Care at Home

When caring for someone else it is often in their own home. It is understandable that although someone may need help for many things, they prefer to stay in the independence of their own home for as long as possible. This situation is actively encouraged by the government and there should be a wide variety of help available to assist people who are old or infirm to stay at home rather than move into residential care.

Local Authority and the NHS

Local authority social services departments are responsible for arranging the different services which help older or disabled people stay in their own homes. They can help with tasks like:

• Getting in and out of bed
• Bathing and washing
• Preparing meals
• Shopping
• Cleaning
• Equipment and adaptations to the home, such as grab rails and bath seats

The NHS can help with:

• Continence advice
• Chiropody
• Occupational therapy
• Physiotherapy
• Medical equipment, such as wheelchairs and special beds

To access these services, the person you care for will require an assessment of their needs. Please refer to the article on Care Assessment.

What Help Will be Provided?

Once a person’s needs have been assessed they should be given a care plan, explaining what services can be provided for them; and how they will be provided. If the local authority assesses that the services are required, there are several ways they can be provided. They can:

• Directly provide their own services;
• Arrange for services to be provided by other organisations;
• Give the person cash to arrange and manage their own care.

The care plan could include services from a number of organisations. For example:

• Social services may provide grab rails for the bathroom;
• A charity might provide meals on wheels;
• A private agency might come in and help your loved one to get up in the mornings; and
• They could have a place in a day centre run by a local voluntary group.

Whoever provides the services, it is the social service department that is responsible that they are appropriate to your loved one’s needs.

Will My Loved One get all the Help they Need?

Unfortunately, because social services and the NHS have a limited amount of money to spend on services they will often ration the amount of help they will give. This can mean that your loved one might not be offered all the services that you think they need. When they decide what services they will provide, the local authority are allowed to set their own rules ('eligibility criteria') about who they will give help to. The local authority can also limit the amount of help they will give anyone at home to no more than it would cost them to pay for a place in a care home.

Paying for Home Care Services

Once the local council has made the care assessment and decided what services are required, it will work out how much needs to be contributed towards the cost. The rules on charging depend on which area of the UK you live in.

The assessment of how much someone should contribute should always come after their needs have been assessed. In other words, the services being offered should never be affected by how much someone can afford to pay towards them.

The rules on funding aren’t always clear and can be complicated. If you would like advice, it is worth contacting your local Citizen Advice Bureau. Please note that it is estimated that 40 – 60% of benefits available for disabled people are not claimed so persuade your loved one not to be put off about being means-tested. They won’t be asked to pay for services they cannot afford.