Options Northamptonshire Spring 2024 by Octagon D&M Ltd

OPTIONS Northamptonshire A guide to care and independent living

Spring 2024

Leaving hospital What’s next?

NHS

continuing healthcare Who’s eligible?

10 SOCIAL CARE

tips

Healthcare services Choosing the right one

Contents

Northamptonshire Adult Social Services West Northants Council (WNC)........................................6 Northampton General Hospital NHS Trust.........................................................................................7 Our hospital team – the Integrated Discharge Team.........................................................................7 The assessment process........................................................................................................................8 Getting the most out of your assessment...........................................................................................9 Intermediate care services.................................................................................................................10 Reablement West...............................................................................................................................11 24 hour care homes............................................................................................................................11 Other sources of help for when you have left hospital..............................................................12-13 NHS continuing healthcare...........................................................................................................14-17 Personal budgets and direct payments........................................................................................18-21 NHS-funded nursing care...................................................................................................................21 Paying for your own care (self-funding)......................................................................................22-23 Alzheimer’s Society Services in Northampton..................................................................................26 Age UK Northamptonshire...........................................................................................................28-29 The Care Quality Commission Social Care top tips...........................................................................30

Welcome and introduction

This guide is intended to help you, your carer and your relatives understand how your local health services can help you after discharge from hospital. Also information to help you to live independently or access support and care services in your area.

Read online

To view this guide online as an interactive ebook visit: www.octagon.org.uk/options/northamptonshire/spring2024

OCTAGON DES IGN & M A RKETI NG LTD

Options Northamptonshire is published by Octagon Design and Marketing Ltd with editorial contributions from West Northamptonshire Council, Northampton General Hospital NHS Trust, Age UK, Alzheimer’s Society, the CQC and the NHS. The editorial contributors have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor do the editorial contributors endorse any of the products or services.

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Proud to be in the “Top 3 Most Recommended” Care Home in Wellingborough Area Established over 30 years ago Meadow View Care Home is based in the beautiful picturesque grounds of Irchester in Wellingborough. The area benefits from a range of amenities including a health centre, a chemist, a school, a library, churches, shops, public houses and a country park. We provide premium residential and nursing care for the elderly, to enable them to continue living an active and independent life, in warm, safe and comfortable surroundings. We deliver a comprehensive range of care under one roof. This includes respite and specialist dementia care and end of life care. We recognise each individual is unique. Our compassionate and experienced Carers ensure that each person receives the care that is tailored to their individual needs, personality and wishes, to enable them to lead the life they like in a dignified way. No wonder Meadow View Care Home is in the ‘Top 3 Most Recommended’ Care Homes in Wellingborough!

Meadow View Care Home 80 High Street, Irchester, Northampton, NN29 7AB T: 01933 355 111 E: meadowview@wellbeingcare.co.uk W: www.wellbeingcare.co.uk

Editorial content supplied by: West Northamptonshire Council

Northamptonshire Adult Social Services West Northants Council (WNC) West Northants Council supports Vulnerable Adults who live in West Northants and may need advice and support to meet their Social Care needs. WNC has Adult Social Services teams based in different areas across the Council. The teams use a strengths-based approach, which means seeing the person and their strengths, rather than focusing on their weaknesses. The approach used is called the ‘three conversations model’, which aims to remove the traditional assessment for services and creates a new culture where practice is structured into three conversations. The model moves the focus away from what’s wrong, and encourages practitioners to think differently, use different language and put the person back in the centre. In short, it’s about asking what matters, rather than what’s the matter, and about focusing on what people can do.

What are the three conversations? Conversation one: Listen and Connect. This is about listening hard to the individual and understanding what really matters to them. It’s also about connecting them to local resources and support that helps them to get on with their chosen life.

In short, it’s about asking what matters, rather than what’s the matter, and about focusing on what people can do.

Conversation two: Work intensively with people in crisis. This is about finding out what needs to change urgently to help someone to regain control of their

life and working with them to build the things they need into a plan, as well as supporting them to make that change. Conversation three: Build a good life. This conversation asks what does a good life look like? What resources, connections and support will enable the person to live that chosen life? And how can the person be helped to build a plan to grow and progress throughout their life?

There are a number of teams in place to support people to live as independently as possible by connecting them to their communities: Community teams who support people of all ages living within their area, with the exception of people with a Learning Disability. Learning Disability teams who support individuals who have a diagnosed learning disability to understand their social care needs and look at what support can be provided to increase their independence and meet identified outcomes. Short-term services promoting independence: Reablement services, short-term services. Teams supporting people to get home from hospital or short-term beds: Flow and Capacity team. Currently teams are based in Towcester, Daventry, Kingsthorpe, Weston Favell and Northampton town centre. Work is underway to expand into further locations and to continue to work more closely with partners and communities to create Local Area partnerships. For more information on adult social care and ways to look after your wellbeing please visit www.westnorthants.gov.uk/adultsandwellbeing

Editorial content supplied by: Northampton General Hospital NHS Trust

Helping you leave hospital The majority of people are able to return home following a stay in hospital without any additional support. If you feel you or your family member will require support to return home, please speak with the ward team who will be able to discuss your options with you. Where necessary, the ward team will work with our Integrated Discharge Team to support you in developing a plan so you can be discharged home, as quickly and as smoothly as possible. This guide explains how our team will help you, the role of our multi-disciplinary team (MDT) and how we work together to help with your discharge from hospital.

Problems or queries If you have queries or are experiencing difficulties relating to your discharge you can either contact your Patient flow coordinator or the ward coordinator should be able to support. They can also give further information and contact details that you may find helpful.

Our hospital team – the Integrated Discharge Team Our team based in the hospital is made up of health and social care workers which enables a holistic approach to safe, effective and timely patient discharge.

Planning for discharge normally begins at the point, or even before, you are admitted to hospital.

Our hospital team is made up of social workers, complex case managers (nurses, social worker and occupational therapist), assessment and enablement workers, flow and capacity team and Northamptonshire carers.

How am I referred to the Integrated Discharge Team? Planning for discharge normally begins at the point, or even before, you are admitted to hospital. The discharge process is coordinated by a member of the nursing team on the ward. An initial assessment by nursing, therapy and medical staff, will be carried out and they will meet with you and family to discuss your discharge plan if you have needs that require ongoing support.

You can give consent to your carer who can ask for a referral to made for ongoing care. If you have any queries when you are staying in hospital or if you would like any general advice, please ask your nurse to contact the team. A patient has to lack capacity for the power of attorney for someone to be able act on behalf of the patient Lasting Power of Attorney (LPA): If you are reading this on behalf of a relative or friend who is a patient with us, and there is a ‘Lasting Power of Attorney’ registered with the Office of the Public Guardian in place for that patient, please ensure that ward staff receive a copy of the document, or are provided with evidence of the LPA for our patient notes. It is important that we have a certified copy of any existing LPA for ‘Person’s Health & Welfare’. Please note that an LPA relating to property and affairs does not give anyone power to make decisions on behalf of the patient in regard to their treatment. However in the event that the patient’s circumstances have changed and they need to be considered for a placement such as a care home or nursing home, if you hold their LPA for property and affairs please confirm this to the nursing team. They will, if necessary, ensure that a member of the Integrated discharge team contact you to review the ongoing needs of the patient. Please also note that we cannot act upon any LPA unless we have certified evidence that it exists. We cannot act upon a verbal notification of its existence. Once we receive the copy or other evidence we will ensure that a care plan is put in place agreed with the person(s) holding the LPA. Please also remember that an LPA is not the same as an ‘advanced directive’ unless this has been included in the LPA.

Editorial content supplied by: Northampton General Hospital NHS Trust

The assessment process A member of the discharge team can be contacted if you need complex discharge support. Any assessments our team carry out are not a test. It is simply finding out what help you might need at home to reduce any risks to your safety or independence. The assessment process will start with discussions with you, your family/carers and the ward staff. This process of information gathering and discussions about your situation will enable the Multidisciplinary Team to work alongside you to: • identify your needs • give you information about services that could immediately support you to be discharged from hospital or support you in the longer term. Depending on how complex your needs are other specialist assessments may also be required. The referral process and ongoing support is following the National hospital discharge and community support guidance July 2022. The length of time required to complete the process can vary depending on how complex your needs are.

The Integrated Discharge Team will do all they can to help people to live independently and safely.

The Integrated Discharge Team will do all they can to help people to live independently and safely. We work with the resources available to us, and therefore prioritise those people who are in greatest need of help. This guide tells you more about the assessments and eligibility criteria. It also tells you what will happen after you have an assessment. This may be relevant to you if you are an older person (65+), have a physical or sensory disability, have mental health problems, or have a learning disability. Please see the information in the following section about our assessment process.

Discharge from hospital Once all ward MDT assessments are completed a Transfer of care form will be completed which outlines your needs. This will submitted to the Multidisciplinary Hub and a decision will be made on the most appropriate pathway to meet your needs. We operate a process called Discharge to Assess for patients who might need support on arriving home from hospital. This involves arranging a support care package to ensure patient safety, with a full assessment being made in the home rather than in hospital. We also use Discharge to Assess, for patients who are medically fit to leave hospital, but require discharge to a community bed, other placement or require further discharge arrangements. Patients and relatives will be given notice of a discharge date as soon as it is provided to the ward.

Important Information before you leave – self checklist There are a number of important questions that you need to be clear on before you leave hospital. If you cannot answer ‘yes’ to one of the questions below please ask a member of the clinical team on your ward to help you gain the answer. 1. Do you feel fully informed of who to contact if you feel unwell when you get home?

Editorial content supplied by: Northampton General Hospital NHS Trust

More about the assessment The ward will ensure completion of a referral in preparation for your discharge assessment. This referral is completed by all members of the MDT involved in your care. Once the ward has completed your referral, the IDT Hub consisting of Therapist, Reablement Team ICT/ CRT, Adult Social Services, Complex Discharge Nurse and External Providers will agree an appropriate Discharge to Assess Pathway. There are no assessments completed by Adult Social Services in hospital these will happen once you are discharged home, community bed or other placement. When you are discharged there will be an assessment completed by Adult Social services or Reablement Team. The assessment is free and will involve discussions about: • What are you able to do for yourself or with the support of your family/social network? • What type of help you feel is needed • How stressful and urgent you feel your situation is. We look at four main areas of life: 1. How much control you have over your own life, and how easy or difficult you find it to make decisions about the way you live 2. Your health and safety, including any risks to your mental health or wellbeing

2. Are you aware of the reason you have been prescribed your medication? 3. Do you know of the potential side effects of your medication, and what to do in the event of one occurring? 4. Do you feel you have all the information you need before you leave hospital?

Getting the most out of your assessment You might want to prepare for your assessment by jotting down anything you want to talk through with the person carrying out the assessment. • What are you able to do for yourself or with the support of your family/social network? • What kind of help are you having at the moment? Or did you have before coming into hospital?

We will listen to your concerns and respect how you are feeling about them.

• Are some days much easier than others? If so, why do you think this is? We know that there are some things which can be difficult or stressful to talk about, but please don't be embarrassed. We will listen to your concerns and respect how you are feeling about them. If English is not your first language or if you use sign language, we can arrange for an interpreter. Please let us know what you need.

3. Your daily routines, such as personal care and domestic chores, and how well you are able to manage them 4. How well you are able to involve yourself in family responsibilities, community life, and work or study. We may want to get information from other people, such as family and if in hospital, the ward staff and/or doctor etc. We might share some of the information you give us with other people, but only when it is necessary to help to plan your care, on a need to know basis and with your consent. On the assessment form we write down everything we discussed and agreed with you during the assessment, and also anything we might have disagreed about. You will get a copy of the completed assessment form to keep. Following the assessment, we will give you information about support that may be available, and any charges involved.

Assessments and carers If you have a carer, relative or friend who provides you with unpaid help – we may want to talk to them about what help they are able and willing to give. Carers may also be entitled to support which helps them in their caring role. If you have an identified carer, this would also be an appropriate time for them to receive a carers assessment from Adult Services. Please ask us for more information on this.

Editorial content supplied by: Northampton General Hospital NHS Trust

Intermediate care services This is a tier of services which offers both bed-based and communitybased services, ie community beds, specialist care centres and the intermediate care team.

You may not be able to return home immediately because of practical difficulties or important decisions that need to be made about your future. Unfortunately the hospital is unable to accommodate you during this process, as we need to provide care for other patients in need of urgent treatment. In some cases the daily multidisciplinary team (MDT) meeting may recommend a period of rehabilitation in order to maximise your independence and enable you to live at home as independently as possible. In this case you will be referred to a community bed. An assessor from the community hospital will ensure you fit the criteria if it is for a medical rehabilitation bed. You will be transferred to the first available bed which may not necessarily be the one closest to home. In the Discharge To Assess process all patients who are unable to go to their permanent place of discharge are transferred to a bed in the community, at centres that have been identified for this process. This will enable all patients who are ready to leave an acute hospital bed to be discharged sooner and therefore reduce the risk of a prolonged length of stay.

ICT also has a team of nurses in the accident and emergency department who can assist you to return home quickly.

We only have one specialist care centre which is accessed by the North team. This is in Corby. In the West of the county we use RIBU beds Recovery Independence Beds which are at Turn Furlong.

Intermediate Care Team (ICT) The ICT is a specialist community-based team of qualified nurses, therapists and doctors that provides comprehensive assessment, treatment and rehabilitation to enable you to return home and continue your recovery following your stay in hospital. (You can benefit from this service even if you live in a residential or nursing home.) As your ‘hospital at home’, ICT provides high quality, intensive healthcare up to a maximum of two weeks

following discharge from hospital, bridging the gap between the hospital team and your GP. In the event that you become unwell following discharge, ICT can access a range of other options to prevent you being re-admitted to hospital unnecessarily. ICT staff will work with you to design a personalised short-term treatment plan for your rehabilitation at home. This may include complex medical treatment for a range of health conditions as well as improving your strength, stamina and confidence with a range of activities that will help you live independently. If you also require social care support, ICT will arrange for Reablement West to provide this for you, alongside your ICT treatment plan. ICT also has a team of nurses in the accident and emergency department who can assist you to return home quickly. Ask a member of the hospital team to contact ICT for you. For more information, please ask the NGH ward team for the ICT leaflet, which provides further details on what we are able to provide for you. More information is also available by telephoning 0300 777 0002 (option 1) or online at: www.nhft.nhs.uk/ intermediate-care-team

Editorial content supplied by: Northampton General Hospital NHS Trust

Reablement West You may be assessed as benefitting from Reablement West for your return home. The service provides reenablement for adults aged 18 years and over within their own homes. Reablement West helps people who have experienced a sudden change in health to help you regain your confidence and your ability to do things for yourself and to achieve optimum levels of independence, thereby remaining safely at home.

Reablement West can help if you need specialist equipment, and they work with you to encourage and support you.

The service could be for a few days or a little longer (maximum six weeks) and in most cases is a free service while we work with you to decide what help you may need in the future.

a move to a care home. You and your family will be involved in this decision. The assessment will identify your care needs and will be carried out in the community as part of the Discharge To Assess process you will be discharged to a care home that can meet your needs where then a full assessment will be performed and then you and your family can help to select your definite care destination. There are three categories of care homes. • Residential care – provides accommodation, meals, care and support throughout the day and night. • Nursing care – offers the same as residential care with the addition of 24 hour care by a qualified nurse.

Reablement West can help if you need specialist equipment, and they work with you to encourage and support you.

• Dementia care which provides specialist extra care for people often due to dementia or other mental health diagnosis.

If the need for continuing help is identified during this period you will be assessed under your local authority's Fair Access to Care Services criteria and a financial assessment would be undertaken as there may be a charge for services.

During the care planning process you should be supported to identify a suitable care home which is registered to meet your needs and has a vacancy. As we have already said, this process will take place in a community bed and not in hospital. Your social worker/care manager can help you with this process. However if the home of your choice has no vacancy, you may have to accept a place in an alternative care home until a place in your home of choice is available.

24 hour care homes If it is felt that you can no longer manage at home even with support, it may be necessary to consider

Editorial content supplied by: Northampton General Hospital NHS Trust

Other sources of help for when you have left hospital North Northamptonshire Council www.northnorthants.gov.uk

help older people remain healthy and well. Access to community information about housing, benefits, products and services (home insurance, motor insurance etc)

West Northamptonshire Council

www.ageuk.org.uk/northamptonshire

0300 126 7000

Northamptonshire Carers

0300 126 3000

www.westnorthants.gov.uk If you think that you may need help from the council you can ask for advice or a care assessment by contacting Adult Care. To make things easier for you we have set up a first point of contact for all our services called Adult Care. You can speak to an officer who will listen to your enquiry, advise and assist you, and make sure you receive an assessment if required.

Northamptonshire Carers aim to offer a comprehensive support service to the unpaid carers of Northamptonshire.

• Social care assessments

We recognise their contribution to society and will endeavour to empower carers in improving their quality of life. Our organisation is carer-led and our developments will be a response to carers’ needs. If you are a carer and would like information and advice to help you in your caring role, you can refer yourself to us by completing the on-line enquiry form at:

• Safeguarding vulnerable adults

www.northamptonshire-carers.org

• Disabled person parking permits (Blue Badge)

Community Occupational Therapy

• Adaptations within your home

01604 366000

• Community alarm scheme - Call Care

By helping you to learn new ways of completing everyday tasks, our friendly Community Occupational Therapy team could help you to do things by yourself again, such as accessing or leaving your house, safely moving around inside your home, climbing the stairs; and getting dressed and washed by yourself.

We can help you with:

If you think that you may need help from the council you can ask for advice or a care assessment by contacting Adult Care.

01933 677837

• Occupational therapy assessments • Any other aspect of your social care • Assistive technology

Age UK Northamptonshire 01604 611200 Age UK Northamptonshire is an independent charity whose objectives are to make the lives of older people in Northamptonshire as fulfilling and rewarding as possible. Age UK Northamptonshire can help you with a variety of day opportunities that are fun and offer companionship when used as part of a care plan can

By talking to you, and finding out what you would like help with, our team will identify any adaptations you might need and pass the recommendations to yourself or your local council.

First Stop Care Advice First Stop Advice is an independent, free service offering advice and information for older people, their families and carers about housing and care options in later life. It is led by the charity Elderly Accommodation

Editorial content supplied by: Northampton General Hospital NHS Trust

Counsel (EAC) working in partnership with other national and local organisations. Their service spans housing, care, finance and rights and is delivered through their website, telephone advice line and network of local and specialist partner organisations. www.firststopcareadvice.org.uk

SERVE Serve was formed in 1981 as an information and resource agency providing support for older people in the Rushden area of Northamptonshire. The organisation now covers the wider area of East Northamptonshire and parts of Wellingborough.

The community nursing service aims to promote health and avoid acute hospital admissions.

Serve was initially operated solely by volunteers and is proud of its traditions; it remains fundamentally a voluntary organisation but many of the services are now delivered by trained, paid staff. Serve's range of service provision covers: • Community Transport • Daily Living Equipment & Mobility Products • Day and Homecare • Handy person services • Hearing Aid Assistance www.serve.org.uk

Physiotherapy Service – Northamptonshire Healthcare NHS Foundation Trust at the Highfields Clinical Care Centre, Cliftonville 03305 556789 Physiotherapists help and treat people of all ages with physical problems caused by illness, accident or ageing. Physiotherapists identify and maximise movement potential through health promotion, preventive healthcare, treatment and rehabilitation. The core skills used by physiotherapists include manual therapy, therapeutic exercise and the application of electrophysical modalities. www.nhft.nhs.uk – search for physiotherapy service.

District Nursing Services – contactable via your GP surgery District Nurses are highly qualified nurses that provide clinical nursing interventions to housebound individuals within the patient’s own home eg wound management, people with chronic long term conditions. The community nursing service aims to promote health and avoid acute hospital admissions.

Editorial content supplied by: the NHS

NHS continuing healthcare 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

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

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.

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.

Editorial content supplied by: the NHS

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.

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.

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. 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.

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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.

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NHS continuing healthcare reviews

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

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

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.

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.

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.

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

Find out more about NHS continuing healthcare from NHS England.

Frequently asked questions about

NHS continuing healthcare

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”.

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.

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.

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.

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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 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:

You can ask the council to either:

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

• manage your personal budget for you

• speak the same language as you

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

• have experience working with your care needs

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

• are a specific person that has been recommended to you • can help you get to shops or social events

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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 6 months. When to consider other options You may decide direct payments are not helpful if:

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.

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 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

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• your financially assessed contribution towards the cost of your care. 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

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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

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

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

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

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

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

• The Money Advice Service has a guide to direct payments

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.

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.

How to complain about personal budgets

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

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.

Who is eligible for NHS-funded 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.

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

The cost of NHS-funded nursing care

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

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.

• 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.

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

Outcome of the assessment

• 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

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

• you become entitled to NHS continuing healthcare instead

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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, and will rise to £100,000 from October 2025 • 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.

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 £850 a week in a residential home • over £1,000 a week in a nursing home

How to arrange your care as a self-funder The price will vary according to where you live and the You can:

type of care you need.

• arrange and pay for care yourself without involving the council

For example, serious health problems like dementia and chronic obstructive pulmonary disease (COPD) can increase the cost.

• 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)

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.

Benefits can help with care costs If you have a financial assessment from the Council, the FInancial Assessment Officer will inform you of any benefits you may be entitled to.

Can I avoid selling my home? We recommend that you seek independent financial advice to discuss your options. Councils will provide funding from either the date that you are assessed or after 28 days from initial contact, whichever is sooner. 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.

Editorial Editorial content content supplied supplied by: by: the the NHS NHS

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help •Telephone PayingForCare, a free information service for older people Get advice on paying for care from:

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•• Society Life Advisers (SOLLA) Age UKof onLater freephone 0800 055 6112on 0333 2020 454 • Independent Age on freephone 0800 319 6789

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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.

Editorial content supplied by: Age UK Northamptonshire

Age UK Northamptonshire A local charity that has been improving later life in Northamptonshire for over 70 years. Get in touch, we can help We provide a wide range of services that enable older people to carry on living independently for as long as they wish and are able to do so. We also support carers and the families of older people.

Home Care Cleaning Service

Appointeeship If you do not have anyone else to manage financial matters for you, we can step in to help. Please call 07554 618 941

Our fully-vetted, reliable staff can help with cleaning, laundry, local shopping and ironing. We charge £20 per hour, which is paid by monthly invoice in arrears. The minimum service we can arrange is one hour per fortnight and most clients prefer a weekly visit.

Money Management Support

Please call us to discuss your requirements.

We help older people to remain independent by carrying out a range of minor household repairs.

Care Support at Home The service supports older people in their own home. We also support carers and the family of our clients. Our staff are discreet, friendly, and experienced.

“Nothing is too much trouble. I showed Debbie round the house and virtually left her to it. It looks beautiful when she’s finished.”

arrangement. The service costs £22.50 per hour and hours can be arranged to suit you.

Some older people do not want to attend a day centre but would benefit from a bit of company or need support to help them stay safe at home. A regular visit from us can have a hugely positive effect on an older person’s wellbeing. We can do a jigsaw puzzle together or potter in the greenhouse or look through family photo albums and reminisce about happy times. You may simply want someone to sit and chat with you whilst you or your carer take a break. What our team do is largely up to you, but please be aware that although we can make a simple meal, we cannot provide personal care. Available Monday to Friday 9am-4pm but we are also able to offer evenings and weekend cover by

We can work with you to help you manage your income and your spending. Call 01604 611200.

Handyperson Service

We fit key safes and handrails, replace light bulbs and plugs and can assemble flat pack furniture. We also

Editorial content supplied by: Age UK Northamptonshire

freshly prepared two-course lunch. Transport may also be available. From £40 per session, Monday to Friday 10am to 3pm.

Information and advice Please call our Information and Advice Service to speak to an adviser on 01604 611207 every Wednesday 9am to 12pm. Or leave a message with our staff on 01604 611200 Monday to Friday 8am to 5pm. We are able to help with claims for Attendance Allowance.

Volunteering and Fundraising Make more of life by volunteering or why not help us raise vital funds. This can be a great way to meet new people, learn new skills, and you’ll be making a difference to older people in your community. We’d love to hear from you on 01604 611200.

Social Prescribing We empower people to take control of their health and wellbeing by connecting them to non-medical support. Call us to find out more.

Products and Services Age UK Northamptonshire works with partner companies to offer many products and services such as personal alarms, mobility aids and stairlifts. We also offer pet insurance and home and travel insurance. install personal alarms. We charge £30 per hour, with an increased cost for specialist work. There are fixed charges to supply and fit certain equipment.

Gardening Service We have gardeners in most areas of Northamptonshire and we aim to provide a general maintenance service. For £24 per hour we can cut grass, prune shrubs and hedges and clear weeds. Our gardeners can also paint garden furniture, fences and sheds.

Toenail Cutting Service Something as simple as cutting your own toenails and looking after your feet can become much harder or sometimes impossible as you get older. Our toenail cutting workers will visit you at home to trim your toenails, and we charge £29 per treatment.

Business and Trades Directory

“I would be completely lost without the help given in my garden.”

Our directory is designed to protect older people from rogue traders by putting them in touch with local reputable traders and businesses. For your peace of mind all businesses are checked and agree to abide by our customer charter. We can put you in touch with businesses including plumbers, builders, electricians and also installers of guttering and double glazing.

Day Centres Our day centres in Northampton and Kettering provide an all-important day out for older people with opportunities to meet new friends, enjoy the company of others and take part in a variety of group activities. The day with us includes tea, coffee and a

Age UK Northamptonshire The William and Patricia Venton Centre, York Road, Northampton NN1 5QJ 01604 611200 www.ageuknorthants.org.uk access@ageuknorthants.org.uk Registered charity 1059995 Age UK Northamptonshire has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser, nor does Age UK Northamptonshire endorse any of the products or services.

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.

Social care Top tips 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. CQC’s Chief Inspector for Adult Social Care, Andrea Sutcliffe 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. 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 meaningful activity and connect the home with the community?

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.

If you would like to organise your care yourself, you can find a care worker or personal assistant through an agency. Your local social services department should be able to provide details of approved agencies.

CQC’s ratings will identify services as:

Outstanding H Good ● Requires improvement ● Inadequate ● This will help you make informed choices around your care.

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 has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.

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