A guide to care and independent living
Leaving hospital
NHS continuing healthcare
Who’s eligible?
SOCIAL CARE tips
Can’t go to Specsavers? They’ll come to you
We caught up with Kejal Shah who has been an Optometrist with Specsavers Home Visits for 8 years. She explains to us how this much-needed service works.
So, tell me more about the Home Visits service…
Our at-home eye test is very similar to what you would have experienced in-store, just with a few adjustments and specialist equipment to make it home-friendly.
Optometrists, like myself, carry out the eye test, adjusting it to your individual needs. If glasses are needed, experienced colleagues will help with frame selection and then return to fit them. And, it goes without saying, all customers are supported with ongoing aftercare.
In response to demand, we’ve also now launched a new audiology home visits service. So far, we have home hearing services in 16 locations in the UK, with plans to expand this over the coming months.
Who is able to benefit from a home eye test?
Put simply, it’s about bringing the service to your door, if you can’t get to one of our stores. So if you, a friend, or loved one, are unable to leave your home or care home unaccompanied, due to a physical or mental illness or disability, we can come to you.
There are a wide range of conditions and reasons why someone might not be able to leave their home. You can speak to us about your situation and we can help you understand if you or your loved one qualifies. What if someone is bedbound, or struggling with communication? Can you still help them?
The Home Visits service is designed to provide eyecare which is as individual as our customers are.
Some customers might be clinically vulnerable or they might be non-verbal or living with dementia. Depending on the situation, we might use pictures instead of letters for example. Even with a customer who is bedbound, we can change the position of the chart so we’re still getting completely accurate results. All the tests are adapted to fit the customer’s environment and comfort level. We can also speak to the customer or their loved one ahead of the visit, to address any questions or talk through the process.
Given that you provide such a personal and tailored service, does your care go beyond just an eye test?
Every colleague I know sees our services as something beyond just a job. Whether it’s sharing stories over a cuppa, popping something in the post for them, or passing them something out of reach, going that extra mile is such a rewarding part of our role. I only need to see a customer’s smile to know I’ve made a difference.
That’s a big part of what we do. Provide a personal service, tailored care and expertise, right to people’s homes, no matter what their situation – in homes, care homes or sheltered housing.
How do I find out whether someone is eligible?
You can head to our website at www.specsavers.co.uk/home-visits which features a simple step-by-step guide to eligibility and a wealth of information. Alternatively, you can call 0800 0890144
TOCU is now in its second year of success
Over a year after TOCU opened, it is seeing more than 1,000 patients a month and is helping to increase the amount of early discharge at Nottingham University Hospitals NHS Trust (NUH).
The unit, which opened in September 2023, provides 24-hour discharge support, seven days a week. It provides a relaxed and comfortable area for patients to wait to get their medications, transport home or anything they need before they get discharged, freeing up beds elsewhere for patients who need them the most.
Patient Sue Woolley, 70, from Nottingham said: “I fell over at home and broke my hip and after almost two weeks in hospital I’m ready to go home.
“This unit is a really nice area, everyone is friendly, and it feels different from the ward, in a good way. I have to do more things for myself here and not use the call button, which is good as it’s getting me ready to go home.”
“Keeping this flow through the hospital is really important, especially in winter when things like norovirus can cause disruption.”
Lisa Wells, Deputy Clinical Lead for Admitted Care at the Trust, said: “For every patient we have on the unit, it positively impacts about five other patients. It is all a knock-on effect, a patient coming on to the unit means an ambulance can go to the next call and a patient from our Emergency Department (ED) can go to the ward they need, so it can have a direct impact on wait times in our ED.
“Keeping this flow through the hospital is really important, especially in winter when things like norovirus can cause disruption.”
Beverley Brady, Lead Nurse for Clinical Service Development, said: “TOCU has achieved so much in its first year and has helped so many patients get home safely. Seeing the unit significantly improve patient safety and help capacity across the Trust like it set out to do is fantastic, I can’t imagine not having it now!
“I think it’s about the little things that make the big difference, like going home with some food or the heating being on when you get home, that’s what we do on the unit.”
With a total of 32 beds and 32 chairs at both Queens Medical Centre (QMC) and City Hospital, the units help to improve patient flow throughout the Trust as winter approaches. Last month the units at both QMC and City Hospital saw 1,545 patients, which had positively impacted more than 7,000 other patients in October alone.
The UK’s first Frailty Admission and Discharge Unit win at the Parliamentary Awards
The UK’s first Orthopaedic Frailty Admission and Discharge Unit (FADU) at the Queen’s Medical Centre, Nottingham, has been recognised at the NHS Parliamentary Awards 2024.
The team behind the unit took home the Nursing and Midwifery Award for creating a new pathway to help manage frail elderly patients at Nottingham University Hospitals NHS Trust (NUH).
Elderly patients are admitted to the new four beddedunit following critical injuries, such as hip fractures, and receive dedicated nursing care in a specialist area rather than waiting in the Emergency Department (ED).
NUH is one of the largest providers of hip fracture care in the UK, treating over 850 such cases a year and the only acute trust in Nottinghamshire. Orthopaedic and trauma surgeon and senior researcher Professor Benjamin Ollivere worked with Emily Mulvaney, Trainee Advanced Clinical Practitioner, and other NUH staff, to establish FADU in 2023.
Within the first 12 months, 625 patients were admitted into FADU who would have otherwise waited in ED.
Emily Mulvaney said: “We were really pleased to win. We are the first in the country to do things this way round, so it’s really nice to be recognised for the different way of doing it. We actively pull patients out of ED into a specialised area with specialised staff.
delighted that the Frailty Admission and Discharge Unit (FADU) Team at Nottingham’s QMC has been recognised for the invaluable work that they do at this year’s NHS Parliamentary Awards. I was incredibly proud to be there to see them win and congratulate them on their welldeserved success.
“I know the multidisciplinary FADU staff work incredibly hard to support and care for our city’s frail residents at a very difficult time. Their efforts make a big difference to patients’ experience if hospital, with 97% of them being now seen within 36 hours by an orthogeriatric consultant after arriving at A&E. The Unit’s approach is truly trailblazing and I hope that this recognition will help efforts to share this best practice across our NHS.”
The unit is open from 7am – 7.30pm seven days a week and has a 100% occupancy rate. The team are hoping to expand the opening hours in the future to benefit more patients. Patients are moved onto a ward by the time the unit closes to provide flow through the hospital every day.
Anthony May OBE DL, Chief Executive at NUH attended the awards alongside the FADU team. He said:
“This award is a testament to their leadership, drive and determination to deliver the best care for our patients.”
“Within the first year, patients who go through FADU have a 50% reduction in delirium and improved survival. It is a much better overall patient experience, getting them off corridors and out of ED quicker and into a unit that is the in-between before getting to a ward.”
The multidisciplinary team came up with FADU to improve the care and dignity of our frailest patients.
Nottinghamshire MPs Alex Norris, Nadia Whittome, Lilian Greenwood, Steve Yemm and James Naish originally nominated the FADU Team for the award.
Lilian Greenwood, MP for Nottingham South said: “I am
“Congratulations to the Frailty Admission and Discharge Unit team for winning the Nursing and Midwifery Award at the NHS Parliamentary Awards 2024.
“The team should be proud of their hard work and efforts to open the first Orthopaedic Frailty Admissions and Discharge Unit in the UK. This award is a testament to their leadership, drive and determination to deliver the best care for our patients. Thank you.”
The 2024 NHS Parliamentary Awards were held on Monday 14 October in Westminster to recognise the outstanding contribution of staff, volunteers and others working in the health and care sector.
Largest neonatal unit in the East Midlands opens its doors in Nottingham
A brand new £32million neonatal unit, the largest in the East Midlands in terms of cots and footprint, has opened at the Queen’s Medical Centre (QMC) in Nottingham.
The new Neonatal Intensive Care Unit at Nottingham University Hospitals (NUH) is four times the size of the previous one, has been designed to be a home-from-home for babies and their families, and it is hoped that it will help to set a standard for neonatal units across the UK.
Funded by NHS England, the Department of Health and Social Care and Nottingham and Nottinghamshire Integrated Care Board, the neonatal unit will provide an additional 21 cots at QMC, taking the total to 38, and the overall footprint of the site has increased from 500m² to 2000m²
has been almost 20 years in the planning, and was only made possible with the funding we received in 2022 from NHS England and the Department of Health and Social Care.
“This funding provided us with a rare and exciting opportunity to design a neonatal unit that not only meets the needs of our families but also provides our highly skilled neonatal staff with a working environment they deserve, both now in the future.
“Thanks to the many people who have played a part in its design and creation, we have a facility that we can justifiably be proud of.”
Key features on the NICU include larger cot bays, providing more space for families when visiting and staying with their babies; glass screening between bays to provide acoustic barriers and privacy; several retractable glass dividers for families with twins and triplets; family accommodation with kitchen and lounge areas for those staying overnight; and two play areas so that siblings have their own space to play.
In a first for a NUH neonatal unit, a dedicated bereavement suite has been introduced, providing families with a calm and peaceful environment at a very difficult time in their lives, and families can stay for as long they need.
State-of-the-art facilities for staff on the unit include a specialised treatment room, Mindray monitors to record vital signs, and pendants to keep medical equipment up off the floor, creating more care space.
NUH’s Chief Executive Officer, Anthony May, said: “The redesign and expansion of our neonatal services
“The unit will make a huge difference to the 800 premature babies we support here at NUH every year and is already attracting interest from national neonatal teams. Thanks to the many people who have played a part in its design and creation, we have a facility that we can justifiably be proud of.”
The limited size of the old QMC unit meant that over 100 babies requiring specialist care had to be transferred out of the area each year. By increasing the capacity at the QMC, we can ensure that the smallest and sickest newborn babies from the whole of the East Midlands are cared for in the best location and with the right resources.
Programme Director, Jenni Twinn, has led the delivery of the neonatal unit and explained that a huge amount of thought has gone into the design.
She said: “We have been on an incredible journey. When we first set out on this project we wanted to do things a bit differently, to provide a unit that is exactly what our families and staff need. We are confident we have achieved this and, in doing so, we have created a real home-from-home.
“Everything has been carefully thought out, from the soothing colours and furniture used to provide a comforting feel, to installing the latest state-of-the-art technology that will enhance the experience of both families and staff. It is this attention to detail that sets this unit apart and which will really make a difference to all those involved.
“This would not have been possible without the hard work and dedication of so many people who have committed to making this beautiful unit a reality.”
previously, too many have been sent out of the area to receive their care. The new unit will have a significant positive impact on the lives and futures of the neonatal babies we care for, as well as the staff who work within it.”
”The new unit will have a significant positive impact on the lives and futures of the neonatal babies we care for, as well as the staff who work within it.”
To ensure the cot numbers are increased in the safest way possible, the NICU will not be expanding the number of cots in use until the new year.
As a result of the new facility, the QMC will become NUH’s Neonatal Intensive Care Unit and the neonatal unit at City Hospital will become a Local Neonatal Unit – where babies can continue to receive intensive care for a short period of time if required, before being transferred to the QMC for longer-term care, if needed.
Dr Lleona Lee, consultant neonatologist and NUH’s Clinical lead for the redesign, added: “I know that staff are really excited to be moving to the new unit, and we have had some lovely feedback from the staff who have visited. We are looking forward to providing our best care for our patients and families in our purposebuilt facility.
“We have long recognised the need to provide more cots for those babies who need our specialist care, as
Nottingham Hospitals Charity have provided more than £322,000 in fundraising support as part of their Big Appeal to support some of the enhancements included on the neonatal unit to help it to feel like a home from home. This includes the frosted glass partition screens for the bays, the children’s play areas and televisions for the family rooms.
Nigel Gregory, Chief Executive of Nottingham Hospitals Charity, said: “Thanks to all those who have generously donated to our Big Appeal, we are delighted to have been able to fund some of the special touches, home comforts and additional equipment that will help make this new neonatal unit a home-from-home for babies and families.
“With poorly babies and their families at the forefront of our minds, we have funded added extras such as glazed screens between bays, to allow families to have space and privacy with their babies, welcoming wall art in the entrance to help visitors feel at home when entering the unit, and comfortable furniture and play equipment for siblings visiting their baby brothers and sisters. I’d like to thank everyone who has donated to make this possible, it will make a real difference to families who may be spending weeks or even months on the unit.”
Elmbank
Nursing Home
Elmbank offers first class accommodation and nursing care in a luxurious setting, combining a whole host of equipment and modern facilities designed specifically to meet the needs of elderly adults.
Facilities and services: Laundry • Dry cleaning (at an additional cost) • Newspapers and magazines (charged monthly to your account) • Toiletries, personal items and stationery can be purchased within the home • Entertainment provided on a regular basis • Activity co-ordinators organise activities including exercise classes, quizzes, birthday buffets and outings to surrounding parks, city shops, markets, restaurants and pubs.
Blossomwood redevelopment
The Trust is excited about this continuing redevelopment and knows it will result in a fantastic facility for patients to receive care and for colleagues to work.
The redevelopment of Blossomwood is progressing well. Robin and Kingfisher wards have both opened providing single ensuite bedrooms for 18 patients over the age of 65 with mental illness and 18 patients with dementia. All bedrooms are spacious with accessible ensuite bathrooms and large bedroom windows providing a quiet therapeutic view onto woodland. Both wards offer therapeutic day space and access to landscaped outdoor space for all patients.
Work is progressing on the final ward, Dove Ward, which is due to open in 2025. This will be a 10-bed ward for flexible use (both dementia or mental health patients).
Rest facilities for doctors will be on the first floor together with a staff base where colleagues can take their breaks.
The new reception area has also opened and boasts a bright environment with new seating areas for
outpatients clinics. The new reception office has been designed with staff input to meet and greet everyone who enters the building. The new area will include access to a coffee bar called the Hive, hosted by Trust volunteers where staff, patients, and visitors can purchase hot and cold drinks with a variety of snacks.
The new kitchen and dining room have been developed with a specialist design team to make sure the new facilities can enable staff to work in a modern environment. The new dining area provides seating together with access to outdoor space in the warmer months. The café offers a wide menu including breakfasts, and meal deals for lunchtimes with the successful ‘take away’ service continuing to provide staff and visitors access to hot or cold food.
The Trust is excited about this continuing redevelopment and knows it will result in a fantastic facility for patients to receive care and for colleagues to work.
Langwith Lodge Residential Home
The Park, Nether Langwith, Mansfield, Nottinghamshire, NG20 9ES
Compassionate Care and Support
Providing quality services for people across the UK
Langwith Lodge is located in beautiful parkland, which includes a large fishing lake. The whole team work together to provide the very best of care for you and your loved one. There is a wide variety of activities to suit all tastes plus a minibus for day trips.
There is an abundance of wildlife within the grounds plus an accessible birdwatching hut and a sensory garden.
Lakeside View provides specialist dementia care, with staff fully trained in dementia care. Langwith has lots to offer, please call for a chat with our Home Manager Zoe or pop in and have a look around 01623 742204
www.yourhealthgroup.co.uk
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
QI 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
Paying for your own care (self-funding)
You will not be entitled to help with the cost of care from your local council if:
• you have savings worth more than £23,250 – this is called the upper capital limit, or UCL
• you own your own property (this only applies if you’re moving into a care home)
You can ask your council for a financial assessment (means test) to check if you qualify for any help with costs.
You can choose to pay for care yourself if you don’t want a financial assessment.
How to arrange your care as a self-funder
You can:
• arrange and pay for care yourself without involving the council
• ask the council to arrange and pay for your care (the council will then bill you, but not all councils offer this service and they may charge a fee)
Having a carer who lives with you costs from around £800 a week. But it can cost as much as £1,600 a week if you need a lot of care.
Paying for a care home
There are 2 types of care home:
• residential homes have staff that help with everyday tasks such as getting dressed and supply all your meals
• nursing homes also offer 24-hour nursing care
A room in a care home costs:
• around £700 a week in a residential home
• over £850 a week in a nursing home
The price will vary according to where you live and the type of care you need.
For example, serious health problems like dementia and chronic obstructive pulmonary disease (COPD) can increase the cost.
Benefits can help with care costs
Even if you choose to pay for your care, your council can do an assessment to check what care you might need. This is called a needs assessment.
Find out what care you need
Even if you choose to pay for your care, your council can do an assessment to check what care you might need. This is called a needs assessment.
For example, it’ll tell you whether you need home help from a paid carer for 2 hours a day or 2 hours a week and precisely what they should help you with.
The needs assessment is free and anyone can ask for one.
How much will care cost?
Social care can be expensive. Knowing how much you’ll have to pay will help you budget.
Paying for carers at home
A typical hourly rate for a carer to come to your home is around £20, but this will vary depending on where you live.
You may be eligible for benefits, like Attendance Allowance and Personal Independence Payment (PIP), which aren’t means-tested.
You can use them to pay towards the cost of your care.
Can I avoid selling my home?
You won’t have to sell your home to pay for help in your own home.
But you may have to sell your home to pay for a care home, unless your partner carries on living in it.
Sometimes selling your home to pay care home fees is the best option.
But there may be other ways to pay care home fees if you don’t want to sell your home straight away.
Contact your local council about 3 months before you think your savings will drop to below the limit and ask them to reassess your finances.
Releasing money from your home (equity release)
Equity release lets you take money that’s tied up in your home without selling it. It’s available if you’re over 55.
But you have to pay interest on the money you take out, which can be expensive.
MoneyHelper has more information on equity release.
Renting out your home
You can rent out your home and use the income to help pay your care home fees.
A deferred payment scheme
A deferred payment scheme can be useful if you have savings less than the upper capital limit of £23,250 and all your money is tied up in your property
The council pays for your care home and you repay it later when you choose to sell your home, or after your death.
Ask your council if you’re eligible for a deferred payment scheme.
You can get more information from:
• MoneyHelper: deferred payment schemes
• Independent Age: do I have to sell my home to pay for residential care?
Get expert financial help
You can get unbiased expert advice from a specialist care fees adviser.
They’ll help you compare all your options before you decide what’s right for you.
Find a specialist care fees adviser in your area with:
• PayingForCare, a free information service for older people
• Society of Later Life Advisers (SOLLA) on 0333 2020 454
Telephone help
Get advice on paying for care from:
• Age UK on freephone 0800 055 6112
• Independent Age on freephone 0800 319 6789
• MoneyHelper on freephone 0800 011 3797
If your savings run out
If your savings fall below the upper capital limit of £23,250, your council might be able to help with the cost of care.
Contact your local council about 3 months before you think your savings will drop to below the limit and ask them to reassess your finances.
Councils provide funding from the date you contact them. You won’t be reimbursed if your savings are below the limit before you contact them.
What you can get for free
You might be able to get some free help regardless of your income or if you’re paying for your care.
This can include:
• small bits of equipment or home adaptations that each cost less than £1,000
• NHS care, such as NHS continuing healthcare, NHSfunded nursing care and care after illness or hospital discharge (reablement)
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.
How can you support Alzheimer’s Society?
1) Fundraising and events
From Memory Walk and Cupcake Day to challenging yourself in marathons and treks. There’s plenty of ways you can get involved to help raise money. Search ‘get involved’ on alzheimers.org.uk
2) Donate
Our dementia support services are made possible thanks to generous donations from the public. However, you don’t have to join an event or seek sponsorship to do this. Simply head to alzheimers.org.uk and donate what you can to unite against dementia.
3) Become a campaigner
At Alzheimer’s Society, we work to amplify the voices of people affected by dementia, to create a world where they get the support and care they deserve. We can’t do this alone. Whether you have dementia, you have a personal connection to dementia or you want to stand with those who do. Together we can make a difference, register to become a campaigner at alzheimers.org.uk
“Dementia can and does affect so many families, including mine.
“My father was diagnosed with vascular dementia and Alzheimer’s disease in the summer of 2012. He passed away in September 2018.
“I wanted to do something to help raise awareness of the condition and tackle the stigma associated, so I reached out to Alzheimer’s Society to see if I could help. It gives me an enormous sense of pride being an Ambassador for Alzheimer’s Society and I feel like I’m making a difference.
“I have also personally enjoyed taking part in fundraising activities like Cupcake Day and Memory Walk, as there is a real sense of togetherness for a good cause.
“For anyone wanting to know how they can help, I’d say get involved. Whatever you can give, be that your time, voice or money, you’ll know you’ve made a difference to the lives of people affected by dementia.”
Meera Syal, actor and Alzheimer’s Society Ambassador
Get in touch
If you are affected by dementia in and would like information and support, contact us:
T: 0333 150 3456
W: alzheimers.org.uk/dementiaconnect
E: dementia.connect@alzheimers.org.uk
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 promote
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.
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 If you are new to an area you can find details of local GP services such as doctors’ practices, out-of-hours services and walkin centres in our online directory of care services www.cqc.org.uk/content/doctorsgps
2 You can search any of these services by the name of the service, a place name or your postcode at www.cqc.org.uk
After an inspection, CQC publishes its findings in a report on its website. You can use these reports to check and compare services in your area 3
There are already over 1,000 reports about GP practices published on the CQC website.
5 CQC launched its new-style inspection reports for GPs – looking at the five key areas SAFE, EFFECTIVE, CARING, RESPONSIVE and WELLLED – you can use the reports to compare local GPs and choose services.
You can also use these new style inspection reports to find out more about local services and choose the one that is best for your needs.
CQC rates all GPs to help people make choices about where they get treatment. This will be on a four-point scale:
CQC will also look at how specific population groups are treated and give a rating. For instance how well they serve: Mothers, children and young people, vulnerable older people (over 75s) and people with long-term conditions People will be able to choose a GP service that rates highly on the areas that matter to them.
We welcome your feedback (good and bad) on the services you, or a loved one, receives from your GP. You can share information with us online at http://www.cqc.org.uk/share-yourexperience-finder or call us on 03000 61 61 61.
03000 616161 • Web: www.cqc.org.uk
Age Gracefully is committed to delivering exceptional care services and support to you or your loved ones in achieving a fulfilling and comfortable life. Our team of experienced carers are dedicated to providing personalised care that is tailored to your unique needs and preferences. We understand that finding the right care service can be overwhelming, which is why we strive to make the process as seamless as possible. From a visit a day to 24 hour or live-in care, we offer a range of services to meet your needs. At Age Gracefully we believe that everyone deserves compassionate and respectful care, and we’re here to help you every step of the way.
As a professional home care service provider, we adhere to strict regulations and maintain full compliance. Our organization is fully insured with comprehensive coverage to ensure your peace of mind. Age Gracefully is deeply rooted in the values of family and operates as a family-run business at its very core.
