Options Norfolk Winter 2024_25

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OPTIONS

A guide to care and independent living

Leaving hospital

What’s next?

Helping you return home safely

NHS continuing healthcare

Who’s eligible?

SOCIAL

CARE tips 10

Free services available for over 50s

Lyncroft Care Home in Wisbech provides family-led residential and dementia care in a luxury setting. The care home is beautifully furnished with thoughtful touches throughout to create a home-from-home setting.

Bedrooms are designed to allow the attentive and dedicated care team to provide care personalised to each residents’ needs. Many of the care team at Lyncroft have worked at the home for many years, making everyone feel at home and creating a real family atmosphere for everyone living there. The wellbeing team provide a stimulating and varied program of activities. From games and crafts to gentle chair exercise and gardening, there is always something going on. They understand that everyone is different, so they treat them that way - always ensuring they are safe, secure and happy in their home.

Lyncroft Care Home has strong connections to the local community in Wisbech. Residents enjoy regular visits from a local pre-school and Devika Care Company visit every Friday to run their Dementia Day Centre. These sessions provide support and care to those with additional personal care and behavioural needs. They provide dementia-friendly activities on a secured floor plus a light lunch and refreshments are also provided.

For more information, please contact our Senior Customer Relations Manager Hannah Mills on 01945 475 229 or Hannah.mills@countrycourtcare.com

Meeting the mental health needs of older people in Norfolk

Mental health issues, including dementia, can affect anyone at any age. Thankfully, services are available to provide support and guidance. The Intensive Older People’s Service, provided by Norfolk and Suffolk NHS Foundation Trust (NSFT), is just one such service.

NSFT provides mental health and learning disability care for people across Norfolk and Suffolk.

The Trust is dedicated to providing high-quality care with compassion, delivering many of the NHS services that are provided outside of hospital and in the community.

It has clinical teams providing services in inpatient, community and primary care settings.

What is the Intensive Older People’s Service (IOPS)?

IOPS Central Norfolk, which is based at the Julian Hospital in Norwich, provides short-term specialist support and treatment for people aged 75+ who are experiencing a mental health crisis. This includes anxiety, depression, psychosis, confusion, dementia (any age) and related behavioural problems. The team operates seven days a week, 07:50-21:00.

It is a multi-disciplinary team, consisting of:

• Matron

Their aim is to support and treat people in their community settings.

• Clinical team leader / advanced clinical practitioner

• Nursing staff

• Occupational therapist

• Assistant practitioners

• Specialist doctor

Their aim is to support and treat people in their community settings.

Who is the service for?

• Service users with dementia of any age, or

• Service users over the age of 75 with functional mental health and physical health complexities

What does it offer?

• The IOPS team responds to mental health emergency (four-hour) and urgent (120-hour) referrals. This team helps people who are open to community mental health teams (CMHTs) as well as those who are either not active to the Trust or are no longer active to CMHTs

• The team provides interventions working with other teams and organisations. The team’s specific role is to provide intensive support to prevent admission to the Trust acute assessment wards

They also offer advice, individual support and information for carers.

• They accept referrals from community mental health teams for patients needing intensive support. They also help patients who meet the criteria referred by the Mental Health Liaison Team at the Norfolk and Norwich University Hospital

• Duty workers triage the referral for further information and suitability for the service. The team will then organise a time and date to assess the referred person

• From this assessment, they agree a plan of action with the individual. If the team assesses a referral as not needing intensive support, they signpost them to other relevant services

For those accepted, interventions may include:

• Assessment and diagnosis of mental health problems

• Risk assessment and risk management

• Monitoring of mental health difficulties and agreed treatment plans

• Therapeutic treatment including medication reviews and management of risk and complex behaviours

The team provides intensive support for around six weeks. The team may discharge the person from care. They may also make onward referrals to social services or community mental health teams.

They also offer advice, individual support and information for carers.

What can you expect?

The team provides additional, intensive support for a short period of time, to help people in a mental health crisis stay in their own home with as much autonomy and independence as possible.

They will:

• Work with service users in their own homes or in nursing / residential homes

• Work together with service users and carers

• Provide therapeutic interventions, carers support and information

• Develop treatment plans for service users with complex needs, working with other agencies, as appropriate

• Request admission to hospital, when the service user’s needs can no longer be met in the community setting

• Continue to work with the service user to facilitate discharge

Service users who are at risk of harm to self, or others, and awaiting admission, should not be left alone. If

a relative / carer feels they are at risk, they should call the police.

Referrals

All emergency and urgent referrals come through the Single Point of Access Team.

120-hour urgent referrals can be made to IOPS via Single Point of Access (SPOA) (referrals are usually via the GP). Four-hour emergency referrals can be made via SPOA (the service user must have been seen faceto-face by their GP).

Care co-ordinators can refer someone who is already supported by community teams.

Other services for older people

NSFT runs a range of community and inpatient mental health services to support older people in Norfolk. You can find out more by visiting the Trust’s website and searching under ‘Our services – Older people’: www.nsft.nhs.uk

Urgent help

Service users in crisis can contact the service using the number they were given.

Anyone in crisis can call 111 and select the mental health option to speak to our 24-hour mental health crisis line.

If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives.

If anyone is at serious risk of harm, call 999 and ask for the police.

For non-life threatening medical situations, call NHS111 on 111.

Be at Home - health and social care referrals

Be At Home services are designed to help keep local people living safely in their own homes.

The services aim to:

• help facilitate early discharge from hospital

• prevent falls

• prevent hospital admission through undertaking fast track home adaptations and/or providing a temporary Be at Home alarm and key safe

Be at Home alarms

This is a complimentary short-term package aimed to assist in early hospital discharge or to prevent admission to hospital. The pack consists of a 24/7 Be at Home alarm with falls detector and a key safe. This helps to boost patient confidence when returning from hospital or following a fall or illness.

The services are only available to permanent residents in the borough of Great Yarmouth and the Waveney area.

Both services were developed by Great Yarmouth Borough Council, in partnership with the NHS Great Yarmouth and Waveney Clinical Commissioning Group and Norfolk County Council. Suffolk County Council and East Suffolk Council are also part of the partnership.

Be at Home adaptations

This project aims to undertake fast track adaptations to those vulnerable people who are most at risk of falls, readmission or hospital discharge who own or privately rent their property.

The types of works undertaken include installation of:

• grab rails and banisters

• half steps

• shallow steps and level access doors

Access to both services is via a Be at Home electronic referral form (opens new window) from health and social care professionals only.

The services are only available to permanent residents in the borough of Great Yarmouth and the Waveney area. There must be a clear understanding of how the recommended work helps facilitate early hospital discharge, falls prevention, reduce admissions and/or readmissions.

If you have any queries about the schemes, or to request password access to the referral system, please contact the project officer Sue Atkins on 01493 846673 or the project administrator

Kerri Drew on 01493 846670 or by email to referrals@great-yarmouth.gov.uk

Getting help

The Help Hub works with partners to get you the right help, whatever the situation.

Help in your community

You may be experiencing loneliness and isolation, have moved into a new area or you may simply want do new things and meet new people. The Help Hub can support you to access a range of support services, groups and activities in your local community. Contact us by completing a Request for Support online or calling 01508 533933/01603 430431.

Help and support to combat isolation is available from Better Together Norfolk, local groups and activities can be found on the Norfolk Directory.

Wellbeing and health

The Help Hub can support you to access the right services or activities to support your physical and mental health and wellbeing. We work with a range of partners in health services and our communities. There are lots of resources online that can help you to improve your wellbeing and health. You can find selfhelp guides and the self-referral form on the Norfolk and Suffolk Wellbeing Service website.

of alternative housing, are made homeless, or require adaptations to enable you to remain within your home, we work with a number of partners who can help facilitate this.

Advice around housing and homelessness is available on the main housing webpages.

If your home needs some adaptations to ensure that is it safe then you might be able to receive support through our Disabled Facilities Grant.

Rented properties should be up to standard - if you’re concerned that the property you rent is not a safe environment or in good condition you can get advice from our Housing Standards Team.

Handyperson service

Simple adaptions to the home can make a huge difference to the health and wellbeing of our older and most vulnerable residents.

If you are caring for a family member, a friend or a loved one, there is advice and support available through Carers Matters Norfolk as well as from Adult Social Care.

The NHS provide lots of advice around healthy living which includes mental health, help to stop smoking and eating well; this can be accessed on the NHS pages. We offer a number of programmes, including Broadly Active as well as a range of leisure and fitness services.

Advice specifically for young people can be found on the Young Minds website. Just One Norfolk has lots of information and guidance for children and parents. Kooth is free and confidential chat service for young people to access support; they have a wealth of information that is available to access any time.

Carers support

If you are caring for a family member, a friend or a loved one, there is advice and support available through Carers Matters Norfolk as well as from Adult Social Care.

Don’t forget that there are lots of support networks for specific conditions, for example Dementia UK and Arthritis Action, try searching online for a wealth of information.

Housing

If your situation changes and you find yourself in need

Our handyperson service helps people to stay living independently in their homes for longer. We can help with hand rails, key safes, smoke alarms, works to prevent slips and falls and small home improvements which can improve people’s quality of life.

For our South Norfolk residents, please call 01508 505284 or email handyperson.snc@ southnorfolkandbroadland.gov.uk.

For our Broadland residents, please call our Housing Standards Team on 01603 430518 or email handyperson.bdc@southnorfolkandbroadland.gov.uk.

For both, a referral form can be completed online.

If your work is more urgent, or if you require more extensive home adaptations and improvements, then a variety of traders can be found through the Norfolk County Council’s Trusted Trader Scheme.

Get help

To get help with any of these issues, or with any other problems visit: www.southnorfolkandbroadland.gov.uk

Helping you return home safely

Careline Community Service, part of the Borough Council of King’s Lynn & West Norfolk, are working in partnership with the Queen Elizabeth Hospital in King’s Lynn, Norfolk, to assist West Norfolk patients who are being discharged to return home safely.

Hospital staff working in the Rapid Assessment and Frailty Team can refer patients to the ‘I’m Going Home’ service.

This means a ‘Go’ mobile alarm unit is provided, free of charge, for six weeks while the patient gets settled back at home. The ‘Go’ is a mobile version of our careline alarm which enables patients to call for help just by pressing the button. A call will be placed to our monitoring centre via the internal roaming sim and our call handlers will assess the situation and call for assistance or the emergency services if required. The device also has a GPS function which will provide the patients location so assistance can be sent to them directly.

Careline Community Service will contact the patient at the end of the six week period to discuss next steps.

Patients are assessed before being referred to this service, but once referred, set up is quick and easy, with no need for a landline. This enables patients to return home speedily where their recovery is likely to be quicker. Careline Community Service will contact the patient once they are discharged to make sure they are confident and know how to use the ‘Go’ device. We will stay in touch during the six weeks to make sure everything is okay and to see if there are any additional requirements.

Careline Community Service will contact the patient at the end of the six week period to discuss next steps. If the patient chooses to keep the ‘Go’ we will explain the cost and send out a service agreement. We can discuss alternative products if the ‘Go’ isn’t suitable or we cancel the service and arrange for the equipment to be returned if it is no longer required.

Contact us

For more information on how Careline Community Service can help you to live safely and independently at home, please contact us on 01553 616200 (option 1) or visit our website www.careline-cs.org.uk

Breckland Council - Inspiring Communities

In April 2024, Breckland Council committed another £1.3m into initiatives which support some of the most vulnerable residents in our communities.

The investment will fund the Inspiring Communities programme which is aimed at helping Breckland residents to lead healthy and happy lives. This significant funding comes after around £1m was previously invested over the last three years on schemes which helped residents, including those who have experienced domestic abuse, mental health issues, or financial hardship.

The services include:

Social Prescribing – working with local GPs to combat loneliness and isolation by connecting people with social activities and support networks

Welfare Support – helping people access valuable resources and services that enhance their health and wellbeing

The Link brings together services from various organisations, ensuring people only need to tell their story once to access the help they require.

Users of The Link can access assistance from Breckland Council’s community and housing officers, Norfolk and Waveney Mind, Citizens Advice, the Department for Work and Pensions, the Boost skills programme, Nova Training, and NHS Talking Therapies.

Initially, The Link will be accessible by referral from the involved partners.

The Shelf Pop-Up Pantry

The Council, in partnership with Citizens Advice Diss and Thetford and the Norfolk Community Foundation have introduced a new food and support service to residents across the district.

The Link brings together services from various organisations, ensuring people only need to tell their story once to access the help they require.

Community Health Workers – knocking on doors to provide personalised support and resources directly to families in their homes

Community Enablers – work closely with community groups and organisations to support and enable the delivery of community-led initiatives to improve resident wellbeing.

Some of the projects launched by Breckland Council since the new investment:

The Link

Breckland Council has launched an exciting new support hub in the heart of Dereham. ‘The Link’ is situated at Breckland Business Centre on St Withburga Lane, and is providing people with health and wellbeing support, financial advice, and skills and employment opportunities.

The Shelf Pop-Up Pantry is bringing affordable food to rural communities throughout Breckland. This project is also a key component of The Nourishing Norfolk Network, delivering fresh fruit and vegetables, chilled goods and pantry stapes at reduced prices to local villages.

In addition to affordable food, The Shelf Pop-Up Pantry offers a range of support services, including advice on benefits and grants, connections to local support groups, employment and training opportunities, and mental health resources.

The service is initially visiting North Lopham, Old Buckenham and Swanton Morley, with further locations being added. For updates on when The Shelf Pop-Up Pantry will visit a location near you, search for ‘The Shelf Pop-Up Pantry’ on Facebook.

Inspiring Communities MatchFunding Grants

Helping local partners provide essential transport services and schemes which improve local people’s health and wellbeing.

Breckland Council is supporting residents and community groups by investing up to £300,000 in Breckland-based schemes and initiatives until 2027.

This includes recently releasing around £30,000 to support some of our most vulnerable residents by helping local partners provide essential transport services and schemes which improve local people’s health and wellbeing. Among the recipients are Thetford Vineyard Church, which received £5,000 to support the Growkids projects, offering children’s clothing and The Kids Matter parenting courses in the town. Another £5,000 grant was given to Wellspring Family Centre to help people of all ages suffering from chronic health issues.

Other grants went to:

- Caring Friends for Cancer: £3,500 – Home-Start Norfolk: £4,648 – Love Dereham Ltd: £5,000 –Norwich City Community Sports Foundation: £2,500

- Breckland Children’s Clothes Bank: £500 – Dereham Cancer Care: £500

- Caring Friends Mid Norfolk: £500 – Dove’s Nest Ministries: £500

- A Little More Kindness CIC: The Kindness Cabin: £500 – Keystone Development Trust: £500 –Swaffham & Litcham Home Hospice: £500

If you would like to know more, please visit our website www.breckland.gov.uk/community, email community@breckland.gov.uk or call 01362 656870

East Coast Community Healthcare – Building Healthier Communities

East Coast Community Healthcare (ECCH) has been providing NHS community and public health services across Norfolk and Suffolk since 2011.

If you are at home recovering from a hospital stay or are being supported at home because your condition doesn’t require treatment in hospital, it’s likely you will have met some of the nurses and therapists who work for ECCH.

ECCH has four multi-disciplinary Primary Care Home (PCH) teams who offer personalised care in patients’ own homes. They support the four groups of GP practices which cover Lowestoft, Great Yarmouth and the northern villages, Gorleston and South Waveney.

Each PCH is made up of clinicians from a wide range of disciplines including nurses, occupational therapists, healthcare assistants, physiotherapists, specialist palliative care nurses and more - all working alongside colleagues from social care.

‘Virtual Ward’ in your own home

The emphasis across the NHS on avoiding hospital stays, where possible, is based on evidence that we recover better in our own homes. ECCH’s Community Virtual Ward is another measure which enables this, allowing patients in Great Yarmouth and Waveney to receive hospital monitoring and treatment at home.

Specialist Services

ECCH has a number of specialist services such as Heart Failure, Diabetes and Podiatry. It also has services such as Musculoskeletal Physiotherapy where patients who need advice and support can self-refer online via norfolkandwaveneycommunityhealth.nhs.uk/msk

Beccles Hospital

ECCH runs Beccles Hospital which celebrated its centenary this year. When the hospital opened in 1924 it had a 24-bedded ward and a similar number of beds remain today. However, these days, paper charts detailing patient’s conditions are long gone and ECCH has transformed the ward with digital technology which means ward staff and GPs can access and exchange information about patients seamlessly.

The ward now acts as an Intermediate Care Unit, providing intense rehabilitation and reablement to patients who no longer need acute hospital care but are not yet well enough to return home. ECCH is also working in partnership with St Elizabeth Hospice to provide specialist palliative care in six beds on the ward.

ECCH has a number of specialist services such as Heart Failure, Diabetes and Podiatry.

The service sees patients trained to use a device which sends observations, including their breathing, heart rate, and skin temperature, directly to the Community Virtual Ward team. It is suitable for patients with conditions including respiratory disease, frailty, and heart failure.

If there is a sign of health deterioration, such as blood pressure rising, the Community Virtual Ward team will get an alert immediately. They will call the patient by phone or video call to talk through any health changes and decide on next steps.

The Virtual Ward is part of an initiative across Norfolk and Waveney involving the ambulance service, hospitals and community healthcare providers.

Investing in local communities

As a staff owned social enterprise, ECCH does not exist to make a profit. Instead it uses any surplus resources to enhance its services and benefit local communities. Good causes which have received funding in the last year include Waveney Jaguars Under 12s Football Team, whose kit was sponsored, and Musical Lifelines who were given funding for free music workshops in Bungay for people with dementia, Parkinson’s or who are at risk of social isolation.

In addition to its 650 staff, ECCH has around 40 volunteers who play an invaluable role supporting its teams to enhance services for patients.

Volunteering

In addition to its 650 staff, ECCH has around 40 volunteers who play an invaluable role supporting its teams to enhance services for patients. Volunteers carry out roles such as providing company and conversation to patients at Beccles Intermediate Care Centre, picking up and delivering grocery essentials for patients recovering from surgery and making weekly telephone calls to chat with a patient to help them with their speech recovery.

Growing ECCH

ECCH has diversified its business in recent years. In 2022 it bought the domiciliary care provider Cavell Healthcare because it felt the two businesses would complement each other and offer new ways to improve patient care.

Since then, Cavell Healthcare has gone from strength to strength, with the award of PCN Framework contracts with Norfolk County Council and a number of national award wins. It is now launching Cavell Choice, a bespoke care package aimed at empowering people to manage their health and maintain their independence through a focus on reablement and personalised care at home.

To learn more about ECCH and how to access its services, visit www.ecch.org

NHS healthcarecontinuing

Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.

Where can NHS continuing healthcare be provided?

NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your own home or in a care home.

Am I eligible for NHS continuing healthcare?

NHS continuing healthcare is for adults. Children and young people may receive a “continuing care package” if they have needs arising from disability, accident or illness that cannot be met by existing universal or specialist services alone.

Find out more about the children and young people’s continuing care national framework on GOV.UK

You should be fully involved in the assessment process and kept informed, and have your views about your needs and support taken into account. Carers and family members should also be consulted where appropriate.

A decision about eligibility for a full assessment for NHS continuing healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.

If you are not eligible for NHS continuing healthcare, you can be referred to your local council who can discuss with you whether you may be eligible for support from them.

If you still have some health needs then the NHS may pay for part of the package of support. This is sometimes known as a “joint package” of care.

Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition.

To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a multidisciplinary team). The team will look at all your care needs and relate them to:

• what help you need

• how complex your needs are

• how intense your needs can be

• how unpredictable they are, including any risks to your health if the right care is not provided at the right time

Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change.

Information and advice

The process involved in NHS continuing healthcare assessments can be complex. An organisation called Beacon gives free independent advice on NHS continuing healthcare.

Visit the Beacon website or call the free helpline on 0345 548 0300.

NHS continuing healthcare assessments

Integrated care boards, known as ICBs (the NHS organisations that commission local health services), must assess you for NHS continuing healthcare if it seems that you may need it.

For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment. However, if you need care urgently – for example, if you’re terminally ill – your assessment may be fast-tracked.

Being referred for a full assessment does not necessarily mean you’ll be eligible for NHS continuing healthcare. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment.

The professional(s) completing the checklist should record in writing the reasons for their decision, and sign and date it. You should be given a copy of the completed checklist.

For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment.

Initial assessment for NHS continuing healthcare

The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed, and what the assessment involves.

Depending on the outcome of the checklist, you’ll either be told that you do not meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility.

You can download a blank copy of the NHS continuing healthcare checklist from GOV.UK

Full assessment for NHS continuing healthcare

Full assessments for NHS continuing healthcare are undertaken by a multidisciplinary team (MDT) made up of a minimum of 2 professionals from different healthcare professions. The MDT should usually include both health and social care professionals who are already involved in your care.

You should be informed who is co-ordinating the NHS continuing healthcare assessment.

The team’s assessment will consider your needs under the following headings:

• breathing

• nutrition (food and drink)

• continence

• skin (including wounds and ulcers)

• mobility

• communication

• psychological and emotional needs

• cognition (understanding)

• behaviour

• drug therapies and medicine

If you’re eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs.

• altered states of consciousness

• other significant care needs

These needs are given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.

If you have at least 1 priority need, or severe needs in at least 2 areas, you can usually expect to be eligible for NHS continuing healthcare.

You may also be eligible if you have a severe need in 1 area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.

In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS continuing healthcare should be provided.

The assessment should take into account your views and the views of any carers you have. You should be given a copy of the decision documents, along with clear reasons for the decision.

You can download a blank copy of the NHS continuing healthcare decision support tool from GOV.UK

Fast-track assessment for NHS continuing healthcare

If your health is deteriorating quickly and you’re nearing the end of your life, you should be considered for the NHS continuing healthcare fast-track pathway, so that an appropriate care and support package can be put in place as soon as possible – usually within 48 hours.

Care and support planning

If you’re eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs.

Depending on your situation, different options could be suitable, including support in your own home and the option of a personal health budget.

If it’s agreed that a care home is the best option for you, there could be more than 1 local care home that’s suitable.

Your ICB should work collaboratively with you and consider your views when agreeing your care and support package and the setting where it will be provided. However, they can also take other factors into account, such as the cost and value for money of different options.

If your needs have changed, the review will also consider whether you’re still eligible for NHS continuing healthcare.

NHS continuing healthcare reviews

If you’re eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within 3 months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs. If your needs have changed, the review will also consider whether you’re still eligible for NHS continuing healthcare.

Refunds for delays in NHS continuing healthcare funding

ICBs will normally make a decision about eligibility for NHS continuing healthcare within 28 days of getting a completed checklist or request for a full assessment, unless there are circumstances beyond its control.

If the ICB decides you’re eligible, but takes longer than 28 days to decide this and the delay is unjustifiable,

they should refund any care costs from the 29th day until the date of their decision.

If you’re not eligible for NHS continuing healthcare

If you’re not eligible for NHS continuing healthcare, but you’re assessed as requiring nursing care in a care home (in other words, a care home that’s registered to provide nursing care) you’ll be eligible for NHS-funded nursing care.

This means that the NHS will pay a contribution towards the cost of your registered nursing care. NHS-funded nursing care is available irrespective of who is funding the rest of the care home fees.

Find out more about NHS continuing healthcare from NHS England.

Frequently asked questions about NHS continuing healthcare

Q I have a local authority support package that works well. I’m now eligible for NHS continuing healthcare – will my support package change?

If you’re concerned about changes to your care package because of a move to NHS continuing healthcare, your ICB should talk to you about ways that it can give you as much choice and control as possible. This could include the use of a personal health budget, with 1 option being a “direct payment for healthcare”.

Q

FAQ’s

Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority?

Consent is not needed for completion of assessments (CHC Checklists, Decision Support Tools (inclusive of FNC by default) and Fast Track), or collation and sharing of information with:

• Care Teams

• Health and Social Care Staff

But consent is needed to share personal information collected for, and as part of, assessments (Checklist, Decision Support Tool (inclusive of FNC by default) and Fast Track) with third parties, such as family, friends or representatives, at the beginning of the process.

There is a legal limit to the types of services that a Local Authority can provide. If you have any concerns about being assessed for NHS continuing healthcare, the ICB should explore your reasons for this, and try to address your concerns.

If someone lacks the mental capacity to consent to sharing of information with third parties (other than Care Teams or Health and Social Care Staff), the principles of the Mental Capacity Act will apply and a best interests decision may be needed.

Q

My relative is in a care home and has become eligible for NHS continuing healthcare. The ICB says the fees charged by this care home are more than they would usually pay, and has proposed a move to a different care home. I think a move will have a negative effect on my relative. What can we do?

If there’s evidence that a move is likely to have a detrimental effect on your relative’s health or wellbeing, discuss this with the ICB. It will take your concerns into account when considering the most appropriate arrangements.

If the ICB decides to arrange an alternative placement, they should provide a reasonable choice of homes.

Q Is it possible to pay top-up fees for NHS continuing healthcare?

No, it is not possible to top up NHS continuing healthcare packages, like you can with local authority care packages.

The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you’re assessed as needing from the NHS. These private services should be provided by different staff and preferably in a different setting.

Personal budgets and direct payments

You’ll be given a personal budget to spend if your local council decide you’re eligible for help with any social care and support you need. You can request an assessment from the council to establish your needs.

The money in your personal budget can be paid to you, to help you make more decisions about how it’s spent. This is known as a direct payment. What is a personal budget?

Your personal budget is the amount of money your local council will pay towards any social care and support you need.

The amount of money in your personal budget is decided by your local council after a needs assessment to work out:

• what kind of care and support you need

• how much it will cost

• how much you’re able to afford yourself

If you’re a carer, you may be entitled to receive a personal budget after having a carer’s assessment to see what might help make your life easier.

Carers and personal budgets

If you’re a carer, you may be entitled to receive a personal budget after having a carer’s assessment to see what might help make your life easier.

A carer’s assessment is free and anyone over 18 can ask for one.

Choosing how to receive your personal budget

You can ask the council to either:

• manage your personal budget for you

• pay the money to another organisation – such as a care provider

• pay the money directly to you or someone you choose – this is known as a direct payment

You can also choose a combination of these options. For example, the council could arrange some of your care but send you the rest of the money. This is often called a mixed package or “mix and match”.

If the council manages your money

The money in your personal budget will be spent for you by the council. They will arrange all your care and support based on your agreed care plan.

They still need to check you’re happy with the care they’re arranging for you.

If your money is paid to another organisation

The organisation you choose, such as your care provider, will speak to the council and arrange the payments.

Sometimes other organisations charge you extra money to arrange payments from the council.

The benefits of direct payments

Direct payments give you more flexibility over how your care and support is arranged and provided.

For example, you could choose to hire care workers or personal assistants who:

• are always the same people and available when you need them

• speak the same language as you

• have experience working with your care needs

• are a specific person that has been recommended to you

• can help you get to shops or social events

There are many ways you could choose to use the money. It’s your choice as long as you’re spending your personal budget on things that meet your agreed care plan.

Most councils will ask for evidence of how you’ve spent your money every 3 months.

When to consider other options

You may decide direct payments are not helpful if:

How to apply for direct payments

You should be offered direct payments as an option after your needs assessment.

You can also ask your local council’s social services department about direct payments.

How direct payments work

You could also consider having someone else manage your direct payments, for example a friend or family member.

• you’re worried about managing money or the people you employ

• you spend a lot of time in hospital

• you would rather the council arranged your care

If you’re not confident about keeping records or managing the people who care for you, your local council should be able to provide support.

You could also consider having someone else manage your direct payments, for example a friend or family member. You’ll need to set up a trust for payments that are managed by someone else.

The Money Advice Service has information about setting up a trust.

If you choose direct payments, the council will send you the money in your personal budget by either:

• paying it directly into a bank, Post Office, building society or National Savings and Investments account

• sending you a pre-paid card

You can then choose how you spend the money on your own care and support, as long as it matches the care plan you’ve agreed with the council.

Signing a direct payment agreement

The council might ask you to sign a document called a direct payment agreement. This says:

• how the council want you to record your spending –for example, keeping receipts

• your responsibilities as an employer - if you’re paying for a care worker

If you spend direct payments on something that isn’t agreed in your care plan, the council could take the money back or end the direct payments.

If you’re struggling to manage your money

Ask your local council for advice or call the Money Advice Service on 0800 138 7777.

If you want someone else to receive the direct payment

You could speak to the council and agree for the money to be sent to someone who will spend it for you. For example:

• a carer

When choosing an agency, decide what sort of service you’re looking for and the tasks you need help with.

• a friend or family member

• someone else who speaks up for you (an advocate)

You may need to write down how they will spend the money and which decisions they can make for you. This is known as a decision-making agreement.

Employing your own carer or personal assistant

If you decide to hire a carer or personal assistant yourself, it’s important to know the responsibilities you’ll have as an employer.

Although support from the council should be available, you may need to arrange:

• background checks or references

• tax

• National Insurance

• pension contributions

Read more about employing someone to work in your home on GOV.UK.

Disability Rights UK also have more information on getting a personal assistant.

If you don’t want to become an employer

You could choose to hire care workers through an agency instead. This removes the legal obligations of being an employer, but could:

• cost you more money

• remove some of the benefits - such as having the same person provide your care

How to research a care agency

When choosing an agency, decide what sort of service you’re looking for and the tasks you need help with. It’s a good idea to contact more than one agency, as they may offer different types of services.

You can find out about local home care agencies by:

• speaking to your local council’s social services department

• contacting the UK Homecare Association

If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the care home.

There are also organisations that inspect care agencies to see how well they are doing. The Care Quality Commission (CQC) regulates all health and adult social care in England.

You might see a CQC inspection rating when you search online for care home agencies. Their 4 ratings are:

• Outstanding

• Good

• Requires improvement

• Inadequate

You could also search for care home agencies on the CQC website to see their full reports.

Telephone helplines

If you would like support to help you manage your personal budget or direct payments, speak to your council or call:

• the Disability Rights UK personal budgets helpline on 0330 995 0404

• the Age UK advice line on 0800 055 6112 (for older people)

NHS-funded nursing care

NHS-funded nursing care is when the NHS pays for the nursing care component of nursing home fees. The NHS pays a flat rate directly to the care home towards the cost of this nursing care.

Who is eligible for NHS-funded nursing care?

You may be eligible for NHS-funded nursing care if:

• you’re not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse

• you live in a nursing home

How will my needs be assessed?

You should be assessed for NHS continuing healthcare before a decision is made about whether you are eligible for NHS-funded nursing care. Most people don’t need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven’t already had one, your integrated care board (ICB) can arrange an assessment for you.

Outcome of the assessment

If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided

How to complain about personal budgets

It’s worth speaking to your council’s social services before making an official complaint to see if they can help.

You still have to the right to complain if you:

• have been told you’re not eligible to receive money towards your care and support

• don’t agree with the amount of money in your personal budget

You could either:

• speak to your social worker about being re-assessed

• call your local council social services and request a complaints form

Your council should also have a formal complaints procedure on its website.

If you’re not happy with the council’s response

Contact your Local Government Ombudsman. They investigate all adult social care complaints.

• Age UK have a detailed fact sheet on personal budgets and direct payments in social care

• The Money Advice Service has a guide to direct payments

by registered nurses employed by the care home. Services provided by a registered nurse can include planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care.

If you’re not eligible for NHS-funded nursing care and you don’t agree with the decision about your eligibility, ask your ICB to review the decision.

The cost of NHS-funded nursing care

NHS-funded nursing care is paid at the same rate across England. In May 2022, the rate was set at £209.19 a week (standard rate) and will be backdated to 1 April 2022.

If you moved into a care home before 1 October 2007, and you were on the previous high band, NHS-funded nursing care is paid at a higher rate. In May 2022, the higher rate was set at £287.78 a week and will be backdated to 1 April 2022. You’re entitled to continue on this rate unless:

• you no longer have nursing needs

• you no longer live in a care home that provides nursing

• your nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £209.19 a week, or

• you become entitled to NHS continuing healthcare instead

Driving and using public transport if you have mobility issues

If you’re older or disabled, there are ways to make it easier for you to use public transport or to drive.

You can get help:

• using public transport

• getting discounts on public transport

• from the NHS with travel costs

• finding community transport schemes

• using taxis

If you have mobility problems and you need a car to get around, you may be able to get help with costs and parking by:

• discounted or free road tax

If you’re using public transport, it’s worth contacting the transport operator before you travel to make sure they’re able to provide the help you need.

• a Blue Badge parking permit

• leasing a vehicle through the Motability scheme

You can also find out about walking aids, wheelchairs and mobility scooters.

Using public transport

All public transport has to be “accessible” so disabled passengers can use it. Public transport also has to accept guide dogs or assistance dogs.

If you’re using public transport, it’s worth contacting the transport operator before you travel to make sure they’re able to provide the help you need.

Buses and trains usually have priority seating for older people and people with disabilities. They also usually have space and wide doors for wheelchairs. Some buses, trains and trams are fitted with ramps.

Public transport in London

London transport (trains, buses and river boats) is being upgraded to improve step-free access, to help with wheelchair access and avoiding stairs on Transport for London.

Staff at underground stations are also trained to help people move around the underground system – for example, by helping you use lifts instead of escalators and steps, and calling ahead to arrange for help at your destination.

Discounts on public transport

Older people and people with disabilities can usually travel free on local buses anywhere in England between 9.30am and 11pm Monday to Friday, and at any time during the weekend and on bank holidays.

Some local councils offer free travel for longer, and some allow a companion to travel with you for free.

Find your local council on GOV.UK.

Apply for an older person’s bus pass on GOV.UK or apply for a disabled person’s bus pass on GOV.UK.

If you often travel by train, it’s probably worth checking the Disabled Persons Railcard website to see if you are eligible for a disabled persons railcard. This gives you, and a companion travelling with you, a third off the price of rail tickets.

Children aged 5 to 15 with disabilities are also eligible for a disabled persons railcard. This lets an adult travel with them for a third of the cost of most adult fares, while the child pays the normal child fare.

NHS help with travel costs

If you pay to travel to a hospital or other NHS setting for NHS-funded treatment or tests, you may be able to claim a refund of reasonable travel costs.

Community transport schemes

These schemes provide transport to and from hospitals, GP surgeries, dentists, opticians and chiropodists and podiatrists.

Many areas offer a free “Dial-a-Ride” service, which gives you door-to-door transport if you can’t use normal buses.

You need to register for some schemes and you may have to pay. Carers may be able to travel with you for an extra charge.

Road tax reductions

You may also be able to get a reduction in your road tax, or not have to pay it at all.

Find out more on GOV.UK about financial help if you’re disabled, such as vehicle tax exemption and vehicle tax reduction.

Blue Badge disabled parking scheme

You may be able to get a Blue Badge parking permit for your car.

This lets you park in disabled parking bays.

With a Blue Badge, you can:

• park for free within certain times

• park on single and double yellow lines

• stay longer in on-street time-limited parking bays

Blue Badge schemes are run by local councils. Most councils will let you apply for or renew a Blue Badge on GOV.UK.

Blue Badge holders can apply for a 100% Blue Badge discount for the London Congestion Charge, on the Transport for London website.

Motability Scheme

The Motability Scheme lets you use your mobility allowance to lease a car, powered wheelchair or scooter. You can also pay extra for a more expensive vehicle.

You need to receive 1 of the allowances used on the scheme and have at least 12 months left on your award.

Many areas offer a free “Dial-a-Ride” service, which gives you doorto-door transport if you can’t use normal buses.

Check with your local council’s social services team whether there is a community transport scheme in your area.

Using taxis

Taxi and private hire companies can provide wheelchair-accessible vehicles if you ask for one when you book.

Some councils give free taxi vouchers to people who find it difficult to use public transport.

Driving with mobility problems

If you have mobility problems and you need a car to get around, you may be able to get help with costs and parking.

The allowances used include:

• the higher rate mobility component of Disability Living Allowance (DLA) for adults on GOV.UK

• the enhanced rate of the mobility component of Personal Independence Payment (PIP) on GOV.UK

• the War Pension Scheme: Mobility Supplement (WPMS) on GOV.UK

• the enhanced rate mobility component of Armed Forces Independence Payment (AFIP), which you can claim on GOV.UK if you were injured while serving in the armed forces

United Against Dementia

Alzheimer’s Society wants everyone affected by dementia to know that whoever you are, whatever you are going through, you can turn to them for support, help and advice.

Dementia Connect

Dementia Connect, from Alzheimer’s Society, is a personalised support service for anyone with dementia, their carers, families and friends.

We understand that dementia affects everyone differently. So whether you, a loved one, a friend or neighbour needs dementia support, we’re here for you.

We’ll connect you to a whole range of dementia support, by phone, online and face to face. Our highlytrained dementia advisers can help people come to terms with their diagnosis and navigate the complicated maze of health and social care services.

It’s free, easy to access, and offers you the support you need. Whether it’s advice on legal documents, help understanding dementia or someone to talk to when things get tough, we’re here to help.

We can keep in touch with you to make sure you keep getting the support you need. And because we know it’s never easy to tell your story, you’ll only ever need to tell it to us once.

Phone support

Our dementia advisers are available to talk to on the phone seven days a week. They will listen and give you the support and advice you need, including connecting you to help in your local area and online.

We can offer you the option of regular calls so we can keep in touch, to find out how you are and help when things change.

Support line opening hours*

Monday – Wednesday: 9:00am – 8:00pm

Thursday – Friday: 9:00am – 5.00pm

Saturday – Sunday: 10:00am – 4:00pm

*Calls charged at standard local rate.

Online support

Dementia Connect online support is available round the clock through our website. Answer a few simple questions about yourself, or someone you know, to get personalised, relevant information and advice. From guides on dementia to advice on making your home dementia friendly, get the information about the things that matter to you.

‘The Dementia Adviser was lovely and full of information. Without Alzheimer’s Society and the Dementia Adviser we’d have nothing. She is a major networker and knows everything and everyone local. I feel in charge and empowered.’ Katherine, living with dementia

If you need further support, you can request a call from our dementia advisers, who should be in touch with you within a week. Our online support includes Talking Point, our online community where you can connect with others in a similar situation, and our Dementia Directory where you can search for local services.

Face to face support

Where possible, our local dementia support workers can meet you in person to offer further support, advice and information. They will also connect you to other face to face services in your area, including local support groups.

Notes: Dementia Connect phone and online support is available wherever you live. As the service is new, some parts of the service may not be available in your area just yet.

The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care. We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one.

You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia.

We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided.

You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care. You can also call us to share an experience of care on 03000 61 61 61.

Here are some tips to help you choose your care.

1 The Care Quality Commission (CQC) registers all care homes and home care agencies. You can find out which ones support specific groups of people, such as people with a learning disability or those living with dementia.

2 CQC’s Chief Inspector for Adult Social Care, always uses ‘The Mum Test’: is a care home safe, caring, effective, responsive to people’s needs and well-led? In other words, is it good enough for my Mum (or anyone else I love and care for)?

Look for care homes and home care agencies where the staff involve people who use services and their families and carers, and treat individuals with compassion, kindness, dignity and respect

Whether you are being cared for in your own home or in a residential setting, the staff looking after you need to be skilled, kind and supportive They should also be capable and confident in dealing with your particular needs. You should always feel that their support is helping you to live the life you want to.

5 A care home will be a home for you or your loved one. Residents should be treated as individuals with their likes and dislikes taken into account. Think about whether a home is close enough to family, friends, and community facilities

Look at how well-led and managed a home is. What does it have in place to ensure that it delivers high quality care? Does it

If you or a loved one needs help with day-today care, you can contact your local council’s social services department. They will ‘make an assessment of your needs’ and depending on circumstances, may be able to help you access financial help. For more advice visit Age UK’s website www.ageuk.org.uk/home-and-care.

Your local social services department should be able to provide details of approved agencies.

Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police. You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.

Free services available for over 50s

Age UK Norfolk is a local charity with over 75 years’ experience of delivering crucial services for older people in Norfolk.

Our dedicated team can assist you with a number of services including:

Information and Advice

Our Information and Advice Help Line is open Monday-Friday 10am to 4pm and our trained advisors can offer guidance on a variety of issues including care assessments, cost of living, lasting power of attorney and local services in your area.

Welfare Benefits

We offer people aged 65+ companionship by phone with a friendly chatty call from a dedicated befriender.

We provide free benefit checks to determine any entitlement to welfare benefits and further practical assistance with applying for benefits.

Advocacy

We support and enable people over 50 to have their voice heard; we can help you with making phone calls and writing letters to help ensure you do not experience any inequality or discrimination.

Money Matters

We offer one to one support from a dedicated volunteer to assist and empower over 65s to remain independent when handling the day-to-day management of household finances and paperwork.

Befriending

We offer people aged 65+ companionship by phone with a friendly chatty call from a dedicated befriender.

Let’s Get Digital

Our Digital Inclusion Champions can assist anyone aged 50+ in learning how to use your digital device, for example, setting up WhatsApp and answering video calls from family and friends to more advanced support like online shopping.

Travelling Companionship

We match lonely and isolated older people with a trained Travelling Companion who can accompany you on journeys you need to make in order to help build your confidence so that you can regain your independence and make journeys alone.

For more information or to access any of our services, please call our team on 0300 500 1217, email advice@ageuknorfolk.org.uk MondayFriday 10am to 4pm, or visit our website www.ageuknorfolk.org.uk

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