Community Care Services, Financial Assistance Towards Care Home Fees and Hospital Discharge

Community Care Services

Community care services are care services that are arranged or provided by the local authority social services department, mainly to adults who have care needs. Community care is a complex area and this paper provides a broad outline of the services.

What services are available?

There is a wide range of community care services that you may be entitled to:

  • A place in a care home
  • Home care services
  • Home helps
  • Adaptations to the home
  • Meals
  • Recreational and occupational activities

Care Homes

If you need long-term care and you cannot manage in your own home anymore, one option may be moving into a care home.

Age UK has a wide range of guides and fact sheets and ‘Wise Guides’ which can help you to choose the right care home. They also have information about paying for residential care and any help that may be available. You can also contact them via their advice line on 0800 169 6565.

Home Care Services

Home care services cover help with personal tasks, such as bathing, washing, getting up and going to bed, shopping and managing finances. Providing home care involves someone coming to your home at agreed times, which could be two or 3 times a day or where necessary even 24 hour care.

Home Helps

Home helps provide assistance with general domestic tasks including cleaning and cooking.

Adaptations to the home

Adaptations can be major or minor depending on your need and may be particularly important in allowing you to remain at home. Major adaptations can include, installation of downstairs toilet, fully adapted bathroom, stair lift. Minor adaptations include handrails in bathroom. The Officers’ Association may be able to help towards the cost of major adaptations if you are eligible for our help.

Meals

This may involve the daily delivery of a meal, or in some areas the delivery of a weekly or monthly supply of frozen food. It can also mean the provision of meals at a day centre or lunch club.

Recreational and Occupational activities

The local authority social services department can provide a range of recreational, occupational, educational and cultural activities for example at a day centre. The social services department may also provide transport to enable you to make use of these facilities.

How to get a community care service

You will need to have your needs assessed by the local authority social services department before they can provide a service for you. The assessment is called a community care assessment and must be carried out for anyone who appears to need a community care service because for example they are elderly, disabled or suffering from a physical or mental illness. If you require a community care service you can contact the social services department of the local authority yourself or your family, friend or carer can ask for an assessment on your behalf.

How the assessment is carried out

An assessment will be carried out by someone and on behalf of the social services department. More than one person may be involved in carrying out the assessment including a social worker, occupational therapist and a physiotherapist. The assessment may involve filling in a form, this will vary from area to area.

The assessment should take into account:

  • Your wishes
  • Whether you have any particular physical difficulties for example walking difficulties
  • Whether you have any particular health or housing needs
  • What sources of help you have access to, such as family, friends or carers
  • Any needs of these people who are providing care to you

What happens after the assessment?

Once the assessment has been completed the local authority has to decide if you are entitled to services to meet your needs. This will be based on the level of your need not on how much money you have.

If the local authority says that you are not entitled to community care services, you should get advice in the first instance from the Citizens Advice Bureau.

If the local authority is going to provide services, this must be set out in a care plan, and you can request for this care plan in writing should you wish.

Paying for community care services

The rules about which community care services must be paid for and how much can be charged is quite complex. The local authority social services department can charge for the provision of some community care services, some local authorities charge for all community care services.

Direct payments

Direct payments are payments of money by the local authority social services department to people to arrange their own community care services, instead of the local authority arranging the services. If you are entitled to get community care services, your local authority social services department must give you the option of getting direct payments, as long as you are able to manage a direct payment.

NHS Continuing Healthcare

This is a package of health and social care funded solely by the NHS when your need for care is primarily due to your need for healthcare. Your needs may be such that you demonstrate a ‘primary health need’ and require the quantity and/ or quality of care to manage your needs.

NHS-Funded Nursing Care

This is the financial contribution paid by the local Clinical Commissioning Group (CCG) towards the cost of meeting your nursing care needs if you live in a care home. It is paid directly to the care home.

If you require further information, do not hesitate to request factsheets giving detailed information about NHS continuing healthcare and NHS-funding nursing.

Receiving Care in Care Homes

The local authority has a duty to provide or arrange permanent care in a home for you if you have been assessed as requiring this care:

If you cannot pay the full cost of the care home because the fees are higher than your income, and your capital is below the upper limit of £23,250, for England and Wales.

Where your income is high enough to pay for care in full, and/or your capital is above the upper limit, but you are not able to make the arrangements yourself, and there is no one who is willing and able to do this on your behalf.
Self-funding

If you have more than £23,250 you may decide to make your own arrangements with a care home. If you subsequently become eligible for financial support because, for example, your capital has reduced as fees for the care have been paid, you should again approach your local authority social services department for help. Even while you are ‘self-funding’ the NHS is responsible for meeting the cost of any care you require from a Registered Nurse. You should be assessed to establish the level of your nursing need and the NHS will make a payment directly to the home, which should then be taken into account in the calculation of your fees.

Adults who fund their own residential care have access to an independent complaints review service provided by the Local Government Ombudsman.

Age UK can provide a comprehensive guide to Care Homes, and paying for residential care which covers the mean test, savings and capital and state benefits.

Regulation of Care Services

In England, the Care Quality Commission inspects care homes and home care services, inspections are unannounced and on a regular basis. In Wales, the Care and Social Services Inspectorate Wales inspects care homes and home care services regularly. In Scotland all care homes and agencies providing support services can be inspected once in every 12 months by Care Inspectorate.

Complaints

If you are not satisfied with the standard of the community care services offered by your local authority, you can make a complaint using their complaints procedure.

Financial Assistance by the Officers’ Association

In the event that the fees in the care home increase to above the assessed level, the Officers’ Association Benevolence Committee may be able to consider assistance to the Third Party. Contact us if you feel that the OA may be able to help or take a look at our advice on money matters.

Each case will be considered on its own merits. In other words, the Officers’ Association Benevolence Committee can consider applications for financial assistance, through a Third Party, towards fees for an eligible applicant to exercise their right to preferred accommodation when they would otherwise be unable to afford to. The Third Party, on behalf of the applicant, would be required to complete the Association’s application form, with personal and financial details and supporting documentation.

Although every case can be considered on its own merits, the Committee uses the following guidelines:

  • Applicants should be in receipt of the maximum Pension Credit and Local Authority funding available.
  • The Officers’ Association cannot sign a Third Party agreement since the use of charitable monies requires regular reviews and approval by the Association’s Benevolence Committee on each occasion the Association is approached. The Third Party agreement is usually signed by a family member or a friend with either an Enduring Power of Attorney or a Lasting Power of Attorney. in cases of difficulty please telephone the Officers’ Association. A copy of the Local Authority’s Contract and Third Party Agreement should be forwarded as part of the application to the Officers’ Association whenever possible.
  • When an applicant for charitable assistance has a spouse/partner ‘at home’ the resources of both partners will be taken into account by the Benevolence Committee when considering the case, in order to assess the level of spouse/partner’s capital savings and income which might be available towards total Third Party contribution.
  • It should be recognized that due to limited resources and reliance on voluntary donations, benevolence charities’ guidelines are usually lower than the state’s. The OA will require next of kin, Enduring Power of Attorney or Lasting Power of Attorney contributions where there are savings above £23,250, or when the shortfall is exceptionally high. A shortfall of £100 per week is considered a maximum weekly amount when considering help towards meeting this shortfall; the OA will contribute up to a maximum of £40 per week, seeking help from other charities to make up the difference.
  • In cases where the applicant has family members, who have independent incomes and are not themselves in receipt of means tested benefits, the Association will expect some contribution from them towards the applicant’s fees, at a level to be negotiated/discussed with the benevolence department.
  • The fees must be reasonable. It should be noted that help towards excessive fees is unlikely unless there are strong mitigating circumstances.
  • Where there is a considerable third party contribution to be considered the Officers’ Association may seek further assistance, in co-operation from regimental, relevant professional and general charities. Income from charities towards the third party contribution is fully disregarded by the Local Authority.
  • Applicants should be aware that a case may take some time to ‘set up`, and they should make provision to cover part of the shortfall for up to four months. In cases of difficulty contact the Officers’ Association.
  • All grants are reviewed by the Committee when circumstances change and not less than annually (in March/April). Those undertaking responsibility for a beneficiary’s affairs must keep the Officers’ Association informed of any changes in the beneficiary’s circumstances, both health and financial.
  • The Officers’ Association will pay all shortfall payments by Bank transfer(BACS) to a nominated account on a calendar monthly basis, in arrears.

Future Increases in Fees – Charitable Help

Whilst future increases in fees may be met by the periodic updating of statutory benefits there is no undertaking that charities can meet any increase in the shortfall between fees and income. In cases where charitable help is already being provided the Officers’ Association should be informed as soon as details of a future fee increase, (or any other changes in financial circumstances) is known, so that consideration is given on whether any increase in charitable help can be provided.

For many people going into a hospital can be a difficult time both for the person and for their family. It is important to know what should happen to ensure that the right support is provided when you are ready to leave.

Whether it is a planned or emergency admission, the quality of care and support that you should receive is provided in the following guides and facts sheets.

Hospital Discharge Arrangements

For many people going into a hospital can be a difficult time both for the person and for their family. It is important to know what should happen to ensure that the right support is provided when you are ready to leave.

Whether it is a planned or emergency admission, general information on going into hospital and hospital discharge arrangements is available.

For further information contact Age UK / 0800 169 6565 for free fact sheets and Counsel and Care / 0845 300 7585. Alternatively contact us.