Options Chester - A guide to care and independent living Spring 2016

OPTIONS A guide to care and independent living

Chester & Ellesmere Port Spring 2016

Leaving hospital What’s next?

FREE

guide

CONTRIBUTORS: Age UK Cheshire Alzheimer’s Society Countess of Chester Hospital NHS FT NHS Choices

Are you looking for a solicitor to advise you on ...

The use of Wills and dealing with Probate?

Inheritance Tax Issues?

Lasting Powers of Attorney?

Then telephone us today or call in to see us.

We all put off the inevitable; believe we are immortal and don’t like to discuss what will happen to our affairs when we eventually die.

If you die without making a will, then something called the Intestacy Rules will apply and this could mean that those who inherit your estate could be different from those you would have chosen.

Here at Blain Boland, if you come to us, we will make the will making process as straightforward as possible so that those you choose to inherit will not be overlooked.

We offer home visits and can deal with matters urgently when required.

We can also advise on Lasting Powers of Attorney (LPA). The rules for these have changed again in January 2016.

For more information on wills and LPA’s or any of our other services, please contact us on the numbers below.

www.blainboland.co.uk 102 Whitby Road, Ellesmere Port, Cheshire, CH65 0AB Telephone: 0151 355 2645 • Fax: 0151 355 2829 The Green, Neston Road, Willaston, Cheshire CH64 IRA Telephone: 0151 327 1301 • Fax: 0151 327 8360

Contents

Welcome and

What is the role of the hospital and what you can expect from us . ....................................................................... 4

Introduction

8 simple steps to keep yourself safe during your stay in hospital...7

This booklet is intended to help you, your partner, carer, relatives and friends understand your journey from your period of ill health through to your recovery and transfer from hospital.

What we expect from you and keeping you safe....................... 8

This will cover:

Planning for you to leave hospital ............................................ 8

• The role of the hospital and what you can expect from us

Your Hospital Team .................................................................. 5 Your stay in hospital and what you can expect from us ............ 6

Support when leaving hospital ................................................. 9 Before you go home .............................................................. 10 NHS continuing healthcare.......................................................11 Assessment for NHS continuing healthcare..............................12 What is NHS-funded nursing care?...........................................13 Paying for care................................................................... 14-15 Direct payments.......................................................................15 The Motability Scheme.............................................................16 How to use your health services...............................................17 Care services in your home................................................ 18-19 Frequently asked questions............................................... 20-21 Questions I want to ask........................................................... 22 Contacts and Support you may need after discharge......... 22-23

• What we expect from you • Your stay in hospital • Leaving hospital • How your care will be handed over to a community team if appropriate • How you will be transferred home or to a care facility that will provide the service you need after the critical phase of your illness • Frequently asked questions • Contacts you may need after leaving hospital If you have any questions or comments please speak to your ward manager, matron or nurse in charge.

Age UK Cheshire, Going home from hospital?.................. 24-25 The Alzheimer’s Society services in Cheshire West & Chester.26-27 The Care Quality Commission Social Care top tips....................28 NHS Hospitals and services in Chester......................................29 Directory - Telephone numbers you may need or find useful.....30

Ward:

Number:

WORKING IN PARTNERSHIP

Countess of Chester Hospital NHS Foundation Trust

Cheshire

OCTAGON DE S IG N & M A R K ET I NG LT D

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What is the role of the hospital and what you can expect from us The role of the hospital Hospitals are the right place to be in when you are in need of acute medical or surgical care.

During this time you may have various tests including x-rays and scans as well as procedures such as blood tests to aid diagnosis and treatment. You will be looked after by a team of doctors and nurses and treated with medications and therapies that might involve having an intravenous drip. It may also involve you or your relative being admitted to the Intensive Care Unit if needed.

However, when you have recovered from this critical phase, it is important that your stay is not delayed for any reason so as to avoid the risks of infection and ailments from prolonged stays in hospital.

What you can expect from us We expect our staff to be courteous to you at all times and in return we would expect the same courteous behaviour from you and any of your visitors.

If there are any behaviours that the staff feel are unacceptable then these will be discussed with you and your visitors and agreements sought as to how we can agree a change.

Your admission When you arrive at the hospital, either as a planned or an emergency admission, the nursing team looking after you will begin the admission process. This is the time that the nursing staff can take all of the important details needed to make sure that you receive the best possible care whilst you are a patient.

It also provides an opportunity for you to ask any questions.

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For your safety While you are a patient in hospital, it will be necessary for you to wear an identification wristband. This states your name, sex, date of birth, unique hospital number/NHS number and the ward you are staying on. For your safety your wristband information will be checked and verified before certain procedures and when you are given medicine, if you are not wearing one please inform ward staff.

Privacy and dignity We aim to provide the highest possible standards of privacy and dignity to all patients all of the time. Your toilet and bathroom will be just for your gender and will be close to your bed area. However patients may be in a mixed sex bay for a short period of time if there is a clear clinical indication why this is required and this will be explained to you.

Your Hospital Team In the hospital you will find a multidisciplinary team consisting of doctors, nurses, therapists, pharmacists, specialist nurses, social workers and discharge liaison nurses. Some, or all, will be involved in your care and will begin to plan your transfer from hospital as soon as you are admitted. The team of clinical experts will explain their key roles to you if they are involved in your hospital care. The multidisciplinary team will identify your needs and will discuss what treatments, help or support is available to you to improve your independence. The members of the team involved in your assessment will discuss their findings and together with you will make a plan for your transfer from hospital. To the right you will find some of the uniforms you will see around the hospital.

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Your stay in hospital and what you can expect from us Moving to another bed, ward or hospital

Language assistance If you have any language difficulties please tell a member of staff. We will ensure that you get the support you need where possible. We can provide telephone and sign language interpreting.

As you recover during your stay it may be necessary to move you to a different ward or hospital in order to continue with your care, this will be due to clinical needs and will help accommodate emergency admissions. If you do have to move at any point, the reasons for this If you have any additional needs that require a will be clearly explained to you. reasonable adjustment, such as communication difficulties you will be asked for your hospital passport. You can access a Hospital Passport If you are a relative or carer of a patient prior to your admission from http://www.coch. who may require particular support needs, nhs.uk or you can request one to be provided arrangements may be made for you to to you on admission. If you already have your stay with the patient, although for further own version of a Health Passport please ensure information with regards to facilities available you provide a copy to staff. it is recommended that you discuss these issues with the ward manager or nurse in charge.

Reasonable adjustments

Support for carers

Safeguarding

Dietary requirements If you require any special diet, please tell a member of staff and this will be arranged as necessary. We will try to ensure you can enjoy your meals undisturbed by hospital staff and visitors.

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The Trust is committed to caring for its vulnerable patients and works with the Local Safeguarding Adult Board to ensure any safeguarding concerns are appropriately recognised and reported within the Hospital. Safeguarding concerns are incidents of abuse, whether intentional or inappropriate care, these can be in the form of physical, sexual, neglect, financial, psychological, discriminatory or institutional abuse. For more information on the types of abuse and responses see the following website: http://www.cheshirewestandchester.gov. uk/ and search Vulnerable Adult. Should you have any safeguarding concerns about yourself or another patient whilst at the Hospital please notify the Nurses in your area or alternatively you can report to Social Services on 0300 123 8 123.

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What we expect from you and keeping you safe What we expect from you You and/or your partner/ carer /relatives must take responsibility for identifying any issues at the earliest opportunities which could delay you leaving the hospital.

Where many relatives regularly visit a patient, we ask that one family member only is selected to contact the nursing staff for updates on the patient’s condition and share this information with the rest of the family.

Where relatives/carers would normally assist

in your care and would like to continue doing so whilst in hospital, for example assisting with meals, this can be arranged following a discussion with the ward manager/nurse in charge.

The Trust, as a provider of healthcare, leads by example in relation to no-smoking on its premises. Smoking is therefore not permitted in any part of the hospital or grounds. The Trust provides support for those who wish to quit smoking; you can ask a member of staff for more information on this.

Planning for you to leave hospital When the time comes for you to go home, the ward manager or your nurse will give you and your relatives as much warning as they can, so that you can make the necessary arrangements.

The plans that are made for you to leave hospital are an important part of your stay whilst you are here. We need to start making these plans as soon as possible, so we have the time to arrange any services or special help you may need after you leave hospital.

The majority of patients will go home from hospital with no additional support.

Additional support Those patients identified as requiring further therapy assessment in their own home or requiring low level support on transfer home will be assessed by the Rapid Response Team.

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Rapid Response Team Rapid Response is a team of Therapists, Nurses, and Community Support Workers that are able to support you with care and rehabilitation in your own home immediately on discharge. Their role is to help you settle back into your own home, assist you with your every day activities, and help you improve your independence and quality of life.

The team can help and support you for up to two weeks on your return home. If you have ongoing care needs after this you will be seen by a Social Care Assessor who will arrange for a longer term package of care to be set up.

Support when leaving hospital Social services If patients require a supportive package of care to return home they will be assessed by a Social Worker. The Social Worker will gather information from the rest of the multidisciplinary team which will enable the Social Worker to assess your support needs and establish eligibility for services. The Social Worker will then arrange for appropriate care to support your return home and to enable you to maximize your independence. Your Carer’s needs will also be assessed during this time. As Social Care provision is means tested there may be charges for care services dependent on your financial situation.

If, due to a significant change in your care needs, you require support in arranging accommodation other than your own home, then the Social Worker can assist you in identifying and arranging this.

Ongoing Assessment Those of you who no longer need an acute hospital stay, but have been assessed by the multidisciplinary team as needing a further period of assessment prior to returning home, will be offered an assessment bed. Assessment beds are provided in various settings and the multidisciplinary team will assess your level of need and decide where your needs will be best met. The multidisciplinary team will discuss this with you.

Care home placement If it is felt that you can no longer manage at home even with support in place the decision may be made for you to move into a care home. You and your family will be involved in this decision. The team involved in your care will inform you of what type of ongoing care you need i.e. nursing or residential. You will be supported by Nurses and Social Workers from within the Integrated Discharge Team.

You and your family will be expected to choose three homes with vacancies to enable transfer out of hospital to take place.

If you no longer need to be in hospital and there is a delay in the start of your care package or preferred placement you cannot choose to remain in hospital.

You will be transferred to a bed within a non hospital setting whilst this is arranged.

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Before you go home Please make sure you have made arrangements to get home and that there is someone to look after you when you get there. If you have any problems please mention them to your nurse. We will only arrange ambulance transport if it is necessary.

Please make sure you have all of your belongings, including any cash or valuables you handed in for safekeeping. If you leave any property behind, this will be put into the Patient Property Store where it is kept for only one month.

• Does your next of kin know that you have been admitted? Are they able to offer any support on discharge if needed?

• Do you have suitable outdoor clothing and shoes to travel home in?

• Have you discussed any concerns you may have regarding any of your medications or possible side effects that you may need to be aware of when you go home?

• Have you collected all of your personal belongings and valuables?

Discharge check list

• Will you require a fit note (formerly known as a sick note)?

• Have you arranged suitable transport home?

• Do you have your house keys?

• Do you have any concerns or worries about your discharge?

• Do you have any home support such as carers who may need to know when to expect you home?

The sooner you discuss these issues with your nurse, the sooner a safe and organised discharge can be arranged for you.

Discharge Lounge When you are ready to leave the ward you may be taken to the discharge lounge. A member of staff will aim to get you there before 11am. This is a comfortable, sociable area where our nursing staff will continue to care for you, providing drinks and any meals you require whilst your discharge arrangements are completed.

You may need to wait for your medicines to be sent to the discharge lounge. Your own medication will be returned to you if it is still appropriate for you to take. Any additional

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medication, prescribed at the hospital which you need to take at home, will be provided by the pharmacy department.

You may also need to wait in the Discharge Lounge for the transport that has been arranged for you or for your relatives and friends. There is a small collection point close by where your relatives can briefly leave their car when they collect you.

Discharge Lounge contact number: 01244 365433

NHS CONTINUING HEALTHCARE NHS continuing healthcare is a free package of care for people who have significant ongoing healthcare needs. It is arranged and funded by the NHS. You can receive NHS continuing healthcare in any setting outside hospital, including in your own home or in a care home.

If you receive care in your own home, the NHS will cover the cost of the support you need from health professionals and the cost of personal care which can include help with washing and getting dressed. If you receive NHS continuing healthcare in a care home, the NHS will also pay your care home fees.

Eligibility for NHS continuing healthcare When assessing your eligibility for NHS continuing healthcare, staff must follow certain processes.

You must be assessed by a team of healthcare professionals as having a ‘primary health need’ for care. This means that you need care primarily because of your health needs.

This is assessed by looking at: • the type and particular characteristics of your needs • how intense and severe they are • the complexity of your needs • how unpredictable your needs are; including any risks to you and others if adequate and timely care is not provided Eligibility is always based on these needs, rather than any particular diagnosis or condition.

When should I be considered for NHS continuing healthcare?

If you have ongoing health needs, there are times when staff should consider whether you may be eligible.

These include: • when you are ready to be discharged from hospital and your long-term needs are clear • once a period of intermediate care or rehabilitation following a hospital stay have finished and it’s agreed your condition is unlikely to improve • whenever your health or social care needs are being reviewed as part of a community care assessment • if your physical or mental health deteriorates significantly and your current level of care seems inadequate • when your nursing needs are being reviewed. This should happen annually if you live in a nursing home • if you have a rapidly deteriorating condition and may be approaching the end of your life In these circumstances, your discharge staff, staff co-ordinating your intermediate care, GP or a member of the social work team should raise the issue of NHS continuing healthcare and assess your eligibility. If they don’t, make sure you ask for an assessment.

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ASSESSMENT FOR NHS CONTINUING HEALTHCARE You should be fully involved in the assessment and have your views taken into account. You can ask a relative or carer to help and support you throughout the process.

Most people will start by completing a checklist.

This assesses your needs and indicates whether or not you should have a full assessment.

If you’re referred for a full assessment, evidence will be collected from all relevant health and social care professionals to give a full picture of your physical, mental health and social care needs.

Then a team of health and social care professionals involved in your care will look at this evidence and recommend whether or not you’re eligible. You and / or your representative can attend and participate at this meeting.

If you are eligible The team will forward their recommendation to the Clinical Commissioning Group (CCG) that is responsible for funding your care. The CCG will then discuss and agree a care and support package with you.

This care and support package will be reviewed after 3 months and then at least every year. If your care needs change, your funding arrangements may also change.

Personal Health Budgets If you’re eligible for NHS continuing healthcare, you have the right to a Personal Health Budget.

Personal Health Budgets allow more choice and control over the services and care you receive and can be used to pay for a wider range of items and services, including therapies, personal care and equipment.

If you choose this, you will develop a care plan with your NHS team that will meet your personal health and wellbeing needs.

See NHS Choices for more information about

Personal Health Budgets.

If you’re not eligible If you’re not eligible for NHS continuing healthcare, you’ll be referred to your local authority to decide whether you’re eligible for help to arrange or pay for care.

However, you may be eligible for NHS-funded nursing care.

If you’re not happy with the decision If you’re turned down, you should be sent a letter telling you why. It should also tell you what steps to take and who to contact if you’re unhappy with the decision.

• If you weren’t given a full assessment, you can ask the CCG to reconsider your case. If you are still dissatisfied you can use the NHS complaints system to pursue your case.

• If you’re not happy after a full assessment, you can ask for the CCG to reconsider its decision.

If you are still dissatisfied, you can ask for an independent review of your case.

• If you’re not happy with any help you receive from the NHS, you have a right to complain.

Details of the complaints procedure are available from the relevant organisation.

Fast Track If you are approaching the end of your life, you may be eligible for ‘fast tracking’ which allows you to bypass the full assessment process mentioned above. You must have a rapidly deteriorating condition that may be entering a terminal phase.

If you’re eligible, a care package should be put in place as soon as possible, preferably within 48 hours.

Age UK 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 endorse any of the products or services.

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WHAT IS NHS-FUNDED NURSING CARE? NHS-funded nursing care is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this registered nursing care.

Who is eligible for NHSfunded nursing care?

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, you can ask your CCG to review the decision.

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

What is the rate of payment for NHS-funded nursing care?

• you are 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. For 2015/16, the rate is £112.00 a week (standard rate).

• you live in a care home registered to provide nursing care

Before October 1 2007, there were three different levels or bands of payment for NHSfunded nursing care – low, medium and high.

How will my needs be assessed?

If you moved into a care home before October 1 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date.

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 clinical commissioning group (CCG) can arrange an assessment for you.

Outcome of the assessment

If you moved into a care home before October 1 2007, and you were on the high band, NHSfunded nursing care is paid at a higher rate.

For 2015/16, the higher rate is £154.14 a week.

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 £112.00 a week, or

If you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the • you become entitled to NHS continuing care home. Services provided by a registered healthcare instead NHS Choices has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does NHS Choices endorse any of the products or services. All figures correct at the time of going to print.

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Paying for care Paying for permanent residential care Most people will be expected to pay something towards the costs of their accommodation and personal care from their income and capital.

If the local authority is involved in arranging your placement, the amount you will have to pay will be worked out via a means test, which is based on nationally set guidelines.

Your local authority will firstly do a care needs assessment to identify what help you need. Then they will carry out a means test to work out how much you have to pay towards your care home fees. Currently, if you have assets of more than £23,250, you will need to pay the full cost of your care. Your home won’t be included in this if a partner or close relative still lives there. Your income is also taken into account.

From April 2015, your local authority must 14

provide a personal budget showing how much they’ve calculated they should pay towards your eligible needs (the ones identified in the care needs assessment).

The Care Act The Care Act is the biggest change in social care in more than 60 years. It is being introduced in two parts in April 2015 and April 2020. It will change the way the social care system works. There are proposed changes to the way that people fund their care, with a new cap on care costs set at £72,000. There are also changes to the means test.

Although these changes were due to be introduced in April 2016, the Government has now announced that it is to delay this timetable to April 2020.

Paying for temporary care in a care home Local authority charging rules differ when a stay in a care home is temporary, rather than permanent.

Some people go into a care home on a temporary basis to give themselves or their carers a break‚ or while they are recuperating from an illness.

Others enter a home temporarily for a ‘trial’ period to decide whether they want to live permanently in that home.

Temporary care may also be part of an ‘intermediate care’ package‚ which should be free of charge.

Paying for care if you have a partner Being part of a couple can affect a care home resident’s eligibility for local authority assistance with care home fees and both partners’

eligibility for social security benefits during the period in care.

At Age UK, we have produced a factsheet that addresses this issue and includes sections on the valuation of jointly owned capital, temporary admissions and where both members of a couple go into a care home.

Government guidance on the rights of a spouse in a care home to pass 50% of their private or occupational pension to their partner living at home are also included.

This factsheet should be read alongside Age UK’s other factsheets on care home charging and benefits‚ particularly Paying for permanent residential care.

Direct payments When your personal budget is paid directly to you this is called a Direct Payment. Direct Payments allow you to arrange your care as you wish.

budget. For example, if one of your assessed needs is help with shopping, you could pay for someone to help you go shopping yourself rather than just pay someone to do it for you.

There are rules about what you can and can’t use direct payments for. The money must be used to meet the eligible needs identified in your assessment.

You can’t use direct payments to:

You can use direct payments for anything that meets those needs, for example: • employ your own care workers • buy services from a voluntary or private agency • buy equipment or pay for home adaptations • purchase other types of support to meet your assessed needs • get to a café to meet your friends, a place of worship, or other places that are important to you.

You can be personal and creative with your

• pay a spouse, civil-partner, live-in partner, or a close relative who lives in the same household as you to care for you (although there may be exceptions to this) • buy services from your local council • pay for permanent care in a care home. You can, however, pay for a short stay of up to four consecutive weeks within any 12-month period if that meets an assessed need.

Not everyone will feel comfortable or capable of managing their direct payments themselves, and you don’t have to if you don’t want to. You can always choose the option for the council to arrange care for you, and you can still have a say in what will best meet your needs.

Age UK 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 endorse any of the products or services. All figures correct at the time of going to print.

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The Motability Scheme The Motability Scheme allows some disabled people getting DLA, PIP or War Pensioners’ Mobility Supplement to obtain a car, powered wheelchair or scooter.

The scheme uses some or all of your mobility benefit payments to cover the cost of “contract hire” or “hire purchase” of an appropriate vehicle. You can also pay an extra amount of money if you want a more expensive vehicle.

With hire purchase, the price of the car will be agreed directly with the Motability dealer, and you will own the vehicle outright at the end of the agreement.

With contract hire, you won’t own a vehicle, but you will get a new car every three years, NHS Choices has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does NHS Choices endorse any of the products or services.

full insurance for the driver and passengers, servicing, maintenance and repairs, vehicle excise duty, replacement tyres and breakdown cover.

Adaptations to the car can be made if needed, although there may be an extra charge for some adaptations. Under the Motability Scheme, cars can also be adapted for people in wheelchairs.

If you don’t need or want a car, you can transfer your allowance to lease a scooter or powered wheelchair.

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Contact Motability To find out more about the Motability Scheme, phone Motability on 0300 456 4566 (8am-7pm Monday to Friday 9am-1pm Saturday). If you have specialist Minicom equipment, call our textphone number on 0300 037 0100. www.motability.co.uk

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HOW TO USE YOUR HEALTH SERVICES There are a range of healthcare services available to help you find the right expert care to meet your needs. Choosing the service most appropriate to your symptoms means you get the right treatment in the right place.

Choking.

Chest pain.

Suspected stroke.

Blacking out.

Severe bleeding.

For symptoms of serious illnesses and major accidents, choose A&E (Accident & Emergency).

Cuts.

Sprains.

Rashes.

Minor fractures.

For trips, falls, skin complaints and minor injuries, choose Walkin Health Centre or Minor Injuries Unit or Urgent Care Centre.

Vomiting.

Ear pain.

Feeling ill.

For infections and persistent symptoms or if your child has a high temperature, choose your GP.

Diarrhoea.

Minor infections.

Headache.

Bites and stings.

For tummy upsets, insect bites and stings, coughs and colds and travel advice, choose a pharmacist.

Unsure?

Confused?

Need help?

For absolutely any questions about your health, choose NHS 111 service.

Grazed knee.

Sore throat.

Cough.

For minor ailments, grazes, bruises and similar problems, choose self-care.

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Care services in your home If you need help around the home, a good option is to have a care worker come in to your home to help you.

Types of care and support Care and support comes in many forms and has many names used to describe it, including home help, care attendants and “carers” (not to be confused with unpaid family or friends who care for you).

Care and support can suit you if you need: • personal care, such as washing or dressing • housekeeping or domestic work, such as vacuuming • cooking or preparing meals • nursing and health care • companionship Care and support can be very flexible, in order to meet your needs, and the same person or agency may be able to provide some or all of these options for the duration of your care: • long-term 24-hour care • short breaks for an unpaid family carer • emergency care • day care • sessions ranging from 15-minute visits to 24-hour assistance and everything in between If you already know what you want, you can search NHS Choices directories for: • local care and support services and agencies • a list of national care and support organisations • services that can help you stay safe and well in your home on a long-term basis; these services, often known as “supported living services”, can include financial, help with medication, advocacy, social and practical support • a place to live in a family who will care for you, known as “shared lives services” or adult placement services If you believe that you might benefit from some help at home, the first thing to do is to contact your social care department to ask for an assessment of your care and support needs. To contact social care, go to GOV.UK: find your local authority.

If you are eligible for care and support services, the 18

local authority may provide or arrange the help themselves. Alternatively, you can arrange your own care, funded by the local authority, through direct payments or a personal budget.

If you have chosen direct payments or a personal budget, or you aren’t eligible for local authority help and want to get care privately, you can arrange it in several different ways.

Independent care and support agencies If you use an independent care and support agency, you or the person you’re looking after has to find the care agency and pay them.

The agency will provide a service through a trained team of care workers, which means you may not always have the same person visiting your home, although the agency will do its best to take your choices into account. Independent care and support providers are regulated by the Care Quality Commission (CQC). Care and support agencies must meet CQC’s national minimum standards and regulations in areas such as training and record-keeping. The CQC has the power to inspect agencies and enforce standards.

Care and support agencies must vet care and support workers before engaging them by taking up references and carrying out Disclosure and Barring Service (DBS) checks on potential employees. Care and support agencies can also: • take over the burden of being an employer – for example, payroll, training, disciplinary issues and insurance • train their care and support workers through national qualifications and service-specific training • replace workers when they are ill, on holiday or resign • put things right when they go wrong An agency will want to see you and the person you’re looking after so that they can assess your needs. This also means that a joint decision can be made about the most appropriate type of care and support.

Hiring a personal assistant You can hire a “personal assistant” to act as a care and support worker for you.

Personal assistants can offer you all that you’ll get from an agency worker, but you’ll also get the continuity, familiarity and ongoing relationship with your assistant.

However, if you employ a personal assistant, you will then have the legal responsibility of an employer. This will include arranging cover for their illness and holidays.

GOV.UK has more information on becoming an employer, while Which? Elderly Care also has advice on employing private individuals.

Employing a care worker on a private basis If you employ a care worker privately, you will not be obliged to use the DBS scheme, but you can use it if you choose to. You need to ask social care or the police to make the checks on your behalf. The care worker must have already applied to be vetted, and must consent to the check.

If you have concerns about the suitability of someone you employ privately as a personal assistant, you can ask Adult Social Care to look into the matter.

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Frequently asked questions What should I bring into hospital?

Please bring only a minimum amount of personal belongings with you to help us keep your bed area free from clutter so that we can maintain our cleaning standards. Please also bring supportive footwear, personal toiletries and suitable clothing.

When coming into hospital, bring all of your medicines in with you including inhalers and eye drops etc. For security and safety reasons, the ward staff will need to lock them away in a locker next to your bed. In some instances, you may be able to self-medicate – if you wish to do so, speak to the nursing staff about this.

When are meal times?

Breakfast is served between 7.30am and 8am; lunch from 11.45am to 12.30pm; and supper from 5.15pm to 6.15pm.

Your nurse will ask you the day before to select your meals from a choice of dishes, including vegetarian, for the following day. We also provide kosher and halal dishes, however we do need 24-hours’ notice for this.

What are the visiting times?

Ward visiting is between 11am - 7.30pm daily. There are some exceptions to these times for example: The Maternity Department, Children’s Unit, Neonatal Unit, ward 33 and the Coronary Care Unit.

Please check with the ward to make sure.

Please be aware that protected meal times are in place and no visiting will be allowed during these times unless agreed with the ward staff.

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Are cultural, spiritual and religious facilities available?

The Spiritual Care Centre is situated on the first floor near the bridge. It is always open and is a place of quiet for everyone. The centre welcomes people of all faiths and beliefs and does not have any allegiance to specific religions. Please contact the Chaplaincy for further details: 01244 364543

When will I get my medication?

Medication rounds are usually breakfast, lunchtime, evening meal and bedtime.

However this will vary dependent on your individual needs.

Wifi access and Hospicom The Countess of Chester Hospital has launched free Wifi access for all patients, visitors and staff in an effort to make the patient experience even greater. To gain access to the Wifi network when on-site, all patients and visitors have to do is connect to the Countess Wifi network and agree to the terms of use. If you are asked for a password this is available from a member of the ward or reception staff.

Most of our bedside areas are fitted with a Hospicom unit giving access to TV, radio and a variety of other communication services. There is a cost associated with using this service - for up to date information please ask a member of staff on your ward.

Will I need an outpatient appointment when I go home?

If any further follow up appointments are required your doctor will inform you of these on your discharge summary and this will be arranged as necessary for you.

I may be in hospital for several days, are there car parking allowances?

What should I do if I feel unwell when I get home?

When you go home if you experience any problem after your hospital treatment you should contact your hospital ward or GP for advice. Out of hours, you may need to contact your GP out of hours service or NHS 111. If you feel the situation is urgent please attend your nearest accident and emergency department.

If you are an inpatient for over two weeks your relatives and carers are entitled to free parking. Relatives and carers of patients on the Intensive Care Unit and Neonatal Unit are entitled to free parking after three days.

You will need to fill in a form which can be collected from the cash office located at the main entrance of the hospital. You can contact the cash office for more details 01244 366208.

How can I access my health records?

You have the right to see any of your written health records. To obtain a copy of your records you will need to submit an application form from the Legal Services Department. For any further information about accessing your health records, please telephone the department on 01244 366457.

How can I get a fit note?

Please inform the ward staff if you need a fit note (previously known as a sick note).

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QUESTIONS I WANT TO ASK…

YOUR PLAN…

CONTACTS AND SUPPORT YOU MAY NEED AFTER DISCHARGE Pharmacy We will give you a copy of your discharge notification form to take with you - it includes details of any medication you need. We will also send a copy to your GP. Once you have gone home, we will send a letter to your GP telling him/her about your treatment and progress.

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the medicines supplied by the hospital please contact the ward where you were an inpatient (number will be on the front of this booklet), or the Pharmacy Department Mon-Friday 9.00am 4.00pm on 01244 365249.

Please contact your usual community pharmacy for information about your regular medications.

We may have used your own medicines for your treatment whilst you have been in hospital. If these are still suitable they should be returned to you when you are ready to be discharged. If any of your medicines have been changed, the nurses will ask your permission to safely dispose of them. The hospital will provide you with any medicines you need to go home with - this will usually be a minimum two weeks supply. If you have any questions about your medicines, please ask to speak with a pharmacist.

PALS

Back at home, if you have any questions about

• Provide information on NHS services

The Patient Advice and Liaison Service (PALS) provides patients, their families and carers with free advice and assistance in dealing with health matters.When you need advice, would like to thank us or have concerns about any aspect of your care in our hospital then please contact PALS.The service is confidential. We will: • Advise and support patients, their families and carers

• L isten to your concerns, suggestions or queries • Help to sort out problems quickly on your behalf Freephone 0800 195 1241 and select option 2 or phone 01244 366066 Email PALS: cochpals@nhs.net or Write to: PALS Manager, PALS, Countess of Chester Hospital Foundation Trust, Liverpool Road, Chester CH2 1UL.

Friends and Family Test We would like to ask our patients one simple question… Would you recommend us to your family and friends?

At the Countess of Chester Hospital, we are committed to delivering the best possible care to our patients.

As part of our drive for continual improvement, it is essential that we hear and understand the views of our patients after they have been discharged.

The Friends & Family Test was introduced nationally in 2013 and allows patients to feed back views of the care or treatment received here at the Countess of Chester Hospital in near real time. This will provide us with valuable intelligence about the quality of healthcare received in our Trust.

All patients, whether an in-patient, out-patient or visitor to our A&E department will be given the opportunity to feedback to us about their experience via two questions: 1. How likely are you to recommend the Countess of Chester Hospital to friends or family if they needed similar care or treatment?

2. Please can you tell us the main reason for the answer you have chosen?

Feedback can be given in a number of ways.

Firstly, patients can choose to use postcards which are in all departments across the Trust (post boxes for these are also located around the hospital). For those patients who have provided us with a mobile telephone number, we also offer the survey via text messaging or an interactive voice message (IVM), both require input via the keypad and the latter allows you to leave a voice message.

Once you have been discharged from the Countess of Chester Hospital you will receive the survey via one of the telephone methods after 48 hours. If you have already completed the survey prior to your discharge using a postcard, you may still receive a feedback request via telephone, please be aware you can disregard this.

The information you give us will help to ensure that we are better able to tailor our services to the needs of our patients. This survey is completely anonymous.

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GOING HOME FROM HOSPITAL? Age UK Cheshire, here to help!

Ageing is not an illness, but it can be challenging. At Age UK Cheshire we provide services and support to inspire, enable and support older people.

Information & Advice Growing older does not come with a manual, so if you need free, confidential and impartial information or advice on anything from health to housing, you can either drop in and speak to an advisor or contact us via phone or email.

• 314 Chester Road, Hartford, Northwich CW8 2AB (Open Monday to Friday, 9am-1pm and 2pm-4pm. Closed Wednesdays from 1pm) t: 01606 881660 e: information@ageukcheshire.org.uk • 4 Queen Street, Chester CH1 3LG (Open Monday to Friday, 9am-1pm and 2pm-4pm) t: 01244 401500 e: informationqs@ageukcheshire.org.uk • Methodist Church Hall, Park Street, Neston CH64 3RP (Open Monday to Wednesday, 10am-12pm) t: 0151 336 8388 Our team will be able to provide expert advice on issues including welfare benefits, where to find a reliable tradesperson, getting your house adapted to suit your needs, how to get help with everyday tasks and who to speak to about your rights. Whenever you need to find out anything from someone you can trust, remember to give Age UK Cheshire a call.

Maintaining Independence If you are starting to have difficulty managing everyday tasks at home and need a little extra care and support, it can often feel daunting and you might not know what help is available or where to start.

We offer a number of practical services designed to meet your needs. Our Supporting You advisors can provide as little or as much 24

www.ageukcheshire.org.uk

support as required, from general advice and guidance on issues such as help to find a cleaner or information on what activities and services are available locally to assessing your eligibility for benefit claims.

If you are in need of a bit more support, our Independent Living advisors can work with you in setting up a care support plan to help you maintain your independence at home. We can help you to take control and stay in control. We also offer a Wellbeing service which is based within local GP surgeries and helps patients to manage long term health conditions.

For more information, please contact: Supporting You t: 01606 881660 Dementia Advisor Service t: 01606 881660 Independent Living Service t: 08450 531 313 Advocacy Service t: 01606 305004 Wellbeing Service t: 01606 881660

Keeping healthy and active Exercise is incredibly important to our overall health. It can reduce the risk of high blood pressure, heart disease, some types of cancer, strokes and type 2 diabetes. Exercise can also help to keep bones strong and assist in reducing the risk of osteoporosis.

Recent studies have shown that exercise may improve memory and slow down mental decline, aid sleep, as well as improve strength and balance. It is also a great way to get out and meet people.

Age UK Cheshire offer a wide range of exercise activities ranging from sports including Tennis,

Cheshire Tai-Chi, Horse riding, Golf, Nordic Walking and Swimming, to more sedate activities such as one-to-one Peer Health Mentoring at home (for people with long term conditions) and Cardiac Rehab classes.

For more information, please contact: Get Active / Get Going Together t: 0151 348 5493/4 Age UK Cheshire also offer a Falls Prevention service which works to reduce the number of people who need to attend the Accident & Emergency Department because they have fallen in their homes.

Men in Sheds provide a shed-like environment for men with a focus on socialising, sharing skills and learning new ones. Our sheds are located in Chester, Ellesmere Port, Crewe and Hartford. We always welcome new members to join us for camaraderie and learning new skills or reviving old ones.

Our Castle Community Centre offers a wide range of activities including T’ai-Chi, French, Italian, arts and crafts and the Computer Centre, where you can develop your IT skills in basic computing, digital photography and accessing the internet. We also have an on-site coffee shop.

For more information, please contact: OPEL & Castle Community Centre t: 0845 618 2858 Men in Sheds t: 01606 305010

By carrying out home visits to individuals and talks to groups, we are able to highlight possible hazardous areas within the home and in turn make minor alterations where necessary.

If you are not sure which service is most appropriate for your query, please contact the Information and Advice service who will signpost you to the correct service.

For more information, please contact: Falls Prevention t: 0845 373 4300

Help us to Support You Age UK Cheshire simply could not exist without the help of our loyal donors and supporters.

Donations are vital to the work of Age UK Cheshire to enable us to continue to provide services for older people. However much you can give, whether it is a regular payment, a single donation or a legacy in your will, we guarantee that every penny will be used for the benefit of older people in Cheshire.

Social groups Loneliness and isolation are major factors in the deterioration of health and wellbeing. Age UK Cheshire aims to relieve this by promoting independence and helping people join activities in their local community.

Our OPEL group (Older People Enjoying Life) offer a wide range of activities in a relaxed and welcoming community setting in a number of locations each week.

The familiarity of the setting, the other group members and the fact that everyone thoroughly enjoys the activities, entertainment and outings, means that new friendships flourish very quickly.

Visit our website for more information or call us on 01606 305000

Become a Friend of Age UK Cheshire Show your support and get some great discounts too!

For an annual subscription of just ÂŁ10 you can become a Friend of Age UK Cheshire and gain access to a wide range of offers and discounts from local companies, a bi-annual newsletter and exclusive early bird discounts on fundraising events.

For more information, please contact: t: 01606 305000 e: friends@ageukcheshire.org.uk

www.ageukcheshire.org.uk

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ALZHEIMER’S SOCIETY SERVICES IN CHESHIRE WEST & CHESTER If you think you may have a form of dementia or are caring for a person who has dementia there are many ways that Alzheimer’s Society in Cheshire West & Chester can help.

Someone to talk to You can phone at any time during our opening hours to talk in confidence with a member of our team. The team are here to listen when you feel the need to talk or to offer information and advice on specific issues – 01606 781110.

Dementia Adviser service If you have recently been diagnosed and are living with dementia, our Dementia Advisers can give you information, advice and guidance tailored to their individual needs.

Dementia Support Workers Our Dementia Support Workers give personalised practical advice and emotional support and can offer information and advice on accessing professional help. Our Dementia Support Workers can signpost to a wide range of services throughout Cheshire West & Chester and refer to other specialists who can help if your concerns are outside of our expertise.

Dementia Adviser/Dementia Support Worker Visits A visit from a Dementia Adviser or Dementia Support Worker can be arranged for you and the person you care for, either at home or a mutually agreed location, to provide information, advice and support.

Information We also have a wide range of information and factsheets which include specific information on different types of dementia, care issues and understanding the needs of the person living with dementia.

Activity and Walking Groups Our Activity groups provide a variety of activities for people living with dementia and their carers to enjoy and socialise with others in a fun and supportive setting. Activities include crafting activities, dominos, bingo and much more. Our Walking groups give people with dementia and their carers and families an opportunity to enjoy a leisurely stroll in the fresh air followed by a cup of tea or coffee together at a café afterwards. Please contact your local office for more information.

Singing for the Brain Singing for the Brain is a stimulating group activity which provides structured musical stimulation for people with dementia and 26

www.alzheimers.org.uk

DEMENTIA FRIENDS PROGRAMME

their carers. Singing provides a way for people with dementia to express themselves, helping general wellbeing and confidence in a fun and supportive group. For more information please contact your local office.

Dementia Cafes and Support Groups Our cafes and groups give people with dementia and their carers an opportunity to meet people in similar situations, to share experiences in a friendly, relaxed and supported environment. Each group and café are staffed by Alzheimer’s Society staff and volunteers. Please contact your local office for more information including venues, dates and times.

We’re here to help If you would like more information about our services or require information, advice and support please call us on 01606 781110. We are open Monday to Friday from 9am to 5pm.

Alzheimer’s Society Cheshire West & Chester office: Unit 1, The Old Printworks, Spencer Street, Northwich, CW8 1BP E: westcheshire@alzheimers.org.uk E: valeroyal@alzheimers.org.uk

Membership All members of Alzheimer’s Society receive a monthly national magazine.

The more members we have, the greater our lobbying power.

Membership is free to carers and people with dementia.

Dementia Friends is a national initiative that is being run by the Alzheimer’s Society. It's funded by the government, and aims to improve people's understanding of dementia and its effects. Through the Dementia Friends programme, we aim to change the way the nation thinks, talks and acts. By 2020, we want four million Dementia Friends who have knowledge and confidence to help people with dementia feel understood and included in their community. Because, together, we can create dementia friendly communities.

How will it work?

We will train and develop a group of volunteers to spread the word about what dementia is and what action individuals can take in their community. We will then ask them to recruit Dementia Friends who will then receive a basic information session on dementia and be encouraged to take action.

What is a Dementia Friend?

A Dementia Friend learns a little bit more about what it is like to live with dementia during a Dementia Friends Information Session and then turns that understanding into action.

What is a Dementia Friends Champion?

Dementia Friends Champions are volunteers who run information sessions where they talk to people about being a Dementia Friend in their communities.

It's easy to get involved. Dementia Friends Champions will attend a training course, receive support as and when they need it and be part of a growing network of people creating dementia friendly communities together.

How can I get involved?

It's easy to get involved. Just visit www.dementiafriends.org.uk and book onto a Dementia Friends Information session.

Alternatively, you can contact your local Alzheimer’s Society office for more information.

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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

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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?

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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 Good ● Requires improvement ● Inadequate ● This will help you make informed choices around your care. There’s also useful advice on the Social Care Institute for Excellence’s Find me good care website www.scie.org.uk/findmegoodcare/

Safeguarding adults who receive social care

10 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.

NHS Hospitals and services in CHESTER Countess of Chester Hospital NHS Foundation Trust

Countess of Chester Hospital NHS Foundation Trust

Ellesmere Port Hospital 114 Chester Road, Ellesmere Port, Merseyside CH65 6SG 01244 365000

Countess Of Chester Hospital The Countess Of Chester Health Park, Liverpool Rd, Chester, Cheshire CH2 1UL 01244 365000

Warrington West

Widnes

Cheshire West & Chester office: Unit 1, The Old Printworks, Spencer Street, Northwich, CW8 1BP 01606 781110

Warrington East

Warrington South Wilmslow

Knutsford Ellesmere Port

Northwich Macclesfield

Winsford

Chester

Congleton

Western Rural

Crewe Nantwich

58 Nicholas Street, Chester, CH1 2NP 0300 123 8 123

Chester 4 Queen St, Chester, Cheshire West and Chester CH1 3LG 01244 401500

Tarporley War Memorial Hospital 14 Park Road, Tarporley CW6 0AP 01829 732436

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Directory - Telephone numbers you may need or find useful…

Action on Elder Abuse - 020 8835 9280

National Osteoporosis Society - 0845 450 0230

Admiral Nursing DIRECT - 0845 257 9406

NHS - 111

Age UK - (Chester office) - 01244 401500

Parkinson’s Disease Society - 0800 800 0303

Alzheimer’s Society - (West Cheshire) - 01244 851 351

Patient Advice and Liaison Service - 01244 366066

Arthritis Care - 020 7380 6500

Rough sleeper advice and support - 0300 123 1562

Red Cross (Chester) - 01244 349550

British Heart Foundation - (Chester office) - 01244 345487

Royal Voluntary Service - 0845 608 0122

Carer Network - 0800 085 0307

Social Services North Wales - 01352 702000

Care Quality Commission - 03000 616161 Chester Citizens Advice Bureau - 03444 772121 Countess of Chester Hospital main switchboard - 01244 365000 Discharge Lounge - 01244 365433 GP out of hours - (please contact your local GP for this number)

Social Services Chester - 0300 123 7034 Social Services Wirral - 0151 606 2006 Stroke Association - 01244 389264 St Werburgh’s Medical Practice for the Homeless - 01244 665834 Therapies (Rapid Response) - 01244 365240 The Pension Service - 0845 606 0265

Cruse Bereavement Care - 0844 477 9400 DIAL (Disability Information Advice Line) - 01244 345655 Disability Benefits - for Disability Living Allowance and Attendance Allowance - 0845 712 3456 Elderly Accommodation Counsel (EAC) - 020 7820 1343 Hospital Pharmacy - 01244 365249 Integrated Care Council - 01379 678243 Mind (National Association for Mental Health) - 020 8519 2122

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Options Chester is published by Octagon Design and Marketing Ltd with editorial contributions from Countess of Chester Hospital NHS Foundation Trust, the CQC, Age UK, the Alzheimer’s Society and NHS choices. 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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