As you get older you may find it more difficult to manage your daily tasks at home. Here, we offer some practical advice and options available to you in order to enable you to continue living at home as comfortably as possible.
If you are facing difficulties, they may be overcome with inexpensive and simple gadgets available from mobility shops around the UK. If you need more substantial gadgets or aids, contact us and we can guide you or look at the Disabled Living Foundation, who can offer equipment.
If your difficulties are substantial, then there may be a need for adaptations to your home, which for some will suffice. It may be possible to obtain adaptations by obtaining a Disabled Facilities Grant (DFG), funded by your district, borough or unitary authority. More information is available here and additional advice on care can be viewed here.
Others may need personal care and support by a family member, friend or a public or commercial care provider in addition to adaptations.
The following steps should be followed when considering care.
If you do not have a friend or family carer to help you, you may need to seek the help of your local Social Services. It may be a good idea for you to discuss your needs with your family doctor first. This will help you better understand what your needs are. It may be helpful to take a pen and notebook with you so that you can take notes. You also need to think about the things you find difficult and those that you have no problem with. It would be helpful to write these down too. Having notes will help you get the best out of meetings with others in the next stages. This process will help you identify whether your needs are personal, physical health, mental health or mobility related. Maybe it will be a mixture of some of these.
If you do not feel confident or have problems which prevent you doing this, you might like to consider using an Independent Advocate to help you. Independent Advocates usually come in three forms: Independent Mental Capacity Advocate (IMCA); Independent Mental Health Advocate (IMCA) and simply Independent Advocates (IA). For most people, an IA is all that is required. For those where mental capacity is an issue, an IMCA may be appropriate and for those with a mental health problem, an IMHA may be appropriate. Independent advocacy is usually a free service at the point of need, and this is a confidential service. Local advocacy organisations can usually be found in the telephone directory or on the Internet. For advice, you can contact Independent Age, a charity which offers free information and advice on issues affecting older people or telephone on 0800 319 6789.
It helps to have a grasp of what might be available to help you. This will enable you to ask about your own issues if the assessor forgets about them.
Community Care Assessment
The next step is for you to contact your local Social Services (sometimes called Adult Services). This can usually be done by visiting your Local Authority (County or Unitary Council) website or find them in the telephone directory. If you think you need adaptations, your local authority may have an Occupational Therapy department, who can be asked to visit and assess your physical needs. If you think you need personal help, you can ask for a Community Care Assessment.
The Community Care Assessment should be an objective assessment of your needs. This identifies the nature and degree of needs that you present with. Unsurprisingly, these are called presenting needs. The presenting needs are then compared with Fair Access to Care Services criteria, and those that are of a nature and degree substantial enough to attract funding are called eligible needs. You may not have any eligible needs; however, if you do, your eligible needs must then be met by the local authority.
Outcome of Community Assessment
If you are assessed to have eligible needs, how these needs might be met is discussed with you, and depending what the needs are, these can be met using a social care provider, the Supporting People scheme (administered by your Local Authority) or any other service provider.
If you are to be managed directly by Adult Services, a care plan will be produced. If you are subject to personalisation, you can take charge of your own situation with your own Individual Budget and Self Directed Support. This enables you to purchase your own support. If you find this daunting, you will be able to use one of a number of independent organisations to help you and do the day-to-day management of your budget for you. Ask your Adult Services for information about which third party organisations can be used to manage your budget.
Relationship Management & Personalisation
Whether your care and support is provided by the local authority or any of many other providers, it is important to realise that it is the meeting of your eligible needs and consequential improvement of your quality of life that these organisations exist for. If they do not deliver the standard of service that you reasonably require, and especially meet the requirements of the Domiciliary Care: National Minimum Standards Regulations, if you are empowered to do so, choose another supplier. Alternatively, use the statutory complaints procedure for local authorities.
(The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 as amended by The Local Authority Social Services and National Health Service Complaints (England) (Amendment) Regulations 2009. Both are available at www.legislation.gov.uk)
Regardless of which system you are using, it is necessary for you to take stock of the assistance that you are receiving and how successful it is in meeting your needs. If your Local Authority funded care package needs tweaking, contact your local Adult Services as soon as possible. If you are self-directing your support, you can deal with it yourself.
It is important to understand that, in the era of personalisation, you are in control. The charity In Control, working with the Royal Mencap, has developed a set of fact sheets that may be useful. Although these were put together in the context of people with a learning disability, they apply equally to other people too. They may be helpful to you in addressing certain issues.
The local authority will review the effectiveness of your support from time-to-time, regardless of which system you are using. This will usually involve a visit to your home and a discussion. It is worth planning for this by assembling your thoughts and writing them down before the meeting. Your notes might include how your needs might have changed, the quality of support you receive, especially its effectiveness in meeting your needs. If you have an Individual Budget and use Self-Directed Support, it will be up to you to address quality shortfalls with your chosen service provider and change the provider if these cannot be resolved. Once again, an Independent Advocate can help you if necessary.
Potentially Unhealthy Relationships
Our advice is that relationships where the care provider and private landlord are the same person or organisation should be avoided because of potential conflicts of interest and the scope for de facto control passing from the cared for to the care/housing provider. Similarly, we feel that an organisation managing funds allocated for care provision on behalf of the cared for should not be the same organisation that delivers care to the cared for.
For all matters relating to unpaid carers (close family and friends) it is suggested that they visit the Carers UK or call them on 0808 808 7777. Most importantly, unpaid carers who do not pay National Insurance Contributions (NICs) should ensure that they arrange for their NICs to be credited for the whole years spent caring to avoid pension problems at retirement. If they do not have a computer, it is suggested that they visit a local library which has computers that can access the Internet.