Having someone who comes into the home of the person you care for to help with their care can be important. You may be able to get paid care workers (known as home help) to provide help in the home of the person you’re looking after. These care workers can also be known as care attendants or personal assistants. They provide practical support to help you to continue to care for the person you’re looking after.
Home help can provide services such as:
- Domiciliary care for the person you’re looking after. This includes help with getting up and going to bed, bathing, dressing, meals and medication.
- Help with shopping.
- Sitting with the person you’re looking after to allow you to have a break.
- Helping the person you’re looking after to go to the cinema, pub, shopping or to enjoy any other community activity.
- Practical tasks around the home such as cleaning and cooking.
However, some local authorities only fund home help in exceptional circumstances.
If you believe that the person you’re looking after may benefit from home help, the first thing to do is to contact their social services department to ask for a community care assessment.
To contact social services CALL 0300 4560111.
A community care assessment is an assessment of the needs of the person you’re looking after. Either you or they can request this.
In a community care assessment, social services gathers a range of information about the circumstances of the person you’re looking after and their need for community care services.
After the assessment, the local authority that runs social services will explain whether it is able to provide services, what it can provide and for how long. The department will then carry out a financial assessment to decide whether the person you’re looking after can afford to contribute towards the cost of the service.
Social services may provide or arrange the help themselves, or the person you’re looking after may choose to receive direct payments or a personal budget in order to purchase their own care.
If the person you’re looking after chooses direct payments, or they are not eligible for help from social services, or they simply wish to arrange their own care privately, this can be arranged in several different ways.
Marie Curie Nurses can provide practical and emotional support for people near the end of their lives in their own homes.
Alzeimers society – (www.alzheimers.org.uk)
There is a variety of financial help available to help you and the person you care for to get support services.
The main sources of support are the NHS and your local social services department but, depending on your circumstances, help may also be available from charitable organisations. Read on to find out more about the different ways you could get support.
The NHS is responsible for funding certain types of healthcare equipment you may need. In some situations, the NHS is also responsible for meeting care needs. This is usually when someone’s need is mainly for healthcare rather than social care. NHS care could be provided in hospital but it could be in someone’s own home or elsewhere in the community.
When care is provided through the NHS there is no financial assessment and no care charges to pay.
However, people are only eligible for NHS care in certain circumstances.
NHS Continuing Healthcare
If the person you care for has very severe and complex health needs, they may qualify for
This is an ongoing package of care that’s fully funded by the NHS.
If someone goes into a residential care home but needs some element of nursing care, they’ll get a payment from the NHS to help pay for their nursing care.
This is called a registered nursing care contribution (RNCC).
Some people can be eligible for intermediate care from the NHS. This is provided on a short-term basis and is intended to help people to recover from an injury or illness, and stay independent. Intermediate care is often provided to elderly people who are being discharged from hospital, and may help someone to keep living in their own home rather than moving into a care home.
People who were previously detained in hospital under certain sections of the Mental Health Act will have their aftercare services provided free.
If someone isn’t eligible for free care from the NHS, their main source of support will be social services. In this case, there are rules that determine whether or not they have to make a financial contribution. These rules vary depending on whether the care is provided in a care home or in their own home.
The rules state how their income (including any benefits) and capital will be taken into account when calculating whether they have to pay anything towards the care they receive. In some cases, a person may have a mixed package of care, including some that is NHS-funded and some that is provided by social services, for which they may be charged.
Both you and the person you care for may choose to receive direct payments so that you can buy the care you want, rather than have it arranged for you by social services. Again, there are rules that state who can receive these types of payment. It’s important to know that if you or the person you’re looking after receive a direct payment to pay a care worker or personal assistant, you become an employer and have legal responsibilities.
Direct payments are part of a move towards ‘personalised’ social care so that people have more choice and control over the support they get.
In some cases, the person who is in need of services is unable to manage a direct payment themselves.
In this case, a user-controlled trust can be set up to assist him or her in receiving and using direct payments to pay for their care.
Other Sources of Funding
There are other sources of funding. The Independent Living Fund, for example, was set up to work with social services to jointly fund care packages. The ILF is no longer open to new applicants, but people already getting support will continue to get it until 2015.
Some charities can help with funding care needs.
For example, the Family Fund is a charity that can help with grants if you care for a severely disabled child 17 or under.
Other sources of help include the Social Fund. This can provide discretionary loans and grants to people who are receiving certain means-tested benefits. The Access to Work scheme can help with work-related needs (such as equipment, adaptations or travel costs) for people with disabilities. Children or students with disabilities may be able to get funding from various education authorities. (See External links, right).
Continence is a problem for many people. As many as one in three people have difficulty controlling their flow of urine. Caring for someone who has incontinence problems or difficulties controlling their bowel or problems with bladder functions may have a significant emotional impact upon you as a carer.
It is quite common for people with mobility difficulties to have incidents of incontinence or leakage because it takes them longer to get to the toilet.
The person you’re looking after may feel embarrassed and will need emotional as well as physical and practical support to deal with issues such as personal hygiene, loss of confidence and perhaps skin irritation.
As their carer you may be involved in helping them to:
- get to the toilet
- use the toilet
- wash afterwards
If the person you’re looking after has incontinence or bladder and bowel difficulties, your GP can advise you on NHS services that may help in your caring role.
Both your GP and local Clinical Commissioning Group (CCG) can provide support, advice and information on this issue. The primary care team includes continence advisers or specialists, occupational therapists, physiotherapists and dietitians.
The continence adviser may be able to provide many small items and other equipment that can help, including:
- plastic or PVC covers to protect beds
- disposable or washable continence pads
- waterproof pants
Your social services department should be able to provide small aids and adaptations for the home, including:
- hand rails
- raised toilet seats
For more information on what other services are available from your social services department, GP and CCG visit the care at home pages. For information about laundry services from your local council, see below.
There is also continence equipment that you can buy yourself. The Bladder and Bowel Foundation provides an independent directory of incontinence products. It also provides useful information and support for carers on a range of bladder and bowel-related problems, including incontinence.