Care Select 2015 by Care Choices Ltd

THE HANDBOOK FOR RELATIVES YOUR COMPANION THROUGH THE EMOTIONAL AND PRACTICAL ASPECTS OF CHOOSING AND FUNDING CARE FOR AN AGEING RELATIVE. FOREWORD BY DAME ESTHER RANTZEN DBE

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WHAT

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Contributors Dame Esther Rantzen DBE, Journalist and TV presenter Les Bright, BCD Care Associates

Contents 6 7 11 16

Foreword by Dame Esther Rantzen DBE Starting the journey

Trish Davies, Care 4 Mum

Understanding their needs

George McNamara, Alzheimer’s Society

Dealing with family pressures

Vicky Hodgkinson, Alzheimer’s Society

20 28 32 42 50 52 64 65

Support to live independently at home Making life easier in the home

Joe Levenson, Dying Matters

Choosing care

Liz Mulvaney, Freeths LLP

Care and support at home Choosing a home care agency checklist

Natasha Molloy, Freeths LLP

Residential care options Choosing a residential care home checklist Specialist housing with care schemes

Was it the right decision?

75 81 84

Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care

Are you a family carer?

How is care funded? Legal issues around needing care and support

Publications

94 104

Essential contacts

107

Region-by-region care homes

111

Advertisers’ index

125

www.careselect.co.uk

@careselectmag

Alternative formats

This Handbook is available electronically at www.carechoices.co.uk. There is also a Browsealoud option for those requiring the information in the spoken word.

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Foreword

by Dame Esther Rantzen DBE

Foreword Starting the journey Understanding their needs Dealing with family pressures

I have never forgotten being invited to tea in a care home in Luton. I had a wonderful afternoon there, having tea and talking to residents. Then a care worker took me to one side to ask if I could do something to counteract the myth that all care homes are bad and that to ‘put Mum into a home’ is the last resort of children who are neglectful, or too busy to care. ‘Look at our residents,’ she said. ‘They would find it so difficult to try to survive in their own homes, they might be lonely, they would never have this standard of food and care, and the company, and the activities. We try to make sure they have a real quality of life here, that they are happy. And we love our work. Yet nobody ever talks about the difference we make, you only ever hear about the horror stories.’ Of course she was right. One effect of the ageism we too often encounter means that the people who work with older people all too often also feel ignored and undervalued. We need to spotlight the best practice and celebrate it. My recent participation in the 3rd Sector Care Awards proved an inspiring reminder of the innovation and excellence in the care and support sector. The Award winners I met are striving to make people’s lives better by ensuring that everyone has the best opportunity in life. Whether individuals are using the creative arts or collaborative working, offering compassion or engaging with the wider community, there is great work in place to make lives better for people in receipt of care. When I visited a sheltered housing project, a retired artist had decided to hold a card-making class for other residents. It was fun, it was creative and

the artist herself felt she was contributing the skills she had honed over a busy lifetime. Everyone enjoyed it, but it was only possible because they were all living together as a community. That being said, we also receive calls at The Silver Line helpline from the residents of sheltered housing and care homes who tell us they are still lonely. One memorable call we received in the depth of winter, soon after we opened, was from a lady making the call from the bathroom, on a borrowed mobile phone, reporting that her care home had no heating on, that the food was inadequate and she was fearful of asking for help. Other callers ring us from sheltered housing to tell us that even there it’s possible to be lonely. Not all the other residents are friendly and the staff are not on site, or not around at weekends or holidays. I remember a lady telling me on Christmas day how empty and silent the place was and how profoundly lonely she felt. This just confirms that finding effective care and support can be a crucial decision for older people and their families and one they need to get right. The aim of this handbook is to assist you, so that you can find the right care and support including well-run homes when your relative needs them, and projects with caring committed staff. It is incumbent upon staff that if things go wrong, they acknowledge them and ask for help. We, in the media, have a responsibility too, to spread the message that ‘being put into a home’ may, in fact, not be a prison sentence, but the reverse, a liberation, and a positive transformation.

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Starting the journey

Foreword Starting your journey

We all talk about difficult decisions – choosing where to live, whether to accept a job offer, the right choice of school for our children, or booking a holiday suited to all the family – but recognising, and then acting on, the need for a parent or another loved one to receive help to carry on with the everyday activities of life trumps all of those decisions, by a very considerable margin.

Why? Well, quite simply this is a very sensitive topic, bringing together – sometimes in conflict with one another – emotional and psychological pressures, as well as practical, financial and relationship matters. This mix of factors could cloud anyone’s judgement at the best of times, but given that the reason you are thinking about it may coincide with events that are perhaps already distressing, for example an accident, illness or bereavement exposing the need for action, then making a decision is likely to become even more challenging. In such a situation you’ll be glad to have information like this handbook to lean on and learn from.

Choosing the right time… It may be especially tricky to talk about your worries because awareness of the need to do something may emerge in different ways for everyone involved, with competing opinions on what is necessary. It’s not easy to keep everyone happy and feeling that their views are understood and respected. This will almost certainly be especially problematic for your relative or loved one whose future will be most intimately affected and whose feelings of anxiety or helplessness may be expressed angrily and emotionally. At such times it is hard to escape

from a feeling of failure or helplessness. No longer able to manage alone, relying on others for tasks, perhaps initially maintaining the house and the household – doing the shopping, washing and housework, but then extending to support with cooking or more intimate personal care needs such as bathing or getting in or out of bed safely. There are a number of ways to meet each of these needs, but when a combination of failing physical health, mental capacity and/or restricted mobility suggests assistance of various kinds is required, all parties may see the need to act.

‘It’s not easy to keep everyone happy and feeling that their views are understood and respected.’ While your mother or father may recognise that the time has come to seek help, this will not make it easier for them to manage their own feelings, or to readily accept and understand your worries about their safety and security. You may also chide yourself for not being able to do more, due to other calls on your time – work or family and the practicalities of managing things at a distance from your home. >>

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Understanding their needs Dealing with family pressures Support to live independently at home Choosing care Care and support at home Choosing a home care agency checklist Residential care options Choosing a residential care home checklist Specialist Housing with Care Schemes Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal issues surrounding needing care Essential contacts Region-byregion care providers Advertisers’ index

...while protecting all parties

Forgetting things we’ve been told is perfectly normal. But if your loved one begins to forget things that may compromise their personal safety, such as locking doors and windows, or that they have switched on the cooker or other appliances, this will be much more alarming for you, and a sign that ‘something must be done’. However, you should still be careful how you discuss these difficulties. For example, repeated ‘near misses’ with the cooker might be addressed by installing a microwave, and problems climbing the stairs to get to the toilet on time, should not focus on the indignity of being too late, but on what can be done to change the situation. Installing grab rails and banisters, or where the building’s structure is suitable, a stair lift or moving elsewhere to accommodation with level access or a ground floor toilet could be what is needed – at least in the early stages of what may be a long and gentle decline. Each of these options could restore confidence, reaching far beyond the problem being addressed.

Making plans – together Regardless of your view on the urgency of finding suitable solutions for the problems that you have identified, it is essential that you take time to involve your parent/s, your siblings or other parties who may want to be involved, as fully as possible. It may sound too formal to suggest a ‘family conference’ but the opportunity for all those who have an emotional and/or practical connection, to sit down together to talk about the situation, the options and their own

feelings about what will be best is well worth trying, even if it feels like you don’t have much time. At the heart of this meeting, though, has to be your parent. This family get-together will give you all the chance to talk about your hopes and fears and to think through the financial implications, providing as much reassurance as is possible, or reasonable, about the impact on the ownership of the family home, a topic which can often evoke strong emotions, and sometimes block progress.

On reflection Like many people your experience of care services, and the experiences of your siblings or parents, may be limited or perhaps even non-existent. If this is the case then your discussion may be framed by what you have learned from ‘undercover reporting’ in newspapers or on television about homes or care services that have fallen short of the standards required by law and expected by residents and their families. Such shocking occurrences are not representative of the overall state of play – there are thousands of care homes and for the most part they provide a highly personalised service to very frail people, many of them with complex needs. Many regular visitors to care homes frequently comment on the kindness and dedication of the staff looking after their relative, expressing gratitude for the way in which they ’go the extra mile’ to make life as good as it can be, leaving them with feelings of confidence that they have made the right decision and that their loved one is safe and well cared for.

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Managing Mary’s new situation Catherine’s mother, Mary, had become less capable of looking after herself since the death of her husband. In the early days, Catherine and her brother were able to offer their mother all the support she needed by taking her shopping and taking turns to telephone her each evening to check that she was okay, reassuring her of their availability if she was feeling lonely or if something unpredictable, such as a light bulb needed to be replaced. But then Mary’s memory began to fade – just a little first but then more worryingly, Catherine was called when her mother had been brought home in a police car after being found wandering late at night. It became clear that she needed more than the little bit of help that her children were providing. Despite their best efforts to reassure her, she was resistant to moving from her long-established home. The ‘straw that broke the camel’s back’ came when Catherine was taken ill, and her brother’s work was set to take him overseas for a period of months.

Mary was adamant that she didn’t want strangers in her house, but when she realised she had no food in the cupboards, then her kettle blew a fuse, plunging the house into darkness she called her son in tears. He knew he couldn’t leave the country with his mother like this so he contacted a nearby care home, recommended by a family friend. Having looked around, spoken to the manager and Mary, together they agreed that this was only a temporary ‘emergency’ answer while he was away and his sister was recuperating. However first Mary, and then her family, discovered that Mary thrived in the care home, she had companionship, was supported with daily activities, she didn’t need to worry about food, or fuses blowing and as her dementia needs increased, everyone was confident that she was safe and well looked after. Although Mary had not been planning to give up her home and neither of her children had thought she was ready for such a big change, when the situation came to a head it was the right solution.

Sometimes the answer isn’t obvious or easy to come to, but it’s important that everyone considers the needs of your relative first and foremost. Trying to balance everyone’s wishes may be an impossible task but with time and consideration to the options, a resolution can be found. The pages that follow explore the differing options from a little assistance in the home, through to care homes. These should help to inform

your thinking and that of your parent and other relatives in order to come to a solution to help your loved one receive the support they need in a way that they are comfortable. Although some parties may not want to accept the ageing process is taking its toll, the sooner conversations are started, the better. If not, you may be forced by an unfortunate incident which takes away the luxury of time in considering the options.

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Understanding their needs Reaching an agreement, hopefully with the active involvement of your loved one that they could benefit from some kind of support to have a reasonable quality of life, is a key staging post along the way to laying more detailed plans.

If you have been able to come up with some solutions by a ‘roundtable’ discussion involving as many family members as are willing and able to be involved, you will now be ready to consider the options. Don’t forget to put your parent’s wishes and personal preferences at the heart of discussions – rather than thinking only in terms of the difficulties being experienced. This will be especially important if you are selecting live-in carers or are setting out to find a new place to live. As with any of us at other stages in life, location will be important, and may be even more important than many other factors.

‘Each situation is different and each family’s journey their own.’ Most of us express the view that we would prefer to carry on living at home for as long as possible, indeed many of us insist that we intend to spend the rest of our life in the family home, and services are increasingly being arranged so as to make that a stronger possibility. However, this may not always be possible or desirable if your loved one’s situation deteriorates and/or becomes more complex. At this point you may need to seek help at a later stage as difficulties become more pronounced and worrying for all concerned. However, that may

not be your current starting point - each situation is different and each family’s journey their own.

Small things make a big difference People can very easily over-react if they have little or no experience of the range and variety of care and support services to enable people to carry on living well, despite changes in their physical or mental health. Don’t rush into organising intensive services – arranging for three calls each day from a home care agency may do little to alleviate the feelings of loneliness a recently bereaved elderly person may be feeling. Instead, finding out whether there are community lunch clubs or other less formal sources of social contact close by, organised for example by Age UK or a local church could make a significant difference. Offering to accompany your loved one, so that taking the big step of attending for the first time is less daunting, could be so much more helpful. The opportunity to meet other people who may have had similar feelings after losing their partners or who may have become less independent, may make a big contribution towards stabilising an otherwise volatile or desperate situation. Sometimes a simple adaptation to the house – installing grab rails beside steps into the house, or placing them in the bathroom, perhaps beside the toilet

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or the bath, will give back confidence, at the same time as reassuring you too. However, don’t be tempted to undertake such works without specialist advice from people whose practical skills are also backed up by an understanding of what works for people with mobility problems. Taking advice, such as reading handbooks of this kind, is probably the single most important first step to take.

Getting a professional assessment Regardless of whether your parent’s financial situation – accumulated resources, income or home-ownership – means that they will not be eligible for any financial assistance from the public purse they are nevertheless entitled to an assessment of their care needs. This is an excellent opportunity to have your parent’s situation looked at by someone in no way emotionally involved and with the professional skills and knowledge that will help you both in charting the next steps. Local authorities are required to carry out an assessment where it can reasonably be assumed that the person requesting the assessment is likely to have care needs. It is generally accepted that older people, or those adult children acting on their behalf, will fit into this category. Sometimes your parent’s GP may be the obvious person to contact the local authority, adding extra professional weight to your request, but if that isn’t possible you can approach the council covering the area in which your parent lives directly and ask for ‘adult social care’ or some local variant on that label. They will most probably ask you to

outline the situation and you can ask that they carry out an assessment.

‘A skilled assessor will be able to establish the key issues that are affecting the quality of life of your parent.’ A skilled assessor will be able to establish the key issues that are affecting the quality of life of your parent. They will take account of the current difficulties that have led you to approach the local authority but will also be able to highlight other issues that may become a concern if ignored. They will form an opinion of your parent’s strengths – all too often hidden beneath the weight of concern about their weaknesses. Such assessments should be based on a home visit, so don’t get fobbed off with a preliminary telephone conversation that purports to be ‘screening’ urgent and non-urgent cases. Making arrangements about the extent and intensity of support is based on being able to observe the wider picture, taking in any difficulties within the home, the number of stairs and any other potential hazards, for example, in the kitchen or bathroom, or in the entrance and garden. The assessor will also want to explore the current support from family and friends and the scope for stepping that up – and the impact increased demands could have on you, as a family member offering informal help, and any others involved in providing support. We are likely to know our limits and

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there is a risk that if we go beyond that point the consequence is that we go under too – that’s why there is also an obligation to assess the principal carer’s needs. This is frequently the husband or wife of the person at the heart of this, whose situation has set the process underway in the first place. However, adult children – perhaps with other responsibilities of their own, for example, children or even grandchildren, as well as work – frequently play this key role, by providing practical support or keeping an eye on their parent. The combination of work, family and caring duties may push you close to breaking point where you can do no more without damaging your own health and limiting your capacity to take on more – a good assessment will recognise and respond to this. This review of your parent’s physical health – including sight and hearing and mental capacity, along with key relationships and the wider network of family and friends providing support in various ways, will all feature in building a fuller picture of what’s needed until they regain strength and can function well again, or to outline the services that can be put in place to manage continuing decline and growing need for help.

The care and support plan The assessment leads to a care and support plan. Regardless of whether or not the authority which produced the plan will be going on to contribute towards or provide any help, the plan is yours to keep and make use of as you continue to marshal support. It will be central to any discussions you have with care providers either to support your parent at home,

or to assist you in finding alternative specialist housing, with or without care, or to make the move to a care home. It will prove invaluable by equipping you with a fuller understanding of the options, and will provide any possible supplier of care services with a fuller picture of the extent and complexity of your parent’s needs. The local authority may also signpost you to voluntary organisations in the area that are able to offer information, advice and support.

‘The assessment will be central to any discussions you have with care providers either to support your parent at home, or to assist you in finding alternative specialist housing, with or without care, or to make the move to a care home.’ If the local authority becomes involved in providing services, they will make a separate assessment of your parent’s financial means to determine the level of charges to be made. Regardless of which agency – public, private or voluntary – is commissioned by you to provide the service, the care and support plan should outline the way in which services will be made available, and this should be reviewed within three months of the original assessment. The review will learn from experience and modify times and types of service in the light of what works well and meets the needs of your parent most effectively. If your parent doesn’t want to receive an assessment from the local authority

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and if you are considering employing a home care agency or moving into a care home, they will undertake an assessment of your parent’s needs.

Coming home from hospital Although there may be pressures to discharge your parent home after a hospital stay this should not happen until there has been a comprehensive assessment of their care needs – not simply a statement that the medical treatment is over. This assessment will be undertaken by one of the team of professionals involved in your parent’s care, or by the local adult social care team and will take the same approach as outlined on page 12 and 13. This is vital to finding an agency or home appropriately equipped and staffed to meet any needs identified.

The assessor should visit your parent’s house, possibly accompanied by them if their health permits, to ensure the fullest understanding of the environment to which they will be returning and to ensure that you don’t look for a more expensive service, such as a home providing nursing care, when that is not necessary. As with a community-based assessment, the professional carrying it out should aim to involve key people so you should make sure that you or any others are included in these vital discussions.

‘It is vital to finding an agency or home appropriately equipped and staffed to meet any needs identified.’

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Sorting out Frank’s house David’s father was fiercely independent and insisted that he needed no help at all – although he was happy to receive hot meals prepared by David’s wife. He had begun to fall with increasing frequency, leading to paramedics being called out to get him back on his feet and to check that he had not broken any bones. David worried that Frank was becoming ‘a bit of a nuisance’ – to hard pressed ambulance services - but was unclear what to do about it. When Frank broke his hip he was taken to the local district general hospital. During his father’s stay, David was interviewed by the discharge co-ordinator who asked if she could take a look at Frank’s house. She looked at various trip hazards, and recommended a series of small changes as well as also supplying a walking aid to assist Frank. When Frank was nearly ready to be discharged home, an occupational Understanding your parent’s needs and requirements is essential to finding the correct support. Local authorities have a duty to undertake these assessments if your parent is likely to need some form of support and should be your first port of call. Although you may experience resistance from your parent as to their requirement for an assessment or any assessed support, you may find that an ‘official’ assessment and understanding of their needs goes some way to helping them appreciate that some help may be

therapist arranged a home visit where she could check through the details of where grab rails – suited to his height and capability – could be installed and also to observe how he moved around with the new walking frame. Frank took notice of her concerns, in a way that he had not done when the same things had been pointed out by his son and daughter-in-law.

‘Frank took notice of her concerns, in a way that he had not done when the same things had been pointed out by his son.’ With these small assessments and changes, Frank was able to continue living at home, giving David peace of mind and his incidents of tripping reduced.

‘Understanding your parent’s needs and requirements is essential to finding the correct support.’ required. It really is beneficial to take these steps sooner rather than later as small elements of support can prolong independence and delay the need for more intensive care or support.

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Dealing with family pressures Each family is unique but as relatives age, there are common concerns that are shared by many. This chapter aims to help you understand that you’re not the only one facing these issues and pressures, and although each situation is different, there is help and guidance available to address or resolve any particular worries you might have.

Making key lifestyle decisions is usually done in an atmosphere of strong emotions. Getting married, having children, changing jobs, moving house - these kinds of decisions are usually made when families are looking forward to improving their lives and future happiness. Even if these decisions are happy ones, making such changes can strain family ties and cause friction between generations. Decisions regarding the future for older relatives are commonly made at a point of crisis, which is likely to put pressure on family relationships. Older people naturally want to maintain their lifestyle for as long as possible, but gradual or sudden deterioration of their health can mean that they can no longer cope at home alone. When that happens, it’s important to make the time to have an honest conversation about how all those involved feel about the situation, what they think and how any decision is going to be made. The extent of that discussion will, of course, depend on the capacity of the older relative. It is probably going to be the last major decision they make in their

life, although no-one may want to admit that, so they deserve the opportunity to express their feelings regarding these changes, what matters most to them about their future and what they are most upset about losing. They should be at the heart of discussions.

‘Decisions regarding the future for older relatives are commonly made at a point of crisis, which is likely to put pressure on family relationships.’ Older people can often be lonely or feel isolated, especially if they have outlived their partner and their friends. It’s very difficult to make new friends in older life and it is not uncommon for them to grow increasingly reliant upon their children and grandchildren to meet their need for company and affection. ‘I know you’ve got your own lives to lead...’ is a common refrain that can be genuinely meant, but sometimes it can also mean ‘you

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don’t give me enough attention’. This can provoke feelings of guilt and add emotional pressure to those already juggling jobs and family commitments.

Where to start Broaching the subject of formal care or support can be the hardest part of the whole process for a family but embarking on the journey as a unit, with clear and agreed goals for your loved one’s needs can help to ease any potential stresses and tensions along the way. Whichever course of formal care has been chosen to help your relative live their life independently, there are various ways of easing them into the decision slowly, and at their own pace, if urgent care is not necessary. This can be particularly important if a loved one may be resistant to change or the idea of formal care.

‘Moving into a care home can provide opportunities for companionship and activity, if it is chosen carefully to match the interests and abilities of your relative.’ If it has been decided that home care, or domiciliary care, may be the best option for your loved one, then it can be arranged for a carer to come into the home in short visits at first, to get to know your parent and build a rapport. This way your relative has the time to get used to somebody else being in their home and the opportunity to feel

comfortable around their carer. If going into a care home feels like it may be the best option then most care homes offer the option of short-term visits so that your relative can see if the lifestyle of that particular home suits them and their needs and it is somewhere they feel they could live happily. Moving into a care home can provide opportunities for companionship and activity, if it is chosen carefully to match the interests and abilities of your relative. A good home aims to make itself a lifestyle choice rather than a last resort. Either way, any formal provider of care will get to know your parent, their likes and dislikes, the way they like to be addressed, any cultural or religious considerations. These will form part of their care plan and anyone involved with supporting them directly, should be aware of these personal details.

Balancing wishes It is possible, however, that not everyone will agree with what is needed or which course of action to take. At these times, it’s important for all parties to remain calm and try to explain their thoughts and emotions. Emotionally charged conversations can impact on everyone, most of all your ageing relative who may already have mixed emotions about their increasing frailty. Most people are likely to be dealing with their own worries about their relative no longer being as able as they once were, some may even be concerned about future inheritance being lost due to the costs of care and support. Everyone will have their own reasons and concerns which they

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bring to the discussion. By encouraging everyone to share these concerns and by making the most of trial visits or experiences of formal care and support,

everybody should feel as confident as possible that an honest assessment has been made and the most beneficial solution can be found.

Mr and Mrs Jenkins Mr and Mrs Jenkins are in their 80s and live in a large and comfortable house in the Sussex countryside. Mrs Jenkins has always managed the home and has a wide circle of local friends; Mr Jenkins was a senior professional and since retirement has had active interests which include playing golf and walking. Two years ago the couple realised that Mrs Jenkins was becoming increasingly confused, before long she was diagnosed with dementia.

‘It can be helpful to seek advice from an impartial professional.’ Mr Jenkins took over all the household tasks and provided personal care for his wife, who was often incontinent at night but refused to wear protection. He couldn’t leave her unattended as she became agitated and had been found wandering along the road looking for him. The couple’s daughter, Molly, lives 180 miles away and visited every couple of months. On her visits she could see that her parents needed support and suggested that some home care would be a good idea. Mr Jenkins knew that he needed more help than that and explained that he wanted to arrange live-in care. Molly was surprised at this, and

didn’t see why her father had asked for such an intensive level of care so soon. She suggested practical ways in which the household routines could be supported, including online shopping and a daily home care worker who would be able to handle the washing, cleaning and cooking. Her father was adamant that home care would not be sufficient; he didn’t want his wife to go into residential care and insisted that live-in care was the best solution. Given the emotions and differing ideas on the best solution, at this stage, it can be helpful to seek advice from an impartial professional. There are three members of this family who each have differing perspectives on the situation, depending on their own needs. They may not find it easy to share their feelings constructively in reaching a decision. Molly wanted to support her parents but was feeling guilty that she was unable to do more. She was uncomfortable at the thought of carers living in the family home, anxious about their reliability and a little concerned at the expense. Mr Jenkins had been struggling for months with the practical tasks and his major change of role; his sleep was often disturbed due to his wife’s incontinence at night; he had to give up all his social activities

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and felt trapped in his own home. The quality of his life has been reduced dramatically and was likely to decline further without major support. Most importantly, he was gradually losing his wife as the dementia progressed and affected her personality and capacity. He had not been able to express all of this to his daughter, but he was emotionally and physically exhausted and had reached his breaking point. Mrs Jenkins was adversely affected by the stress of her husband; she would benefit from a calmer atmosphere, personal care from a female carer and some opportunities for gentle outings to enjoy their surroundings. The family took advice and were helped to consider their options. Mr Jenkins was able to explain to Molly why he preferred live-in care rather than domiciliary support. The house was spacious and could accommodate a carer without compromising his privacy; he would be relieved of much of the stress and be able to enjoy his activities again whilst being assured that his wife was well cared for. Mrs Jenkins would have continuity of care and attention to her personal needs, and most importantly they would remain living together. Molly acknowledged the reasons for her father’s decision and appreciated how urgently he needed help. Mr Jenkins was anxious to proceed quickly but

accepted that it may take some weeks to set up this type of service. Local agencies providing live-in care were researched and information about staff recruitment, training and supervision obtained. The family selected two whose terms are agreeable to Mr Jenkins and were able to carry out a prompt assessment. Mr Jenkins was impressed with the kindness of the agencies’ staff whilst Molly was reassured. Mr Jenkins chose an agency and was relieved when they were rapidly able to provide a suitable carer. This situation was unique to the Jenkins’ family but it came from differing emotions and an inability to share or fully understand the situation and pressures on everyone involved. These aspects are usually the crux of differing thoughts and potential tension when it comes to considering an elderly relative’s best support options. In cases where tensions may rise or solutions cannot be agreed upon, it’s worth seeking input from outside the family, someone impartial and unlikely to be caught up in the emotion. Whether this is an advocacy organisation, a local authority assessor or a specialist in care and support they may be able to see through the emotion and help all parties understand that at the heart of this is care and consideration for an ageing loved one who needs some form of support.

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Support to live independently at home The time may have come when your relative is starting to need a little extra support around the home with tasks that they once found simple. When this happens it can be common to immediately think the worst and question what the next step should be. Do they need to go into residential care? Should you be visiting them more often despite your own commitments? Will something happen to them and you won’t be around to help? These are all common concerns when a relative starts to show signs of declining health, especially if they don’t want to admit that they need help themselves.

The good news is that there are plenty of steps you can take to ensure that your loved one can remain at home independently in a safe environment and the first signs of declining independence may not necessarily point to the need for formal care.

A little encouragement

Support to live independently at home Making life easier in the home Choosing care Care and support at home Choosing a home care agency checklist Residential care options Choosing a residential care home checklist Specialist housing with care schemes

It’s true of most ages that a fundamental part of maintaining a healthy and independent life is consuming a balanced diet and taking regular exercise. This is especially important for older people who can sometimes mistake the common aches and pains associated with getting older for indicators that they should be taking it easy and reducing their activity. If your loved one has started to wonder if they can cope with tasks at home and what the future may hold, you may find they begin to worry. Simply asking how they are feeling may not give you a clear indicator but keeping in touch whether by phone or dropping in should help you to notice little things that may have an impact. Also, listen to the comments they make, you might pick up little hints

here and there, such as they struggle to reach the pot in the top cupboard, or the lightbulb in the hall has been blown for a while.

‘The good news is that there are plenty of steps you can take to ensure that your loved one can remain at home independently in a safe environment.’ If your loved one is relatively mobile, encouraging them to take regular walks or doing a little light housework can be enough to loosen up any aches or stiffness. This can benefit them physically and mentally. Regular exercise can not only improve mobility and wellbeing but it can also help to reduce the risk of developing certain long-term health conditions such as high blood pressure, heart disease and stroke and osteoporosis. If your relative has a health condition, contact their GP before starting any

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exercise. For more information on physical activity guidelines for older people visit the NHS website: www.nhs.uk

Staying safe at home It’s no surprise that most people prefer to remain living in their own homes for as long as possible. More often than not, it is the family home and it is natural for all members of the family to feel attached to it and the memories that come with it. However, it’s important to consider whether the house is contributing to any decreasing independence. Do they struggle to get upstairs? Is getting in and out of the bath a problem? If they live on their own, do you worry that they may fall and you wouldn’t be there to help? These are common, everyday worries but there is an abundance of practical aids, technological innovations and levels of support that can help your relative live safely in their own home for longer. From what can seem like the smallest, simplest implementation to more complex suggestions, don’t be surprised if they are met with some initial resistance at first. Nobody likes to admit that they are struggling to look after themselves or can no longer cope in the same way that they always have. With a little gentle persuasion and persistence your loved one may come round to your suggestions and see that a few simple changes can enhance their standard of living.

Aids and equipment If you think your relative may benefit from some simple aids, you’ll probably be surprised by the level of innovation in aids to daily living. If you’re not sure where to start an occupational therapist may be able to help. They may be able

‘There is an abundance of practical aids, technological innovations and levels of support that can help your relative live safely in their own home.’ to suggest items, aids or adaptations to make independent living easier. If your relative is having an assessment by the local authority, an occupational therapist should be involved. Alternatively, there are private occupational therapists who you can contact directly or your local independent living centre may have an in-house occupational therapist you can speak with. Some independent living centres are open to the public, though you may need to make an appointment, others are run by the local authority so you may have to go through them in the first instance. A quick internet search should show you if there is a centre nearby. The Living Made Easy website offers help and advice on daily living as well as details on equipment that could help your loved one in the home, from small products such as a kettle tipper or bath chair right up to stair lifts, grab rails or external rails. For more information visit www.livingmadeeasy.org.uk The website is run by the Disabled Living Foundation and works in conjunction with AskSARA. AskSARA can also help you find useful advice and products that make daily living easier. For more information visit www.asksara.org.uk See page 28 for other solutions to make life easier in the home.

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Home adaptations Home Improvement Agency (HIA) services may be able to assist you in improving, repairing, maintaining or adapting your parent’s home. They can advise and guide homeowners and private tenants as well as undertaking a financial benefits check to see if the resident is eligible for any help to live independently. HIAs help vulnerable people to ensure their home is comfortable and safe and can help to identify reputable tradespeople if small repairs or adaptations are needed around the home. They can also oversee the work. Work can include simple jobs like installing grab rails or ramps right up to reconfiguring the home or widening doorways. You can find your local HIA via the Foundations

website www.foundations.uk.com Some homeowners may be eligible for a Disabled Facilities Grant to help with the cost of adaptations. To find out more information you can contact the local authority who will arrange for an occupational therapist to visit your relative’s home and assess their needs. If they recommend any alterations and the council agrees and approves the work, then some forms and a financial assessment will need to be completed to determine how much may be expected to be contributed towards the costs. The Government website www. gov.uk/disabled-facilities-grants has more information.

WHAT ARE THE CARE OPTIONS? HOW WILL ITHE KNOW WHICH TO CHOOSE? WHAT ARE CARE OPTIONS? WHATWILL IF MUM DOESN’T AGREE? HOW I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 CALL CARE389 SELECT2077 FOR MORE INFORMATION: 0800 389 2077 22

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Technically speaking Apart from the more obvious aids such as grab rails and stair lifts, home alterations can include new lighting, cooking equipment or even lower work surfaces. Technological advances have also brought about new telecare and assistive technology to help keep people independent in their homes for longer. Community alarms are the most commonly used and come in the form of pendants, pullcords or buzzers. In the event of an emergency, your relative activates the alarm and it either contacts you directly or goes through to a central call centre which makes the relevant call to you or a nominated relative or friend.

‘Many people are surprised by what’s available to assist in maintaining independence. Simple items can have a huge impact on your parent’s independence and wellbeing, small changes can have huge benefits.’ Some of these systems have a base unit where the controller can speak directly to the caller until help arrives. There are also a wide range of sensors that can give you peace of mind as they can detect carbon monoxide or gas; or flooding from a running tap; while others detect movement and falls or the front

door being opened. It is even possible to set a voice-recorded message alert in different areas of the home to reassure or prompt your loved one about certain things. It is this type of technology that can prove the most helpful in providing the reassurance to the ‘what ifs’ you and your relative may have. Advances such as these can be the key to everyone feeling confident that your relative can live independently at home and leaving the family home isn’t necessary just yet. Little changes like these can also mean your relative remains independent for longer, delaying the need for more formal support. Many people are surprised by what’s available to assist in maintaining independence. Simple items can have a huge impact on your parent’s independence and wellbeing so it is recommended to research what may be available. You may be surprised how small changes can have huge benefits.

Wheelchair hire If your relative is beginning to have issues with their mobility, some organisations offer wheelchairs for short and long-term hire either for a small charge or a donation. The British Red Cross, for example, offer a volunteer-led medical equipment service that provides wheelchair hire and short-term loans of equipment. You can search its website for your nearest service www.redcross.org.uk

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Hot meals for Ted Ted and Jane had been married for 50 years and during that time, they had taken on their own particular roles within the home. Whilst Ted maintained the garden, it was Jane who cooked all of the family meals and did the weekly shop. When Jane passed away, Ted was understandably devastated so his children felt it would be a good idea if he went to stay with one of his daughters, Cheryl, for a few weeks. Aside from the emotional trauma of losing his wife, Ted was well and able to live independently at home so after his short stay with Cheryl, he returned home. Cheryl offered to drop in on him every other day.

‘Whilst Ted maintained the garden, it was Jane who cooked all of the family meals and did the weekly shop.’ On one of Cheryl’s visits she brought along her children, who wanted a snack. As Cheryl looked for a suitable snack, she realised that Ted’s cupboards were almost empty aside from a few tins of vegetables. She also noticed his fridge was almost bare. Cheryl had previously visited in the evening, after work, but not at mealtimes. After speaking with Ted about

her concerns that he was not eating properly, Ted admitted that he didn’t know where to start when it came to cooking hot meals and had found using tinned food much easier. Cheryl initially felt guilty that she had over-looked her Dad’s practical capabilities and had focused more on his emotional wellbeing but talking it through with her sister she realised that this was understandable. The whole family was dealing with the loss of Jane and were trying their best to help Ted. She contacted the local council to enquire about Meals on Wheels service. Ted didn’t want to have his care needs assessed as he didn’t feel he needed adult social care to get involved, so the council’s customer services adviser gave Cheryl the details of a local company who could deliver regular hot meals and frozen ones too. Cheryl arranged for a weekly delivery of frozen meals to be delivered in bulk so that Ted would always have something to hand. She also discussed with him what he’d like to eat and set about helping him cook basic meals, with the involvement of his grandchildren too. After a while Ted began to pick up a few favourite recipes and decided to phase out the frozen meals in favour of a weekly online grocery delivery. Cheryl felt confident that her dad was having hot, nutritious meals and Ted felt good at being able to cook for himself when he felt like it.

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Help with getting around Mobility

Community transport

If your relative still drives but has a disability which receives a higher level of mobility allowance, the Mobility Scheme enables people to use their Government-funded mobility allowance to lease a new car, scooter or powered wheelchair. If they are in receipt of the Higher Rate Mobility Component of the Disability Living Allowance, Enhanced Rate of the Mobility Component of Personal Independence Payment, Armed Forces Independence Payment or the War Pensioners’ Mobility Supplement, they may be eligible to join the Mobility Scheme. To find out more about what Motability entails, visit www.motability.co.uk Other ways to help your loved one get around and remain independent can include:

Community transport is a scheme to help people to still get around if they can’t use existing transport. It is arranged by the local council and you will need to contact them or search the internet to find out more about what’s going on in the local area.

Free bus pass

Those living in England may be entitled to a bus pass giving free off-peak travel on local buses. Entitlement starts at ‘eligible age’. This is calculated on when your parent was born and the age at which they became eligible for State Pension. You can find out more by searching ‘Free bus pass’ on the Government’s website www.gov.uk A bus pass can be applied for from the local council and the Blue badge scheme www.gov.uk website can link you A blue badge enables people to through to the correct page on your park closer to where need to parent’s local authority’s website via WHAT ARE THEthey CARE OPTIONS? WHAT ARE THE CARE OPTIONS? go in order to make it easier for postcode search. A free bus HOW WILL I KNOW WHICH TOa simple CHOOSE? HOW WILL I KNOW WHICH TO CHOOSE? them to IF shop and access local pass is a great way for people to keep WHAT MUM DOESN’T AGREE? WHAT IFFor MUM amenities. more DOESN’T information AGREE? in touch with friends, visit family and visit the Government’s website stay socially active – without the worry VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK www.gov.uk/apply-blue-badge of driving or the cost of keeping a car. VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

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0800 389 2077 0800 389 2077

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Stella’s social life After losing John, her husband of 35 years, Stella suddenly found herself alone in the family home and suffered a complete loss of confidence, feeling like she couldn’t socialise with her friends without the company of John. Stella and John had two daughters; Gemma lived in Australia and, Steph, lived 30 miles away near the coast. After suggesting to Stella that they could sell the family home and buy something closer to Steph, the family began to worry about Stella’s wellbeing and isolation when she declined the offer. As Steph was unable to relocate her own family closer to Stella, she began to look into local services provided by the Council that would enable her Mum to get out and about with some assistance, and at regular times.

Staying social Getting older can mean that friends are no longer around and this can result in loneliness and isolation, particularly if a loved one is living alone. Befriending services can offer companionship and support and also accompany your loved one on appointments or outings. They can even just pop by for an informal cup of tea and a chat. Companions may be volunteers or employed by private companies such as home care agencies. For peace of mind, it is important to ask whether the befriender has had a

Steph found that one service on offer was a Friday get-together including a hot lunch followed by an afternoon of pre-arranged activities such as bingo or crafting at the local village hall. The service also arranged transport to and from the hall by bus. Knowing that her Mum was anxious about socialising without her husband, Steph went to the first lunch with Stella and took the bus with her so that she knew what to expect each week. Stella now makes sure she never misses a Friday and she has made friends that she meets away from the club. Steph feels peace of mind knowing that her Mum can retain her own social life and independence without her or her late father. This simple service has boosted Stella’s confidence and eased everyone’s anxieties.

Disclosure and Barring Service check, or whether any organisation offering befriending does suitable background checks. To find befriending organisations contact the local Age UK. Day care services are also available to provide the opportunity for older people to get out, meet friends and try new activities. Some even offer hot lunches and arrange transport. These services can be chargeable but they offer the chance of regular social stimulation for your loved one and something to look forward to each week. Some local care

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homes offer day opportunities which is a great way to become familiar with the care home setting, even if it is not needed at that time.

Small steps These smaller changes are ways to help your loved one live independently and safely in their own home for longer whilst bringing peace of mind to both you and them. The advances in technology are gradually making this easier and more possible for people. Don’t be disheartened if your loved one appears resistant to change at first, it is natural to not want to accept help

‘Day care services are available to provide the opportunity for older people to get out, meet friends and try new activities. Some even offer hot lunches and arrange transport. ’ straight away. For this reason, it may be best to introduce one step at a time. By introducing the most unobtrusive changes first, your relative can gradually feel comfortable that the small things can make a big difference.

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Making life easier in the home In the living room

Plug with handle

Easi-reach YB NOR

Chair raisers

WHAT IS DIFFICULT FOR YOU?

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

GETTING IN AND OUT OF CHAIRS

• Block of foam in chair base • Buy ready-made chair raisers if your chair is too low • Buy a new chair – get professional help to make sure the height is right • Take regular, gentle exercise

• Buy an electric riser chair

OPENING AND CLOSING WINDOWS

• Move any furniture out of the way • Install/purchase a fan • Purchase a gadget to open/close window

• Remove the window opener • Install environmental controls or air-conditioning • Install new windows

• Change the switches • Fit a timer switch • Purchase a standalone heater

• Move the heating controls • Install new or additional heating system

• Install a light switch toggle • Purchase a socket extension • Purchase handi-plugs

• Move the light switches • Replace the light switches • Install environmental controls

• Replace the fire with a heater • Apply for the winter fuel payment • Use a trolley to safely transport the fuel

• Get a grant to insulate your house • Change to a cheaper heating system • Change to an easier-to-use heating system

• Use subtitles • Purchase wireless headphones

• Request an assessment for a hearing aid • Install a room loop

Standing up from sitting is difficult

Can’t reach the windows Not secure to leave windows open

CONTROLLING THE HEATING Can’t reach the controls for the fire or heating

SWITCHING LIGHTS ON AND OFF Can’t reach the switch The switch is difficult to use

KEEPING WARM Insulating your home Affording the fuel Carrying the fuel

WATCHING TV Hear the sound of the TV

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In the bedroom

Pillow raisers

Easy grip scissors

M T W T F S S

Bed raisers

WHAT IS DIFFICULT FOR YOU? GETTING IN AND OUT OF BED Standing up from sitting on the bed

SITTING UP IN BED, TURNING OR ROLLING OVER Bed is too soft Bedding is too heavy Nothing to lean on

KEEPING WARM IN BED Checking the safety of your electric blanket

GETTING DRESSED

Pill dispenser

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

• Learn new techniques for moving safely • Purchase a leg lifter • Raise the bed • Fit grab rails

• Use a transfer board • Install a hospital bed • Buy an electric adjustable bed • Use a mobile hoist or a ceiling track hoist

• Change bedding • Learn new techniques for moving safely • Purchase a pillow raiser • Change the mattress

• Buy a bed cradle/bed ladder • Use a bed lever • Buy a specialised mattress • Install a drop-down rail • Install a monkey pole

• Buy a heavier duvet • Buy thermal clothing • Contact an electrician about any electrical blanket safety concerns • Learn new techniques for dressing • Buy simple gadgets: long-handled shoe horn; elastic shoe laces; dressing stick; button hook; stocking aids • Contact n (see key below) regarding an assessment of needs

• Consider home support

• Buy easy grip scissors

• See a podiatrist

Opening bottles Remembering to take tablets

• Ask your pharmacist for an easy to open bottle • Keep a note when you have taken a tablet

• Get a pill dispenser with days and times on • Get an automatic pill dispenser • Ask someone to prompt you

READING THE TIME

• Buy a clock with larger numbers

• Buy a clock that ‘speaks’

Difficult to reach all of your body

CUTTING YOUR NAILS Can’t reach your feet Hard to hold scissors

TAKING YOUR TABLETS

Seeing the clock to tell the time

n Contact the local authority

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In the kitchen

Teapot tipper

Large handled cutlery

Pan handle holder

Liquid level indicator

Chopping board with spikes

Perching stool

WHAT IS DIFFICULT FOR YOU? REACHING CUPBOARDS

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

• Re-arrange things in cupboards/on surfaces • Buy an Easi-Reacher or Handi-Reacher

• Alter the spring in the door closers • Lower or raise the cupboards

• Fit tap turners • Purchase Handi-Plugs

• Change switches • Raise or reposition taps • Fit lever taps or new taps • Alter the kitchen

• Sit at a table • Consider kitchen gadgets including: knife with a thick handle; chopping board with spikes; pan handle holder; teapot tipper; lid gripper

• Use a food processor • Purchase a perching/high stool • Buy a trolley • Change the height of the work surface • Make space under the work surface for your knees when sitting

• Re-organise the furniture

• Review mobility equipment used • Adapt the kitchen • Consider the suitability of the kitchen

Cutlery is hard to grip Food/plate keeps slipping Can’t carry food to table Can’t lift cup

• Use large handled cutlery • Use a non-slip mat • Use a lightweight insulated cup • Use a cup with two handles • Contact n (see key below) regarding an assessment of needs

• Buy a trolley • Consider home support for meal times

LAUNDRY AND IRONING

• Install a wall-fixed ironing board

• Raise/lower the washing machine • Change the washing machine or iron

Cupboards are too high or low Cupboards are too deep Cupboard doors are too heavy

USING TAPS AND SWITCHES Taps or switches are too awkward Can’t reach taps or switches

CUTTING, CHOPPING, PREPARING AND COOKING FOOD Work surface too high or low Hard to grip packets or jars Hard to grip a knife Pans or kettles are too heavy to lift

MOVING AROUND THE KITCHEN Not enough space

EATING AND DRINKING

Washing machine is too high or too low Putting up ironing board

n Contact the local authority

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In the bathroom

Grab rail

Shower board

Tap turners

Toilet seat and support frame

Raised toilet seat

Long-handled sponges

WHAT IS DIFFICULT FOR YOU? WASHING HANDS, FACE AND BODY Turning the taps Standing at the basin Basin is too low or too high Can’t reach all parts of the body

HAVING A BATH Turning the taps Stepping into the bath Risk of slipping in the bath Getting up out of the bath Washing your back

DRYING YOURSELF Floor is slippery Room is too cold Difficulty in drying your body

USING THE TOILET Toilet is too high or too low Difficult to clean yourself Flush lever is awkward Toilet is hard to get to

CLEANING TEETH Gripping the toothbrush Standing at the basin

HAVING A SHOWER Difficult to stand for long shower Shower too high Shower controls are awkward Shower is slippery

SIMPLE SOLUTIONS

COMPLEX SOLUTIONS

• Install tap turners • Purchase a long-handled sponge • Purchase a flannel strap • Contact n (see key below) regarding an assessment of needs

• Install lever taps or new taps • Purchase a stool • Raise or lower basin • Consider home support

• Have a strip wash • Purchase a non-slip mat for the bath • Install tap turners • Buy a long-handled sponge • Use a half-step • Install grab rails • Use a bath board or bath seat

• Install lever taps or new taps • Install a bath lift • Use a mobile hoist • Use a ceiling track hoist • Replace the bath with a shower • Convert the bathroom to a wet room • Consider home support

• Heat the bathroom safely • Use a non-slip mat • Purchase a towelling gown

• Change the floor covering • Purchase a hot air body dryer

• Install a raised toilet seat • Use a combined toilet seat and support frame • Install a flush lever extension • Contact n (see key below) for a needs assessment

• Review mobility equipment used • Adaptation to bathroom • Consider home support

• Purchase a toothbrush gripper • Purchase an electric toothbrush • Use a stool • Have a strip wash • Use non-slip mats • Purchase a half-step • Contact n (see key below) for a needs assessment

• Use a shower board • Use a shower chair or stool • Replace shower controls • Consider home support

n Contact the local authority

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Choosing care The majority of older people want to stay in their own home for as long as possible - ideally until the end of their life. People are generally leading longer lives, and as of 2012 the average life expectancy of someone living in the UK was 81.5 years. The implications of this are clear; extreme old age usually brings with it a variety of chronic and disabling conditions, which can make everyday life more challenging than it once was.

The ability to manage activities of daily life such as meal preparation, household tasks and personal care (dressing/ undressing, bathing and using the toilet) may be limited by severe arthritis, a heart condition, incontinence, deafness or poor eyesight. Sitting for prolonged periods affects muscle tone and balance, falls are common and all or any of these may be further complicated by the onset of dementia. With all of this to consider, remaining at home without some formal assistance may not be possible.

At a glance Helping older people to remain independent of 24-hour care is likely to require aids and adaptations to the home. These can aid mobility, and this handbook provides helpful references for obtaining these practical services, starting on page 21. Further domiciliary support can be organised to deal with household tasks, and hot meals can be delivered daily. Your older relative may resist any or all of these solutions if they do not like change, but increasing frailty may later mean arranging personal care which is significantly more intrusive. Try to

discuss all options with your loved one as soon as possible to avoid having to make any crucial decisions in a moment of crisis. The decisions can be difficult to broach but taking the time to discuss options is far easier than if they are thrust upon you after a fall or sudden deterioration in health. Try to remember that acknowledging that you can no longer manage and that you need support can be frustrating, and knowing that your ability to cope is only likely to decline further is a frightening thought. Needing intimate care can spark feelings of resentment, embarrassment and humiliation which may hide behind their resistance to change. Those offering informal care also experience a range of emotions; it is not unusual for carers to struggle with guilt at not being in a position to meet a parentâ&#x20AC;&#x2122;s or partnerâ&#x20AC;&#x2122;s needs. Both sides can end up angry and distressed and say things that they later regret. See page 16 for more advice with how to deal with family pressures.

Weighing up your options Your relative should always be involved

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in making difficult decisions about their own life and be supported to express how they feel, but if you care for your relative too, your life as a carer is also central to the decision and your needs are important. Whether there is a caring role involved or not, try to consider the options calmly and honestly, being firm about what is realistic and the pros and cons of various types of care. It might be helpful to write a list, perhaps weighting some issues more heavily than others, and see how they balance. Coloured pens to mark each topic with ticks or crosses can provide visual cues for people with sight loss or dementia.

‘Your relative should always be involved in making difficult decisions about their own life and be supported to express how they feel.’ You may need to consider wider family members in this process. Sometimes those living at a distance don’t see how much a parent may have declined, or the level or support they need. It may be that if you are caring for your relative you are growing resentful of other family members living at a distance, ‘not pulling their weight’. It may be that you live at a distance and worry about your relative’s safety, wellbeing or isolation. All of these points and more are likely to need to be considered when deciding on any care and support needs. Ultimately, though,

your relative needs to be at the centre of the process. The conversations may not be easy, they may need time for people to agree, see others’ ways of thinking or come round to ideas. Try not to let it affect relationships in the long-term - you should all have the best interest of your relative at heart.

Home care vs. care home Care at home provides your loved one with familiarity of surroundings and neighbourhood. Furniture doesn’t just occupy a space or hold glassware and Coronation mugs, it brings back memories of a life lived, where and when bought and celebrations enjoyed with someone dear. It is hard to accept that these items are now sources of risk, impeding mobility or trip hazards. Being in the neighbourhood, local friends may be able to pop in and the well-known family GP can continue to provide health care. Continuity of environment should ideally be complemented by continuity of care in the home and this is understandably what older people most often ask for. Some home care agencies are better than others at achieving this with the care staff that are assigned to care for your parent, but clearly no single care worker can cover all the hours that your parent may need during a week. If your relative requires more consistent care than can be provided in the home, is growing increasingly isolated or at risk of falls, then it may be worth considering the possibility of a care home – some of which also provide nursing. Despite the bad press around care homes, your loved one would receive 24-hour care and support. >>

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24 hour, one to one care at home throughout the UK. Short term, long term, respite and convalescence care at home. Companionship, comfort and hands on support in your own home Contact us on 0844 209 2646 www.country-cousins.co.uk Country Cousins Est 1959

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>> Care homes are also great for combating loneliness for those who may have outlived the majority of their friends or struggle to get out to groups and social gatherings. Residential care homes provide a social environment in which your elderly relative can live alongside like-minded individuals whilst receiving the care and support they need. Consider that your loved one may be resistant to the thought of leaving the security of their own home, so it’s important that you evaluate the needs of your relative in order to determine the specific level of care they require. You can even contact the local authority for an assessment of their care needs to determine exactly the level of support they may require. Remember that your relative’s opinions have to be central to all conversations and decisions being made.

Mid-ground – housing with care There is a mid-ground to consider, something that sits between staying at home and residential care. That is housing with care. This is discussed more on page 65 however it can cover a variety of different housing schemes from traditional sheltered housing through to extra care or retirement villages. Here, your parent can have the security of their own home, albeit, not the family home, which discussed above may become too much to manage. Your parent can also have the security of differing levels of care and support as needed from a warden through to onsite home care services. As there is a real mix of these types

of schemes across the country, your parent may be able to stay in their own neighbourhood or move closer to family members, whilst retaining some independence with support available if needed. Some families find this mid-ground an agreeable solution to a parent’s growing dependence or loneliness. It can also help to address any resistance to a care home setting.

Quality of care If you and your parent are looking for home care, it’s important to ask agencies how they recruit their staff, how long they keep them, and probe the training and supervision programme. Use the Care Select website www.careselect.co.uk and its linked care service search to local providers and check recent inspection reports. Also ask around if anyone you know has experience of using the agencies you’re considering. Word of mouth is often a useful (though not a fool proof) source of recommendation.

‘A good agency will arrange to visit and talk to your parent, preferably when you can be there too, to make an assessment of his/her care needs.’ A good agency will arrange to visit and talk to your parent, preferably when you can be there too, to make an assessment of his/her care needs. They should ask questions that systematically cover practical, physical and personal care, engaging with your elderly relative as

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much as possible, rather than asking you all the time. Ask about continuity of staff (a team of two or three, no more, is preferable), be specific about how long each visit should last, what the hourly/ half hourly charge is and contract terms.

‘Reports of inspection findings, and quality ratings, are published on the Care Quality Commission’s website.’ Care at home can be flexible to changing circumstances; stepping up the level of support as your parent becomes more dependent. Even so, there may come a time when a difficult decision has to be made regarding what is safe and acceptable, both for the individual and for the carers. An independent viewpoint, such as from a GP or social worker, may be helpful in reaching such a decision. Residential care often receives a bad press which can deter families from considering it, but good quality care can be found that provides a comfortable final home, not just a last resort. If your loved one’s needs are such that a residential care home or care home with nursing is the best option to meet their needs, draw up a list of the homes you and your loved one like the most, and that offer the care and support your parent requires. These could be close to the family home or another family member, or even somewhere else completely. Some people prefer big, new care homes, others prefer smaller, familyrun homes. They are as different as the people who live in them.

The best way to get a feel for a care home is to visit. You can do this by contacting the manager and arranging a visit where you can talk to the staff and residents. Alternatively, you can just drop by and get a feel for the home when visitors aren’t expected. You may also find it helpful to know that the Care Quality Commission, the regulator and inspector of all health and social care providers has recently introduced a new rating system which will make it easier for older people and their relatives to form a clear understanding of the standards of care homes and home care providers throughout the UK. Inspections look at whether the service is: Safe; Effective; Caring; Responsive to people’s needs; and Well-led. This will then lead inspectors to rate the home against national essential standards as ‘Outstanding’, ‘Good’, ‘Requires Improvement’ and ‘Inadequate’. Reports of inspection findings, and quality ratings, where these have been awarded, are published on its website but good providers will offer to show you the latest report themselves and discuss any questions you might have. Providers also have a duty to display their quality rating where the public can see it, so if the homes or agencies you visit have been rated, not everyone has yet, you should be able to see the rating on display. The CQC hopes to have awarded all social care providers with quality ratings by April 2016. Any social care or health care service is expected to have an internal quality assurance system for assessing how well it is providing care and it is a good idea >>

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Answering your questions on elderly care When you’re considering care for your elderly loved one, speaking to us can really help to put your mind at ease. Whether it’s advice on choosing the right care, or understanding how to pay – our team of elderly care advisers are here to guide you through your options, to help you make the right decisions.

To find out more about your elderly care options Call

0333 414 9650†

‘Bupa Care Homes’

† Calls are charged at no more than local rate and count towards any inclusive minutes from mobiles. Calls may be monitored and may be recorded.

>> to ask the manager how that works. Asking the customers should be central to any quality assurance system so expect to see the comments of residents.

‘Whatever care you are choosing at whatever stage in your relative’s life, make sure the provider puts your loved one’s needs at the heart of what they do. ‘ When asked for their views about the care they receive, residents usually mention kind and caring staff who don’t change frequently and get to know them well. They like good food with plenty of choice and variety, and a wide range of activities to suit varied interests and quiet

privacy in their own room if they choose it. They expect prompt attention to call bells, a clean and fresh atmosphere and surroundings, with no unpleasant smells, in short, a well-managed, friendly place in which to live. Whatever care you are choosing at whatever stage in your relative’s life, make sure the provider puts your loved one’s needs at the heart of what they do. They must consider their likes, dislikes, preferences and specific care needs. They should be open to suggestions and comments, quick to help you and support you in your decision. As with any big decisions in life, having the luxury of time will help you come to the right solution, however if time is of the essence make sure you still step back and ensure your parent’s wishes are carefully considered.

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Frederick’s increasing needs Frederick is in his early nineties and lived in his own bungalow. He had been receiving home support for 12 years, weekly assistance with shopping and cleaning, and had his bathroom adapted to provide a walkin shower with a seat. He started to become less mobile and often unsteady on his feet. He had an alarm call system but never used it, despite a couple of serious falls. His failing mobility made it difficult for him to wash, dress/ undress and manage his catheter, which the district nurse changed on her weekly visit. His kidney condition meant he attended hospital regularly for monitoring, taken by his daughter. He became confused if dehydrated or suffering a bladder infection, which occurred regularly.

‘The GP was kind but direct in describing the risks to Frederick himself and to his carers and family of the health hazards of his condition.’ Someone from Frederick’s extended family visited him weekly and helped him to maintain the garden, once his pride and joy. Despite this he often complained about being lonely although he wouldn’t consider attending a day centre. His son and

daughter held a family meeting with him and gently pointed out that he needed daily support with his morning routine which they couldn’t provide. He protested that he was alright but after some discussion eventually was persuaded to agree to an assessment meeting with a local home care agency. This went well and he accepted support from a small team of carers with whom a morning routine was established to suit his early rising habits. Six months later, on a visit to his daughter, Frederick had an incident when toileting and was taken to A&E where no obvious immediate cause was found and he was discharged home. A follow-up appointment for investigations was made but Frederick declined to attend, saying he was too old to be put through such procedures. Frederick continued to experience similar, unpredictable episodes and became increasingly unable to manage his personal hygiene. His carers and family found it challenging to keep him and the bungalow clean and sanitary whilst Frederick started to become very distressed. He again declined a further hospital appointment so the family asked the GP to visit to discuss the situation. The GP explored Frederick’s fears about the investigative procedures the hospital wanted to carry out and was sympathetic to his view

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that he is too old for any operation. Frederick insisted he wanted to remain at home and ’get by’.

‘Frederick now thrives in the care home, where his care needs and wellbeing are supported by the caring staff.’ The GP was kind but direct in describing the risks to Frederick himself and to his carers and family of the health hazards of his condition. They discussed the indignities he was suffering. It was clear that Frederick now needed care that was on hand and could respond immediately if and when an episode occured, whatever the hour. Sheltered housing with extra care could have been a possibility if Frederick had been prepared to move before he reached this level of infirmity. However, his needs had already passed beyond the threshold for placement in such a service and he reluctantly accepted the advice of his GP and family that the time had come to look for a care home. Frederick’s condition meant that he needed an en-suite toilet and shower and a single room large enough for him take some small pieces of furniture and a favourite armchair with him. He also wanted there to be a garden in which to be able to potter, with

assistance if necessary from his family on their regular visits. Frederick’s daughter researched homes in the area and telephoned to find out which had vacancies. This gave her an opportunity to check some of her father’s particular requirements and how well they would be received. She obtained brochures from several homes that seemed suitable, printed off the CQC reports and discussed these with Frederick and other family members. They arranged to visit the two they liked the most and were happy with what they saw. The manager of each home arranged a formal assessment of Frederick, including his medical conditions, communication, mobility and personal care needs, interests and background, and both considered they could provide appropriate care. This assessment formed the basis of a care plan when he moved in. Neither home had a vacancy but between the home care agency and family they thought they could manage for a while longer until there was a vacancy. The family used this period to help Frederick sort through some of his possessions and decide what to keep and how to dispose of the rest. They shared many fond memories, a few tears and a lot of laughs. Frederick now thrives in the care home, where his care needs and wellbeing are supported by the caring staff.

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Weâ&#x20AC;&#x2122;re here when you need us... Since 1983 our family have been running award winning nursing, residential and dementia care services which constantly exceed industry standards. Our philosophy is simple; Our residents and their families are at the heart of everything we do! Our homes extend a warm welcome to all visitors. Feel free to get in touch be calling 0843 506 9452, email info@countrycourtcare.com or visit our website at www.countrycourtcare.com Visit www.carechoices.co.uk for further assistance with your search for care 41

04 Foreword Starting your journey Understanding their needs Dealing with family pressures Support to live independently at home

Care and support at home When a loved one needs help to continue living their life as happily, safely and independently as possible in their own home, the different options available can seem daunting, often made all the more confusing by your desire to help your relative make the right choice.

Choosing care Care and support at home Choosing a home care agency checklist Residential care options Choosing a residential care home checklist Specialist Housing with Care Schemes Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal issues surrounding needing care Essential contacts Region-byregion care providers Advertisers’ index

Receiving care in their own home can be the preferred choice for many older people as it means they can remain in familiar surroundings, carry on with any social activities they may be involved in or see friends or family regularly. It’s worth bearing in mind, however, that if this is not the case and a loved one is feeling increasingly isolated or lonely whilst needing care, then a housing with care community, a care home or a care home with nursing may be the most beneficial option for them and their emotional, as well as physical, needs.

Home care Home care, also known as domiciliary care, involves trained care staff assisting your loved one with personal care tasks. These can include: • Getting up in the morning, washing, showering, bathing and dressing. • Preparing meals and helping with eating if needed. • Help with any specific social needs, including the prompting to take medication.

What are the types of home support?

• Helping with mobility – home care staff have specific training covering moving, handling and the use of hoists.

Home help

• Help to get to bed at night.

Home help will come into the home and offer support with a range of household jobs. These may include:

Care staff can visit your relative’s home every day for as long as necessary. Before a routine is set in place, visits should be arranged between the agency, your parent, you or anyone who may offer regular, unpaid support and anyone else who may be able to advise on your loved one’s care and support needs. This will look at your parent’s specific care needs and how they will best be met with support. A clear care and support plan will then be drafted. This way, everyone knows when visits are to be expected and the tasks the care assistant will support your parents with. If it would be more beneficial for visits to take place for shorter periods of time but more frequently, then it can be arranged for more than one visit to occur in a day. >>

• Cooking, shopping and gardening. • Helping with pet care. • C ompanionship and help with getting to and from social activities or appointments. • S mall maintenance jobs or installing security equipment such as emergency alarm, entry phone or key box. Home help doesn’t include personal care. If your relative doesn’t have any specific care needs but would benefit from additional company throughout the day and some help with small jobs around the house, then home help could be the right choice.

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CARE VISITS AT HOME & LIVE-IN CARE Caring for your lifestyle Care Visits With visit times ranging from 15 minutes right up to 24 hour-a-day Live-In Care, you benefit from as much or as little care as you require.

We offer everything from personal care to shopping, cleaning or social visits. In fact everything you need to stay in the comfort of your own home.

Live-In Care This provides a realistic alternative to residential care when flexible, full-time support is needed. Our service is tailored so that you, or your loved ones, can continue to enjoy an independent lifestyle in the comfort of your own home.

Please call to arrange a free visit from a friendly member of our team to discuss your care needs.

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>> Typically, care services are available from 7am until 10pm. Night-sitting can also be arranged, if needed, which can prove a really helpful service if your loved one experiences difficulties sleeping at night and a family carer may be struggling to cope with day and night demands. The hourly rates for this type of service vary depending on the specific services required, the time visits are arranged for and the location. If your relative lives in a more rural location then this may incur an additional charge to the hourly rate. Always ask for a clear breakdown of costs, any additional charges and whether they are reviewed annually before deciding on an agency.

Live-in care If your relative has demands which need

to be met round the clock but they feel happy to remain in their home; 24-hour live-in care may be the best solution for them. Some people prefer live-in care to moving into a care or nursing home. It can also be a useful service to offer short-term respite to a family carer who may be going on holiday or feels that they need a break or some support in the home. Short-term live-in care can also be used following a hospital stay if your loved one needs care but only for a limited period of time following their discharge. As well as all the tasks you would expect a care assistant to help with, live-in carers can also become great companions and provide assistance with other tasks that a loved one may be struggling with, such including running the household and accompanying them on social activities.

Johnâ&#x20AC;&#x2122;s home help John had lived on his own for two years, following the death of his wife. His daughter lived close by but worked full-time in a job with unsociable hours which made it difficult for her to assist him with the things he had begun to find difficult. Whilst he could maintain his own personal care, the daily tasks of cooking and cleaning were beginning to take their toll and he was becoming increasingly tired and stressed over what were once simple tasks to complete. He also felt he was no longer able to take his dog for daily walks but dreaded the thought of being separated from his closest companion. After a long discussion with his daughter and other family members who lived further away, John agreed to try daily home care visits to enable both him and his dog

to stay in the home he shared for so long with his wife. Every day, a care worker visits John for an hour to ensure that his dog receives the exercise that he needs as well as preparing his evening meal for him and carrying out the housework which was becoming too tiring. The companionship that his care worker provides also relieves a bit of pressure from his daughter who would often worry if she had to stay at work later and be delayed in checking in with her father at the end of the day. Having this home help has enabled John to live independently at home, surrounded by the things that are important to him whilst reassuring him that if a time comes when he needs further assistance, it is readily available to him.

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Choosing the right service As you head towards making such an important decision for your loved one, it is worth remembering that being as informed as possible may make the whole process feel easier. Be sure to contact several different providers that may be able to meet your relatives care needs. You can request a ‘Service User’s Guide,’ which you can read in your own time, ask for clarification of their charges and you can also ask to see a copy of the care providers’ most recent inspection report, and if they have been awarded a quality rating, that too. This information is also available from the regulator, the Care Quality Commission at www.cqc.org.uk or via the care search option linked to the Care Select website www.careselect.co.uk

‘The CQC inspects on Essential Standards of Quality and Safety, covering all aspects of the operations.’ The CQC inspects on Essential Standards of Quality and Safety so it can be an important area to familiarise yourself with whilst making your decision. The standards cover all aspects of the operations from involving your loved one in their care, ensuring they

are safe, the number of staff employed, the range of skills the staff have and the procedures they must follow.

Help in your search for care and support The Care Select website is a useful addition to this handbook. It has more information and gives you the opportunity to search for care provision in your given area via the publisher, Care Choices’, website (www.carechoices. co.uk). The interactive service, backed up with a friendly helpline enables you to look for providers based on your parent’s specific requirements. It will result in a tailor-made list of care services matching individual needs and preferences. Visit www.careselect.co.uk or call 0800 389 2077 to start your search for care and support.

Where to start If time allows and your decision isn’t an urgent one, research a number of different care agencies in your relative’s area. The Care Select website www.careselect.co.uk links through to comprehensive details of all care providers in a given region and can help you narrow your search. Alternatively, call the helpline 0800 389 2077. If you or your loved one knows of someone else locally who receives support at home, ask them for a recommendation. Although everyone is different so make sure you do your research. Make sure you check the agencies’

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inspection reports. All home care and live-in care providers are regulated and inspected by the Care Quality Commission which publishes inspection reports and quality ratings on its website www.cqc.org.uk. The agency should provide you with a copy of its most recent inspection report but they are available online if they don’t. Home helps are not regulated as they don’t deliver personal care. However, for peace of mind, check that they have had a Disclosure and Barring Service check to ensure they are suitable to work with vulnerable people. Disclosure and Barring Service checks have replaced CRB checks. When considering an agency, the manager should come to visit your relative and you, to discuss care needs and support requirements before any service is set up. They should also take into account your parent’s personal preferences.

assessment from their local authority, this will form a good starting point for conversations with any care agencies. Care in the home is provided by local and national organisations, large and small and there are many agencies that can support your relative. It is also possible to employ someone directly to undertake this role. If you feel unsure about the level of assistance your loved one may need, a care needs assessment by the local authority can help to identify specific needs and the type of care which may be most beneficial to your relative. If your loved one is funding their own care they can choose whomever they prefer to provide them with the care they need, as long as they are able to meet those assessed needs. If they are eligible for a local authority contribution towards their care then there may be certain considerations. It is best to speak to your relative’s local authority about this if they are conducting a care needs assessment. For more information on assessments see page 12.

‘When considering an agency, the manager should come to visit your Careful consideration relative and you, to discuss care Care or support to help someone to needs and support requirements remain living in their home can feel like before any service is set up.’ the most natural option to many and one A clear care plan is essential to set out your loved one’s specific needs and ensure they are fully supported. If your relative doesn’t agree that they need support, this may prove difficult. It may be that you’ll need to have a couple of meetings to discuss needs or look to an external adviser to help with the process. If your relative has had a care needs

that many feel obligated to strive for when considering a loved one’s wellbeing. There are differing levels of support in the home but if a relative displays an increasing attachment to their surroundings and home comforts, but their mental and physical needs are not being met, then it’s important to consider the right level of support to meet their needs – wherever the location.

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We work closely with you to help you make the right decision and provide a service tailored around your exact needs. We tailor our care packages to meet your individual requirements • Personal care • Nutritional support • Dementia care • Practical home help • Companionship • Help with medication • Domestic support

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Choosing a home care agency checklist These questions may be useful when considering using the services of a home care provider to help you build up a picture of how your relative’s care needs will be met in their own home. Agencies

Care workers

• What experience does the agency have in your relative’s particular field of need?

•

You should expect your relative’s personal preferences, dignity and privacy to be respected. Discuss this with the agency and ask how the most suitable care assistants for your parent’s particular care are chosen. Can you talk to them before deciding?

•

Care assistants should be fully trained or be in on-going training. Ask the agency about their policies on this.

•

Your relative will have a care plan drawn up by the agency which the care assistants will work to. Ask how often this plan will be reviewed by the agency.

•

Care assistants must be checked with the Disclosure and Barring Service (DBS) and have a criminal records disclosure – make sure this is the case.

• Can they supply references for you to check? •

Home care agencies providing personal care, must be registered and inspected by the Care Quality Commission. Ask to see a copy of their registration certificate and most recent inspection report.

• How long has the agency been operating? •

How many care workers would the agency assign to care for your relative and would they see the same one every day? If not, how does the staff rota operate?

•

What happens if the care assistant goes on holiday or is sick, will your loved one be notified in advance that a different person will be attending?

• How can the agency be contacted in an emergency or outside office hours?

Paying

• If you need to, how can you make a complaint? How are things then put right?

•

If your loved one’s care has been arranged privately you should check carefully the fee rates charged and exactly what the payment covers.

•

For care packages that have been arranged by the local authority, contracts and care plans will have been completed by the care manager and the agencies used will have been accredited to work for the local authority.

Ask for a copy of the agency’s contract terms and Service User Guide. Read these carefully. Ask any questions you may have before signing anything. The Citizens Advice Bureau or Age UK could help with this.

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Carte Blanche Care is a new family run live-in care agency, providing personal care to ensure that you or a loved one remain independent at home. We invest in our carersâ&#x20AC;&#x2122; learning by expanding their skill set to deliver a consistently high quality service. We believe that care should be personable, and we therefore provide care that is tailored to suit you.

For more information on our services contact us on:

T: 0208 399 5303 E: info@carteblanchecare.co.uk W: www.carteblanchecare.co.uk

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04 Foreword Starting your journey Understanding their needs Dealing with family pressures Support to live independently at home Choosing care Care and support at home Choosing a home care agency checklist Residential care options Choosing a residential care home checklist Specialist Housing with Care Schemes Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal issues surrounding needing care Essential contacts Region-byregion care providers Advertisers’ index

Residential care options The idea of moving a loved one into a ‘home’ can sometimes be one that people don’t feel ready to entertain and it can be seen as a last resort when it comes to sourcing the right kind of care for a relative. That’s probably because, for most people, what they hear or know about care homes are the snippets of news coverage, usually portraying a negative or sensationalised image of one particular care home. A more accurate picture of care homes can really only start to form when people are well-informed about their practices and values, and the benefits that they can offer to your loved one. The right care home can empower your relative, open up new opportunities and allow them to socialise in a way that they may not have been able to at home. Care homes and care homes with nursing can offer 24-hour care and support to your relative if they are no longer able to live independently at home and they require more intensive care than a home care agency is able to provide. Of course, every care home is different and making the right choice to meet a loved one’s particular needs, preferences and personality is the most important thing. They can provide peace of mind that in the event of something happening and you not being there, they are well looked after.

What is a care home? Every care home is different and some may be large hotel-type buildings with a high number of residents, sometimes divided up into smaller units, while others may be a smaller and more intimate setting. Generally, they offer communal living where your relative would have their own bedroom, usually with en-suite facilities. In some older homes, there may

be the option for couples to continue sharing a bedroom. Dining and living facilities are also shared, though some homes may offer a variety of dining and living rooms. Care homes are divided into two categories - those offering just personal care and those offering nursing care too. Some may specialise in care for people with specific medical conditions such as dementia.

Personal care If your loved one is becoming increasingly frail or in need of support and would like greater security and constant companionship whilst receiving personal care, then a care home offering only personal care may be the best option for them. The staff can assist your relative with a range of tasks including: • Washing and bathing. • Feeding. • Helping to dress or undress. • Help getting in and out of bed. • Continence care. You will find many care homes of differing styles across the country and it is worth exploring a few options before deciding on the best one to meet your loved one’s needs. Each home will have its own feel and it is important that it feels like home to your parent. >>

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W O N E N P O

THE ANGELA GRACE NORTHAMPTONâ&#x20AC;&#x2122;S PURPOSE BUILT PREMIER CARE FACILITY Cheyne Walk, Northampton A.G.E. Nursing Homes Limited, caring since 1984, has opened a NEW luxurious and prestigious CARE CENTRE in Cheyne Walk, Northampton. Ideally located to benefit from all the local amenities found in the heart of Northampton countryside. Facilities within the centre include a cafe, cinema, hair & beauty salon, reminiscence kitchen & specifically designed engaging outdoor environment.

For all enquiries: Tel 01604 â&#x20AC;&#x201C; 633282 or email admin@theangelagrace.co.uk Caring since 1984 A.G.E. Nursing is a trusted care home provider. Now offering both town centre and village locations. Our sister home Brockfield House - a delightful home in the village of Stanwick that is registered to care for 45 residents. Specialising in the care of people living with the after effects of long-term mental heath problems and those living with dementia.

Brockfield House

Nursing Homes Limited Caring Since 1984

Villa Lane, Stanwick, Wellingborough NN9 6QQ Tel: 01933 625555

>> Nursing care If your loved one has medical or nursing needs, a care home with nursing offers a higher degree of specialist care. They will typically offer: • 24-hour support.

Care homes as a short-term solution A care home isn’t always a permanent decision. There are a number of ways that a care home can meet a loved one’s needs for shorter periods of care.

• Registered nurse supervision. • H igher staffing levels due to higher needs of the residents. Care homes with nursing should only be considered if your parent has nursing needs that can only be met by a registered nurse.

Care needs assessment To determine which setting will best suit your relative and their particular needs, they will require a care needs assessment by their local authority. This can also help to alleviate any pressure you may feel in making the right decision about the specific care that they require. If your relative has been discharged from hospital into a care home, the discharge team should assess their needs before they are discharged to ensure that they are going into the right setting for them. A care needs assessment is completely free of charge and available to anyone who appears to need care and support; the assessment will determine the specific level of care your loved one requires and, therefore, help you narrow down your search for the best care home to suit their needs. They may also offer to undertake a financial assessment to determine how much your parent may need to pay towards their care – this is explained in more detail on page 94. To request an assessment, you should contact your parent’s local authority directly.

Short break or respite Short-term stays, short breaks or respite as they are sometimes known can prove really helpful to family informal carers. This stay in a care home can enable carers to take a break, possibly go on holiday or just recharge. It is possible to have a number of short stays in a care home throughout the year. These are chargeable and each fee will depend on the individual care home. Short-term stays in a care home can be particularly useful if a permanent move is something your relative is considering for their future. This stay enables them to become familiar with the home and see if the lifestyle may be suited to them. It also introduces the idea gradually so that your loved one can become accustomed to the home, staff and other residents. Of course, this luxury of time is only afforded if urgent care is not necessary.

Intermediate residential care If your family member is being discharged from hospital but isn’t yet able to return home then they may, depending on the policy in the area, be discharged into a care home. If they no longer have any acute medical needs and a prolonged stay in hospital is unnecessary then a care home may be a suitable setting for your loved one to rest and recuperate. If it is decided by the hospital, local authority and other professionals, that intermediate care in a care home is >>

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A Centre of Care & Excellence

Discover a haven that you will be happy to call home

Hertfordshire Luxury Care Home In a serene and peaceful location set in the midst of trees and yet within minutes of the centre of Hitchin is this superlative hideaway. Whether your needs are for long term, respite, convalescent or palliative care we have staff trained in the provision of optimal assistance in all these areas. We have an experienced team of care staff who can assist those with a range of physical and sensory issues, as well as a specialised dementia facility. We have plenty to offer including: • • • • • • • • • • • • • •

An artistically designed, spacious home with vast amounts of sunlight Luxury rooms with sumptuously equipped en-suites Beautiful vistas of the Hertfordshire countryside from your window Restaurant with an outside dining experience serving an a la carte menu A ‘Sow, grow & eat’ experience with our very own vegetable garden An on-site shop selling everything from stamps to clothing Sensory rooms to amplify your senses Exceptional gardens, grazing horses and an abundance of wildlife A hairdressing salon and nail bar for therapy Exercise rooms Dedicated GP consulting room, working in partnership with local GPs A Library Internal CCTV for comfort and protection Plus, an activity programme to tempt us all

For more details or to set up an appointment please contact us on 01462 410 767 or email us care@foxholescarehome.com. You can also visit us at www.foxholescarehome.com.

“Working with extreme passion to give the best care we can!”

Please see our virtual tour – www.foxholescarehome.com

Pirton Road, Hitchin, Hertfordshire SG5 2EN

John’s care isn’t our only priority. Being in good company is just as important. Of course, the quality of nursing care John receives is paramount. But socialising in a vibrant retirement community is what really makes a difference.

At Peterhouse Care Home we treat our residents like mums, dads, brothers and sisters because we understand how important family is. • Full CQC compliance • Compassionate, stable team • 3 acres of beautiful grounds

YOU CAN FIND US IN THE OLD TOWN OF BEXHILL-ON-SEA. Contact Hazel Silverlock on 01424 730809 or email gm.peterhouse@nabs.org.uk

A care home where your loved ones come first

www.peterhousecare.com Grange over Sands

Minehead

Our Westerley Christian Care Homes aim to provide the best in time of need for people looking for actively Christian residential care

Westcliff on Sea

in their retirement. A caring environment with permanent, respite or day care. A Christian ‘family’ with daily acts of worship. High quality en-suite rooms with comfortable lounges,

Woodhall Spa

homely atmosphere and a wide range of activities. The warmest of welcomes for you and your family and friends.

Call us now for a brochure or to arrange a visit Tel: 01702 342059 Email: homesadmin@lwpt.org.uk 56

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>> the best solution for your loved one, they will not be charged for the first six weeks of intermediate residential care. Typically, a placement will last for a maximum of six weeks, after which a decision should have been made as to any future care and support needs and how these will be paid for. Depending on what is best for your relative’s needs, this could be returning home with a home care package in place or a permanent move into a care home.

Temporary residential care This type of care can last up to 52 weeks with the aim of your loved one returning to their own home to live independently. It is a chargeable service, though it won’t take any property into account when assessing any contribution to the cost of the care (as long as the temporary stay does not exceed 52 weeks without good reason and subject to conditions). Instances when a relative may need temporary residential care can include needing to leave their home for any reason whilst major repairs or renovations are being carried out but being able to return once they are completed.

Choosing the right care home Sometimes the most difficult part of making a big decision can be knowing where to start. When it comes to choosing the right care home, a great starting point can be to look at the services within this issue of Care Select. The book is accompanied by a website www.careselect.co.uk which also links through to a searchable database of care providers. To make it as easy to navigate as possible, you can search by postcode, region or county and find out more detail about the providers in that particular area. At a glance, you can see how they

perform against essential standards of inspection and whether they have been awarded a quality rating, it also links through to the Care Quality Commission’s (CQC) website www.cqc.org.uk where you can read a full inspection report. There is also an option to request a brochure to be sent directly to you from the home. As with home care services, all care providers in England must be registered with the CQC. All care providers must be registered under a system which brings adult social care, independent healthcare and the NHS under a single set of essential standards of quality and safety. The Care Quality Commission (CQC) registers, inspects and reviews all adult social care and healthcare services in England in the public, private and voluntary sectors. This includes care homes, care homes with nursing, home care agencies and NHS services, amongst others. Inspectors carry out a mixture of announced and unannounced inspections looking at the quality and safety of the care provided. They look at whether the service is: Safe; Effective; Caring; Responsive to people’s needs; and Well-led. Inspection teams are led by an experienced CQC manager and often include experts in their field. The team may also include professional or clinical staff; Experts by Experience; people who use services and carers. Following an inspection, each care home and home care agency is given a report of how it rates against the national essential standards of quality and safety. CQC has also started rating services as ‘Outstanding’, ‘Good’, ‘Requires Improvement’ and ‘Inadequate’. By March 2016, CQC expects to have rated every adult social care service in England. This should make it easier for you to make >>

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Let’s talk about better care. 01442 899 000

Rose Lane Hemel Hempstead Hertfordshire HP3 9TE www.watermillhousecarehome.co.uk

Watermill House in Hemel Hempstead is a new purpose-built care home providing high quality residential, nursing and dementia care. It provides a high standard of living and outstanding facilities for residents including a bistro, spa and hair salon, private dining area, fitness suite and cinema. Both the care provided and the environment focus on independence, meaningful days and social interaction for residents and their families.

• Care focuses on an individual’s holistic needs enhancing wellbeing and quality of life • Highly experienced and trained nursing and care team • An uplifting, relaxing and homely environment with a high standard of décor • A full programme of lifestyle activities and events • Much needed support and reassurance for all the family

>> informed decisions regarding your loved one’s care. When considering care services, it’s always a good idea to check a service’s inspection report and rating on the Care Quality Commission’s comprehensive website www.cqc.org.uk or ask the care provider you are considering for a copy of their latest inspection report.

‘Your relative has the right to choose any care home that they would like to live in and that meets their needs.’ Your relative has the right to choose any care home that they would like to live in and that meets their needs. If they are funding their own place, they are free to visit and decide upon any care home, anywhere in the country. If the local authority is contributing towards the care place, your loved one still has the right to choose a home that can meet their assessed needs but there may be conditions. Also, if the cost of accommodation is higher than the local authority would usually expect to pay a third party, with the financial means, may be required to top-up the difference in cost.

Care home contracts If your loved one is funding their own care, they will have to sign a contract with the care provider. It is important to speak with an independent solicitor with experience in this field before you or your relative sign anything. Any contract should explain the cost of care, what services are included in this price and how often this is reviewed; how any medication will be administered, your

relative’s rights and the obligations of the care provider under the contract, the company’s complaints procedure and how the contract can be cancelled, if needed.

Important considerations It may be useful to make a shortlist of care homes with your relative discussing what is important to them. You may want to consider whether the home is close to where your relative’s current home is so that they can keep social ties? Would they like to be closer to other family members? Is there a choice of good local amenities or transport links? Consider what they want from their new home’s location, would they like a home with a garden? Once inside the care homes that your relative has chosen to look around, you should expect: • S taff should be friendly and caring in nature and take the time to get to know your loved one and interact with them. • T he home, staff and management should always take into consideration your relative’s personal, cultural and religious wishes and ensure they are incorporated into daily life. • T he environment should always be clean and welcoming so that it can make your loved one feel as at ‘home’ as they possibly can. • R esidents should be engaged, staff should be approachable and the atmosphere should be agreeable. When moving into a care home, your relative should never be expected to leave their rights as a citizen at the door. It will be their home and they have the right to live as normal a life as possible, whatever that means to them. This will include the right to: • B e treated with dignity, respect and sensitivity.

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Becket House Nursing Home Pitcher Lane, Loughton, Milton Keynes, Buckinghamshire MK5 8AU Situated in the prestigious village of Loughton, specialising in Dementia Care and Nursing for the Elderly. • Long and short stay

• Local GP service

• Visiting clergy

• Respite and convalescence

• Personal laundry service

• No restrictions on visiting

• Varied menus and special diets

• Regular activities and outings

• Visiting hairdresser & chiropodist

Tel: 01908 231981 Email: manager@beckethouse-carehome.co.uk Web: www.beckethouse-carehome.co.uk

Carleton Court Residential Home Carleton Road, Skipton, North Yorkshire BD23 2BE Residential Home for the Elderly with genuine care, professional staff, a warm and welcoming environment. • Managed by a qualified team

• Elegant, comfortable surroundings

• Single en-suite rooms

• Close to local amenities

• Special diets catered for • Nurse Call systems in all public rooms as well as bedrooms

Tel: 01756 701220 Email: info@carletoncourtskipton.co.uk Web: www.carletoncourtskipton.co.uk

Rosebery House Residential Home 2 Rosebery Avenue, Eastbourne, East Sussex BN22 9QA The home specialises in providing care for people suffering from Dementia and Alzheimer’s. • Long and short stay

• Varied menus and special diets

• Next to the park

• Respite and convalescence

• Personal laundry service

• No restrictions on visiting

• Local GP service

• Regular activities and outings

• Visiting hairdresser & chiropodist

Tel: 01323 501026 Email: enquiries@rosebery-carehome.co.uk Web: www.rosebery-carehome.co.uk

Simply Care Home

>> • Privacy and their own space. • B e as independent as they can and want to be. • D ecide for themselves what they do or do not want to do. • G o where they want as long as it is safe to do so. • B e involved in all decisions about their care at all times. • E xpect the home to keep them fit, alert and stimulated and support them in daily living. • K eep in touch regularly with friends and family and expect the home to facilitate this. • E xpect that the routines of the home, such as meal times, will suit their needs. • B e offered the opportunity to be involved in activities taking place inside and outside the home. • H ave any complaint they wish to raise dealt with quickly, fairly and efficiently.

‘When moving into a care home, your relative should never be expected to leave their rights as a citizen at the door.’ Who’s who in a care home? There are lots of different people in a care home and it can help to familiarise yourself with who does what and the part each person will play when it comes to your loved one’s daily care.

Registered manager The registered manager is in charge of the day-to-day regulated services within the care home. They are also responsible for ensuring the home meets the national standards. They must be qualified to NVQ

Level 4 in Leadership and Management for Care Services (formerly the Registered Managers Award), registered with the Care Quality Commission, and fully DBS checked. They may be the first person you come into contact with when you start to look for a suitable care home or they may pass you onto somebody else in the team depending on the size of the home. They may also be supported by a deputy manager.

Care assistant Care assistants deliver the day–to-day care and support in care homes and are the people who your loved one will come into contact, and hopefully bond, with the most. A good care assistant should be caring, personable, compassionate and friendly. It is also important that they are patient and supportive. They should be DBS checked and will have completed a 12-week induction training which covers national minimum standards of care which will enable them to work towards further qualifications. Senior care assistants may take on more of a management function whilst also having a caring role.

Activities co-ordinator A good care home should offer your relative the opportunity to participate in daily activities and enjoy their life to the full. Some homes will have a dedicated activities co-ordinator who interacts with residents to provide a range of meaningful activities to interest and stimulate them. They will encourage everyone to participate, including staff, but will also respect that sometimes people don’t want to join in or would prefer to do something else. The types of activities can range from bingo or card games to helping with gardening, laying the table or folding washing. They may also arrange

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events such as garden parties, Christmas parties or coffee mornings.

Ancillary staff Care homes will also have ancillary staff depending on their size, including administrators, cooks, housekeepers, laundry assistants and gardeners. Everyone should work together to support your loved one to lead their life the way that is best for them.

Give it time Beginning to think about a care home as a permanent setting for your parent can be emotional. It is a big decision and you may find that people within the family have their own ideas about the best course of action to take. It is important that families try to support each other as much as they can and even more important to support the loved

‘It is important that families try to support each other as much as they can and even more important to support the loved one whose life is changing.’ one whose life is changing. They should be at the heart of all decisions and their wishes considered. It is a process that should take patience and planning to get right, if the situation is not the result of an unexpected emergency. With plenty of research, an accurate care needs assessment and enough time to visit a number of care homes you should be able to find the right home to support your relative to feel confident and happy.

FAR FILLIMORE CARE HOME • Accommodation for 26 residents • 2 double rooms for couple sharing • Long and short term respite care • Large landscaped gardens

“Home away from home”

• For elderly people and people with Dementia • Group activities • Palliative care • Local GP visits

Wood Lane, Hanbury, Burton-on-Trent DE13 8TG Telephone: 01283 812 180 • Email: farfillimorehome@aol.com • Web: www.farfillimore.co.uk

NIGHTINGALE COURT CARE HOME • Accommodation for 43 residents • Long and short term respite care • Regular group activities • Sensory room

“Offers a sense of togetherness”

• For elderly people and people with Dementia • Palliative care • Sensory gardens • Local GP visits

11/14 Comberton Road, Kidderminster DY10 1UA Telephone: 01562 824 980 • Email: nightingalecourt@btconnect.com • Web: www.nightingalecourtcarehome.co.uk

LITTLEOVER NURSING HOME

“Premier nursing home”

• Accommodation for 40 residents • Specialise in palliative care with unrestricted visits • Regular group activities and entertainment • Within walking distance of shops and post office • Local GP visits • On-site nurse 149 Stenson Road, Littleover, Derby DE23 1JJ Telephone: 01332 760 140 • Email: littleovernh@aol.com • Web: www.littleovernursinghome.co.uk

“Warm, friendly and professional residential homes”

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Choosing a residential care home checklist Home 1

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Home 2

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Home 3

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First impressions • Are staff warm, friendly, polite, clean and respectful? • Do the residents seem happy, active and sociable?

• Can you handle your own money?

• Does the home feel homely and welcoming?

• Does the home provide its own transport?

• Is the home fresh, clean and comfortably furnished? Accommodation • Are bedrooms single or shared? Is there a choice? • Can you decorate and arrange your own room? • Can you bring your own furniture and TV? • Is there a call system for emergencies? • Can you control the heating in your room? • Can you lock your room/secure place for valuables? • Is there a separate dining room? Bar? • Are there both adapted showers and baths? • Does the home have the right adaptations and equipment to meet your needs? • Are all areas safe and accessible (e.g. for wheelchair users)? • I s there adequate provision for sight or hearing difficulties?

• Does a hairdresser/chiropodist visit?

• Do staff have appropriate language skills/knowledge? • Are the staff formally trained? • Is there an adequate number of staff on day and night? • Are visitors welcome at all times? Can they stay overnight? • May your visitors join you at meals? • How much choice do you get about meals? • Is the food varied and interesting? • Can the home cater for your dietary needs e.g. Black and Minority Ethnic diets? • Can you have snacks or drinks any time? In your room? • Can you continue to pursue your hobbies? • What activities and entertainment are organised?

• Are the grounds/gardens attractive and/or quiet?

• Are outings and holidays arranged? At what cost? £ ........................................................................

Life within the home

Fees and contract terms

• Are there any rules and restrictions (e.g. going out, returning)?

• How much are the fees? Do they cover all services available? £ ........................................................................

• Can you choose when to get up and retire every day? • Are residents involved in decisions on life in the home? © Care Choices Ltd 2015

1 2 3

• What arrangements are there for religious observance? (e.g. are places of worship nearby/Is there a prayer room)?

• Under what circumstances will the fees alter? • Can you retain your own room if away?

• Can you make and take calls in privacy and comfort?

• Can you have a short-stay or trial period?

• Is alcohol served or permitted?

• Will you be given a statement of terms on admission?

• Are there smoking and non-smoking areas?

• Are all procedures clearly spelt-out?

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Specialist housing with care schemes Beyond home care and residential care homes, there is another, perhaps lesser known, option for older people who may need support with daily living or more companionship. Housing with care is a concept which combines independent living, a home with security of tenure, along with care and support services. By promoting social wellbeing, housing with care schemes can empower older people by combining independence with security whilst meeting additional care needs at the same time.

Who would use housing with care? Due to its nature, there are no real definitions of housing with care schemes however, terms you may come across whilst exploring this option include sheltered housing, very sheltered housing, retirement housing, assisted living, extra care or close care. Provider organisations can take quite different approaches to type of tenure, care services and provision of amenities and facilities. There is no real example of which type works best because its success would depend entirely on your loved ones particular interests, preferences and needs.

‘Housing with care can be a great solution for older people. It is a mid-ground for many people and a happy compromise.‘ Typically, though, housing with care is suited to older people who would like to live independently but may prefer to be

close to other people with whom they can share interests; people who may struggle with the practicalities of managing the family home but don’t need the 24-hour support of a care home, couples where only one partner needs support; and people who want the peace of mind of living in a supported environment. Housing with care may have levels of care and support on site or arranged by external companies. Your relative would have the security of their own home with a link to an on- or off-site manager, warden or care provider. Housing with care schemes may also offer services arranged by the organisation that manages the site or a contracted company including: • H elp to arrange or receive care services. • C are staff visiting at arranged times delivering agreed care services. • On-site care staff. • On-site care home. • A restaurant or dining room offering meals. Housing with care can be a great solution for older people. It is a mid-ground for many people and a happy compromise.

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The level of support can be increased as your relative’s needs develop and those with on-site care homes can enable families to become familiar with the services long before they may need them.

Finding a scheme The best place to start is the Care Select website www. careselect.co.uk, as it accompanies this handbook and can offer more information than we can cover here. It also links through to the Care Choices website www.carechoices. co.uk which will enable you to search for care and support by postcode, town or region and it also has a housing with care search. Once you have made a shortlist of services in your chosen area, make arrangements to visit the service and meet with the manager. Organisations such as the Joseph Rowntree Foundation have been commissioning research into housing with care since the first continuing care community was established in the UK in the late 1990s. The Foundation is a research and development charity which works in partnership with the Joseph Rowntree Housing Trust to understand the root of social issues, one of these being how to help ageing people have a better quality of life within their surroundings. Their website can provide useful studies and reports into the various housing with care models and how they can meet older people’s needs. If you’d like to read around the subject of housing with care, visit www.jrf.org.uk

Different forms of housing with care As mentioned on page 65, it can be difficult to form a true definition of housing with care but the following are the most common terms you may come across when looking into the scheme:

Sheltered housing Also called retirement housing, sheltered housing is designed for older people who want to remain living independently but with the reassurance of having assistance on hand in an emergency. Schemes are available both to buy and rent and typically consist of 15 to 40 dwellings. Some sheltered housing schemes are designed to meet the needs of older people and are linked to a community alarm. Many schemes have a scheme manager or warden either visiting or based on site as well as the community alarm service and there may be communal facilities such as a lounge, laundry, guest flat and garden. Meals are not usually provided but a few schemes may include a restaurant and some can arrange hot meals.

Extra care housing When a retirement housing scheme offers on-site personal care – the kind of services available in a residential care home (without nursing), it is more likely to be called extra care housing. Extra care housing describes developments of self-contained homes with design features and support services enabling self-care and independent living. They can be popular with people with disabilities, or those who are frail or >>

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Where older people love living Snapshot of Sunrise • 27 beautifully-appointed communities throughout the UK • High quality 24 hour residential care from our dedicated team • Personalised, individual care plan

When it comes to senior care, Sunrise continues to set a standard that is, quite simply, exceptional. Our focus - pure and simple - is to do everything we can to make sure that your dignity, independence and choice comes first. Everything we do is born from a commitment to providing only the very best care to older people; from assisted living and nursing care to our ground-breaking Reminiscence neighbourhood bringing comfort to those living with dementia and memory loss.

Don’t just take our word for it. Visit sunrise-care.co.uk to find your local community. 0808 231 3352

sunrise-care.co.uk

• Nursing, dementia care and assisted living • Freshly cooked, nutritious meals served in our beautiful dining room • Activities programme seven days a week • Regular outings and musical entertainment • Landscaped gardens and beautiful interiors offering all the comforts of home • Single and couples suites available

>> whose health needs make ordinary housing unsuitable but who don’t need or want to move into residential care. They may provide a high level of services and facilities, such as on-site domestic support, meals and recreational facilities, as well as one- or twobedroom self-contained accommodation. Wheelchair accessibility and level access showers are often at the heart of their designs and this type of housing can be owned, rented, part-owned and partrented or leasehold. Some developments may mix these types of tenure.

Very sheltered housing Very sheltered housing is a form of extra care housing. Usually provided by the private sector it enables older people who are becoming increasingly frail or need more assistance, to retain their independence in a home of their own for as long as possible by providing meals, domestic assistance and 24/7 housekeeping staff cover. It can be housing that sits between traditional sheltered and modern extra care.

Assisted living Assisted living is similar to very sheltered housing and extra care housing. It is privately-provided, shortterm rental properties with care services for older people who can no longer live on their own at home but don’t need round the clock, complex medical supervision. Should they need additional assistance, it is easy to arrange through the management team, available 24-hours a day.

Retirement/care villages Retirement or care villages offer a variety of accommodation specifically for older people. They have many community facilities and a typical

retirement village may have one-, twoor three-bedroom flats and bungalows, to buy or rent, and a restaurant, clubroom, shop, laundry and cleaning services, leisure facilities and perhaps a medical centre, care staff and a minibus. The size of these developments means they are often in rural locations or on the edge of towns, not very close to public amenities but are extremely popular with their residents.

Close care Close care schemes are usually small - often six to 25 flats or bungalows on the same site as a care home. Residents can purchase additional services such as meals, personal care and cleaning directly from the care home.

How to make the right choice If your loved one feels that housing with care may be right for them, it can be helpful to think about what makes that particular scheme distinctive when trying to match it with your relative’s needs and wishes. Things to consider should include: • E ntry criteria – Having criteria to meet upon entry is generally to give priority to those needing the services on offer. It also ensures that the specific needs of residents match the level of care services available. • S ize – Some places can be small whilst larger schemes can be termed ‘villages’ because of their ability to house a large number of people and offer a wide variety of facilities and amenities. • L ocation and design – Is it in a town or the countryside? This would also determine the level of local amenities on offer and how easy it is to get to. Is there public transport or adequate >>

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The best possible care... In Whiteley Village Care Centre, our highly trained, award-winning nurses and care staff meet the individual needs and choices of our residents from residential care, through to nursing, respite and end-of-life care, in a safe and peaceful environment. The UK’s original retirement village. Nestled in 225 acres of beautiful and tranquil Surrey woodland. Reg. Ch. 1103056

In the best possible environment... Residents are able to enjoy the beautiful surroundings and be part of village life in a friendly and caring community. The Village was described by HRH Prince Charles as a “national treasure”. Family and friends are welcome to visit at any time.

01932 857821 www.whiteleyvillage.org.uk

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>> parking for family and friends to visit your loved one? Is there wheelchair access? Would they be able to accommodate your relative if their care needs increased? • Cost and affordability – The cost of care will depend on your loved one’s individual care needs. As with residential care homes, self-funders will have to pay for personal care services, whilst social services may contribute towards services for those who have been assessed as eligible for a contribution. It is also worth considering the type of tenure that is right for your parent. Will they want to buy their property or rent it? Not all sites offer a mix of tenure so it’s important to consider the options available at any schemes being considered. Visit prospective schemes, meet the staff and, if possible, talk to the residents. There may be a guest room so if your parent would like a trial stay, ask if that is possible in order to get a feel for the lifestyle and whether it may be suited to them.

How to purchase or rent Purchase Most buyers finance their purchase through the sale of their house.

Shared ownership The purchaser buys a share in a property and the developer, housing association, local authority or managing company owns the remainder and is let to the owner. Most buyers finance this through the sale of their house. Speak to the scheme you are considering about how this works with them as some schemes vary.

Market rent The resident rents from the owner at a fixed price. Sources of finance include annuities, pensions, investments or proceeds of the sale of a house.

Social rent This rent is subsidised by the State. This form of tenure is generally reserved for ex-local authority and housing association tenants and for those unable to raise sufficient capital for the sale of their property or from other sources. In these situations your parent may be eligible for Housing Benefit. In all cases, speak to the company running the scheme or the local authority about how the process works with them and the options they offer as it can differ from scheme to scheme.

One size doesn’t fit all Housing with care offers older people the opportunity to live independently, maintain a social life and interact with others whilst knowing care and support can be on hand if needed. As with all types of formal care, whilst it can meet a number of needs that older people may have, it is worth remembering that perhaps not all care and support needs can be met within the schemes. If your loved one has dementia or can display behaviours that are challenging then it is important to make sure that a scheme can cater to their needs. There are many different options in many different locations so ensuring that you and your parent have taken the time to consider what they want and need from a scheme is essential. This way, they are more likely to find something that best suits the way they want to live.

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Was it the right decision? Deciding whether the choice of care or support is the right one can be difficult to gauge. Your parent may be resistant to change and may take a while to settle into the new routine. There are ways to consider whether there are simple teething problems of more significant problems underlying.

Settling in

Talk to staff

If they have had a comprehensive assessment of their situation, whether by the local authority or your chosen care or support provider, a plan will have been put in place for your parent. The service or home you all selected will be suited to their identified needs and expressed preferences. You will have been assured that the chosen provider is capable of meeting those assessed needs and can offer a personal service that builds on that professional knowledge. No less important, after talking with you about your parent’s personal history and preferences, staff should feel that they have a better understanding of their new client’s ‘back story’. It may feel that it is almost inevitable that after so much change – possibly even turmoil - arising from a possibly sudden, and certainly fundamental series of changes that there will be a settling period in which things are more fraught than any of you might have hoped for. If your parent isn’t settling into the new routine or environment and change of life, how can you tell if it’s teething problems or something more serious? Is the cry of, ‘Take me home, please’ or the reluctance to engage with visiting care staff, a sign of something worrying or simply a reaction to the situation – a change from the past where your parent was capable, independent and ‘in charge’.

It is distressing if you face someone you love looking unhappy and to appear, to them at least, to be disinterested or unprepared to take any action. If you are confronted with such heart-rending appeals for help, you should seek another opinion. Ask the manager, a senior care worker or the member of staff identified as your parent’s ‘key worker’ for some time to talk through your concerns. No matter how busy they might appear to be they ought to make time to reassure you, or to address any underlying problem that may be contributing to your parent’s distress. They will be aware of the situation you describe because it is a very reasonable and not at all unusual reaction to such a big set of changes – experience suggests that it can take many weeks for things to settle down. There is no absolute timescale that can be applied in such circumstances, and you may have to steel yourself for this emotionally taxing situation to be repeated for some time.

Don’t let it get you down However, if the content of these ‘cries for help’ changes from general unhappiness and a wish to come home or cancel the service, into specifics such as, ‘Don’t leave me here, when she’s on duty,’ or ‘They don’t take me to the toilet when I need to go’, you will need to pursue this so as to satisfy yourself that your parent is being

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Was it the right decision?

looked after appropriately. It may be that the member of staff has been picked out because she is associated in your parent’s mind with something unsettling, such as the first time a hoist was used to transfer to or from bed, or when waiting too long to be taken to the toilet, resulting in an upsetting indignity. Your own observations are likely to be as important as any professional reassurance, and you are likely to see many examples of the sort of tenderness and kindness that leads many relatives to describe staff as ‘going the extra mile’.

‘Not addressing concerns can lead to a loss of trust and getting to a point where it becomes difficult to ever feel confident that you have made the right choice.’ Managers would prefer you to raise your concerns with them rather than letting worries build up and fester. Not addressing concerns can lead to a loss of trust and getting to a point where it becomes difficult to ever feel confident that you have made the right choice, and that your parent can be assisted to lead as full and rewarding a life as is possible. Care staff know that you may continue to feel guilty – at least until such time as you can see your parent thriving again – because you feel that you, perhaps, could have done more to support them to carry on living alone at home, with lots of support. It’s always worth measuring such feelings against the objective reality that the level, complexity and intensity of support and specialist knowledge and skills deployed to care for your parent is way beyond the capacity of a wellmeaning and loving family member.

Keep on talking Nothing will be resolved by deciding to stop raising your concerns with the manager or care staff, so if you continue to be perturbed by your parent’s difficulty settling-in, or later on after the teething troubles have been overcome, you should make an appointment to talk things through with the manager in greater detail, giving them time to have pulled together all relevant information. If troubles persist you may want to consider using the provider’s complaints procedure in order to have the problem fully investigated and hopefully resolved. It’s also worth thinking about passing on your compliments in a similarly formal way – letting the manager and staff know how grateful you are for a ‘job well done’. Thank you cards are always welcome because they can be displayed on a notice board in a care home or agency office, using your satisfaction as a way of conveying confidence to others – perhaps another new client’s relative, going through the same doubts as you have experienced, will be encouraged by your words and experience.

And if problems persist The most extreme situation will be if you decide that your relative will benefit from moving to another home or care provider. Think very carefully before considering this option. Problems may persist because your parent is inconsolable at the loss and failure they associate with no longer being independent and maintaining a home of their own, rather than living alongside of others or having daily support. They may see living with others or receiving care in their home, even though they have their own private space, as too much of a compromise about almost everything, even when great care is taken to support

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them to live independently at home or offer choice around every dimension of daily living in a care home. It will be important to all parties for you to demonstrate that you see yourself as being in partnership with the provider and its staff and that you want things to work out for the best. A good home or provider – and most of them are, most of the time – will want to work with families to ensure the best possible care for their clients and to focus on promoting well-being and fulfilment rather than fire-fighting recurrent gripes that can be easily resolved.

Some people settle into these changes with ease, whereas others don’t. If your parent isn’t settling, is distressed and not engaging with the new service, take your time to try to get to the bottom of things. It might be teething problems, it might be something else. Speak to the provider about their experiences and the solutions they may have to help. They should be forthcoming and willing to support your parent to settle. If this doesn’t help, over time, you may want to consider a new provider or home, but make sure it is a carefully thought out decision as it can be a big upheaval.

Keeping Betty clean Bill and Ann were generally fairly happy with the way things seemed to be going at the care home that Bill’s mother had moved into a few months earlier. They had overcome most of the doubts they had felt initially about Betty’s ability to adjust and live alongside of others. But one thing continued to bother them – she complained about a particular member of staff, someone whom they had got to know and who appeared very pleasant. Betty was uncharacteristically scathing and unpleasant about this woman. When they decided to talk with the deputy manager about their mother’s description of the carer, and to express their alarm about the relationship with this woman, it became clear that the carer was the person who had responsibility for organising Betty’s bath. Betty fought, literally, against being

bathed. She did not enjoy this at all – viewing it as clinical, undignified and just too quick. It became obvious that the bath embodied elements of all that Betty had feared about living in a care home. She had always enjoyed the sensory experience of a long, relaxing soak in the bath, rather than the necessity of being washed. Together the home and Ann, who had been assisting Betty in the months before she moved into the home and therefore enjoying her confidence, devised a plan for Ann to assist the carer as a way of subtly shifting the balance for cleanliness alone to cleanliness with pleasure. Over time, Betty became more comfortable with the carer and her baths, although still a functional way of keeping Betty clean, returned to being enjoyable, relaxing experiences.

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Gordon’s story Following a serious illness, Gordon, a widower in his 80s, was discharged from hospital into a care home to recover. His assessment declared that he was unable to manage at home alone, even with domiciliary care support. He felt pressurised to agree with this assessment and had relented to give up his home, but he was very unhappy in his placement. His daughter, Joan, recognised that Gordon was becoming depressed and withdrawn but the demands of her young family and work limited the frequency of her visits. The home’s manager was unresponsive when Joan raised her concerns and Joan was worried that pursuing them further might have adverse repercussions for her father. They explained the situation in confidence to Gordon’s case worker at the local authority, Sandra, and asked her to consider finding an alternative home.

‘Finding the right support for the right person can be tough.’ Gordon’s placement had been hurriedly made in order to free a hospital bed, and he had virtually no choice in the process. He was a down to earth East-ender, mentally very alert although physically frail, and the other residents did not have the same level of capacity. The home, which met the required standards

on inspection, was large, with comfortable en-suite rooms, but felt rather impersonal to him. Sandra knew that Gordon was entitled to exercise choice but care home places are in scant supply and she was doubtful about finding anywhere else. After a few weeks, a place became available in a smaller, less modern home with a long-standing, very outgoing manager. It had a stable staff team who engaged residents in numerous lively activities, creating a warm ‘open house’ atmosphere, and there were always visitors around. Gordon visited with Joan and liked what he saw, so he decided to move in. Joan called a few weeks later to check how he was settling in and found her father much changed. He was enjoying his food, mealtimes were a social occasion, and his physical condition was improving. A beaming Gordon told her that he wished he’d found this place years ago as he hadn’t felt this happy in ages. Whilst some elderly parents may deny that they are not coping and resist the idea of support at home or residential care, others may have clear views about what type of care they need. There are a wider range of services now available other than traditional home help or residential/ nursing home care, including live-in care or personal assistants. Finding the right support for the right person can be tough but exploring the options and considering their personal needs and preferences can lead to the right solution.

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04 75

Dementia and dementia care What is dementia? There are currently 850,000 people in UK with dementia - of those - more than 40,000 are under the age of 65. Many believe dementia means losing their memory to the point where they do not recognise loved ones. Most do not know that it can start years before it becomes that severe and early signs can be as unassuming as losing the thread of conversation.

‘Each person experiences dementia differently and their circumstances may change over time.’ Dementia describes a set of symptoms that may include memory loss, mood changes and problems with communicating and reasoning. The symptoms of dementia occur when the brain is damaged by certain diseases. Dementia affects people in different ways and the onset of the condition will vary depending on the disease. Dementia is predominantly a condition that affects older people but it is indiscriminate of social class, gender or ethnicity. Alzheimer’s disease is the most common form of dementia, but there are over 100 other varieties including vascular dementia, frontotemporal dementia, and Pick’s disease.

Foreword Starting your journey Understanding their needs

Each person experiences dementia differently and their circumstances may change over time. Therefore their care needs should be carefully considered around them, their needs, wishes and current condition and monitored closely as their condition develops and symptoms or behaviours arise. Identifying support networks and getting proper assessments when changes are noticed is essential.

Dealing with family pressures Support to live independently at home Choosing care Care and support at home Choosing a home care agency checklist Residential care options

How can dementia be supported at home?

Choosing a residential care home checklist

As many as two-thirds of people with dementia live in the community. The home can be a safe and familiar environment when a person’s cognitive ability begins to change. However, as the condition develops, people often need increasing amounts of support. As time goes on, older husbands and wives may begin to find caring for their loved one increasingly hard as they have to help them get up in the morning, get washed, feed them at mealtimes and help them to the toilet. Providing this level of care can become too much, especially if the carer has their own health problems. Additional support may be available from adult social care, but many pay for private care. As with other conditions, a local authority care needs assessment can establish your relative’s specific needs and whether adult social care will provide any support. For a person with dementia >>

Specialist Housing with Care Schemes

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Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal issues surrounding needing care Dementia Essential and dementia contacts care Dementia Region-by-– spotting the region care first signs providers Residential Advertisers’ dementia care index checklist

Princess Christian Care Centre

Located close to Woking, in the heart of the Surrey countryside, Princess Christian is a purpose-built centre providing specialist Residential or Nursing care for elderly people who have been diagnosed with Dementia. The Home offers varied and modern en-suite accommodation, outstanding amenities, and is staffed by a dedicated and highly skilled team of Nurses and carers.

Excellent facilities

Set off a quiet rural lane in beautifully landscaped gardens, the centre comprises individual en-suite accommodation for over 90 residents. Rooms are spacious, airy and equipped with all modern amenities. Other amenities include: a sensory room to aid relaxation, physiotherapy services, an onsite hair salon and a purpose-built cinema showing a varied programme of popular films.

Information

We welcome new residents from social services and the private sector. We maintain an open-hours visiting policy, which means relatives and friends are welcome to drop by and see their loved ones at any time of the day, seven days a week. Please also call for information on Convalescence, Rehabilitation and Respite Care services.

Our philosophy:

“The wellbeing of our residents is central to all that we do. Our focus is always on the individual, and we are committed to enabling each person within our care to lead an active and fulfilled life, based on dignity and choice.”

Call 01483 488917 or email princess.christian@nellsar.com www.nellsar.com

Care Services offered:

• Dementia Care • End of Life Care • Nursing Care • Nursing Dementia Care • Rehabilitation • Residential Care • Respite Care, Short Breaks & Day Care

>> this could be someone coming into the home to help in the morning and at mealtimes. Carers should also be assessed, enabling them to access invaluable services including respite care.

more information on what’s available in your area. With the right support and assistance, people can live well at home with dementia, however as with all aspects of care and support, it’s not one-size-fits-all.

Implications of living at home with dementia

Innovation and technology within the home

While there are many benefits to living at home, including familiar surroundings and support networks, it can be isolating if people live alone and people with dementia can struggle to access the support they need. It is essential that health and social care services are designed around the needs of people with dementia. People with dementia and family carers can live well at home if they have access to good quality, integrated care that is affordable.

Having dementia can make day-to-day life more difficult and increase the likelihood of accidents at home. Mistakes like leaving the tap on or the gas unlit can make any home potentially hazardous. Assistive technology, if used in the right way, has the potential to aid memory and recall and increase independence and autonomy both for the person with dementia and those around them. Simple touches like automatic calendar clocks can be helpful and labelling cupboards or rooms can prevent disorientation. However, it is really important to note that people react differently to different products. Where possible, decisions about alterations in the home should be made by those with dementia. If not, those responsible must have the person’s best interests at heart and be mindful that unfamiliar additions to the home can cause distress rather than comfort. For more information on technology and innovation in dementia, the Alzheimer’s Society has an ‘assistive technology’ factsheet, available on its website www.alzheimers.org.uk

‘With the right support and assistance, people can live well at home with dementia, however as with all aspects of care and support, it’s not one-sizefits-all.’ There are also a wealth of local initiatives and services provided by the voluntary sector that can help people with dementia to live well at home. There are even courses for family carers and other members of the public to help them to manage daily life and the changes that dementia brings. Your local Age UK, Alzheimer’s Society or even home care provider may have

Issues concerning more vulnerable sufferers living at home As dementia develops family and friends may worry more as their loved one’s behaviour changes. At the first >>

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Growing old is inevitable Growing up is optional

Our care homes treat every resident as an individual and their families as our guests; and of course we offer exceptional levels of nursing, dementia, and end of life care. 01564 820140 www.caspiacare.co.uk enquiries@caspiacare.co.uk

Elliscombe House 01963 33370

If you have any questions or if you are unsure about what care you or your loved one needs, you can speak to one of our care experts who can discuss your options with you.

Hurst Manor 01935 823467

Hendford

01935 470400

>> sign of concern, it’s best to seek help immediately, as the right support and information often offers an answer to the issue. For example, some people with dementia may go for walks, at first it may seem they do not have a purpose, and it can be referred to as ‘wandering’. However, they may want to walk and be walking with purpose - the solution is to find out how they can do it safely.

‘Although a move to a care home can be an emotionally difficult time, for some, the consistency and quality of care provided is higher than they can provide themselves.’ For those who are not the primary carer, they may worry their loved one could be mistreated and taken advantage of. People with dementia can be particularly vulnerable to abuse and mistreatment. Dementia can also make it harder to detect when abuse is taking place. The person with dementia may not have the capacity to understand what they are being told to do or they may not have the cognitive ability to remember what has happened to them. Both financial and physical abuse can be reduced with greater training for carers and the right support and information. To prevent physical abuse

within a family setting it is vital that carers receive adequate provision of respite breaks, day care and home care services. In addition, carers must be given the right support and information. There are things you can do; Alzheimer’s Society ‘Top Tips for Carers’ is a useful place to start and is available on its website www.alzheimers.org.uk

When the time comes for a care home As a person’s dementia progresses they will need more support and care, and there may come a time where full-time residential or nursing care is needed. If the person cannot make this decision for themselves, it often comes down to their carer or the wider family. Being prepared for this eventuality early on, and having discussions as early as possible, can help to make this decision slightly easier when the time comes. Prior to making this decision, consider whether housing with care would be appropriate. Respite care is another option. It offers a chance to experience residential care on a short-term basis and gives the carer a break. It may also help to discuss the decision with a social or health care professional, such as a social worker, GP or consultant. Often they can give their professional opinion on the type of care that a person needs. A social worker can review the needs assessment, which can help with deciding the level of care required and the right care setting to meet those needs. Although a move to a care home can

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be an emotionally difficult time, for some, the consistency and quality of care provided is higher than they can provide themselves. There are also social benefits of living in a care home such as the interaction and friendships that are built between residents and the activities that care homes can provide. Talking about relatives’ continuing involvement in the care of their loved one with the staff of the care home may help when deciding whether it is the right solution.

How can dementia be supported in care homes? It is thought that more than 70% of care home residents have dementia or severe memory problems. Consequently, there are many care homes which have a full appreciation of the complexities and difficulties of dementia, and are able to cater to the individual needs of each resident. Not all care homes, however, are suitable for people with dementia, so choosing the right home is key. A good care home will focus on the individual rather than their dementia. This approach is known as person-centred care – it takes into account the individual’s unique qualities, interests and needs. Often this can be achieved through small but significant actions, like finding out what they like to be called, or what their preferred daily routine is. Equally their beliefs can shape many aspects of their lives, and explain why they do certain things. Where possible the individual, or a relative, fill in a leaflet by listing likes, dislikes, hobbies and habits - it can then

be shared with care workers so they can understand more about the person with dementia. Ask specific questions to explore the care home manager’s understanding of person-centred care - a ‘good’ answer would be one that recognises the emotional needs of insecurity and loss and an attempt to respond to these needs.

‘Not all care homes, however, are suitable for people with dementia, so choosing the right home is key.’ A suitable care home should also provide a range of activities that are meaningful. Research has shown that the availability of activities and opportunity for occupation is a major determinant of quality of life. Whatever stage of dementia they are at, giving residents interesting activities to occupy them throughout the day can transform the environment – this could include daily tasks from laying the table or folding laundry to music and art therapy. We all know people with dementia can live well if they have timely access to the necessary support and care that they need throughout their dementia journey. If someone is worried about their memory, or the memory of a loved one, it is best to seek advice from your GP. The earlier people seek help, the sooner they can get information, advice and support.

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Dementia – spotting the first signs It is easy to joke about your own, or a relative’s, forgetfulness from time to time and it can be a common reaction to brush it off as ‘senior moments’ or an inevitable part of the ageing process. Memory problems can be due to a number of reasons and dementia affects everyone in different ways but if you are worried that a loved one could be displaying symptoms of dementia then it can be helpful to know other signs to look out for.

The key symptoms to look out for include: • S truggling to remember recent happenings but being able to recall things from the past. • F inding it hard to follow conversations or programmes on television. • F orgetting the names of friends or common everyday objects. • I nability to recall things they have heard, seen or read. • R epeating themselves or losing the thread mid-conversation. • Having problems reasoning. • Feeling anxious, depressed or angry. • F eeling confused even in familiar surroundings.

What to do next If you’re worried that a relative could be showing signs of dementia, encourage them to visit a GP. It is understandable for them to feel fearful and resistant to the idea, so it may be helpful if you or someone close to your relative offer to go along with them as well. There are many reasons for memory loss

apart from dementia – these include depression, infections and vitamin and thyroid deficiencies. A GP will be able to test for treatable conditions and rule out other reasons for confusion such as poor sight or hearing, emotional upsets from perhaps a bereavement or a move, or the side effects brought on from certain drugs. If however, the visit does lead to a diagnosis of dementia, it means you can get access to information and details of the support available, so it’s worth getting it checked out as early as possible.

What does the assessment comprise? The GP will first look at your loved one’s medical history for other conditions which might affect memory and cognition. You can expect the GP to spend some time talking to your relative and the person accompanying them, to ascertain some of the symptoms. Normally a GP will carry out a physical examination and a number of tests such as blood and urine to identify other conditions that may be causing the confusion. They may also ask a series

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of questions to test thinking and memory. The GP may want to send your loved one to a memory clinic for further specialist assessments. A diagnosis of dementia is made in memory clinics and can take from four to 12 weeks to diagnose if scans and other investigations are required. If tests do not indicate dementia, patients may be invited back every six to 12 months to monitor symptoms.

What treatments are available? While there is no known cure for dementia, there are drugs and other therapies that can help with the onset of symptoms. With a combination of these treatments, lots of people can live well with dementia for many years. Dementia is a collection of symptoms that result from damage to the brain. These symptoms can be caused by a number of conditions and there are different types of dementia. The most common form of dementia is Alzheimer’s disease. It is well worth finding out which type of dementia a loved one has so that treatments and support can be tailored to their specific needs.

cognitive stimulation therapy. It is likely that you will be put in touch with local services offering support or your loved one may be offered the chance to attend groups or take part in activities that could help you and any carer to cope better.

Simple tips to cope with memory problems If your relative is having difficulty remembering things, you may like to suggest some of these ways of helping them cope.

For everyday life • Use ‘to do’ lists. • B reak up tasks into small chunks to make them seem less overwhelming. • Do one thing at a time. • T ry to have a routine to give a structure to each day. • T here’s no rush. Tell them to take their time.

Memory aids • W ear a watch, use clocks and put up a calendar to help keep track of time and dates. • K eep a diary to help you remember appointments and ‘to do’ lists. • U se sticky reminder notes.

‘While there is no known cure for dementia, there are drugs and other therapies that can help with the onset of symptoms.’ Drugs aren’t the only way to treat or manage the symptoms of dementia. There are many other things that can help people to live well such as talking therapies, reminiscence therapy and

• K eep important things like keys, money, glasses in the same place. • K eep a list of important phone numbers by the phone. • A rrange to pay important bills by direct debit or standing order. People living with dementia can be supported by early diagnosis, simple methods to manage the changes and support and guidance to live on a daily basis.

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Beechcroft Manor Nursing Home Our newly refurbished 18 bedded Nursing Home Home provides a smaller friendly environment caring for older people and adults with physical disabilities. We strive to promote independent living, preserve dignity and maintain privacy at all times. We provide: • Specialist Dementia nursing care

• Palliative care

• Person-centred nursing care

• Respite care

• Fully vetted/trained staff

1 Beechcroft Road, Alverstoke, Gosport, Hampshire PO12 2EP

 02392 583908

 www.thecontemplationgroup.co.uk WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF I MAKE THE WRONG CHOICE? WHAT IF MUM DOESN’T AGREE? CAN WE AFFORD IT? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

KIMARA

SUPPORT

We are committed to providing a service that is flexible and realistically tailored to your needs. Our staff are respectful, professional, flexible, resourceful, positive, problem solving and have a realistic view of life’s complications. We employ specialist learning disability nurses and so are the ideal choice for people with learning disabilities. We also employ experienced personal assistants who provide support to the elderly, frail, physically disabled, infirm or those with sensory disabilities. Our services include but are not limited to • • • • • • • •

Personal care Keeping safe at home and out in the community Developing independent living skills Activities of daily living (shopping, laundry, cleaning, gardening, filing and general organisation) Accessing social, religious or cultural activities including holidays Accessing employment, education or training Managing finances Social Companionship

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 Call the Care Select Helpline - 0800 389 2077 - for more information

KIMARA

SUPPORT Tel: 0203 291 3436 • Fax: 0203 727 0836 Email: info@kimara-support.com

Residential dementia care checklist Things to look for in care homes specialising in dementia. Please use in conjunction with the care homes checklist on page 64.

Residents The best indication of a good home is that the residents appear happy and responsive. • Are there rummage boxes around the home to stimulate residents?

Access If the person with dementia needs or is likely to need equipment or adaptations you may want to check: • There is adequate signage and cues for different parts of the home such as dining room and bathroom. • The home’s policy about locking external doors.

Bedrooms You may want to find out whether the person with dementia can have a single room and whether:

• Residents are encouraged to bring in some of their own furniture and possessions to increase familiarity.

Activities Residents should be stimulated without feeling stressed. • Are reminiscence activities available?

• Are residents able to compile memory boxes? • Do staff compile life story books including photographs and mementoes?

Staff It is important to note whether staff seem friendly and caring towards residents and whether they treat residents with respect. • Do they have any training and experience in dementia care? • Will the person with dementia have a member of staff particularly responsible for their care? • Is there a member of staff you can talk to about your own worries about the person with dementia?

Manager/head of home A manager who is caring as well as efficient can make all the difference to a home. •D oes the manager have knowledge of dementia and can they deal with difficulties that may arise in an understanding way? • I s there a full assessment at home before a resident is admitted?

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Thinking of end of life care

04 85

Every minute someone in the UK dies, but for many of us talking about dying and facing up to our own mortality and that of our loved ones remains something we ignore or avoid for as long as possible.

Foreword Starting your journey Understanding their needs

People deal with the prospect of a parent or family member reaching the end of life in different ways, and there’s no right or wrong approach. You may be aware that there are warning signs that one of your parents, for example, could be coming towards the end of their life, but other family members may not agree or may have conflicting views on whether or how to approach this. Or, it may be that a family member wants to talk about their end of life wishes but that you or others in your family aren’t ready to have this difficult conversation. You only die once. It has been said that what we fear most about dying is the associated loss of control. By giving parents the power to express their wishes much of the control can be restored, and opportunities to live well until they die can be maximised.

Key facts • A round 40% of adults say they have made a will. • 2 9% have let someone know their funeral wishes. • 6 % have written down wishes or preferences about the care they would want if they couldn’t make decisions. • 5 1% of people with a partner were unaware of their partner’s wishes. • N early two thirds of us would prefer to die at home, but around half of people die in hospital.

We need to talk about dying Talking about dying may not always be easy but it can help people to make the most of life.

Dealing with family pressures Support to live independently at home Choosing care

‘People deal with the prospect of a parent or family member reaching the end of life in different ways, and there’s no right or wrong approach.’

Care and support at home Choosing a home care agency checklist Residential care options

Without communication and understanding, terminal illness or approaching the end of life can be a painfully lonely and stressful experience both for the person dying and for their friends and family. Addressing the subject of dying with a parent, whether the likelihood is still years off or more imminent, can help the whole family plan and hopefully see through as many of their wishes as possible. This can make the whole experience a better one for everyone.

Broaching the subject Nobody wants to be the first to bring up and start such a depressing and emotional conversation but many have reported that bringing it out into the open can be a relief and allow others the chance to talk about their own death too. Try to choose the right place and the

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Choosing a residential care home checklist Specialist Housing with Care Schemes Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal issues surrounding needing care Essential contacts Thinking of end of life care Region-byregion care providers Advertisers’ index

right time to start the conversation. Avoid stressful situations and gauge how happy your parent is to talk about their future. Maybe use discussions about retirement or care planning to bring up their final wishes too. There’s no right or wrong way to address the topic of dying but here are a few sensitive suggestions:

‘Try to choose the right place and the right time to start the conversation. Avoid stressful situations and gauge how happy your parent is to talk about their future.’

Consider • T hough others may initially want to change the subject when you talk about dying, talking about it will ultimately make everyone’s lives easier. • Talking about dying doesn’t have to be depressing and humour can be a real help. • If your parent is worried about talking about death with those they love, suggest they perhaps talk to someone else they respect and trust like a nurse or friend. • D on’t be so worried about saying the wrong thing that you don’t say anything.

Why plan ahead? Starting the conversation • Broach the conversation with a question rather than a statement, ‘Have you ever wondered what would happen…?’; ‘Do you think we should talk about…?’ • Sometimes it helps to start with something direct but reassuring, like, ‘I know that talking about these things is never easy…’ or ‘We’ve never talked about this before but…’ • It may be easiest to ask people about what they definitely wouldn’t want – as a way of getting the conversation started. • Encourage everyone to be totally honest about how they feel from the start. If you’re all open, there may be both laughter and tears – don’t be afraid of either.

• D on’t leave it too late to have important conversations about life and death. • F or those with a terminal illness, or approaching the end of their life, it makes sense to make plans for care in advance. It involves thinking and talking about wishes for how your relative is cared for in the final few months of life which can make things easier for partners or family members. It could include where a loved one would like to die, if they wish to be resuscitated or if they want to refuse any kinds of treatment. • By discussing these questions with your relative, you are ensuring that you don’t have to make the difficult decisions on your own later on.

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Planning dying well In the checklist below are some of the areas that people often leave too late to discuss. Because it may not be easy to talk about, you could leave this with your relative for their consideration. When planning ahead for yourself, it is important to think about all the things you want well in advance, talk to your family, write it down and keep it safe.

1. Consider legal and financial matters • Plan for your future care and support, for example by setting up a Lasting Power of Attorney and writing an advance care plan. • Write a will, setting out who gets what in order to avoid difficult legal problems for your family – and make sure you take legal advice if needed. • If you need to, make sure you make financial plans to ensure the people you care about are protected.

towards the end of your life. • Where you would like to die. • W hether you have any particular worries you would like to discuss about being ill and dying. • W hether you want to be resuscitated or not.

3. Save other lives - through organ donation • I f you want to be considered as an organ donor then it’s essential you register and share your wishes with those close to you. Or you may want to make arrangements to leave your brain or body to medical research, e.g. to help with dementia.

4. Consider how you would like to be remembered • W hat would you like people to know before you die?

• M essages, memory boxes, videos • Record your funeral wishes so your for loved ones. family know what you would like, and WHAT ARE THE CARE OPTIONS? consider how funeral costs would be Prepare for bereavement HOW WILL I KNOW WHICH TO5.CHOOSE? met. WHAT IF MUM DOESN’T AGREE? • I f you need help or advice, find out 2. Make a plan for what you want where to go for support.

VISIT NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK whenTHE you die • F ind out what to do about legal • The type of care you would like

and financial matters after death.

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As the end approaches Wherever your parent is being cared for, in their own home or a care home, you should be confident that the people charged with caring for them will have the necessary training to help make their end of life as comfortable as possible. A good understanding of someone’s wishes can help to avoid unnecessary admission to hospital. Most people would prefer not to die in a hospital and with good planning the care staff should help to ensure this happens. Care staff should assess your parent and be familiar with their specific wishes. Each organisation should have its own end of life care policy, ask your parent’s care provider of their policy and training on the subject. End of life should be a sympathetic time and care staff, whilst being professional, will also be sympathetic and understanding of the situation and the emotions surrounding it.

‘The Gold Standards Framework (GSF) helps doctors, nurses and care assistants provide the highest possible standard of care for all patients who may be in the last years of life.’ The Gold Standards Framework Living with, or caring for someone, who is nearing the end of their life or who is living with a life-limiting condition can be demanding, stressful and emotional. Feeling confident that the person you are living with, or caring for, is receiving

the right care, in the right place at the right time, all the time, undoubtedly helps ease those concerns. The Gold Standards Framework (GSF) helps doctors, nurses and care assistants provide the highest possible standard of care for all patients who may be in the last years of life. It is clear training the professionals need in order to provide co-ordinated, joined-up care, so that no matter what stage of their illness your relative or loved is at, or where they are being cared for, everyone involved in their care knows about their wishes and is best prepared to ensure they are fulfilled. GSF helps link together all of the people who provide this care to prevent people from falling through the cracks. Many care homes have completed GSF training and some have received GSF accreditation so they have demonstrated that they are properly identifying the people who need special care at this time of their life, assessing what they need and planning their care in close conjunction with them and their families and carers. GSF accredited care homes are twice as likely as other care homes to care for people in the home up until the end. That means very few inappropriate admissions to hospitals that can be distressing for all concerned. GSF encourages doctors, nurses and care assistants to talk to their patients at the earliest and most appropriate time, about how and where they want to be cared for. GSF accredited GP surgeries are in a better position to provide the individualised care that people want. People nearing the end of their life deserve the best care - the

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‘gold standard’ of care. That means high quality, reliable and consistent support. GSF encourages doctors, nurses and care home staff to help families and carers too, so they can work together to avoid ‘crises’. Better planning of people’s care means a last minute prescription panic or something more major can be averted. Speak to your relative’s care provider about GSF and how they approach end of life care.

Palliative care Palliative care (from the Latin ‘palliare’: to cloak) focuses on the relief of pain and other symptoms and problems experienced in serious illness. The goal of palliative care is to improve quality of life, by increasing comfort, promoting dignity and providing a support system to the person who is ill and those close to them. Palliative care is appropriate for anyone of any age who is facing serious illness. It can be delivered alongside active treatments designed to try to prolong life at an early point in the disease process. It is also applicable at the end of life and into bereavement. Palliative care neither hastens nor prolongs death. It makes the most of life, even when time is limited. It regards dying as a normal process. Palliative care can be delivered in any care setting, including at home, care homes, hospitals and hospices. Hospices provide palliative care services at home, in day care centres or hospice inpatient units. Most people who have inpatient hospice care return home once their needs for care support are addressed.

Team delivery In palliative care, decisions about treatment and care are made with the help of the members of a multidisciplinary team and in line with your parent’s personal goals and preferences. Team members usually include doctors, nurses and social workers. Occupational or physiotherapists, chaplains, pharmacists, nutritionists and others might also form part of the team.

‘The goal of palliative care is to improve quality of life, by increasing comfort, promoting dignity and providing a support system to the person who is ill and those close to them.’ Myths about dying Many of the preconceptions of dying stem from our childhood and images we see on television and in films. Some are wrong but as many of us don’t talk about dying a lot, these misconceptions grow. Don’t let the myths get in the way of planning properly for how you’d like yourself or your parent to live at the end of their lives.

The most common myths Myth 1: There’s no point in thinking about dying Thinking about death does not bring it any closer. If we think about it a little in advance, we can plan for the kind of death we’d actually wish for. Encouraging your parent to make a will,

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decide what kind of care they’d like, or just practical things to help those left behind, can make the last days easier and help reduce feelings of regret. People who have gone through this process report being able to get on with life more happily and the same goes for those caring or supporting them.

Myth 2: Most of us will die in hospital – it’s inevitable Currently in the UK, it’s true that more people die in hospital than elsewhere, but that doesn’t make it inevitable as increasing numbers of people are getting the support they need to be able to die in their own homes. Some will die in hospices, care homes or supported housing. Planning ahead and talking to the health or social care team and encouraging your parent to write down their wishes may make it more likely that they will die where they want to.

Myth 3: It’s better to keep family in the dark to protect their feelings Being honest about illness or dying with those you love can be hard, as no-one likes causing avoidable upset. Facing illness together can bring people closer, take away unanswered questions and make the situation easier for all to cope with.

Myth 4: Death is generally very quick or very painful TV and films often portray deaths that happen in a romantic, violent or very quick way but everyone’s death is different and often the dying process is gradual. If people are given good care, there is no need for them to be in pain.

There are many different medications available to doctors and nurses to control pain and although morphine is one of them, it does not mean someone is going to die if they are being prescribed it as a controller of severe pain.

Myth 5: Everyone is vulnerable and powerless at the end of their life Many people remain in control because they’ve prepared for a time when decision-making won’t be as easy. Leaving instructions for where and how they’d like to be cared for, when they would like treatment to stop and who they would like to make decisions for them.

‘Being honest about illness or dying with those you love can be hard, as noone likes causing avoidable upset.’ Practical help There are a range of organisations that can help you and your parent to plan the support and care they need towards the end of life, advise on writing wills and advance care plans, and provide advice on the emotional issues surrounding dying. Dying Matters www.dyingmatters.org and the NHS Choices websites are useful starting points www.nhs.uk/Planners/end-of-life-care You can also find information about a range of practical services to support people approaching the end of life, their family and their carers at http://help.dyingmatters.org/

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Are you a family carer? While most major life changes are clearly signposted and easily recognisable as an event which will affect your life hugely, becoming a carer isn’t usually one of them. Whether caring for a loved one has been thrust upon you suddenly or evolved over a long period of time, the fact that it can feel like the most natural thing in the world may make it understandably difficult to take a step back and recognise that you have actually become a carer. If you are supporting a relative or friend with daily living tasks then this may be you. It can be a confusing, exhausting and emotional time and it is common to reach a point where you feel you need a support system of your own.

‘Caring can be extremely complicated. The maze of rights and entitlements can be complicated. Filling in paperwork can be complicated. Getting a break can be complicated. Our feelings about caring can certainly be complicated.’ Carers UK

Caring is commonly identified as when a loved one steps in to support someone they know at the point where they begin to need that extra support to get by. It may be that they’re struggling with their memory and need a little prompting with certain things or as mentioned above, they need some help with day-to-day activities. Informal carers provide a variety of emotional or practical support, and are often more inclined to say they are just helping out a family member, doing what’s expected of them or being a supportive friend rather than as a ‘carer’.

Looking after yourself Understanding your role Just like the individual, no two caring roles are the same. Taking the time to identify your role will also help to identify your needs. One carer might be responsible for managing their relative’s finances, whilst another might need to help their loved one bathe, get in and out of bed, or assist with going to the toilet. When daily tasks such as cooking, cleaning and shopping are ones that your relative can no longer keep up with; this is usually where your journey of an informal carer begins.

Caring can be a really rewarding experience which may make you feel happy, comfortable and fulfilled in the role you undertake as a carer. However, it can also be stressful. If you are taking on the sole responsibility as a carer whilst trying to juggle other responsibilities such as family, work and more, it can have an impact on you. Shifts in relationships which have been the same all your life can also be hard to deal with, particularly when it’s a parent you’re caring for, and it can be an emotionally difficult time to see their

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Are you a family carer?

health and independence decreasing. You may even find that they are resistant to your support which can also put a strain on the relationship. These situations are very common and there are organisations out there to help, who can offer advice, guidance, or even just a place to meet with other carers and have a break. Your local authority, local Carers UK branch or Carer’s Trust may be able to point you in the right direction of local support.

‘Carers have rights and one of them is the right to receive a carer’s assessment from the local authority where you appear to have such needs.’ It’s worth remembering the importance of looking after yourself too. Caring can be both a physically and mentally draining process, and it is easy to forget that you have your own needs to attend to. Try to set aside regular time for you, to do something you enjoy and take your mind off of your caring role. There may be short breaks available in your area where you can arrange for the person you care for to visit a day centre or have a formal care worker support them while you take a break. Consider other members of your family who may be able to relieve you once in a while. Also, make sure you raise your caring role with other family members. Many people don’t speak up about their caring role once they have assumed it and relatives at a distance may not realise the true extent of what

you do. Communicating with everybody around you can help and always speak up if you’re starting to struggle.

Your rights as a carer Carers have rights and one of them is the right to receive a carer’s assessment from the local authority where you appear to have such needs. The person you care for doesn’t need to be receiving services from the authority for you to request an assessment. Informal carers play an important role in society and your needs should be considered by the authority to support you to carry on caring whilst also continuing with your life. The local authority will consider the impact of caring on you and your dayto-day life and what you want and need to achieve in your own life. It must also consider other important issues, such as whether you are able to carry on working or studying whilst you care for a loved one. Contact the local authority to ask for a carer’s assessment as you may be entitled to support, services or carers’ related benefits. As a carer you may be entitled to Carer’s Allowance. This benefit is granted to those who look after someone with substantial caring needs. You don’t have to live with the person you care for, but you do have to be over the age of 16 and spend at least 35 hours a week caring for them. For more information on Carer’s Allowance and whether you are eligible, visit www.gov.uk/carers-allowance If you work as well as undertaking a caring role, you have employment rights including the right to request flexible working hours from your employer. You

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may want to speak to your employer about your caring role if you are finding balancing both roles difficult.

Being practical To aid your caring role and your relative’s independence, you may want to consider aids to daily living. These can range from hand rails to help them get around the house, a mobility scooter, raised chairs or kitchen aids. The range of things on offer is vast and the chapter ‘Support to live independently at home’ on page 20 covers this subject in more depth. Telecare and telehealth services are also available which use technology such as personal alarms and motion sensors to help people to live independently in their own homes and give you, as the carer, peace of mind that they are safe and well.

Caring after a hospital stay Sometimes the unexpected happens and you might suddenly find yourself in a position where you need to provide immediate care. You might not have considered yourself a carer up until this point, and coming to terms with this new and potentially stressful situation can seem daunting. If your relative has been in hospital, you may need to prepare for their return and offer support to help them get back on their feet. Before your relative is discharged, they should have received an assessment of their care and support needs. This will assess whether they need formal care and support, whether they are entitled to a short-term period of rehabilitation or whether they need specific aids to assist with their daily living. All details and instructions regarding future care should be discussed with you, as their carer, by the relevant social worker prior to release.

If your relative requires care or support services, a care plan should be drawn up to set out what is required, and a financial assessment may be carried out to determine any charges for services.

Keeping the balance Most people don’t choose to become carers when the person requiring care is a relative, it is often more a case of falling into the role. As a result, a shift in the dynamics of a relationship takes place, which can be unsettling for everyone involved. Just as your loved one has to come to terms with being cared for, you too have to come to terms with your new role of responsibility, and this can put new strains upon relationships and provoke feelings of resentment or frustration.

‘There are over 6.5 million informal carers in the UK; accepting the role as a family carer can be a daunting task, but there is an abundance of resources and support which can aid you.’ All of these feelings are completely normal and natural. It’s crucial to remember to take care of yourself just as much as you ensure the needs of others are met; consider researching respite stays or accessible holidays, that way both you and your loved one can enjoy a much-needed break. The important thing is to know that you’re not alone. There are over 6.5 million informal carers in the UK; accepting the role as a family carer can be a daunting task, but there is an abundance of resources and support which can aid you.

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94 04 Foreword Starting your journey Understanding their needs Dealing with family pressures Support to live independently at home Choosing care Care and support at home Choosing a home care agency checklist Residential care options Choosing a residential care home checklist Specialist Housing with Care Schemes Was it the right decision? Dementia and dementia care Dementia – spotting the first signs Residential dementia care checklist Thinking of end of life care Are you a family carer? How is care funded? Legal How isissues care surrounding funded? needing care Legal issues Essential surrounding contacts needing care and support Region-byregion care providers Advertisers’ index

How is care funded? Getting the right care arrangement is one issue; understanding care funding is another. Many people believe social care, like the NHS is free at the point of delivery – this isn’t generally the case. Social care is usually a paid-for service with only those meeting national care and financial eligibility criteria, following an assessment by your relative’s local authority, being able to claim assistance with funding.

Care needs assessment The way through the current maze of complexity for all starts with securing a free care needs assessment from your relative’s local authority. As explained elsewhere in this handbook, this assessment aims to establish physical care needs and also any unique specific needs related to emotional, religious and cultural wellbeing, as well as the best location for care, taking into account the need to maintain family relationships and links with friends. Carers are also able to ask for an assessment of their own needs. Not everyone wants an assessment of their needs, however this is the first step to understanding what support may be required, is available locally and the costs involved.

Funding healthcare needs Medical care If your relative is assessed as having ‘primary healthcare needs’ then the NHS will pay for all your relative’s care. This means their healthcare needs (e.g. the services of a nurse) as well as associated social care needs (e.g. personal care and domestic tasks, including help with bathing, dressing, food preparation and shopping) will all be provided free of charge. If care is provided in a care home, then the NHS will pay

for all the fees including board and accommodation. This is known as a ‘Continuing Healthcare Package’. If it is considered that continuing care is needed then the local authority will involve a multi-disciplinary team in a joint assessment of needs although the local NHS Clinical Commissioning Group (CCG) will have responsibility for funding. A place in a care home will also be free if your relative: • I s receiving intermediate NHS care for a six week period to facilitate recovery, avoid hospital admission or premature entry into long-term residential care. Or: • T hey are a war pensioner who needs disability-related skilled nursing care (funding in this case is provided by Veterans UK, which is part of the Ministry of Defence).

Nursing care Similarly the NHS will pay for nursing care provided in the community or in a care home. Funded Nursing Care (FNC) - or Registered Nursing Care Contribution (RNCC) as it is sometimes called - will usually be paid directly by the CCG to the care home that employs the registered nurse. In residential care homes, the community nursing service

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will usually provide the required care as part of their rounds. Those already self-funding their care in a nursing home employing a registered nurse will benefit from a reduction in their costs once the CCG starts paying for the nursing aspect of their care. In some cases, the need for nursing care may mean that your relative will be advised to move from the family home to a care home or from a long-term residential care placement into a care home which is able to provide the required level of nursing support. At this time eligibility for a full NHS Continuing Healthcare package should be considered. Ask your relative’s current care provider, GP, local authority or CCG for more information about NHS Continuing Healthcare and eligibility criteria.

Personal/social care funding When the need for care is not primarily health focused then the local authority will consider whether your relative needs personal/social care and support. From April 2015, under the Care Act, a national minimum need threshold for eligibility has been introduced that should be applied consistently across England. Whether or not any care found to be needed by your loved one will be provided free of charge will depend on the outcome usually of a detailed financial assessment of your loved one’s means. In some circumstances a less intrusive ‘light touch’ approach assessment may be appropriate but you should make enquiries about options. Although you may feel there is little

chance that your relative will ever be eligible for financial support, from April 2016 a lifetime care cost cap will be introduced, initially set at £72,000. Whilst a new daily living charge set at £230 per week will be introduced at the same time, the lifetime care costs cap, means that the State will meet the cost of eligible social care needs above this cap. As a result, this may alter views about the merits of assessment. Generally an assessment, undertaken at the point of finding there is a need for care, will assist to clarify options, affordability and the arrangements required to cover costs. It will also ensure that the local authority starts a record (a care account) enabling a tally to be kept of your relative’s own expenditure on care, which from April 2016 will start to count towards the ‘lifetime care costs cap’. The ‘eligible amount’ under the Care Act is effectively the usual cost the local authority pays for the relevant type of care locally that will be sufficient to meet your relative’s assessed eligible needs. It is the record of self-funded eligible expenditure which will determine the point at which assistance from the State may kick in to help your loved one. It is possible to register personal expenditure without undergoing means testing and before April 2016 you should ask your relative’s local authority for details about the various approaches best suited to your relative’s situation.

Financial assessment The financial means assessment calculation can be complicated. It looks to establish available or ‘eligible’ means taking account of various property and

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income, disregards as well as benefit and other allowances which can, of course, alter when moving into a care home. The key details are discussed below. However, you may well feel the need for independent personal advice about investment, legal estate and property issues. The local authority will also help signpost you to organisations and providers with whom you can discuss your relative’s support needs, the services available and the costs involved. Presently, there is an upper capital limit for support set by the Government at £23,250. Someone with capital and savings above this figure will not receive any financial support towards the cost of meeting their care needs. This means they are classed as a ‘self-funder’ who will have to pay for their own care and support. If your relative is assessed as being a self-funder then they can choose any care provider they want at any price they can afford. Local authorities may, though, assist to arrange the care subject to payment of a fee. If your relative has capital and savings below £23,250 but above the lower capital limit of £14,250 then they will be assessed as having income amounting to £1 for every £250 between these capital limits. They may receive some financial support from the local authority but will be expected to contribute their income towards this cost, subject to any income disregards and the Personal Expenses Allowance set by Government. Indeed, even when your relative’s savings have dropped below the lower capital limit they will be expected to contribute eligible income, above the permitted personal expense allowance, towards their care costs. The permitted personal expense allowance (currently set at £24.90 per week) is regarded as pocket-money that

may be retained for use by your relative to budget for clothes and expenses such as hairdressing not provided as part of a care package. Your relative’s local authority can advise further on the specifics of the financial assessment process. You should note that any assessed contribution your relative may have to make now towards their care may change in the lifetime of this handbook and with the changes coming into force under the Care Act in April 2016. If your relative is already paying for their care then seek advice from your relative’s local authority to ensure all appropriate assessments have been undertaken and that a record of personal expenditure on care, counting towards the lifetime care costs cap, will be kept.

Permanent property disregard Where care is provided in your loved one’s home then the value of their home is completely disregarded in the financial assessment. If your relative has chosen to enter a care home then the capital value of their home will also be disregarded entirely if their spouse, civil partner or partner lives there or if an estranged or divorced partner, who is a lone parent, lives there. The value of their property will also be ignored if a close relative continues to live there who is over 60 or incapacitated, or if your relative has a dependent child living in the property. The local authority may also exercise discretion and disregard the value of the property if someone gave up their own home some time ago in order to live with and care for your relative before they needed to move into a care home. Again, it is important to speak with your relative’s local authority about this. >>

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Temporary property disregard

If your relative moves into a care home temporarily for a trial period or for respite care but plans to move back home then the value of their property will be disregarded. It can be disregarded for up to 52 weeks or longer in exceptional circumstances. If your loved one moves into a care home permanently and is the sole owner of their own property then the value of their home will currently be disregarded for the first 12 weeks unless it is sold before this period ends. If your relative has been paying for their own care fees and their capital has diminished to bring them into the financial bracket entitling a contribution from the local authority to funding then the ‘twelve-week property disregard’ will not be available.

Income disregards Everyone is permitted to retain a personal expense allowance currently amounting to £24.90 per week for spending on personal items. A larger amount may be allowed for those having to pay standing charges on a house in the process of being sold or to help support a partner at home make payments for repairs or paying joint debts. The local authority will ignore 50% of income from an occupational pension or retirement annuity used to support a partner living in your relative’s home and the following types of income are not included in the financial assessment:

Payments). • Pension Savings Disregard. • Christmas bonus. • Winter fuel payment. • C hild Tax Credit or Guardian’s Allowance. • £ 10 per week of War Widows’, War Widowers’ or War Disablement Pension. • I ncome from a mortgage protection policy.

‘If the local authority is undertaking an assessment of your relative’s care needs or finances, then entitlement to any benefits should be explored.’ Benefits If the local authority is undertaking an assessment of your relative’s care needs or finances, then entitlement to any benefits should be explored. Other local support organisations may also be able to help with benefits checks and Age UK has an online benefits calculator which can be a useful starting point to see if your relative is eligible. Benefits they may be entitled to include: • Attendance Allowance. • Disability Living Allowance. • Personal Independence Payments.

• The mobility component of Disability Living Allowance/Personal Independence Payment.

• Pension Credit.

• The War Pension Scheme Mobility supplement.

Benefit entitlements may cease or be changed by a move to a care home even on a temporary basis so it is important to check.

• War Widows’ special allowance (also referred to as War Widows’ Special

• Winter Fuel Allowance. • Council Tax reductions.

Visit www.careselect.co.uk for further assistance with your search for care

Third party top up payments If your loved one is receiving funding from the local authority and chooses to go into a home that costs more than the council’s standard or usual weekly rate for the care your relative has been assessed as needing, then someone will be expected to pay the difference. This is called a third party top-up. Councils should provide potential third parties with better information enabling informed decisions about the commitment they are being asked to make. Carers are now entitled to assessment of their own needs and from

April 2016, the Care Act will allow your relative to pay their own top-up fee even when their capital savings have dropped below the threshold. This is because the threshold is rising – see the box for more information. You should be confident that you can cover the cost of a top-up for as long as it may be required, otherwise your relative may need to move to a cheaper care home. Also, always ask for details of further charges which care providers may make for services such as hairdressing, outings and delivery of newspapers which are not included in the weekly care charge.

The Care Act and paying for care The new Care Act will, from April 2016, change the way that people pay for their social care. How the Care Act financial reforms will work haven’t yet been finalised however, the upper capital limit is expected to be increased to £27,000 in non-residential care or where the value of the resident’s home is disregarded, or £118,000 where the value of the resident’s home is not disregarded. Significantly, the lifetime expenditure on care costs is expected to be capped at £72,000 for all adults over the State Pension age, with a ‘Minimum Income Guarantee’ for those cared for at home and a protected personal expense allowance for those in care homes remaining in place. However the cap only relates to care fees and not the cost of board and accommodation or any top-up payment.

Local authorities will be expected to set up ‘care accounts’ for individuals receiving care and support, whether or not this is arranged by the council. The council should also track personal expenditure at the local eligible weekly care rate, noting that a self-funding individual will clearly not become eligible for financial support until the £72,000 cap on care costs has been exceeded. To be sure that allowable expenditure starts to count towards the cap from April 2016, you and your relative should seek a care needs assessment now to ensure that they are known to the authority and check, in April 2016, that their care account is live. It is important to be aware that the cap only applies to eligible needs as assessed by the local authority and that final details of how these changes will work are still being worked out.

Call the Care Select Helpline - 0800 389 2077 - for more information

Will I need to sell the family home? The family home can hold dear memories and emotions for everyone involved but it usually has a large amount of capital tied up within it. It may not be necessary to sell the family home to fund care. When introducing the new Care Act, the Government said that no-one should be expected to sell their home in their lifetime to pay for their care. Speak with a professional adviser about this, either a financial adviser experienced in this area or a specialist solicitor.

Deferred payment agreement Under the new Care Act, deferred payment agreements are available from all councils across England. A deferred payment agreement is a loan arrangement between your relative and their local authority whereby the council will pay your relative’s care home bills until your relative decides to sell their home. This could be after they pass away. The council will expect to be repaid the care home fees that they have paid out once your loved one’s home has been sold. Councils will charge interest on the loan and a fee for setting up the arrangement.

less than £23,250 (not including the value of their home or their pension). Deferred payment agreements may not suit everyone. It is always difficult to forecast how the property market may perform and to know whether values will increase at a rate greater than the cost of care. You may need legal and financial advice concerning the merits of selling or entering into a deferred payment agreement. Contact your relative’s local authority to find more out about the terms and conditions of these arrangements.

Will I be able to leave an inheritance?

• They are receiving care in a care home (or are going to move into one soon).

It may be felt that the Care Act reforms mean care will not cost more than £72,000. However, changes to the eligibility test, an increase in capital limits, the exclusion of top-ups from the tally towards the cap and introduction of a daily living charge of £230 per week will all impact on the amount of money that may be available for any inheritance. Added to this, care costs rise yearon-year and local authorities have significant pressures on their resources. As such, the prospect of leaving an inheritance may diminish. However, this may encourage more people to consider savings or investments to meet their care needs. Also, it may increase the role of the family in supporting relatives to live in their own homes for longer. Overall, support for loved ones in their later life is likely to improve with a more diverse range of services and the Care Act’s commitment to recognising the importance of good support at home and in care homes.

• They own their own home (unless their partner or certain others live there).

Financial and legal advice

• They have savings and investments of

Understanding fully the assessment

‘Under the new Care Act, deferred payment agreements are available from all councils across England.’ Your relative is likely to be offered this option if:

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rules, allowances, benefits, pension and tax positions as well as legal issues related to agreements that your relative (or third party) may be asked to sign is not easy. The Care Act reforms oblige councils to signpost you and your loved one to appropriate sources of information and independent advice. The reforms also clarify rights to support from independent advocates and others during assessments and appeals. Seeking advice is recommended, if possible, well ahead of needing any care because sound financial and legal advice may enable care costs to be covered without need for any deferred payment arrangement and facilitate passing on legacies to the next generation.

The cost of care The cost of care whether provided in your relative’s home or in a care home will vary from provider to provider depending on your relative’s specific care needs, the type of service on offer and even the care location. It is important to ask different providers about their services and charges and think, for instance, about comparing the activities provided within different settings when you and your relative are comparing costs. Care fees will increase, usually annually and if your relative’s needs change or they ask for a change of service, such as upgrading their room. It is important to take this into account when planning to cover costs through, perhaps, to end of life. If you are being asked to pay a top-up fee then you will also be asked to enter into a

contract with the local authority so it is recommended that you seek specialist financial and legal advice.

Self-directed support If the local authority is contributing towards or arranging your loved one’s care then they will most certainly use a system called ‘self-directed support’. Self-directed support puts people in control of the support they need to live the life they choose. People funding their own care already have the freedom to spend their money however they wish to meet their care needs.

Personal Budgets If your relative is eligible for social care support, self-directed support gives them a Personal Budget based on an assessment of their eligible social care needs. They may need support or help to manage day-to-day activities and everyday tasks such as washing and dressing, help with eating and drinking or getting out into the community. With their own budget your relative can then choose what social care and support services to spend this money on. They can be as creative as they want about how they spend the budget as long as it is spent to meet their care needs. A Personal Budget can be received in various ways: • A Direct Payment (DP) – the local authority pays your loved one an amount of money. The money can then be spent on solutions and services of your relative’s choice to meet their eligible social care needs, and they are in control of this money.

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• An Indirect Payment (IP) – this is made available if your loved one is not able to consent to a Direct Payment, but where a Direct Payment is deemed to be in their best interest. It can be paid to a person who is ‘suitable’ on your relative’s behalf. There are rules and guidance to help the council decide who is a ‘suitable person’. • Individual Service Funds – your Personal Budget, or some of it, can be lodged with a service provider for your relative to draw from to get support as and when needed. Or • The local authority can arrange and pay for the support. These options may vary from authority to authority, so speak to your relative’s local authority about their Personal Budget arrangements.

Direct Payments Direct Payments are financial payments made to people who have been assessed as eligible to receive support from their council. Instead of the council arranging or providing services directly, your relative can use these payments, either by themselves or with assistance, to purchase support that they consider most appropriate to meet their assessed social care needs. However Direct Payments cannot currently be used to pay for residential care. Carers may also be able to receive Direct Payments to support them in their role.

Why have a Direct Payment? Direct Payments allow more control over the decisions that affect your relative’s life. They provide more flexibility and choice, as your relative can buy appropriate support tailored to their individual needs. Another option is for the council to source a portion of the care/support needs through services

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commissioned directly by them and also provide a Direct Payment to arrange those remaining services that your relative wishes to have more control over.

What can Direct Payments be used for? If your relative receives a Direct Payment, the money is used to arrange support to meet eligible needs. They may choose to employ someone directly, to buy services from an independent or voluntary sector provider or purchase equipment to help live more independently. With Direct Payments, people or agencies employed are accountable to your relative and not to the local authority. Therefore, Direct Payments enable more control, choice and flexibility over how your relative plans their support to fit with their life. It is important that their plans meet their assessed needs. Therefore, provided the money is used lawfully, and eligible needs are met, the flexibility that these payments allow means it is impracticable to outline here exactly what the money can be spent on. However, there are certain items on which these payments cannot be spent, for instance: • S ervices that should be provided by the NHS. • R outine living expenditures, utility and household bills etc. Most Direct Payments are made to meet regular on-going support needs; however they can also be made as a single payment, for example, to purchase equipment or a short respite break. Speak with the local authority for more information and consider taking legal advice concerning, for example, the obligations your relative will acquire if they take on the role of an employer.

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Free wills and trusts information

If you have a loved one with a learning disability in your family, you will know how it feels to worry about their financial future. What will happen when you are no longer around? Mencap are here to help ease that worry. We offer free information and advice on the importance of writing a will and setting up a trust, so you can be sure your loved one with a learning disability will get the financial support and protection they need when you are gone. We offer: â&#x20AC;˘ free Planning for the Future seminars across England, Wales and Northern Ireland giving you the opportunity to access face-to-face specialist legal advice â&#x20AC;˘ free wills and trusts information booklets â&#x20AC;˘ a list of specialist legal professionals in your area Well thought out plans will give you peace of mind and ensure your family is protected for the future.

To book a place at an upcoming seminar or to order a free information pack by post or online, please contact: 0207 696 6925 willsandtrusts@mencap.org.uk Visit www.carechoices.co.uk for further assistance with your search for care www.mencap.org.uk/willsandtrusts

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Registered charity number 222377 (England and Wales); SC041079 (Scotland) 2015.067

Legal issues around needing care and support People are always telling us that we are part of an ageing population. Our relatives are living longer and whilst we are glad to have them around this brings its own problems.

Ageing relatives may have all sorts of medical and care needs and these can change quickly and unexpectedly which means that it is hard to be prepared. The most common reasons that our elderly relatives need care are physical frailty, disability and loss of mental capacity, perhaps through the onset of dementia.

What do I do if my relative might not have mental capacity? If your relative has assets of their own, such as property or bank accounts, you may find that when they are suddenly in need of care, they also need assistance with their financial affairs. Nobody is automatically entitled to take over the management of the financial affairs of another person, even if they are the closest relative. If you are concerned that your relative might lose the ability to make decisions for themselves the first thing you should consider is, whether your relative has granted anyone a power of attorney?

What is a power of attorney? A power of attorney is a document that your relative can use to appoint ‘attorneys’ to manage their financial affairs should they no longer wish to do so themselves or if they become incapable of doing so. Before October 2007, powers of

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attorney, which could be used when someone lost mental capacity to manage their own affairs, were known as ‘Enduring Powers of Attorney’, however, since then a newer version called ‘Lasting Powers of Attorney’ has been used. If your relative has an older Enduring Power of Attorney, it will still be valid as long as it was prepared before October 2007.

‘Nobody is automatically entitled to take over the management of the financial affairs of another person.’ Your relative will have to choose who to appoint as their attorney and they can appoint more than one attorney, who can act together or independently depending on the terms chosen by your relative. They can also place restrictions on the powers of the attorneys, such as which assets they can or can’t deal with. A power of attorney with no restrictions would allow an attorney to access all the financial affairs of the elderly relative (including being able to buy and sell property on their behalf) as long as all actions taken are in the best interests of the relative. In order to use an Enduring Power

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of Attorney where your elderly relative has lost capacity to manage their affairs you must ensure that the document is registered at the Office of the Public Guardian. If there is a Lasting Power of Attorney, the document must be registered before it can be used, regardless of the capacity of the person who made it.

What if my relative doesn’t have a power of attorney? Powers of attorney must be prepared when your relative still has the capacity to understand it. A diagnosis of dementia does not automatically stop a person from making a power of attorney as they may still have periods of lucidity which are enough to understand what a power of attorney is. Likewise, physical disability, perhaps through a stroke, is not in itself a reason for an elderly relative to be unable to enter into a power of attorney as someone else can sign on their behalf as long as they are able to understand it and to communicate their understanding in some way. Sometimes, it is just too late to take this route as your relative has lost their mental capacity. However, all is not lost as there is an alternative option which is an application to the Court of Protection for the appointment of a ‘deputy’.

to be appointed as their deputy. Anyone can be appointed as a deputy as long as they are over the age of 18, so there are no specific restrictions on which relative (or indeed friend) can apply. The appointed deputy will have a similar role to that of an attorney; however, a deputy’s authority to manage the financial affairs of their elderly relative comes from a court order.

Is it too late for my relative to make a will? It is true that around 60% of us have not made a will. When your elderly relative is told that they need care, the realities and consequences of age are brought home and we start to think about what happens next. It’s not always possible to know if your relative has made a will. It is a document that is confidential and in many cases the original document is kept at the office of the solicitor that drew it up. If your relative is no longer able to tell you if they have made a will you can search through their papers or contact local solicitors to see if they have one but if there is no trace of a will or if the terms of the will are out of date, there are options.

How is a deputy appointed?

‘It is true that around 60% of us have not made a will.’

You will have to submit an application to the Court of Protection to be appointed deputy for your relative. This application involves detailing your suitability for the role and providing information about your relative’s financial circumstances. The application will go to a judge at the Court who will consider whether your relative lacks the necessary capacity to manage their financial affairs and, if so, whether it is in your relative’s best interests for you

If your relative wishes to make a new will, you need to find out whether they have ‘testamentary capacity’ to do this. Where there is any doubt that your relative has the capacity to make a new will, a GP can be asked to assess this. If medical opinion is that your relative lacks testamentary capacity then an application can be made to the Court of Protection for a ‘statutory will’. The

Call the Care Select Helpline - 0800 389 2077 - for more information

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person making the application does not need to be the deputy or the attorney of the relative. A statutory will is essentially a will that is prepared on behalf of your relative with terms that are believed to be in their best interests. The Court of Protection then considers the will and the wishes and feelings of those people who would otherwise inherit and decides whether to approve the will. This process can be very complex and it is advisable to seek advice from a specialist solicitor to make this type of application in all cases but in many cases it will be better for all concerned than allowing a relative to die without a will in place.

The family home and inheritance If your relative dies before making a will, this can often lead to stress and confusion for those left behind. The law ensures that spouses and children are provided for, where possible, from whatever money, property or possessions that have been left when a person dies, once any debts have been settled. However, the intestacy provisions may not work well for every family. If someone is not married then the law views a partner as a friend and they may not receive any provision, leaving them in financial difficulties. Only by writing a will can your relative ensure personal possessions and other assets are left precisely in accordance with their wishes. If your loved one has been living in their own home before entering longterm care, they or you, if you are their attorney, will need to decide what will happen to the property by assessing the options carefully and making sure that all legal protection is in place. Funding of residential care can be a

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source of great anxiety for some people and a major concern is whether or not your relative will have to sell their home to pay for care and whether it is possible to avoid this. For more information on this see the paying for care chapter on page 94.

Contractual considerations There are also contractual considerations associated with care and support. A good, specialist solicitor should be able to advise you on the acceptability of contractual terms with care providers and others. If you do not have a solicitor, there are organisations that can help you to locate one with specialist knowledge. The useful contacts on page 107 include details of some.

â&#x20AC;&#x2DC;It is important that your relative has assurance that their wishes are understood and will be adhered to.â&#x20AC;&#x2122; Considering the legal aspects of care, arrangements for managing finances, end of life wishes, including inheritance provisions, in advance of needing support can give everyone peace of mind. It is important that your relative has assurance that their wishes are understood and will be adhered to. It may help to discuss options and for you, and your loved one, to have the benefit of independent advice. A specialist solicitor can advise on all aspects of law around ageing, care and support and may recommend various steps to your loved one and yourself about how best to manage care arrangements to suit needs all round.

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Essential contacts Action on Elder Abuse (AEA)

BCD Care Associates

Helpline: 0808 808 8141 Web: www.elderabuse.org.uk Works to protect, and prevent the abuse of, vulnerable older adults.

Web: www.bcdcareassociates.org A consultancy offering support to the social care sector – particularly focusing on care homes, their residents, managers and staff.

Age UK Advice line: 0800 169 6565 Web: www.ageuk.org.uk Information on issues affecting older people and their carers.

Alzheimer’s Society Helpline: 0300 222 11 22 Web: www.alzheimers.org.uk Promotes its unique knowledge and understanding of dementia, develops quality in its care services, to support people with dementia, their families and their carers. Its confidential advice, information and support helpline is open seven days a week, with trained advisers who understand the needs of people affected by dementia.

Ask SARA Web: www.asksara.org.uk Guided advice about daily living.

Association of Charitable Organisations Tel: 0207 255 4480 Web: www.aco.uk.net A national umbrella body for ‘benevolent charities’.

Association of Independent Care Advisers (AICA) Tel: 01483 203066 Web: www.aica.org.uk Represents member organisations around the country that help people decide on the best choice of care.

Care 4 Mum Tel: 01223 511 487 Web: www.care4mum.com An experienced and professional service to help you choose the best care for yourself or your elderly parents.

Care Choices Tel: 0800 389 2077 Web: www.carechoices.co.uk A leading social care publisher whose publications include Care Select and regional directories of care services. Operates a friendly helpline for those searching for care and has a comprehensive, fully-searchable website of care provision in England and Wales.

Care Quality Commission Tel: 03000 616 161 Web: www.cqc.org.uk National organisation responsible for inspecting and regulating care services.

Care Select Tel: 0800 389 2077 Web: www.careselect.co.uk The online version of this handbook with many more features, plus a link to online care search and helpline via the publisher Care Choices (see above).

Carers Trust Tel: 0844 800 4361 Web: www.carers.org The largest provider of comprehensive carers’ support services in the UK.

Call the Care Select Helpline - 0800 389 2077 - for more information

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Essential contacts

Carers UK

Gov.uk

Advice line: 0808 808 7777 Web: www.gov.uk Web: www.carersuk.org Information portal for Government Provides support to anyone who is a carer. services and information.

DLF Tel: 0300 999 0004 Web: www.dlf.org.uk A national charity that provides impartial advice, information and training on daily living aids. Also runs database of daily living equipment - DLF Data (www.dlf-data.org.uk).

Dying Matters Tel: 08000 21 44 66 Web: www.dyingmatters.org Aims to change public knowledge, attitudes and behaviours towards dying, death and bereavement.

Housing Options for Older People Online Web: hoop.eac.org.uk Online questionnaire to help consider the most suitable housing for your parentâ&#x20AC;&#x2122;s needs.

Independent Age Tel: 0800 319 6789 Web: www.independentage.org.uk Helps older people on very low incomes to live independently in their own homes and when this is no longer possible, they can help with care home fees.

Joseph Rowntree Foundation

Elderly Accommodation Counsel

Tel: 01904 629241 Tel: 0800 377 7070 Web: www.jrf.org.uk Web: www.housingcare.org Uses evidence and practical experience Helps people make decisions about where of developing housing and care services to live and any support or care they need. to influence policy, practice and public debate.

FirstStop Advice

Advice line: 0800 377 7070 Web: www.firststopadvice.org.uk Advice and information on finance and rights for older people.

Freeths Tel: 0845 634 2600 Web: www.freeths.co.uk National law firm with offices in Birmingham, Derby, Leeds, Leicester, London, Manchester, Milton Keynes, Nottingham, Oxford, Sheffield and Stokeon-Trent.

Friends of the Elderly Tel: 0207 730 8263 Web: www.fote.org.uk Committed to enhancing the quality of life for older people by providing a range of high standard services.

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NAPA - National Activity Providers Association Tel: 0207 078 9375 Web: www.napa-activities.co.uk Works to create new opportunities for community involvement and activity in care settings.

NCF - National Care Forum Tel: 024 7624 3619 Web: www.nationalcareforum.org.uk Represents the interests of the not-forprofit care sector.

National Council for Palliative Care (NCPC) Tel: 020 7697 1520 Web: www.ncpc.org.uk Umbrella organisation for all those who are involved in providing, commissioning

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and using hospice and palliative care services in the UK.

Pension Service, The Web: www.gov.uk/contact-pensionservice Helps with State Pension eligibility, claims and payments.

Relatives and Residents’ Association, The Advice Line: 0207 359 8136 Web: www.relres.org Offers support and information to families, friends and relatives about issues affecting care homes.

Safe and Settled Limited Tel: 07768 126548 Web: www.safeandsettled.co.uk An independent Social Enterprise comprised of experienced professionals. Its aim is to support people, their families and friends to find solutions and make the best decisions possible when they are considering care support.

Silver Line, The Helpline: 0800 470 8090 Web: www.thesilverline.org.uk

Free 24-hour helpline providing information, friendship and advice for older people.

Society of Later Life Advisers Tel: 0845 303 2909 Web: www.societyoflaterlifeadvisers.co.uk A not-for-profit organisation aiming to ensure that consumers are better informed about the financial issues of later life and can help you find an accredited adviser.

Solicitors for the Elderly Tel: 0844 567 6173 Web: www.solicitorsfortheelderly.com A national association of solicitors, barristers and legal executives providing and promoting a range of legal services for older people.

United Kingdom Homecare Association Tel: 0208 661 8188 Web: www.ukhca.co.uk Promotes high standards of homecare and takes an active role in liaising with local and central government on all homecare and related issues.

WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? WHAT ARE THE CARE OPTIONS? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 Call the Care Select Helpline - 0800 389 2077 - for more information

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Hengist Field Care Centre

Located near Sittingbourne, in the heart of the Kent countryside, Hengist Field is a centre providing specialist 24-hour care for elderly people with General Nursing needs or who have also been diagnosed with Dementia and related illnesses. Purpose-built in 2012, this state-of-the-art accommodation offers outstanding amenities, and is staffed by a dedicated and highly skilled team of nurses and carers.

Excellent facilities

Set in beautiful landscaped gardens, Hengist Field provides an exceptional setting for care. The Home comprises individual en-suite accommodation for up to 75 residents. Other amenities include: specially adapted bathrooms, a sensory room and garden to aid relaxation, five lounges, an onsite hair salon, activity centre, internet café and purpose-built cinema.

Information

Our philosophy:

Pond Farm Lane, Sittingbourne, Kent ME9 8LS

Call 01795 473880 or email hengist.field@nellsar.com www.nellsar.com

Care Services offered:

• Dementia Care • End of Life Care • Nursing Care • Nursing Dementia Care • Rehabilitation • Residential Care • Respite Care, Short Breaks & Day Care

Region-by-region care homes North West

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North East

Yorkshire and the Humber

East Midlands West Midlands East of England

London

South West

South East

> East Midlands

112

Derbyshire and Northamptonshire.

> East of England

> South West

121

Gloucestershire and Somerset.

113

Cambridgeshire, Essex, Hertfordshire.

> London

123

South London.

> North West

114

Cumbria, Greater Manchester.

> South East Berkshire, Buckinghamshire, East Sussex, Hampshire, Kent, Oxfordshire, Surrey and West Sussex.

115

> West Midlands

124

Staffordshire, Warwickshire and Worcestershire.

> Yorkshire and the Humber

Region-byregion care homes

124

North Yorkshire.

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• Accommodation for 31 residents • Regular group and individual activity sessions • For elderly nursing and residential care • Palliative care with unrestricted visiting • All single rooms - majority are en-suite • Local GP visits • Local to town centre & amenities www.burtonlodgenursinghome.co.uk

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SUTTON COURT, LODGE & MANOR

VALLEY LODGE

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Valley Lodge is located on the outskirts of Matlock on the A6 Bakewell Road. The home is set within stunning countryside with panoramic views of the River Derwent and the High Peak Railway.

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112

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SUTT LOD

Priest Notti Tel: 0 Web

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Derbyshire continued

Northamptonshire

WEST HALLAM

8 Newdigate Street, West Hallam, Ilkeston, DE7 6GZ Tel: 0115 9440329 Web: www.ashmere.co.uk Manager - Sarahjane Hooley

We tailor our care packages to meet your individual requirements

West Hallam care home was opened in 1988. Within easy travelling distance from Ilkeston, Derby and Nottingham. The Home is situated in a quiet residential area only minutes away from Shipley Country Park.

ONES

CARE HOMES FOR LOVED ONES

NOW OPEN

• Personal care • Dementia care • Companionship • Domestic support

Tel: 01604 636980

Facilities within the centre include a cafe, cinema, hair & beauty salon, reminiscence kitchen & specifically designed engaging outdoor environment.

For all enquiries: Tel 01604 – 633282 or email admin@theangelagrace.co.uk

8 Queensbridge, Northampton NN4 7BF

Brockfield House 01933 625555

Villa Lane, Stanwick, Wellingborough NN9 6QQ

Nursing Homes Limited Caring Since 1984

East of England

Regulated by the Care Quality Commission

www.carexl.co.uk

THE ANGELA GRACE Cheyne Walk, Northampton

We work closely with you to help you make the right decision and provide a service tailored around your exact needs.

• Nutritional support • Practical home help • Help with medication

Brockfield House, established in 1984, is a delightful home registered for 45 residents and situated in the village of Stanwick, close to amenities and local transport. The Home specialises in the care of people living with the effects of long-term mental health problems and those living with dementia. Nurses and care staff are respectful and sensitive to the individual needs and choices of residents and provide care in a comfortable and safe environment.

Cambridgeshire Home from home with nursing needs

Individual requirements catered for

Soham Lodge Care Centre, specialising in care for the elderly with nursing needs. All rooms are ground floor, large bedrooms with en-suite wet rooms, communal areas for meals, socialising and activities and enclosed garden areas.

T: 01353 720775 E: info@sohamlodge.co.uk Qua Fen Common, Soham, Ely, Cambs CB7 5DF www.sohamlodge.co.uk

Essex Specialist residential dementia care focused on enhancing quality of life. • Care focused on individual needs • A home from home – comfort and reassurance • Experienced and trained care team • Activities that promote overall wellbeing • Support for all the family

Let’s talk about better care.

Call the Care Select Helpline - 0800 389 2077 - for more information

113

01992 800 138

www.honeylanecarehome.co.uk HoneylaneGM@carebase.org.uk Honey Lane, Waltham Abbey Essex, EN9 3BA

Essex continued Silverpoint Court Residential Care Centre

29-31 Silverpoint Marine, Canvey Island, Essex SS8 7TN

Located at the tip of Silverpoint Marine on Canvey Island, the Home boasts scenic views of the Thames estuary. We provide 24 hour Residential Care for up to 33 residents.

Call us: 01268 515 564

www.nellsar.com

WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

Hertfordshire

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25/03/2015 16:10

Hertfordshire Luxury Care Home Stunning 3D virtual tour on your smartphone /desktop at www.foxholescarehome.com Pirton Road, Hitchin, Hertfordshire SG5 2EN

For more details or to set up an appointment please contact us on 01462 410 767 or email us care@foxholescarehome.com. You can also visit us at www.foxholescarehome.com.

North West

Cumbria

Enabling the best in time of need... ... at the Westerley in Grange-Over-Sands

We offer a caring environment in which to enjoy permanent, respite or daily support.We are a Christian ‘family’ with daily acts of worship and regular celebration of Holy Communion. 24 hour personal and pastoral care is on hand to help and assist in every way. Please call us on

01539 532408 email at grangem@lwpt.org.uk or visit www.lwphomes.org.uk

Greater Manchester

A Brighter Approach to Senior Living

Sunrise of Bramhall

Sunrise of Hale Barns

0161 820 9448

0161 820 9586

1 Dairyground Road, Bramhall, Stockport SK7 2HW

sunrise-care.co.uk/bramhall

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295 Hale Road, Hale Barns, Altrincham WA15 8SN

sunrise-care.co.uk/halebarns

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25/03/2015 09:30

Visit www.careselect.co.uk for further assistance with your search for care

South East Berkshire Becket House Nursing Home Pitcher Lane, Loughton, Milton Keynes, Buckinghamshire MK5 8AU

Situated in the prestigious village of Loughton specialising in Dementia Care and Nursing for the Elderly. • Long and short stay • Respite and convalescence • Varied menus and special diets • Local GP service • Personal laundry service • Regular activities and outings • Visiting clergy • No restrictions on visiting • Visiting hairdresser & chiropodist

T: 01908 231981 E: manager@beckethouse-carehome.co.uk W: www.beckethouse-carehome.co.uk

Buckinghamshire

Weedon Hill, Hyde Heath, Amersham HP6 5UH Tel: 01494

773606

Email: admin@careatrayners.co.uk

Rayners, the first purpose built Residential Home for the elderly in South Buckinghamshire was opened in June 1990, designed specifically to provide the elderly with a level of care and comfort that is unsurpassed. In addition to the high level of care provided we are able to offer ‘extra care’, in the event of a resident becoming more dependant. This degree of care is not usually available in residential homes and gives the resident and their relatives alike confidence and peace of mind. Rayners also has the ability to accommodate respite or short stay residents, subject to suite availability. Rayners who is still family owned and managed is also proud to offer luxurious ‘Assisted Living Apartments’ at Maple Tree House, situated on the same site as Rayners Residential Home.

www.careatrayners.co.uk WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? Hampshire East Sussex WHAT IF MUM DOESN’T AGREE?

Alverstoke House VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK Care Home with Nursing Rosebery House Residential Home

NUR S ING HOME

The home specialises in providing care for people suffering from Dementia and Alzheimer’s.

• Long and short stay • Respite and convalescence • Local GP service • Varied menus and special diets • Personal laundry service • Regular activities and outings • Next to the park • No restrictions on visiting • Visiting hairdresser & chiropodist

T: 01323 501026 E: enquiries@rosebery-carehome.co.uk W: www.rosebery-carehome.co.uk

IS T E R E

2 Rosebery Avenue, Eastbourne, East Sussex BN22 9QA

O C IAT IO N

Alverstoke House is a purpose built, family run nursing home specialising in Caring for the Elderly who have complex nursing care needs. We also specialise in terminal care and provide care for those needing nursing after leaving hospital before returning home. • Excellent reputation in the Alverstoke Area • 30 beds, some en-suite, two sitting rooms, dining room and two conservatories. • We operate an open door policy for visits of family and friends.

“An ideally situated Care Home with Nursing offering a high standard of care by our specialist team" Telephone: 02392 510254 • Office: 02392 529908 • Fax: 02392 503054

WHAT ARE THE CARE OPTIONS? HOW WILL ITHE KNOW WHICH TO CHOOSE? WHAT ARE CARE OPTIONS? WHAT ARE THEDOESN’T CARE OPTIONS? WHATWILL IF MUM AGREE? HOW I KNOW WHICH HOW WILL I KNOW WHICH TO TO CHOOSE? CHOOSE? CALL CARE SELECT FOR MORE INFORMATION: WHAT IF MUM DOESN’T AGREE? WHAT IF MUM DOESN’T 0800 389 2077 VISIT THE NEW CARE SELECTAGREE? WEBSITE WWW.CARESELECT.CO.UK VISIT VISIT THE THE NEW NEW CARE CARE SELECT SELECT WEBSITE WEBSITE WWW.CARESELECT.CO.UK WWW.CARESELECT.CO.UK Call the Care Select Helpline - 0800 389 2077 - for more information

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South East

continued

Hampshire continued

Beechcroft Beechcroft Manor Manor Nursing Nursing Home Home

11 Beechcroft Beechcroft Road, Alverstoke Gosport, Hants PO12 2EP Tel: Tel: 02392 583908 www.thecontemplationgroup.co.uk www.thecontemplationgroup.co.uk

Our Ournewly newlyrefurbished refurbished18 18bedded beddedNursing NursingHome Home provides provides aa smaller smaller friendly friendly environment environmentcaring caringfor forolder olderpeople peopleand andadults adults with with physical physical disabilities. disabilities. We We strive totopromote promoteindependent independentliving, living,preserve preserve dignity dignity and and maintain maintain privacy privacy at at all times. We Weprovide: provide: •Specialist & Trained Trained Staff Staff SpecialistDementia Dementia Care Care with with Nursing Nursing • Fully Vetted & Person-Centred Nursing Nursing Care Care • Palliative Care •Person-Centred RespiteCare Care •Respite

Rotherbank

Tel: 01730 892 081

Rotherbank is a small, friendly, family owned and operated residential care home. We are registered for dementia care and the frail elderly. We provide a homely environment affording security, independence with supportive care. Our care assistants are your personal carers, friends and companions. Your needs are constantly met and reviewed following an individual plan of care. All staff are trained to NVQ 2, 3 & 5. All staff are happy and settled which promotes an excellent friendly atmosphere for residents. Staff turnover is extremely low resulting in agency staff never having to be used. If you would like further information, please call us on the telephone number above or feel free to visit us any time.

www.Rotherbank.com

Rotherbank Farm Lane, Liss Forest, Hampshire, GU33 7BJ

Where your loved ones come first. • Compassionate stable team who treat residents like family • Qualified nurses 24 hours a day • 3 acres of beautiful gardens

A Brighter Approach to Senior Living Sunrise of Bassett

YOU CAN FIND US IN THE OLD TOWN OF BEXHILL-ON-SEA. Contact Hazel Silverlock on 01424 730809 or email info@peterhousecare.com

111 Burgess Road, Bassett, Hampshire SO16 7AG

023 8098 6307

sunrise-care.co.uk/bassett

www.peterhousecare.com

A Brighter Approach to Senior Living

ADV_BAS_1214_CareSelectProfile_01.indd 1

Established over 35 years, an independent and family run home set in extensive grounds. Providing 24 hour nursing 25/03/2015 care with excellent facilities and services.

Sunrise of Winchester

Stockbridge Road, Winchester, Hampshire, SO22 5JH

01962 658 469

sunrise-care.co.uk/winchester

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116

London Road, Hillbrow, Liss, Hampshire, GU33 7PD Telephone: 01730 895125/892711 • Email: wenhamadmin@btconnect.com www.wenhamholt.uk

25/03/2015 09:31

Visit www.careselect.co.uk for further assistance with your search for care

09:30

South East

continued

Kent Abbotsleigh Care Centre

George Street, Staplehurst, Kent TN12 0RB

Abbotsleigh is a modern, purpose-built facility specialising in both Residential and Nursing care for those with Dementia or related illnesses. The Home is set in a beautiful semi-rural setting just 15 minutes from Maidstone.

Call us: 01580 891 314

Tel: 01303 254019 www.ashwoodhealthcare.co.uk

www.nellsar.com

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26/01/2015

The Grange provides quality services and individual care to make our residents feel as much at home as possible. Come and visit us or telephone for a brochure.

22 Cornwallis Avenue, Folkestone, Kent CT19 5JB

84-86 Shorncliffe Road, Folkestone, Kent CT20 2PG

Tel: 01303 252394 www.ashwoodhealthcare.co.uk

Cumbria House provides quality services and individual care to make our residents feel as much at home as possible. Come and visit us or telephone for a brochure.

WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? 17:07WHAT IF MUM DOESN’T AGREE? WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

SIT BACK AND RELAX • • • • • •

Beautiful victorian house with mature gardens Family run for over 30 years Full activity programme Book a free trial: Lift to all floors 020 8460 6555 En-suite rooms Excellent home cooking www.theheathers.co.uk

 

Hengist Field Care Centre

Country Country House House Living Living for for the the Elderly Elderly with with 24 24 Hour Hour Care Care

80 Woodstock Road, Sittingbourne, Kent

A superior purpose-built Care Home providing 24 hour care for people with Nursing needs and those who have been diagnosed with Dementia. The Home also offers a wide range of Rehabilitation and Physiotherapy Services.

Call us: 01795 420 202 NEL_101_HF_90Wx53H_AD.indd 1

We We offer offer tailormade tailormade care care packages packages in in our our beautiful beautiful Edwardian Edwardian home, home, including including full full time, time, respite respite and and day daycare. care.

www.nellsar.com

Visit Visit our our website: website: www.highhilden.co.uk www.highhilden.co.uk High High Hilden Hilden Close, Close, Tonbridge, Tonbridge, Kent, Kent, TN10 TN10 3DB. 3DB.

Telephone: Telephone: 01732-353070 01732-353070

25/03/2015 16:11

Call the Care Select Helpline - 0800 389 2077 - for more information

117

South East

continued

Kent continued Lulworth House Residential Care Centre

Lukestone Care Centre

7 St Michael’s Road, Maidstone, Kent ME16 8BS

Queens Avenue, Maidstone, Kent ME16 0EN

Located in the bustling town of Maidstone, Lukestone is a Residential Nursing Care Home providing 24 hour care for elderly people who have been diagnosed with Dementia or long-term mental health problems.

Call us: 01622 755 821 NEL_101_LU_90Wx53H_AD.indd 1

A very attractive 1920s property on a leafy avenue in a highly desirable area of Maidstone. The Home comprises two spacious lounges, 38 bedrooms and a conservatory & patio area.

www.nellsar.com

Call us: 01622 683 231

25/03/2015 16:10 NEL_083_LH_90Wx53H_AD.indd 1

Loose Valley Care Centre

15 Linton Road, Loose, Maidstone, Kent ME15 0AG

26/01/2015 17:07

The Old Downs Residential Care Centre

Castle Hill, Hartley, Dartford, Kent DA3 7BH

Loose Valley is a Nursing Home that provides specialist 24-hour care for the elderly. Set amidst three acres of landscaped grounds, it offers panoramic views of the countryside – the perfect relaxing environment.

Call us: 01622 745 959

Located in the tranquil Kent village of Hartley, The Old Downs is a Residential Care Home providing specialist 24 hour care for elderly people, including those with Dementia.

www.nellsar.com

Call us: 01474 702 146

NEL_101_OD_90Wx53H_AD.indd 1 26/01/2015 17:06

NEL_083_LV_90Wx53H_AD.indd 1

www.nellsar.com

Sonya Lodge Residential Care Centre

www.nellsar.com

25/03/2015 16:10

St Winifreds Residential Care Centre

10 High Road, Wilmington, Dartford, Kent DA2 7EG

236 London Road, Deal, Kent CT14 9PP

Sonya Lodge is a ‘home from home’ Residential Care Home providing specialist 24 hour care for elderly people who have been diagnosed with Dementia.

Located in the picturesque seaside town of Deal, St Winifred’s is a Residential Home providing specialist 24-hour care for elderly people who have been diagnosed with Dementia.

Call us: 01322 289 768

www.nellsar.com

Call us: 01304 375 758

WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? NEL_101_SL_90Wx53H_AD.indd 1 25/03/2015 16:10 NEL_083_SW_90Wx53H_AD.indd WHAT IF MUM DOESN’T AGREE? WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

A specialist Residential centre providing 24 hour care for people with Dementia or related illnesses. Situated in Sittingbourne, the Home has an outstanding reputation.

Call us: 01795 420 202 NEL_083_WO_90Wx53H_AD.indd 1

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26/01/2015 17:09

Woodstock Residential Care Centre

80 Woodstock Road, Sittingbourne, Kent ME10 4HN

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

www.nellsar.com

26/01/2015 17:05

Visit www.careselect.co.uk for further assistance with your search for care

South East

continued

Oxfordshire

Exceptional Care. Exceptional Luxury. Exceptional Value.

• High quality residential, nursing and dementia care • Care focused on individual needs • Highly trained nursing and care team • Homely luxury in a uniquely-styled care home • Exceptional facilities – spa, hair salon, bistro, fitness suite and cinema Thames View, Abingdon, Oxfordshire OX14 3UJ

01235 856 002

www.bridgehouseabingdon.co.uk

info@bridgehouseabingdon.co.uk

Surrey We are committed to providing a service that is flexible and realistically tailored to your needs. Our staff are respectful, professional, flexible, resourceful, positive, problem solving and have a realistic view of life’s complications.

Carte Blanche Care is a new family run live-in care agency, providing personal care to ensure that you or a loved one remain independent at home.

KIMARA

SUPPORT

We employ specialist learning disability nurses and other qualified staff so are the ideal choice for people with learning disabilities. We also employ experienced personal assistants to provide support to the elderly, frail, physically disabled, infirm or those with sensory disabilities.

Our services include but are not limited to

For more information on our services contact us on:

• Personal care • Keeping safe at home and out in the community • Managing finances • Developing independent living skills • Activities of daily living • Accessing employment, education or training

T: 0208 399 5303 E: info@carteblanchecare.co.uk W: www.carteblanchecare.co.uk

K I M A R A SUPPORT

Tel: 0203 291 3436 Fax: 0203OPTIONS? 727 0836 • Email: info@kimara-support.com WHAT ARE THE• CARE HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT IF MUM DOESN’T AGREE?

VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

389 Nursing 2077 Abbey 0800 Chase

www.abbeychase.co.uk

Home

Our aim is to create a friendly family atmosphere between staff and residents and to ensure that all of our guests are very happy, comfortable and content in their retirement. Set in 10 acres of beautiful grounds Beautiful views of the riverside grounds and paddocks Within walking distance of Chertsey town centre Orchards and moorings on the Abbey River First class, spacious accommodation Outdoor or indoor leisure activities l

Tel: 01932 568090

Email us at: info@abbeychase.co.uk

Call the Care Select Helpline - 0800 389 2077 - for more information

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Surrey continued Specialist nursing and dementia care focused on an individual’s holistic needs. • Experienced care team highly trained in dementia care • Comforting and reassuring environment • Support for all the family • Activities that promote overall wellbeing

Princess Christian Care Centre

Stafford Lake, Bisley, Woking, Surrey GU21 2SJ

01483 324 088

In the heart of the Surrey countryside, Princess Christian is a Nursing and Residential Care Home providing specialist 24 hour care for elderly people with Nursing needs or for those who have been diagnosed with Dementia.

www.claremontcourtcarehome.co.uk ClaremontGM@carebase.org.uk Harts Gardens, Guildford Surrey, GU2 9QA

Let’s talk about better care.

Call us: 01483 488 917 www.nellsar.com WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? NEL_101_PC_90Wx53H_AD.indd 1 25/03/2015 WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT IF MUM DOESN’T AGREE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

Whiteley Village Care Centre

Whiteley House

Meeting the needs of individuals requiring nursing, palliative, respite or end of life care in a safe and peaceful environment.

The UK’s original retirement village.

Ingram House

Nestled in 225 acres of beautiful and tranquil Surrey woodland.

Residential care in well appointed rooms with en-suite facilities. Our friendly and caring community guarantees security and peace of mind.

Reg. Ch. 1103056

01932 857821 www.whiteleyvillage.org.uk

West Sussex

First class care, nursing & dementia homes

We can care for people living with dementia throughout their journey in our exceptional environment at Haviland House, Worthing.

www.guildcare.org

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Care homes, home care and wellbeing day facilities in West Sussex. Please contact 01903 327327 or enquiry@guildcare.org Charity 1044658 established 1933

Visit www.careselect.co.uk for further assistance with your search for care

16:10

South East

continued

West Sussex continued Established over 35 years, an independent and family run home set in extensive grounds. Providing 24 hour nursing care with excellent facilities and services.

London Road, Hillbrow, Liss, Hampshire, GU33 7PD Telephone: 01730 895125/892711 • Email: wenhamadmin@btconnect.com www.wenhamholt.uk

South West Gloucestershire

Chapel House

Woodstock

WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? Chapel House is our new acquisition and we oﬀer home from home services, a range of superb en-suite rooms, Permanent Residency, Respite care, and Convalescence.

t: 01452 500005

Horton Road, Gloucester GL1 3EY info@coatewatercare.co.uk | www.coatewatercare.co.uk

A 28 bedded Nursing Dementia home, set on the outskirts of Gloucester, three miles from the town centre, with easy access to the ring road and the M5/A38/A46.

t: 01452 616291

North Upton Lane, Gloucester GL4 3TD info@coatewatercare.co.uk | www.coatewatercare.co.uk

VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

honeybourne gate Luxury living in a landmark retirement complex

A new beginning at Honeybourne Gate Designed and equipped to the highest specification, these 55 apartments set a new standard for retirement property in Cheltenham, offering independent living plus a range of flexible services including personal care.

1 bed apts from £198,000

Tel: 0800 4714793 WHAT ARE THEwww.honeybournegate.co.uk CARE OPTIONS? 2 bed apts from £295,000 HOW WILL I KNOW WHICH TO CHOOSE? WHAT ARE THE CARE OPTIONS? WHAT MUM AGREE? CALL CAREIF SELECT FORDOESN’T MORE INFORMATION: HOW WILL I KNOW WHICH TO CHOOSE? 0800 389 2077 WHAT ARE THE CARE OPTIONS? WHAT IF MUM DOESN’T VISIT THE NEW CARE SELECTAGREE? WEBSITE WWW.CARESELECT.CO.UK HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF NEW MUMCARE DOESN’T VISIT THE SELECTAGREE? WEBSITE WWW.CARESELECT.CO.UK Call the Care Select Helpline - 0800 389 2077 - for more information

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South West

continued

Somerset Our care homes treat every resident as an individual and their families as our guests; and of course we offer exceptional levels of nursing, dementia, and end of life care. If you have any questions or if you are unsure about what care you or your loved one needs, you can speak to one of our care experts who can discuss your options with you.

01564 820140 www.caspiacare.co.uk enquiries@caspiacare.co.uk

Elliscombe House 01963 33370

Enabling the best in time of need... ... at the Westerley in Minehead

Hurst Manor 01935 823467

Hendford 01935 470400

Please call us on

01643 702066 email at mineheadm@lwpt.org.uk or visit www.lwphomes.org.uk

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

Wiltshire

Ashbury Lodge

Situated on the outskirts of Swindon in a handsome building right next to the beautiful Coate Water Country Park. We ﬁrst opened in 2000 and now have 59 full-time residents.

Church View

Church View is a well-established care home which provides Residential, Respite, Day Care and nursing care. Situated in a quiet residential area on the outskirts of Stratton.

t: 01793 820761

t: 01793 496827

261 Marlborough Road, Swindon SN3 1NW info@coatewatercare.co.uk | www.coatewatercare.co.uk

Rainer Close, Stratton St Margaret SN3 4YA info@coatewatercare.co.uk | www.coatewatercare.co.uk

Downs View

Situated in the quiet rural hamlet of Badbury, just off the A346 (Swindon to Marlborough road) approximately 1 mile from Junction 15 off the M4, offering residentail, day care and respite.

t: 01793 740240

Badbury (Near Chisledon), Swindon SN4 0EU info@coatewatercare.co.uk | www.coatewatercare.co.uk

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Visit www.careselect.co.uk for further assistance with your search for care

London South Bromley Park Care Centre

75 Bromley Road, Beckenham, Kent BR3 5PA

Suite 4, 47 Belsize Park Gardens, London NW3 4JL

Situated on the outer edges of Bromley, the Home provides Nursing Care for elderly people with a diagnosis of Dementia. The converted Georgian house was extensively refurbished in 2014 – a very homely environment.

Providing high quality home care services, tailored to your individual requirements. T 0207 722 5096

info@chalcotcare.com

A beautiful, small, family-run home

www.chalcotcare.com

Tel: 020 8660 6646

www.nellsar.com

Call us: 0208 650 5504

A Home away from Home

NEL_101_BP_90Wx53H_AD.indd 1

47 Foxley Lane, Purley CR8 3EH

25/03/2015 16:11

Tel: 020 8688 7022 84 Coombe Road CR0 5RA

Lloyd Park is a modern and highly-skilled care facility, that can show a proven record in functioning as satisfying elderly care accommodation for a wide range of individual health requirements.

As a small home we have the time and resources to ensure each resident receives the very best in care and facilities.

This facility’s dedicated team are not idle or unimaginative in the care solutions they bring to their residents.

www.heatherwood.org

www.lloydparknursing.org • info@lloydparknursing.org

Lyle House Care Home

Marling Court Care Home

Lyle House Care Home is a purpose built home providing personalised residential and dementia care to the highest of standards. Our philosophy is simple; Our residents and their families are at the heart of everything we do!

Marling Court Care Home is a purpose built home providing personalised residential and dementia care to the highest of standards. Our philosophy is simple; Our residents and their families are at the heart of everything we do!

t: 020 8783 0157 e: marlingcourt@countrycourtcare.com w: www.countrycourtcare.com

t: 020 8878 3806 e: lylehouse@countrycourtcare.com w: www.countrycourtcare.com

Meyer House Care Centre

28 Meyer Road, Erith, Kent DA8 3SJ

The Care Home is a refurbished two-storey purpose-built Home offering spacious and well equipped accommodation – for both Nursing and Residential care. Meyer House is based in the busy Kentish town of Erith.

Call us: 01322 338 329 NEL_101_MH_90Wx53H_AD.indd 1

www.nellsar.com

CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077 25/03/2015 16:10

Call the Care Select Helpline - 0800 389 2077 - for more information

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West Midlands Staffordshire

A Brighter Approach to Senior Living

VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK

Sunrise of Tettenhall

73 Wergs Road, Wolverhampton, West Midlands WV6 9BN

01902 267 243

CALL CARE SELECT FOR MORE INFORMATION:

sunrise-care.co.uk/tettenhall

0800 389 2077 CALL CARE SELECT FOR MORE INFORMATION:

0800 389 2077

Warwickshire

Worcestershire

ADV_TET_1214_CareSelectProfile_01.indd 1

25/03/2015 09:30

Mockley Manor

Set in beautiful, well-maintained grounds on the outskirts of the pleasant village of Ullenhall, near Henley in Arden providing Nursing Care, Respite Care and Palliative Care.

t: 01564 742325

Forde Hall Lane, Ullenhall B95 5PS info@coatewatercare.co.uk | www.coatewatercare.co.uk

Westley Court

Situated in the peaceful village of Cookley, near Kidderminster. Delivering a high standard of care in comfortable, homely surrounds and specialising in Palliative Care, Nursing Care and Respite Care.

t: 01562 852952

Austcliffe Lane, Cookley, Kidderminster DY10 3RT info@coatewatercare.co.uk | www.coatewatercare.co.uk

Yorkshire and the Humber North Yorkshire Carleton Court Residential Home Carleton Road, Skipton, North Yorkshire BD23 2BE

Residential Home for the Elderly with genuine care, professional staff, a warm and welcoming environment. • • • • •

Managed by a qualified team Single en-suite rooms Elegant, comfortable surroundings Close to local amenities • Special diets catered for Nurse Call systems in all public rooms as well as bedrooms

T: 01756 701220 E: info@carletoncourtskipton.co.uk W: www.carletoncourtskipton.co.uk

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Visit www.careselect.co.uk for further assistance with your search for care

Advertisersâ&#x20AC;&#x2122; index A

Abbey Chase Nursing Home 119 Abbotsleigh Care Centre 4, 117 AGE Nursing Homes 53, 113 Age UK 27 Alverstoke House Care Home and Nursing 115 Angela Grace, The 53, 113 Ashbury Lodge 122, Inside back cover Ashmere 38, 112, 113 Ashwood Healthcare 3

Elliscombe House

B Becket House Nursing Home Beechcroft Manor Nursing Home Bluebird Care Bridge House Care Home Brockfield House Bromley Park Care Centre Bupa Burton Lodge Nursing Home

F Far Fillimore Care Home Firs, The Foxholes Care Home Freeths

63 38, 112 55, 114 97

G Good Care Group, The Grange Care Home, The Guild Care

34 3, 117 120

61, 115

83, 116 43 10, 119 53, 113 123 37 112

Haviland House 120 Heathers, The 117 Heatherwood Inside front cover, 123 Hendford 78, 122 Hengist Field Care Centre 110, 117 High Hilden 117 Home Instead Senior Care 44, 45 Honeybourne Gate 121 Honey Lane 113 Hurst Manor 78, 122

C Carebase 58, 113, 120 Care Select 14, 22, 25, 83, 87, 109, 114, 115, 117, 118, 119, 120, 121, 122, 123, 124 Care XL 49, 113 Carleton Court Residential Home 61, 124 Carte Blanche 51, 119 Caspia Care 78, 122 Chalcot Homecare 49, 123 Chapel House 121, Inside back cover Church View 122, Inside back cover Claremont Court 120 Coate Water Care 121, 122, 124, Inside back cover Codnor Park 38, 112 Contemplation Homes 83, 116 Country Court Care 41, 123 Country Cousins 34 Cumbria House Care Home 3, 117

D Downs View

78, 122

I Ingram House

120

K Kidsley Grange Kimara Support King William

38, 112 83, 119 38, 112

L Littleover Nursing Home 63 Lloyd Park 123 Loose Valley Care Centre 118 Lukestone Care Centre 118 Lulworth House Residential Care Centre 118 LWP Homes 56, 114, 122 Lyle House 123

M 122, Inside back cover

Maple Tree House

Call the Care Select Helpline - 0800 389 2077 - for more information

115

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Advertisersâ&#x20AC;&#x2122; index continued Mencap 103 Meyer House Care Centre 123 Mockley Manor 124, Inside back cover Marling Court Care Home 123

N Nellsar 4, 76, 110, 114, 117, 118, 120, 123 Nicholas James Care Homes Outside back cover Nightingale Court Care Home 63

O Old Downs Residential Care Centre, The

118

Smalley Hall 38, 112 Soham Lodge 113 Sonya Lodge Residential Care Centre 118 St Winifreds Residential Care Centre 118 Sunrise Senior Living 67, 114, 116, 124 Sunrise of Bassett 116 Sunrise of Bramhall 114 Sunrise of Hale Barns 114 Sunrise of Tettenhall 124 Sunrise of Winchester 116 Sutton Court, Lodge & Manor 38, 112

V Valley Lodge

38, 112

Peterhouse 56, 116 Princess Christian Care Centre 76, 120

Promedica24

Water Mill House Care Home 58 Weald Group 34 Wenham Holt Nursing Home 116, 121 West Hallam 38, 113 Westerley in Westcliffe on Sea 56 Westerley Christian Care Homes 56, 114, 122 Westerley in Grange Over Sands 114 Westerley in Minehead 122 Westerley in Woodhall Spa 56 Westley Court 124, Inside back cover Whiteley House 120 Whiteley Village Care Centre 69, 120 Woodstock 121, Inside back cover Woodstock Residential Care Centre 118

51, 114, 115, 119

R Rayners 115 Regal Outside back cover Rosebery House Residential Home 61, 115 Rotherbank 116 Royal Alfred Seafarersâ&#x20AC;&#x2122; Society, The 69, 120

S Silverpoint Court Residential Care Centre 114 Simply Care Home 60, 61, 115, 124

Care Choices Limited has taken every care to ensure that the information contained in Care Select is accurate. The company cannot accept responsibility for any errors or omissions or if a home varies from the facilities listed either in an advertisement or the listings. Care Choices Limited does not endorse or support any particular institution included in the publication.

Publisher: Robert Chamberlain.

ISBN 978-1-910362-43-3

Sales Executives: Steve Howett, Vanessa Ryder.

Ref. No: 4001/CareSelect05/15. Reproduction of any part of this publication in any form without the written permission of Care Choices Ltd is prohibited.

Director of Creative Operations: Lisa Werthmann.

Published by: Care Choices Ltd, Valley Court, Lower Road, Croydon, Nr Royston, Hertfordshire SG8 0HF. Tel: 01223 207770.

Creative Artworkers: Gemma Barker, Kathryn Regan.

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Director of Sales: David Werthmann. Head of Editorial: Emma Morriss. Assistant Editor: Emma Cooper. Regional Team Manager: Russell Marsh. National Sales Manager: Paul Leahy. Senior Sales Executives: Debbie Feetham, Elaine Green, Rachel Joseph.

Assistant Production Manager: Jamie Harvey. Designer: Holly Cornell. Distribution: David Mulry.

Visit www.careselect.co.uk for further assistance with your search for care

www.coatewatercare.co.uk

Coate Water Care is a family run business that provides a high quality care service in all our Nursing, Residential and Dementia care homes. • We provide 24 hour nursing, residential and specialist dementia care • Specialist care for clients with end of life, palliative care needs • Respite care available • Qualiﬁed and experienced personal care staﬀ • All food is freshly prepared on premises to restaurant standards • Our bedrooms are spacious and all have en-suite facilities and TVs • Organised entertainment and outings • Engaging and appropriate activities and hobbies • Attractive secure gardens • Hair and beauty treatments • Free internet usage • Visiting chiropodist

Choose the right home, with care, for you or an elderly loved one

Ashbury Lodge

261 Marlborough Road, Swindon SN3 1NW

Chapel House

Horton Road, Gloucester GL1 3EY

Church View

Rainer Close, Stratton St Margaret SN3 4YA

Downs View

Badbury (Near Chisledon), Swindon SN4 0EU

Mockley Manor

Forde Hall Lane, Ullenhall B95 5PS

Westley Court

Austcliffe Lane, Cookley, Kidderminster DY10 3RT

Woodstock

North Upton Lane, Gloucester GL4 3TD

t: 01793 821200

e: info@coatewatercare.co.uk

Our homes in Kent and Sussex have Coastal and Woodland views. Why not pay a visit to one of our care homes...

For more info please... Call: 0845 873 1234 Email: info@njch.co.uk Web: www.njch.co.uk

â&#x20AC;&#x153;Passionate about the care we provide...â&#x20AC;? Our homes can be found throughout the UK. Each home is unique with its own character. We deliver high quality care for those needing Nursing, Dementia and Residential Care both short and long term.

Our homes are located nationally.

For more info please... Call: 0208 668 1500 Email: info@regalcarehomes.com Web: www.regalcarehomes.com