored to your needs.Ripley As a resident you can bus links to nearby and Heanor beassure will continue to have access to wellyou as Derby and Nottingham. health, leisure and community services.

CARE HOMES FOR LOVED ONES

CARE HOMES FOR LOVED ONES

KING WILLIAM

a shmere

Lowes Hill, Ripley, DE5 3DW Tel: 01773 748841 Web: www.ashmere.co.uk

RYKNELD VIEW NURSING HOME 410 Burton Road, Derby, Derbyshire DE23 6AJ Email: rvnh.admin@primushc.com Telephone: 01332 365 240 • Accommodation for 31 residents • Regular group and individual activity sessions • For elderly nursing and residential care • Palliative care with unrestricted visiting • All single rooms – majority are en-suite • Local GP visits • Local to town centre & amenities

A purpose built care home Codnor Park The residential home Codnor itself has is set28offbed the main road through plenty of benefit character, having once good been a and we from extremely public house. specialize all aspects bus links to We nearby Ripley with and Heanor of caring for the elderly and physically as well as Derby and Nottingham. disabled.

a shmere

Main Road, Smalley, DE7 6DS Tel: 01332 882848 Web: www.ashmere.co.uk

SUTTON COURT, LODGE & MANOR Priestsic Road, Sutton in Ashfield, Nottinghamshire, NG17 2AH Tel: 01623 441130 Web: www.ashmere.co.uk

A purpose built care home Codnor Park is set offHall theismain through Codnor Smalley a 27 road bed residential home on and we benefit from village, extremely good the outskirts of Smalley Derbyshire. bushome links to nearby Ripley and Heanor The is full of character having once as well Derby andto Nottingham. been the as coach house Smalley Hall.

A purpose built care home Codnor Park Our up the Ashmere Care is sethomes off themake main road through Codnor Centre. With our Sauna pool, and we benefit from hydrotherapy extremely good Jacuzzi, physiotherapy rooms regular bus links to nearby Ripley andand Heanor activities, care centre is ideal for rest and as well asthe Derby and Nottingham. relaxation.

CARE HOMES FOR LOVED ONES

CARE HOMES FOR LOVED ONES

94

“Premier nursing home”

www.rykneldview.co.uk

“Warm, friendly and professional care homes”

CARE HOMES FOR LOVED ONES

SMALLEY HALL

a shmere

160 Heanor Road, Smalley, DE7 6DX Tel: 01773 769807 Web: www.ashmere.co.uk

a shmere

Visit www.careselect.co.uk for further assistance with your search for care


East Midlands

continued

Derbyshire continued VALLEY LODGE

a shmere

Bakewell Road, Matlock, DE4 3BN Tel: 01629 583447 Web: www.ashmere.co.uk

WEST HALLAM

a shmere

8 Newdigate Street, West Hallam, Ilkeston, DE7 6GZ Tel: 0115 9440329 Web: www.ashmere.co.uk

A purpose built care home Codnor Park Valley is located on the outskirts is set Lodge off the main road through Codnor of Matlock the A6 Bakewell Road. and we on benefit from extremely goodThe home is set stunning bus links to within nearby Ripley andcountryside Heanor with panoramic views the River Derwent as well as Derby and of Nottingham. and the High Peak Railway.

A purpose built care home Codnor Park West was opened in 1988. Within is setHallam off the main road through Codnor easy from Ilkeston, and travelling we benefit distance from extremely good Derby andto Nottingham. Home is bus links nearby Ripley The and Heanor situated in a quiet residential area only as well as Derby and Nottingham. minutes away from Shipley Country Park.

CARE HOMES FOR LOVED ONES

CARE HOMES FOR LOVED ONES

Leicestershire

Lincolnshire TEL: 0116 442 2181 EMAIL: info@helpfulhomecare.co.uk Second Floor | 2 The Parade Oadby | Leicester | LE25BF

Helpful Home Care is dedicated to enabling adults and older adults in Leicestershire with support needs to live independent lives in the comfort of their own home and to participate within the communities they live in. SERVICES WE OFFER INCLUDE: Home Care Carer Respite Convalescence

Social Care Shopping Personal Care

Enabling the best in time of need

Westerley Woodhall Spa offers…

A person centred environment for permanent residential, • respite or day care. Christian ‘family’ with daily acts of worship • AHigh quality en-suite rooms with comfortable lounges, inspiring • gardens and a wide range of activities • The warmest of welcomes for you and your family and friends. Westerley, The Broadway, Woodhall Spa, Lincolnshire, LN10 6SQ Phone: 01526 352231 Email: woodhallm@lwpt.org.uk

www.helpfulhomecare.co.uk

Active Christian Care for the Elderly

www.lwphomes.org.uk

Northamptonshire

THE ANGELA GRACE PURPOSE-BUILT, LUXURY CARE CENTRE

The Angela Grace is a purpose-built, luxury care centre located right in the heart of Northampton, close to amenities and opposite the Hospital. Providing residential, nursing, specialist dementia care as well as respite and end of life care.

Tel: 01604 633282 Email: admin@theangelagrace.co.uk 4-5 Cheyne Walk, Northampton

Nursing Homes Limited Caring Since 1984

Brockfield House 01933 625555

Villa Lane, Stanwick, Wellingborough NN9 6QQ

Brockfield House, established in 1984, is a delightful home registered for 45 residents and situated in the village of Stanwick, close to amenities and local transport. The Home specialises in the care of people living with the effects of long-term mental health problems and those living with dementia. Nurses and care staff are respectful and sensitive to the individual needs and choices of residents and provide care in a comfortable and safe environment.

We specialise in Dementia care.

enquiries@harlestonehomecare.co.uk Main Office: 01604 419600 Fax: 01604 419604

An exclusive family run business, catering for private clients across Northamptonshire. At Harlestone Home Care our key purpose is to deliver reassuring, compassionate and supportive care and companionship.

Our services include:

Personal Care • Dementia Care • Friendship • Home Help Medication Assistance

www.harlestonehomecare.co.uk

For assistance with finding care and support, call Care Select on 0800 389 2077

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East of England Cambridgeshire

Bedfordshire

Crossways Nursing Home Our Nursing Home provides a friendly environment caring for older people and adults with physical disabilities. We strive to promote independent living, preserve dignity and maintain privacy at all times. We provide: • Person-centred nursing

• Palliative care

• Respite and re-ablement

• Dementia care

Caring for the elderly with nursing needs

Soham Lodge Care Centre, specialising in care for the elderly with nursing needs. We aim to provide residents with a safe and secure, relaxed and homely environment in which care, well-being and comfort are of prime importance. All rooms are ground floor, large bedrooms with en-suite wet rooms, communal areas for meals, socialising and activities and enclosed garden areas.

Contemplation Homes

• Fully vetted and trained staff

T: 01353 720775 E: info@sohamlodge.co.uk www.sohamlodge.co.uk Soham Bypass A142, Soham, Ely, Cambridgeshire CB7 5WZ

86 Hookhams Lane, Renhold, Bedford MK41 0JX

01234 771694 • www.thecontemplationgroup.co.uk

Cottenham Court Care Home High Street, Cottenham, Cambridge CB24 8SS Nursing Residential Respite Palliative Convalescence

North West

You don’t need to be a Bupa member to stay here. To find out more about Cottenham Court Care Home call:

01954 768 622 Lines are open seven days a week. We may record or monitor our calls.

Cheshire East

Hazelmere House Care Home

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Pinewood Road, Wilmslow, Cheshire SK9 2RS Nursing Residential Respite Parkinson’s Palliative Convalescence You don’t need to be a Bupa member to stay here. To find out more about Hazelmere House Care Home call:

01625 838 893 Lines are open seven days a week. We may record or monitor our calls.

Manchester

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The Home Care Specialists

Do you need a Helping Hand? To find out how we can help Call: 01618 250 117 Visit: www.helpinghands.co.uk

Merseyside

10/04/2017 10:22

If you are looking for extra support at home or an alternative to residential care homes, then we’re here to help.

The Manor House Care Home Moreton Road, Upton, Wirral CH49 4NZ Nursing Residential Huntington’s Convalescence Palliative Respite Parkinson’s Dementia residential You don’t need to be a Bupa member to stay here.

From as little as 30 minutes per week to full-time Live-in Care.

To find out more about The Manor House Care Home call:

0151 909 2932 Lines are open seven days a week. We may record or monitor our calls.

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South East Buckinghamshire Rayners, the first purpose built Residential Home for the elderly in South Buckinghamshire was opened in June 1990, designed specifically to provide the elderly with a level of care and comfort that is unsurpassed. In addition to the high level of care provided we are able to offer ‘extra care’, in the event of a resident becoming more dependant.

Weedon Hill, Hyde Heath, Amersham HP6 5UH Tel: 01494

This degree of care is not usually available in residential homes and gives the resident and their relatives alike confidence and peace of mind. Rayners also has the ability to accommodate respite or short stay residents, subject to suite availability. Rayners who is still family owned and managed is also proud to offer luxurious ‘Assisted Living Apartments’ at Maple Tree House, situated on the same site as Rayners Residential Home.

773606

Email: admin@careatrayners.co.uk

www.careatrayners.co.uk

East Sussex

Cheriton

www.cheritonhomecare.co.uk 
 info@cheritonhomecare.co.uk

Welcome home...

We care for you as we would our own family.

H o m e c a r e

• • • •

Residential, nursing & respite care Sheltered housing & day care Compassionate and stable team 3 acres of beautiful grounds

OLD TOWN IN BEXHILL-ON-SEA 01424 730809 or email info@peterhousecare.com ☎ 01273 273 277

Specialist Live-in care provider

Award-winning ✔ ‘Good’ CQC Rating www.peterhousecare.com

Copper Beech Care Home

Care home or YOUR home? You do have a choice...

Eastbourne Road, Ridgewood, Uckfield TN22 5ST

Our expert care workers live in your home with you, 24-7 as a companion, a carer and a friend.

01273 273 offer a genuine alternative ☎ to residential care277 CheritonWe www.cheritonhomecare.co.uk homes. We help elderly and vulnerable people to info@cheritonhomecare.co.uk

safely in their own homes by providing 24 H o m e c a r remain e hour, live-in care. Carers are matched to you based on personality, hobbies, interests and overall care needs.

Specialist Your live-in companion/care package starts from just £695pw Live-in care For provider more information for please call Lesley on 07388 326 686 or 01273 257 465 Sussex and or visit www.promedica24.co.uk/brighton Surrey

Hampshire Choose to maintain your 


You don’t need to be a Bupa member to stay here. To find out more about Copper Beech Care Home call:

01825 818 554 Lines are open seven days a week. We may record or monitor our calls.

R

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IS TER E EG

D

NURSING HOME

SS

A

Care Home with Nursing

Nursing Palliative Respite Parkinson’s Convalescence Post operative care

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independence at home

Alverstoke House

OC IATIO

N

Alverstoke House is a purpose built, family run nursing home specialising in Caring for the Elderly who have complex nursing care needs. We also specialise in end of life care and provide care for those needing nursing after leaving hospital before returning home. • Excellent reputation in the Alverstoke Area • 30 beds, most en-suite, two sitting rooms, dining room and two conservatories. • We operate an open door policy for visits of family and friends.

“An ideally situated Care Home with Nursing offering a high standard of care by our specialist team" Website: www.alverstokehouse.com • E-mail: info@alverstokehouse.com Telephone: 02392 510254 • Office: 02392 529908 • Fax: 02392 503054 20 Somervell Close, Alverstoke, Gosport, Hampshire PO12 2BX

For assistance with finding care and support, call Care Select on 0800 389 2077

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South East

continued

Hampshire continued

Rotherbank

Tel: 01730 892 081

Rotherbank is a small, friendly, family owned and operated residential care home. We are registered for dementia care and the frail elderly. We provide a homely environment affording security, independence with supportive care. Our care assistants are your personal carers, friends and companions. Your needs are constantly met and reviewed following an individual plan of care. All staff are trained to NVQ 2, 3 & 5. All staff are happy and settled which promotes an excellent friendly atmosphere for residents. Staff turnover is extremely low resulting in agency staff never having to be used. If you would like further information, please call us on the telephone number above or feel free to visit us any time.

www.Rotherbank.com

Rotherbank Farm Lane, Liss Forest, Hampshire, GU33 7BJ

Leading the way in care Somerset Care has an innovative new approach to care in your home and the community, offering a wide range of flexible in Hants & Surrey care packages across Hampshire and Surrey. These are truly built around the individual needs of our customers and not about watching the clock. To find out more contact us on: 02392 258 022

www.somersetcare.co.uk

Kent

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LU X U RY C A R E H O M E

OPENING AUGUST 2017 Baycroft Grays Farm Road is our inaugural luxury care home, providing expert 24-hour residential, nursing and dementia care. We are creating homes that feel like home, where you can truly feel at ease. As much thought has been invested into the dining experience, the engaging social activities and the high quality facilities as the exemplary standards of care. These elements combined create the comfortable and happy lifestyle you deserve.

Gr a y s Fa r m Ro a d , Orpington BR5 3BD 020 8821 5400 baycroft.co.uk info@baycroft.co.uk

We are dedicated to making a better every day for you and aligning our care and services to your needs.

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South East

continued

Kent continued

SIT BACK AND RELAX • Beautiful victorian house with mature gardens • Family run for over 30 years • Full activity programme • Lift to all floors • En-suite rooms • Excellent home cooking

Book a free trial:

020 8460 6555 I www.theheathers.co.uk

 

NEL_367_CARE_SELECT_HF_90Wx53H_AD_OUT.indd 1

Country Country House House Living Living for for the the Elderly Elderly with with 24 24 Hour Hour Care Care We We offer offer tailormade tailormade care care packages packages in in our our beautiful beautiful Edwardian Edwardian home, home, including including full full time, time, respite respite and and day daycare. care.

Visit Visit our our website: website: www.highhilden.co.uk www.highhilden.co.uk High High Hilden Hilden Close, Close, Tonbridge, Tonbridge, Kent, Kent, TN10 TN10 3DB. 3DB.

Telephone: Telephone: 01732-353070 01732-353070

Surrey

Abbey Chase Nursing Home

www.abbeychase.co.uk

Our aim is to create a friendly family atmosphere between staff and residents and to ensure that all of our guests are very happy, comfortable and content in their retirement. Set in 10 acres of beautiful grounds Beautiful views of the riverside grounds and paddocks Within walking distance of Chertsey town centre Orchards and moorings on the Abbey River First class, spacious accommodation Outdoor or indoor leisure activities l

l

l

l

l

l

Tel: 01932 568090

Email us at: info@abbeychase.co.uk

For assistance with finding care and support, call Care Select on 0800 389 2077

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27/03/2017 14:15


South East

continued

Surrey continued

West Sussex

First class care, nursing & dementia homes

We can care for people living with dementia throughout their journey in our exceptional environment at Haviland House, Worthing.

Care homes, home care and wellbeing day facilities in West Sussex. Please contact 01903 327327 or enquiry@guildcare.org

www.guildcare.org

Charity 1044658 established 1933

Care home or YOUR home? You do have a choice...

Our expert care workers live in your home with you, 24-7 as a companion, a carer and a friend. We offer a genuine alternative to residential care homes. We help elderly and vulnerable people to remain safely in their own homes by providing 24 hour, live-in care. Carers are matched to you based on personality, hobbies, interests and overall care needs.

South West

Your live-in companion/care package starts from just £695pw For more information please call Chris on 07836 256 639 or 01243 684 085 or visit www.promedica24.co.uk/west-sussex

Bristol

Gloucestershire

Druid Stoke Care Home 31 Druid Stoke Avenue, Stoke Bishop, Bristol BS9 1DE Nursing Residential Respite Huntington’s Palliative Convalescence

Chapel House is our new acquisition and we offer home from home services, a range of superb en-suite rooms, Permanent Residency, Respite care, and Convalescence.

You don’t need to be a Bupa member to stay here. To find out more about Druid Stoke Care Home call:

t: 01793 821200 | Horton Road, Gloucester GL1 3EY Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

0117 911 8624 Lines are open seven days a week. We may record or monitor our calls.

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Chapel House

10/04/2017 10:22

Visit www.careselect.co.uk for further assistance with your search for care


South West

continued

Gloucestershire continued

honeybourne gate Luxury living in a landmark retirement complex Tel: 0800 4714793 www.honeybournegate.co.uk

A new beginning at Honeybourne Gate Designed and equipped to the highest specification, these 55 apartments set a new standard for retirement property in Cheltenham, offering independent living plus a range of flexible services including personal care.

1 bed apts from £238,995 2 bed apts from £295,000

Poole

The Lindsay Care Home 47A Lindsay Road, Poole BH13 6AP

Woodstock A 28 bedded Nursing Dementia home, set on the outskirts of Gloucester, three miles from the town centre, with easy access to the ring road and the M5/A38/A46.

t: 01793 821200 | North Upton Lane, Gloucester GL4 3TD Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

Somerset

caringcommunities Latimer Lodge at Yeovil Care Community A beautifully-renovated Victorian villa in the heart of Yeovil offering luxury residential care for long term and respite stays.

Tel: 0800 022 6000

38 Preston Road, Yeovil, Somerset BA21 3AQ www.yeovilcarecommunity.co.uk

Nursing Respite Convalescence Palliative Dementia nursing Post operative care You don’t need to be a Bupa member to stay here. To find out more about The Lindsay Care Home call:

01202 031 754 Lines are open seven days a week. We may record or monitor our calls.

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caringcommunities

Martock Care Community Set in the beautiful village of Martock in Somerset our Georgian Grade IIlisted home offers residential, nursing and dementia care in luxurious rural surroundings.

Tel: 0800 022 6000

Hurst, Martock, Somerset TA12 6JU www.martockcarecommunity.co.uk

caringcommunities Tyndale House at Yeovil Care Community A beautifully-renovated Victorian villa in the heart of Yeovil offering luxury residential and dementia care for long term and respite stays.

Tel: 0800 022 6000

36 Preston Road, Yeovil, Somerset BA21 3AQ www.yeovilcarecommunity.co.uk

10/04/2017 10:22

Enabling the best in time of need

At Westerley in Minehead we offer…

We offer a caring environment in which to enjoy permanent, respite or daily support. We are a Christian ‘family’ with daily acts of worship and regular celebration of HolyCommunion. 24 hour personal and pastoral care is on hand to help and assist in every way. Westerley, King Edward Road, Minehead, Somerset, TA24 5JB Phone: 01643 702066 Email: mineheadm@lwpt.org.uk

For assistance with finding care and support, call Care Select on 0800 389 2077 101

Active Christian Care for the Elderly

www.lwphomes.org.uk


South West

continued

Somerset continued

Home is where the heart is Whether you’re looking for short-term respite care, or a longer term move to a residential home, Somerset Care has care homes throughout Somerset. For details of your nearest homes, please call us on: 0800 9884 337 or visit: www.somersetcare.co.uk

Live your life the way you want to. We make it happen. Our Willows care service is designed around you, providing tailored support packages in your own home to help you achieve your aims and improve your quality of life. Get in touch and see how we can support you. 0800 0902 312

www.willows-care.co.uk

Wiltshire

Ashbury Lodge

Church View

Situated on the outskirts of Swindon in a handsome building right next to the beautiful Coate Water Country Park. We first opened in 2000 and now have 42 full-time residents.

Church View is a well-established care home which provides Residential, Respite, Day Care and nursing care. Situated in a quiet residential area on the outskirts of Stratton.

t: 01793 821200 | 261 Marlborough Road, Swindon SN3 1NW Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

t: 01793 821200 | Rainer Close, Stratton St Margaret SN3 4YA Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

Downs View Situated in the quiet rural hamlet of Badbury, just off the A346 (Swindon to Marlborough road) approximately 1 mile from Junction 15 off the M4, offering residentail, day care and respite.

t: 01793 821200 | Badbury (Near Chisledon), Swindon SN4 0EU Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

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Visit www.careselect.co.uk for further assistance with your search for care


London Central

All areas We provide high-quality care to adults of all ages in the comfort of their own homes. We offer daytime, overnight, and live-in care, to ensure that we provide exactly what our clients need and when they need it.

12 Parkgate Road, Battersea SW11 4NN

Our care services include but are not limited to:

Nursing Residential Respite Palliative Convalescence Parkinson’s Dementia care

Personal care Companionship Household help Dementia Respite Post-discharge

We are regulated by the CQC.

Meadbank Care Home

Palliative Nursing Visits from healthcare professionals, including GPs Transportation Meal delivery

You don’t need to be a Bupa member to stay here. To find out more about Meadbank Care Home call:

020 3468 1753

Call us on 020 3034 4737, we are available 7 days a week. Email: info@joincera.com www.ceracare.co.uk

Lines are open seven days a week. We may record or monitor our calls.

North

A beautiful, small, family-run home

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Tel: 020 8660 6646 47 Foxley Lane, Purley CR8 3EH

Situated in Purley, south east London, Heatherwood Nursing Home provides high quality nursing, residential and palliative care to 22 residents. We are a family-run Home that focuses on individual care and attention. As a small home we have the time and resources to ensure each resident receives the very best in care and facilities.

Tel: 0208 642 4117 59 Burdon Lane SM2 7BY

At the heart of what we do is a desire to provide everyone we support with the opportunity to continue to live life to the full. This means much more than just providing good care; it is about working with each resident to understand their life story to-date, as well as their dreams and aspirations for the future. Armed with this understanding, we can achieve these dreams together.

Heatherwood

Willow Lodge nursing home

nursing home

www.heatherwood.org

10/04/2017 10:22

Live your life and believe in your ideas!

info@heatherwood.org

www.willowlodge.org

info@willowlodge.org

East

Looking for home care you can trust? • Personal & post-op care • Housekeeping and companionship • Specialists in dementia, end-of-life and complex disabilities ✔ CQC approved Contact us for a chat today and arrange a free assessment

Tel: 01708 548250

www.lodgegroup.com

South East The Home Care Specialists

Do you need a Helping Hand? To find out how we can help Call: 02081 857 819 Visit: www.helpinghands.co.uk

If you are looking for extra support at home or an alternative to residential care homes, then we’re here to help. From as little as 30 minutes per week to full-time Live-in Care.

NEW CARE HOME

NOW OPEN! in Blackheath

We are the difference between quality and excellence and between caring at work and caring like family.

Call our team on 020 8318 2272, visit cinnamoncc.com/leah or email leah@cinnamoncc.com Blessington Road, Blackheath, London, SE13 5EB

For assistance with finding care and support, call Care Select on 0800 389 2077 103


London

continued

South

South West

A Home away from Home

Heathland Court Care Home

Tel: 020 8688 7022 84 Coombe Road CR0 5RA

56 Parkside, Wimbledon SW19 5NJ Nursing Parkinson’s Palliative Convalescence Respite Residential Residential dementia

Lloyd Park is a modern and highly-skilled care facility, that can show a proven record in functioning as satisfying elderly care accommodation for a wide range of individual health requirements. This facility’s dedicated team are not idle or unimaginative in the care solutions they bring to their residents.

You don’t need to be a Bupa member to stay here.

Lloyd Park

To find out more about Heathland Court Care Home call:

nursing home

020 8108 3960

www.lloydparknursing.org

info@lloydparknursing.org

Lines are open seven days a week. We may record or monitor our calls.

North West

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Erskine Hall Care Home

10/04/2017 10:22

Watford Road, Northwood HA6 3PA Nursing Respite Parkinson’s Residential Convalescence Palliative Physically disabled You don’t need to be a Bupa member to stay here.

West Midlands

To find out more about Erskine Hall Care Home call:

01923 889 798

Warwickshire

Lines are open seven days a week. We may record or monitor our calls.

Alveston Leys Care Home Kissing Tree Lane, Alveston, Stratford-upon-Avon CV37 7QN Nursing Residential Day care Respite Parkinson’s Palliative Residential dementia Huntington’s Nursing dementia Convalescence You don’t need to be a Bupa member to stay here.

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10/04/2017 10:22

To find out more about Alveston Leys Care Home call:

01789 867 296 Lines are open seven days a week. We may record or monitor our calls.

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Worcestershire

10/04/2017 10:22

Mockley Manor

Westley Court

Set in beautiful, well-maintained grounds on the outskirts of the pleasant village of Ullenhall, near Henley in Arden providing Nursing Care, Respite Care and Palliative Care.

Situated in the peaceful village of Cookley, near Kidderminster. Delivering a high standard of care in comfortable, homely surrounds and specialising in Palliative Care, Nursing Care and Respite Care.

t: 01793 821200 | Forde Hall Lane, Ullenhall B95 5PS Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

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t: 01793 821200 | Austcliffe Lane, Cookley, Kidderminster DY10 3RT

Please call for your copy of our home brochure info@coatewatercare.co.uk | www.coatewatercare.co.uk

Visit www.careselect.co.uk for further assistance with your search for care


Advertisers’ index A

Druid Stoke Care Home

Abbey Chase Nursing Home

99

Abbotsleigh Care Centre

4, 98

AGE Nursing Homes Ltd

51

Age UK

41

Alverstoke House Care Home with Nursing

97

Alveston Leys Care Home

104

Angela Grace, The

51, 95

Ashbury Lodge Ashmere

102 31, 94, 95

Ashwood Healthcare 

3, 98

E Eight Wealth Management

85

Elmbridge & Runnymede

35

Epsom & Kingston

35 104

Erskine Hall Care Home

F Far Fillimore Care Home

56

Firs, The

31, 94 73

Future Legal Services

G

B Baycroft

98

Bluebird Care

35

Brockfield House Bupa

100

51, 95

31, 96, 97, 100, 101, 103, 104

Grange Care Home, The

3, 99 100

Guild Care

35

Guildford & Waverley

H

C

Harlestone Home Care

Care Choices   13, 16, 22, 32, 45, 50, 72, 91

Hazlemere House Care Home

96

Heathland Court Care Home

104

Caring Communities  101, Outside back cover Cera

43, 103

Chapel House

100

Cheriton Home Care

39, 97

Church View Cinnamon Care Collection

102 56, 103

Coate Water Care 64, 100, 102, 104, Inside back cover Codnor Park

31, 94

Contemplation Homes

61, 96

Cooksons Court

53

Copper Beech Care Home

97

Cottenham Court Care Home

96

Crossways Nursing Home Cumbria House Care Home Cura

61, 96 3, 98 56, 94

D Downs View

102

39, 95

Heathers, The

99

Heatherwood Nursing Home  Inside front cover, 103 95

Helpful Homecare Helping Hands

33, 96, 103

Hengist Field Care Centre

99

High Hilden

99

Honeybourne Gate

101

K Kidsley Grange

31, 94

King William

31, 94

L Latimer Lodge at Yeovil Care Community Leah Lodge

101 56, 103

Lindsay Care Home, The

101

Littleover Nursing Home

56

Lloyd Park Nursing Home  Inside front cover, 104

For assistance with finding care and support, call Care Select on 0800 389 2077 105


Advertisers’ index continued Lodge Group Care LWP Homes

103 55, 95, 101

M

– Moorlands Lodge  Smalley Hall

100 31, 94 96

Soham Lodge Somerset Care

53, 98, 102

Manor House, The

96

Martock Care Community

101

Sutton Court, Lodge & Manor 31, 94

Mase Group, The

39

T

Meadbank Care Home

103

Mockley Manor

104

My Family Our Needs

92

N

101

U

Nellsar

4, 98, 99

Nightingale Court Care Home

56

P Peterhouse Promedica 24

55, 97 33, 97, 100

R

UK Hearing Care

97

Reigate

35

Rotherbank

98

Rushmoor & Surrey Heath

35

Rykneld View

94

S Signature – Miramar 

99, 100 99

Care Choices Limited has taken every care to ensure that the information contained in Care Select is accurate. The company cannot accept responsibility for any errors or omissions or if a home varies from the facilities listed either in an advertisement or the listings. Care Choices Limited does not endorse or support any particular institution included in the publication. ©2017 Care Choices Limited. ISBN 978-1-911437-43-7 Ref. No: 4001/CareSelect05/17. Reproduction of any part of this publication in any form without the written permission of Care Choices Ltd is prohibited. Published by: Care Choices Ltd, Valley Court, Lower Road, Croydon, Nr Royston, Hertfordshire SG8 0HF. Tel: 01223 207770.

41

V Valley Lodge

31, 95

W West Hallam

Rayners

106

Tyndale House at Yeovil Care Community

31, 95

Westerley Christian Care 55, 95, 101 – Minehead  55, 101 55 – Westcliffe-on-Sea 55, 95 – Woodhall Spa  Westley Court

104

Willow Lodge Nursing Home  Inside front cover, 103 Willows

102

Woodstock

101

Publisher: Robert Chamberlain. Director of Sales: David Werthmann. Head of Editorial: Emma Morriss. Editor: Angharad Jenkins. Content Editor: Emma Cooper. National Sales Manager: Paul Leahy. Regional Team Manager: Russell Marsh. Care Select Manager: Paul O'Callaghan. Regional Team Supervisor: Vanessa Ryder. Senior Sales Executives: Mark Dalton, Elaine Green. Sales Executive: Kara Morrallee. Director of Creative Operations: Lisa Werthmann. Studio Manager: Jamie Harvey. Designer: Holly Cornell. Creative Artworkers: Ruth Clarry, Bobbie Johnson. Distribution: Elayna Cordes.

Visit www.careselect.co.uk for further assistance with your search for care


Your loved ones are guaranteed a warm and safe environment at Coate Water Care —

Coate Water Care is a family-run business that provides a high quality care service in all our Nursing, Residential and Dementia care homes.

Fully Secure Homes Fresh Home Cooked Meals Friendly Helpful Staff

We provide 24-hour nursing, residential and specialist dementia care, as well as specialist care for clients with end of life and palliative needs. Respite and day care services are also available. All these services are provided by our friendly and fully qualified care staff.

We care because you care —

CQC Regulated Full Activity Programme Specialist Care Services Specialist Trained Staff On-site Hair & Beauty

Let us help you find the right care for your loved ones. Please contact our ‘Welcome Team’ to arrange a visit to your local Coate Water Care home.

Call: 01793 821200 or Email: info@coatewatercare.co.uk to order a home brochure.

For assistance with finding care and support, call Care Select on 0800 389 2077 107

Ashbury Lodge | Chapel House | Church View | Downs View | Mockley Manor | Westley Court | Woodstock


caring communities

5-star living, care and support Seeking the perfect location for a short respite break? Or perhaps a longer-term residence where your loved one’s every need is catered for in 5-star luxury? Caring Communities’ beautiful assisted living and care homes offer premium accommodation for residents seeking that little bit extra care, comfort and companionship in their later years. With 24-hour concierge and room service, fine dining and luxurious interiors (and even a chauffeur-driven Bentley on standby for local trips) our homes offer residents independence and privacy, with the peace of mind of knowing that professional care and support will always be at hand. We’re developing homes across the south-west. Visit us now to find out more.

0800 022 6000

caringcommunities.co.uk

luxury living for later life

Care Select - The Handbook For Relatives 2017  

Your companion through the emotional and practical aspects of choosing and funding care for an ageing relative.