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
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CHOICE? HO W W ONG ILL WR I EE? HOW WILL I K KNO HE AGR W N ET T O W W WHAT ARE THE C AK SN’ W H A R I M DOE ICE? E O HI C THE CARE OPT I P O M RE HO TI N C O TA OW WILL I KNO S? G W HA W W IT? HI AGREE? WHAT I F RD SN’T IM E? S O W HA OE CHO OW W T IT? I £9.95
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Contributors Dame Esther Rantzen Les Bright, BCD Care Associates Jane Preedy, Enable Payroll
Contents 6 7 11 15
Foreword by Dame Esther Rantzen Is it time for support?
Vicky Hodgkinson, Alzheimer’s Society
Understanding their needs
Simon Chapman, National Council for Palliative Care and Dying Matters Andrew Grey, National Council for Palliative Care and Dying Matters
Dealing with family pressures
Choosing a residential care home checklist
19 26 30 38 46 48 53 65
Was it the right decision?
66
Support to live independently at home Making life easier in the home Choosing care Care and support at home
Laura Bennett, Carers Trust Liz Mulvaney, Freeths LLP Consultant
Choosing a home care agency checklist Specialist housing with care schemes Residential care options
Residential dementia care checklist
68 75
Thinking of end of life care
76
Are you a family carer?
82
Dementia and dementia care
Legal considerations
86 94
Essential contacts
97
How is care funded?
Publications
www.careselect.co.uk
100 113
Region-by-region care homes Advertisers’ index
@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 My wish for 2016 is that we tackle the epidemic of loneliness in Britain today. I know from my own personal experience the stigma attached to admitting you are lonely. But the only way we can ever solve this problem is by discussing it and working together. We know from the 1,200 calls we receive daily at The Silver Line that the simple act of talking, and feeling listened to in return, is transforming lives. One comment from a gentleman which stays in my memory was that when he put the phone down he felt like he had joined the human race.
“Everybody has a responsibility to spread the message that ‘living in the right home’ can be positive and transformative.”
Foreword Is it time for support? Understanding their needs Dealing with family pressures
People being honest about how they feel and what they need gets more important as they grow older and this is particularly true of choosing the right care and support. The aim of this handbook is to assist older people and their families through the emotional and practical aspects of finding the right help at the right time. I have visited older people in many different types of settings. On one particular visit to a care home, where I was invited to have tea with the residents,
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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’ should not be seen as a callous act. ‘Look at our residents,’ she said. ‘If they were trying to survive in their own homes, they would never have this standard of food or 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.’ I know from my recent hosting of the 3rd Sector Care Awards, the importance of not only recognising but also celebrating the outstanding work that goes on behind the scenes. If things aren’t right, it needs to be known but recognising a care home or a similar support service when they are providing excellent care and support can inspire and promote positivity for the sector and those who rely on it. Everybody has a responsibility to spread the message that ‘living in the right home’ can be positive and transformative. By doing this, we will be one step closer to ensuring that the silver generation doesn’t feel invisible or inaudible, rather, they feel listened to and, with the help of family and friends and information such as this handbook, able to choose the right kind of care for them.
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Is it time for support?
Foreword Starting your journey
Important decisions can be hard to make at the best of times, but when they concern your immediate family and their wellbeing, they may feel much harder. Accepting that your parent or loved one has come to a point in their life where they need help to live the way they want to live is understandably difficult for all involved.
Understanding their needs Dealing with family pressures Support to live independently at home Choosing care
It marks a shift in how you see one of the most important people in your life, perhaps how you see yourself and your subsequent relationship with them. In this situation, there are lots of different emotions, felt by a number of different people, as well as the specific needs of your parent or loved one. Each of these may have to be met, or at least acknowledged, in order for life to feel functioning and positive once again. How do you help your ageing relative come to terms with how their life is changing, when you are seeing them in a different way to how you have known them? How will you know exactly what support they need and how to find it? Where do you start? It will almost certainly be a difficult time. However, with the lines of communication firmly open between everybody involved and tools such as this handbook to help, the start of this process should begin to feel easier. At first, getting your head around the situation may feel overwhelming because you don’t have all the answers about what life will look like in the near future. Making an informed decision will always feel more difficult when you don’t know all the variables. However, by assessing what your relative needs help with now, and what they want to
feel more confident about in the future, you will hopefully address the issues head-on and help to secure a better future for them.
Care and support at home
How do you know when the time is right?
Residential care options
Choosing a home care agency checklist
In an ideal world, noticing that a parent or loved one needs more help and support in their day-to-day life would come before they find that they are really struggling. This would allow for plenty of time to think about small changes around the house or the different types of care and support that may help them. In reality, however, the realisation could well come later and conversations and decisions may feel more rushed than you would like. If an accident or sudden illness has prompted action for the first time, this will heap additional pressure onto the emotions you are already feeling, and the urgency of the situation may understandably cloud your judgement. The situation also depends on who broaches the subject first. After a few visits to your parent’s home, you may have noticed that they are no longer finding daily tasks as easy to carry out on their own. They may be struggling to keep on top of the housework or
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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 Region-byregion care providers Advertisers’ index
laundry, or finding it increasingly difficult to maintain their usual standards of personal hygiene, such as bathing or just getting in and out of the bath safely. Alternatively, your loved one may have come to you and mentioned that they think they need help. If the idea to seek help has stemmed from you or other family members initially, it may feel like a sensitive subject to broach. Far from making your ageing relative feel that they are failing at things they once found easy, it is natural for you to want them to know that you are just trying to help and support them. Ensuring that they feel understood and respected at the same time may feel like a challenge, but broaching the subject gently may help to reassure your parent. It is important that they feel in control of the situation and that their thoughts and opinions are central to the process.
“It is important that they feel in control of the situation and that their thoughts and opinions are central to the process.” On top of this, you may be feeling guilty that you are unable to do more due to other demands on your time. Everyday things such as work and family are hard enough to balance, but if you are trying to support your loved one from a distance, or even nearby, it may well feel like there are not enough hours in the day.
Sensitive subject Noticing, and possibly even joking about, a loved one’s forgetfulness is something which probably happens daily in households up and down the country. Perhaps they rush around looking for their keys just as you are all leaving the
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house or maybe they forget a relative’s birthday because it isn’t written on their calendar. These things are normal. However, if these small occurrences start to escalate and compromise your relative’s personal safety, then they should start to be taken more seriously. By focusing on home improvements instead of pointing out what your loved one is struggling with, you and your relative will be taking the small steps necessary to restore confidence and encourage independence. This is something that everybody deserves to feel regardless of their age. Installing grab rails or banisters is a good way of addressing your relative’s concerns early on without having to rely on a more serious measure straight away. There are many innovative solutions to make life easier around the house, items that you may never have considered. If you feel that your loved one will need more support further down the line, these simple aids and adaptations will allow time for everyone to think about what action should be taken at a later date. Even if your loved one does have higher support needs, small changes to their home environment can work alongside more formal support.
Stay connected Each family has their own dynamic but it is important that all the people who are connected to your parent or loved one have the opportunity to express their opinion. Make the time to involve your siblings or other close family members. If everybody lives far away from each other, arranging a get-together will offer the chance for everyone to talk about their hopes, fears or concerns about the future of their loved one. It may be that some relatives don’t realise the changes in your parent, so a chance for everyone to get together will help them to see the
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points you are trying to make. It is likely that, at some point during the many conversations you have, people will disagree with what the best option may be. There may come a point where you need to accept that not everyone can be kept happy. If this occurs, remember that the most important thing is that your loved one feels happy and comfortable with the decisions and is involved in directing what is best for them. As emotional as this process may be, there are also financial and practical considerations. Discussing topics such as what could happen to the family home, which may well have been where you and your siblings grew up, is a topic likely to divide opinion. However, it is important that everybody has the chance to say how they are feeling. During this process, it is always important to remember that your loved one’s wishes and opinions stay central to the conversation.
On reflection It may be that you and your family have little or no experience of the types of support that you are exploring. If you don’t know anyone who has received home care, lived in a care home or used the services you are looking into, you will naturally rely on what you may have read in the newspapers or heard about in the news. Putting your trust in people you don’t know, particularly if your relative feels like they don’t need care in the first place, will be difficult initially. However, there are care providers up and down the country which provide excellent care and a highly-personalised service. There are also ratings of care services which help
you to understand the level of support offered by different organisations. Most of the people who work within the care sector do so because they are caring individuals who want to look after people and help them to live independently.
“Most of the people who work within the care sector do so because they are caring individuals who want to look after people and help them to live independently.” However, it is also important to realise that decisions don’t have to be final. If you and your loved one choose a support system which doesn’t live up to expectations, there is lots of information out there explaining what to do if you are not happy with the care you are receiving. The pages that follow this chapter explore many of the different options available to you and your loved one. Some of them you may have heard of, but others you may have not. They should help inform your thinking and final decisions about the best route to go down to secure the most appropriate support for your relative. Regardless of any difficulties in coming to terms with the ageing process, the sooner conversations are started, the better. This way everyone can spend as much time as possible researching this big decision. It is also worthwhile remembering that the outcome of these lengthy and emotional discussions should be a positive one; your loved one should be able to receive the care or support they need to live their lives.
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Understanding their needs When the time arrives to seek support, you will be confronted with the task of establishing what is needed. The personal insights you have, based on detailed knowledge of your relative's background and preferences and some of the difficulties that have emerged over the preceding months and years, will be valuable. However, you may also be ‘too close’ to see things clearly – and are unlikely to have a full picture of the range of solutions.
It is most likely that you and your ageing relative will start by focusing on what is proving difficult, for example, simple household tasks that are going undone, or feelings of isolation and weariness. These may be the most obvious signs of decline, but alongside them, it may be good for you both to take stock of the activities and tasks that are not problematic. If your loved one retains an interest in cooking and wants to carry on, while finding it more difficult to stand up or to collect shopping, you might consider supermarket home delivery services and small changes in the kitchen that will enable cookery to continue as a highlight of the day. If weekly visits to social events are important to them but driving is becoming tricky, consider local transport options or asking other attendees if they are able to provide a lift.
Small changes, big impact Until you become familiar with the range of options available, and there are lots, you should resist the temptation to be ‘efficient’ and organise lots of changes. These could have a very unsettling effect. Instead, consider whether there
are small changes that could make a big difference. For example, installing grab rails beside steps into the house, or in the bathroom, will give confidence back, at the same time reassuring you too. You may be tempted to take on apparently simple jobs yourself, but any practical skills need to be backed up by a good understanding of what works for people with a mobility problem or any other kind of impairment. There is a wealth of different aids, adaptations and technological devices that can support people at home, things that you may not have considered or even be aware of. The chapter starting on page 19 goes into these in more detail, as do the graphics on pages 26 to 29.
Loneliness Your parent may be feeling lonely as a result of living alone for the first time in many years. If this is the case, a quick review of local opportunities such as any lunch clubs in the community – perhaps organised by churches or charities like Age UK – could be a useful starting point. No matter how old you are, it can be a very big step to go out alone for the first time, so try to find someone to
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act as a companion or support. These informal settings can often prove to be pivotal in changing perceptions of the ‘awfulness’ of being alone. Others who have travelled the same path can share their ‘top tips’ and provide some much needed stability or friendly companionship.
Formal social care support Most of us are clear that we want to carry on living at home for as long as possible. Our homes are a source of comfort, filled with mementoes and memories. For those who want, and are able, to remain living at home, services are increasingly being arranged to make that possible. These can range from home help to home care, live-in carers or employing staff. More information on care in the home starts on page 38.
“A good care home can make a huge difference to someone’s quality of life.” However, remaining in the family home may not always be possible, or desirable, as your parent’s health or mental capacity deteriorates. Many people feel that, at this stage, it is time for residential care. However, there is a spectrum of interim options called housing with care or retirement housing. These schemes are variations of traditional sheltered housing and offer different levels of support within a property that can be owned, rented or part-owned and part-rented. Further information on housing with care is
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available on page 48. As your parent’s needs continue to grow, the time may come to consider residential care. Although care homes and care homes with nursing can get a bad press, they often do wonders for people. A good care home can make a huge difference to someone’s quality of life. There can be a real community feel, lots of activities, visitors, events and opportunities to participate in everyday life, from helping with the food, or laying the table, or just relaxing and enjoying being supported throughout the day and night. More information on care homes, care homes with nursing, choosing the right home and also evaluating the decision are found starting on pages 53 and 66. Details of care homes, region-by-region, start on page 100. As the need for formal social care grows, you should consider calling on the local authority for an assessment of your loved one’s care and support needs. This will enable you to get a better understanding of what their specific needs are. You can then use this information to make sound decisions about the best way to meet their current and future needs.
Calling on the professionals Local authorities have long had a duty to carry out assessments of those people who could be considered to be in need of care services. This has recently been strengthened by the Care Act 2014, which enshrines in law someone’s right to an assessment if that person appears to require care and support. It also recognises that people, acting as carers for a loved one, friend or
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relative, may also need support. Carers are also entitled to an assessment, regardless of whether the person they support is being assessed. For more information on carers, see page 82. The local adult social care department, or equivalent with a slightly different title, should be in the phone book or can be found by a simple internet search. You may find that it’s your parent’s local council, although in some areas smaller councils don’t have responsibility for social care. In those cases, is it usually the county council. Social care is a paid-for service, it is not free like the NHS. However, depending on your parent’s specific financial situation, there may be assistance available with paying for care or financial products – each requires specialist financial advice before commitment. Your parent’s right to an assessment, and the authority’s duty to conduct it, should in no way be influenced by their financial situation – income, capital, or savings. That is a separate matter which should not intrude or lead to undue delay. An assessment of care and support needs should be conducted by a professional assessor. It provides an opportunity to look at your loved one’s overall ability to continue the normal activities of daily life. It also looks to identify the steps that can be taken to improve any issues they may have, to establish their personal preferences and take on board the views of significant others – including you and other family members. The assessment should be based on a home visit, but you may be offered a preliminary telephone call. However, ensure you do get that visit, as making
decisions about the extent and intensity of your loved one’s need for care and support relies upon a professional observing the wider picture.
“Your parent’s right to an assessment, and the authority’s duty to conduct it, should in no way be influenced by their financial situation.” This can include 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 extent of current help from family and friends, the scope for stepping that up, and the impact increased demands could have on you and any others involved in providing help. If you do face undue delays in getting the assessment started, you might consider asking your parent’s GP to contact the local authority, bringing their professional weight to your request by outlining their perspective on their patient’s situation.
A plan for care Following the assessment, a care and support plan should be produced. This will identify your loved one’s needs and wishes in considerable detail. Regardless of whether the authority decides that the level of urgency or need is such that they will organise and/or meet some cost of the services provided, you are left with a key document to assist you in setting up the
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right kind of services independently. It will be invaluable in 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 loved one’s needs.
“The aim of reablement is to support your relative to relearn skills or build confidence.” 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 organisation is commissioned by you to provide the service, the support plan should be reviewed regularly to take account of the impact it has made. A review also offers the opportunity to modify times and types of service in light of what works well and meets the needs of your loved one most effectively. This review can be undertaken by the support provider or, alternatively, you can reapply for an assessment from the local authority.
Leaving hospital If you are thinking through these issues while your relative is in hospital, there may be pressure to complete their discharge if they no longer have acute medical needs. However, they should not feel compelled to leave hospital without a comprehensive assessment of their care needs – an opinion that medical treatment on that site is no longer required should not be seen as sufficient. If it is decided that
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your parent should leave a medical ward, but they still need further rehabilitation support to return to the community, they may be offered a short stay in either a smaller ‘community hospital’ or in a care home that is registered to provide care that is variously known as ‘reablement’. This may even be a shortterm package of care offered in their own home. The aim of reablement is to support your relative to relearn skills or build confidence they may have lost due to the hospital stay or the incident which saw them admitted to hospital. Again, there should be a detailed assessment, a plan of the steps to be taken, the desired outcomes from this approach, and the likely timescale for moving back home or elsewhere. In hospital, the 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. It will take the same approach as outlined above and is just as critical to finding a care agency or home appropriately equipped and staffed to meet their identified needs. Ideally, the person undertaking the assessment 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. As with a communitybased 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 any discussions. Again, your parent’s wishes and best interests should be central to any decisions. For information on paying for care services, see page 86.
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Dealing with family pressures When a relative starts to require more support on a daily basis, it can stir-up emotions thoughout the family. Managing these can take time, patience and understanding.
We’re all in it together If a loved one, who had formerly been seen as the ‘head of the household’, displays some of the tell-tale signs of struggling to manage an independent life, then it is likely that a range of emotions and barelysuppressed tensions may also come to the surface – from all directions within the family. These telltale signs could include, mobility problems – finding the stairs more of a challenge; other physical impairments – no longer strong enough to complete common tasks safely; memory issues – struggling to remember everyday events or missing appointments; problems communicating clearly – failing to understand and act on straightforward advice. While no two families are the same, the range of responses emerging from within the family circle may be more predictable. Families are more geographically dispersed than ever before; consequently, there are likely to be marked disparities in siblings’ knowledge and understanding of their parent’s situation. A daughter living close to the family home with frequent, possibly daily contact may well have observed – and reacted to – signs of difficulty rather more easily than her brother living in another region who makes regular phone calls to stay in
touch. She is more likely to be the one who gets involved in taking her father shopping, keeping his house clean – all the while perhaps also noting a less than perfect approach to maintaining his appearance and cleanliness. Lack of attention to shaving, hair or changing clothes sufficiently frequently are each signs that point towards possibly more deep seated problems. Then something happens – a fall is the most common occurrence – that leads to a crisis, and a subsequent rallying around begins. At this point, some of the hidden tensions or ‘secrets’ – the things we would rather not talk about – may be revealed.
Pressures Those closest to your relative tend to get drawn into assisting in a range of ways, though this is not universally the case as not all family members will respond in the same way. Some may be very happy to roll up their sleeves and do the housework, take your loved one shopping, or cook meals for the freezer. While another relative, living just as close by, but with a full time job and a hectic family life – including lots of hobbies and interests – may be reluctant to commit as much time and may see the relative that is assisting as ‘making a
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rod for their own back’. Added to this, you may have an ‘outsider’ who lives at some distance, comes for a visit, brings treats or arranges a trip out to a local pub or restaurant for a meal and is then gone again – attracting plenty of thanks from a grateful loved one who recognises the time, effort and money put into making a lengthy journey.
“Seeking the involvement of others, including outside experts, to assess the situation may take the heat out of a difficult situation.” Any of these approaches may be welcomed by an ageing relative: one keeps the show on the road, holding back the day when crucial decisions have to be made; one has limited involvement which may lead to your loved one paying for a service rather than accepting help from within the family which can maintain privacy and control; while the occasional visitor creates highlights to lift events above the daily routine.
Conflicts Whatever your situation, it seems almost inevitable that some conflict will arise during tough times – hopefully thinking things through in the ways outlined will minimise the length and depth of them. Those who feel they are carrying the greatest weight – making regular and possibly frequent commitments to ensure that their relative remains safe
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and leads a dignified existence – may see themselves as taken for granted. Others may view this as creating a dependency, or papering over the cracks by delaying formal support. One of the powerful arguments for ‘keeping it in the family’ is that outside agencies are sometimes unable to keep their commitments on time – due to no fault of their own. For example, care staff may be affected by traffic problems or competing priorities, such as another client having some kind of crisis. Although this may be true, it is not inevitable and the alternative – one person carrying the physical and emotional weight of caring and carrying on with normal life – may cause too much stress. Love and concern doesn’t turn us into experts, even though we may have detailed knowledge, gleaned over a lifetime, of our relative’s lifestyle. Seeking the involvement of others, including outside experts, to assess the situation may take the heat out of a difficult situation and throw light on what needs to be done and the best way of doing it.
Seeking resolutions Beginning the process of seeking help and involving third parties, in the form of professionals to assess your loved one’s need for care and support, is likely to be useful for the rest of the family. While acting as a family mediation service is not a primary consideration for a hardpressed social care assessor, they can fall into that role as a result of the questions they ask, and the way in which they share what they find. They also recognise the importance of family support to augment what can be done by professionals, and the need to
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protect individuals from unmanageable demands. By taking stock of what has been going on and identifying the strengths and weaknesses in existing arrangements, it will become clear who plays a pivotal role in holding the household together. If you or someone has been taking on the role of informal carer, they may have held back from outlining the depth of their involvement and the demands they have been routinely fielding to keep their loved one at home as they wish, because they don’t want to appear self-promoting.
You’re not alone Supporting a frail older person is not easy, even when the person in question is compliant and welcomes outside help. Even though your relative’s income
or savings may mean that they will not qualify for financial assistance in meeting the cost of their care, you should look for help to identify the best way forward. As stated earlier, an assessment will enable you to make sound judgements on what is needed. It will also act as a focus for discussion within the family, allowing you to face the difficult decisions together to address the perhaps unsaid and sensitive concerns you all may have about the impact on assets. Your loved one may well be holding back from looking for more assistance because they have a strongly held wish to pass on their home or their savings as an inheritance. Considering these issues will help you all to make timely and sustainable plans for the best possible quality of life. See page 86 for more detailed information on paying for care.
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Mabel and Jim’s story Mabel is five years younger than her husband Jim and much fitter. He is partially-sighted and uses a wheelchair. Mabel has found herself taking on more tasks as Jim has become less capable. She is determined to do this because of her deep love for him, but it has begun to take a toll on her in many ways. She is always tired and began neglecting garden routines that gave her so much pleasure. Both of their children live abroad, and while she and Jim look forward to their annual trips back to the family home, they cannot be relied on to assist with their daily needs. Mabel talked to both of them via video-chat and it was agreed that she should look for help with managing the extensive garden and paddock where her horse grazed. They figured that gardeners were cheaper than care workers, that their father would be resistant to being helped with personal care and that their mother would not be so physically rundown if the hard work in the garden was being done by someone else. They took no account of the therapeutic value of gardening and the respite this provided Mabel from the increasing demands of her husband’s growing care needs. However, this arrangement did not hold for long as Mabel fell while pushing Jim in his wheelchair and broke her arm and wrist. Suddenly, she was unable to care for herself effectively, and crucially could not help Jim. Also, she could not drive the car, thus stranding them both until the break mended. Luckily, the gardener had been
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happy to step up her involvement, in particular by driving them to various appointments and assisting with shopping. In no time at all, the strain of everyday life caused Mabel to visit her GP to discuss her own deteriorating health and the prospects for her husband’s care. Her children were concerned that this could lead to their father entering a care home, leading to the need to sell the family home to meet the costs. They both agreed to come home, without their own families in tow, to have a roundtable discussion about the future. Their mother’s visit to the family doctor was the key to convening a family discussion. It was also attended by a social worker and an occupational therapist. The professionals led them through the options available and enabled them to make sound decisions for the short-term, while Mabel was incapacitated, and longer-term plans too. As well as coming up with a workable plan for the present, they were also able to explain the complexities of the funding arrangements associated with the various care solutions. They pointed out that Mabel would not have to sell their home and find a new smaller place for herself if Jim finally needed to move into a residential care home. Their children were able to travel back overseas knowing that both their parents’ welfare was assured – for now – as a result of all of them sitting down together with people who had ‘seen it all before’ and knew what to do.
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Support to live independently at home
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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 supporting them more often, despite your own commitments? Will they be in danger or 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 increasing needs, 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 be supported 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 goes a long way It’s true of most ages that a fundamental part of maintaining a healthy and independent life is a balanced diet and 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 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 improve mobility and wellbeing as
well as helping to reduce the risk of developing certain long-term health conditions such as high blood pressure, heart disease, stroke and osteoporosis.
“It’s true of most ages that a fundamental part of maintaining a healthy and independent life is a balanced diet and regular exercise.” If your relative has a health condition, contact their GP before starting any exercise. For more information on physical activity guidelines for older people visit the NHS website: www.nhs.uk
Staying safe at home
Support to live independently at home Making life easier in the home Choosing care
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 idea. Be observant of their daily activities. If you don’t live with them, 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
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Care and support at home Choosing a home care agency checklist Specialist housing with care schemes Residential care options Choosing a residential care home checklist
there, such as they struggle to reach the pot in the top cupboard, or the light-bulb in the hall has been blown for a while.
and see that a few simple changes can enhance their standard of living.
Aids and equipment
“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.” 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 increasing dependence. Do they struggle to get upstairs? Is getting in and out of the bath a problem? Can they reach all the cupboards in the kitchen? 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
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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 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 accessible clothing. 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 26 for other solutions to make life easier in the home.
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Simple but effective changes Phyllis had been living on her own for five years, since her husband John passed away. She had an active social life and enjoyed meeting friends and family regularly for coffee, lunch, local events and much more. She took pride in her appearance and was always impeccably turned out. However, as the years passed, she began to struggle to wash her hair and bathe regularly. She confided in her son, Colin. Colin was immediately concerned that his mum was going to need someone to help her wash and dress on a daily basis. He phoned a few care agencies to see if they could help. Phyllis also mentioned it to her friend, Catherine, who recommended an occupational therapist that she’d used. Phyllis made an appointment and Susan came to visit. As a qualified occupational therapist, Susan looked at Phyllis’ home and talked to her about the issues she
Adapting the home There are a number of adaptations that can be undertaken on a family home – from installing a downstairs bathroom or stair lift, through to refitting the kitchen, lowering the worktops or widening doors for wheelchair access. 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
was having. She found out that Phyllis was struggling with her bath. She could not get in and out easily, she had no separate shower and used an attachment to the taps to wash her hair. This involved leaning over the bath, something which was causing Phyllis pain. Susan recommended a bath seat as an interim measure and advised Phyllis and Colin to consider removing the bath and installing a shower cubicle with shower seat. Colin purchased the necessary equipment and arranged for a local tradesperson to come round and install it. Phyllis was delighted. It gave her the opportunity to feel like herself again, without the need for more formal support. She carried on with her regular social events and was extremely happy. Colin was happy too, as he realised his mum was still very independent, she just needed a few small changes in the home.
and private tenants on what may be possible as well as undertaking a financial benefits check to see if your your relative is entitled to any support from the Government. 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. You can find your local HIA at www.findmyhia.org.uk They also have an option for you to
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find a handyperson. Handypeople are able to undertake small jobs around the home, including safety and security checks and minor adaptations. Some homeowners may be eligible for a Disabled Facilities Grant to help with the cost of larger adaptations. The local home improvement agency may be able to help with the grant application, but make sure you look into the grant before starting any work. The Government website www.gov.uk/disabled-facilitiesgrants has more information.
Assistive technology In the current technological age, there is an increasing range of telecare and assistive technology to help support people in their homes for longer. The most familiar piece of assistive technology is likely to be community alarms. This could be worn as a pendant or wrist button, or pull cords around the home. In an emergency, your relative activates the alarm and it either contacts you or a nominated person directly or it goes through to a central call centre which calls you, a nominated person or the emergency services if necessary. Some of these systems have a base unit where the controller can speak directly to the caller until help arrives. There is also a wide range of sensors that can detect carbon monoxide or gas; or flooding from a running tap; 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. Also, don’t overlook the benefit of a tablet computer. Their rise in popularity has been huge and they can make a real difference – from automatic calendar reminders to video calling and beyond. You may find local groups offer training on using and getting the best from a
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tablet for you and your parent, if you’re a little unfamiliar with how they work. Alternatively, employ the skills of one of the family’s younger generation. These items can all add to peace of mind if you’re concerned about your loved one being alone at home. Little changes can also give your relative confidence in their daily life, potentially 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 so it is recommended to research what may be available. With the speed at which technology changes, new products are coming to the market all the time.
Equipment hire A mobility impairment can leave a loved one feeling isolated and dependent on others. However, it is possible to hire equipment to aid with daily living. The British Red Cross, for example, offers short-term loans of wheelchairs and other equipment including crutches, backrests, bath seats, walking sticks and frames, commodes or bedpans. You can search its website for your nearest service, visit www.redcross.org.uk Alternatively, there is a wide range of private providers that hire out such equipment. A quick search of the internet will help you find what’s on offer nearby.
Getting out and about Mobility If your relative still drives but has a disability which means that they receive the enhanced rate of the
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mobility component of the Personal Independence Payment, the higher rate mobility component of the Disability Living Allowance, War Pensioners’ Mobility Supplement or Armed Forces Independence Payment, they may be eligible for the Motability Scheme. Motability enables people to use their mobility allowance to lease a new car, scooter or powered wheelchair. To find out more, visit www.motability.co.uk There are other ways to aid getting out and about and remaining independent.
Blue badge scheme A blue badge enables the holder to park closer to where they need to go, making it easier for them to shop and access local amenities. For more information, visit the Government’s
website www.gov.uk/apply-blue-badge
Community transport Community transport can help people to get to appointments if they can’t use existing transport. To find community transport in your relative’s region, visit the Community Transport Association’s website www.ctonline.org.uk/search/england
Free bus pass Those living in England may be entitled to a bus pass giving free off-peak travel on local buses. Men and women both become eligible at the State Pension age for women. You can find more about eligibility by searching ‘Free bus pass’ on the Government’s website www.gov.uk A bus pass can be applied for from
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the local council and the www.gov.uk website can link you through to the correct page on your relative’s local authority’s website via a simple postcode search. The free bus pass can help people to get out into the community, see friends and family and stay socially active – without the worry of driving or the cost of keeping a car.
Staying social As people get older, they can find themselves feeling lonely or isolated. Where once there was a wide social group, there may now only be one or two friends. These friends may struggle with mobility or live at a distance, making social activities more difficult to organise. This can lead to loved ones going out less, or feeling less inclined to try new activities without friends to accompany them.
“The Silver Line offers a free, 24-hour helpline providing information, friendship and advice for older people.” You may feel under pressure to fill the void, visiting frequently, arranging days out, offering lifts to or from events. This is fantastic, if you’re willing and able to do it, however, it can take its toll on you and your family. Local befriending services may be a solution. They can offer companionship and support as well as accompanying your loved one on appointments or outings if they’d like. They may even pop by for a 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 the necessary
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background checks like a Disclosure and Barring Service check, or whether any organisation offering befriending does suitable background checks. To find befriending organisations contact the local Age UK. There is also a service called The Silver Line, set up by Dame Esther Rantzen. It offers a free, 24-hour helpline providing information, friendship and advice for older people. Volunteers can be on the end of the phone at any time and the organisation can match people to volunteers for weekly calls and catch-ups over the phone. Such a simple gesture can go a long way to making someone’s day if they’re feeling a little lonely. Day opportunities should also be available in the area. These offer your relative a great opportunity to get out and about, possibly have lunch, meet new people, make friends and enjoy themselves. Some even arrange transport. These services are likely to be chargeable but they offer the chance of regular social activities for your relative and something to look forward to each week. Look around the local council website, the community centres or ask Age UK or similar organisations if they know of any day opportunities in the area. Some local care homes also offer day opportunities which is a great way to become familiar with the setting and the community feel it can bring.
Small steps Knowing what’s available for inside the home and in the wider community can make a big difference to your relative’s life. Small changes can go a long way to keeping them independent and safe in their own home for longer. If you find that your parent isn’t as open to change as you’d have liked, don’t be disheartened. Take things slowly and don’t overwhelm them.
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Helping Joy at home Joy lives on her own but has a very close relationship with her daughter Zoe, who visits her twice a week. Joy had a hip replacement about a year ago and, whilst the surgery had gone well and improved Joy’s ability to get around, her hip still causes her some discomfort. Joy has always taken pride in how tidy her home is and how much her family love her home-cooked dinners. Before her grown up children had all moved away, Joy’s favourite part of the week was when her children and grandchildren all came round for Sunday dinner. Joy saw her home as somewhere that brought her family together which is why she took so much pride in it. After visiting a few times more recently, Zoe noticed that whilst the downstairs of the house was immaculate, the upstairs was starting to get dusty and untidy and the folded piles of washing were being left downstairs instead of being taken upstairs and put away. Although they had a very close relationship, Zoe was reluctant to talk to her Mum in case she offended her. After one particular visit, where
Joy was trying to persuade Zoe to use the downstairs toilet instead of the upstairs bathroom, Zoe decided to bring the subject up with her Mum over a cup of tea. After chatting for a while, Joy admitted that she was finding it difficult to get up and down the stairs more than once a day when she went up to bed and woke up in the morning. Zoe got in contact with her Mum’s local Home Improvement Agency (HIA), who advised that Joy may find a handrail going up the entire length of the staircase helpful as there wasn’t one there before. Joy was also advised that she might find one outside her front door useful as there was a fairly big step leading up to the house. Zoe also arranged for somebody to visit her Mum’s house once a fortnight to mow the lawn and keep the outside tidy as Joy admitted she was struggling to carry things in and out of her garage. These small changes allayed Joy’s fears that she would have to leave her house. She soon felt confident again that she could live the way she wanted to and keep her house the way she liked it to be kept.
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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 Standing up from sitting is difficult Chair too low
• Block of foam in chair base •B uy ready-made chair raisers •B uy a new chair that is the right height • Take regular, gentle exercise
• Buy an electric riser chair
OPENING AND CLOSING WINDOWS Can’t reach the windows Not secure to leave windows open
• 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
CONTROLLING THE HEATING • Change the switches Can’t reach the controls for • Fit a timer switch the fire or heating • Purchase a standalone heater
• Move the heating controls • Install new or additional heating system
SWITCHING LIGHTS ON AND OFF Can’t reach the switch Switch is difficult to use
• Install a light switch toggle • Purchase a socket extension • Purchase handi-plugs
• Move the light switches • Replace the light switches • I nstall environmental controls
KEEPING WARM Insulating your home Affording the fuel Carrying the fuel
• Replace the fire with a heater • Apply for the winter fuel payment • Use a trolley to safely transport the fuel
•G et a grant to insulate your house •C hange to a cheaper heating system •C hange to an easier-to-use heating system
WATCHING TV Hear the sound of the TV
• Use subtitles • Purchase wireless headphones
•R equest an assessment for a hearing aid • Install a room loop
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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?
Pill dispenser
SIMPLE SOLUTIONS
GETTING IN AND OUT OF BED • Learn new techniques for moving Standing up from sitting on the safely bed • Purchase a leg lifter • Raise the bed • Fit grab rails
COMPLEX SOLUTIONS • Use a transfer board • Install a hospital bed • Buy an electric adjustable bed • Use a mobile hoist or a ceiling track hoist • Buy a bed cradle/bed ladder • Use a bed lever • Buy a specialised mattress • Install a drop-down rail • Install a monkey pole
SITTING UP IN BED, TURNING OR ROLLING OVER Bed is too soft Bedding is too heavy Nothing to lean on
• Change bedding • Learn new techniques for moving safely • Purchase a pillow raiser • Change the mattress
KEEPING WARM IN BED Checking the safety of your electric blanket
• Buy a heavier duvet • Buy thermal clothing • Contact an electrician about any electrical blanket safety concerns
GETTING DRESSED Difficult to reach all of your body
• Learn new techniques for dressing • Buy simple gadgets: long-handled shoe horn; elastic shoe laces; dressing stick; button hook; stocking aids • Contact the local authority regarding an assessment of needs
• Consider home support
CUTTING YOUR NAILS Can’t reach your feet Hard to hold scissors
• Buy easy grip scissors
• See a podiatrist
TAKING YOUR TABLETS 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 Seeing the clock to tell the time
• Buy a clock that ‘speaks’
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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?
SIMPLE SOLUTIONS
COMPLEX SOLUTIONS
REACHING CUPBOARDS Cupboards are too high or low Cupboards are too deep Cupboard doors are too heavy
• Re-arrange things in cupboards/on surfaces • Buy an Easi-Reacher or HandiReacher
• Alter the spring in the door closers • Lower or raise the cupboards
USING TAPS AND SWITCHES Taps or switches are too awkward Can’t reach taps or switches
• Fit tap turners • Purchase Handi-Plugs
• Change switches • Raise or reposition taps • Fit lever taps or new taps • Alter the kitchen
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
• 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 •C hange the height of the work surface •M ake space under the work surface for your knees when sitting
MOVING AROUND THE KITCHEN Not enough space
• Re-organise the furniture
• Review mobility equipment used • Adapt the kitchen •C onsider the suitability of the kitchen
EATING AND DRINKING 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 the local authority regarding an assessment of needs
• Buy a trolley • Consider home support for meal times
LAUNDRY AND IRONING Washing machine is too high or too low Putting up ironing board
• Install a wall-fixed ironing board
• Raise/lower the washing machine • Change the washing machine or iron
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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?
SIMPLE SOLUTIONS
COMPLEX SOLUTIONS
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
• Install tap turners • Purchase a long-handled sponge • Purchase a flannel strap • Contact the local authority regarding an assessment of needs
• Install lever taps or new taps • Purchase a stool • Raise or lower basin • Consider home support
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
• 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 •C onsider home support
DRYING YOURSELF Floor is slippery Room is too cold Difficulty in drying your body
• Heat the bathroom safely • Use a non-slip mat • Purchase a towelling gown
• Change the floor covering • Purchase a hot air body dryer
USING THE TOILET Toilet is too high or too low Difficult to clean yourself Flush lever is awkward Toilet is hard to get to
• Install a raised toilet seat • Use a combined toilet seat and support frame • Install a flush lever extension • Contact the local authority regarding an assessment of needs
• Review mobility equipment used • Adaptation to bathroom • Consider home support
CLEANING TEETH Gripping the toothbrush Standing at the basin
• Purchase a toothbrush gripper • Purchase an electric toothbrush • Use a stool
HAVING A SHOWER Difficult to stand for long shower Shower too high Shower controls are awkward Shower is slippery
• Have a strip wash • Use non-slip mats • Purchase a half-step • Contact the local authority regarding an assessment of needs
• Use a shower board • Use a shower chair or stool • Replace shower controls • Consider home support
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Choosing care Making the right choice about the future care of anyone is rarely straightforward and is likely to be even more challenging when the person in question is dear to your heart. An already difficult process may become more complicated by the fact that the work of finding out what is needed, and then exploring the options available, often happens at a time of crisis – after illness or a stay in hospital, or during a period of bereavement. Any of these events may adversely affect all parties’ ability to think clearly.
Emotions may be running high with sorrow, guilt, anger or resentment coming to the fore because of these recent – possibly sudden and dramatic – changes. If you are one of a number of close relatives, such sensitive issues may be played out against competing opinions on what is needed, or is seen to be most convenient. Even if your loved one has accepted that they can no longer manage without some help, this does not mean that the process of selecting and engaging a service will be plain sailing. They may perceive different benefits and drawbacks to any plans that you – or others concerned for their wellbeing – put before them. Time spent responding to worries expressed at that time may appear to slow things down, but in the interest of making good and sustainable decisions you should resist the temptation to rush this stage.
Pace...and timing It is worth reflecting on how you might feel if faced with a similar set of questions and decisions about your own future. Consider how you might feel if it seemed like someone was trying to
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get you to make up your mind and move quicker than you wanted to, without due consideration for the things that matter most to you. There’s a lot to absorb, with some fine shading in the differences, benefits and drawbacks associated with the various options. You may spot changes in your loved one’s physical capability or mental functioning – or both. However, they may not share your opinions about the difficulties they are having maintaining their property, getting around the house, shopping, cooking – all while staying safe. Any denial or difference in opinion is likely to need approaching carefully. You should avoid highlighting difficulties in a way that could make your relative feel unhappy or that they are a failure. For many of us, the whole process of considering care and support needs is about dealing with failure, a very uncomfortable feeling at any time, likely to be heightened by their current situation. You should try to be sensitive to this and so, in drawing attention to problems such as climbing the stairs and getting to the toilet on time, focus on what can be done to change the
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situation, rather than the indignity of arriving too late. Installing a stair lift or moving somewhere with level access or with more toilets may provide an ideal solution. Each of these options could restore confidence reaching far beyond the problem that you are setting out to address, and the process of talking to suppliers of services may give you answers to questions you had not yet begun to consider.
There are choices It is important that you and other family members involved in the process see this as being about more than working your way through a set of unfamiliar professional terms and services and recognise that personal preferences are important too. The assessment of care needs will provide vital information to assist in selecting the option most suited to your loved one’s needs. It will ensure that you don’t, for example, choose a care home with nursing – costing significantly more than will be necessary for someone not deemed to be in need of that level and type of support. Armed with a better understanding of your relative’s needs and the options available, you will also, most importantly, have knowledge of things that matter to them, and their opinions on whether they want to stay in the locality or move to another area, closer to remaining family members.
Home care Many people feel that being cared for at home is the ideal answer, enabling them to lead as full a life as possible while remaining surrounded by familiar people and things. It also enables services to be stepped up gradually, in line with your relative’s readiness to
accept more support or in response to changes to their capabilities. If your relative is resistant to the suggestion that they could benefit from some help with personal care – bathing and using the toilet – there is scope for a skilful care assistant to build a trusting relationship, from which it should prove easier to move on to deal with more intimate needs.
“Many people feel that being cared for at home is the ideal answer, enabling them to lead as full a life as possible while remaining surrounded by familiar people and things.” Being looked after at home should cause minimal disruption to routines as it is possible to remain registered with existing doctors, dentists or opticians. It also enables your loved one to continue using other mainstream services, for example the library, or to carry on visiting favourite places, like parks and gardens, churches, shops or pubs, alone or with support. However, things change over time and so a deterioration in physical health can make this apparently ideal option become more difficult to sustain, with multiple daily visits, fewer trips outside the home and a growing sense of isolation, indications that it may be time to reassess the best way of managing. While your relative may have become used to – and at peace with – the need for assistance at home, the realisation that a move will be necessary may stir up feelings of defeat and unhappiness. Given how emotive the subject of the family home is, you should think through the possibility of this happening to prevent an already difficult situation becoming a bigger problem. Also, if one
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person living there has increasing care needs, consider the future and wishes of anyone else living with them. There are options to avoid people needing to live separately as one person’s needs increase. More detailed information on home care is available on page 38.
Housing with care Specialised housing with care can provide a continuing sense of independence that many feel may be lost in a full-blown care home. This solution offers security of tenure, rented, part-owned or fully-owned, with support services available to suit individual requirements, while maintaining the important symbol of independence – your own front door.
“Your loved one should be fully involved in the decision about which home to opt for.” This way of meeting care and support needs provides the opportunity to live near others of a similar age, with the potential to retain a high level of independence. It enables partners to consider living together and could be the solution that suits you all. It is also possible to step up the amount of care provided in line with changing needs, whether temporarily due to illness, or permanently as a result of a general downturn in physical or mental health. However, such settings cannot generally provide 24-hour care, unless a live-in carer is employed. There are many different types of housing with care, some offer a wealth of on-site activities or facilities, some just have a few communal spaces. Further information can be found on page 48.
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Care homes It may be that your relative’s care needs assessment points towards moving to a care home as the best solution. People frequently think of what may be lost through such a change – no more ‘own front door’, or at least not in the same symbolic way as with the family home, a retirement flat or sheltered housing. However, this can be more than compensated for by the rich combination of care by qualified staff alongside the companionship of other people, regular meals, and assisted baths. Your loved one should be fully involved in the decision about which home to opt for. They may want to decide on the most desirable location – staying close to the family home, or using the opportunity to move closer to other family members. They may have preferences over the size and type of care home – larger homes are most likely purpose-built and can be easier to get around, with fewer internal steps or other obstacles. These homes may provide a wider range of facilities and services. Smaller homes on the other hand, may be based on a careful conversion of an older property and set out to create a more intimate family ethos. Care homes vary in how they look and feel – some, in contrast to homeliness, covey a sense of luxury, but they are all required to comply with relevant legislation and to employ sufficient, carefully vetted and suitably qualified staff. Although the style and ethos is undoubtedly important, the most important considerations are the extent to which the home can meet your parent’s assessed needs and the quality of care being delivered. You should ask the manager whether the home operates a key worker system, so that you and your parent can build a relationship with someone who will get
Visit www.careselect.co.uk for further assistance with your search for care
Bournemouth, Dorset and surrounding areas Tracy King • 01202 052 070 Tracy.King@Triangle.care
Sutton, Croydon and surrounding areas Leroy Frere-Edwards • 020 8660 4565 Leroy.Frere-Edwards@triangle.care
Triangle Community Services is a registered charity providing exceptional homecare services across England. It is our mission to help you to stay in the comfort of your own home for as long as you want to. Our motto is your home, your care, your way. We support hundreds of people across the country with a range of care, from some help getting ready in the morning to taking medications, preparing meals, shopping and cleaning. Our specially trained staff can support you in whatever way you need, leaving you free to enjoy the comforts of your home for as long as you wish. You can access more information about our services on our website www.triangle.care. Alternatively to discuss your individual needs with us please call or email the specialist manager for your area using the adjacent contact details.
Woking, Surrey and surrounding areas Leroy Frere-Edwards • 01483 757 751 Leroy.Frere-Edwards@triangle.care
East London and surrounding areas Tessa Hope-Lewis • 020 7017 2835 Tessa.Hope-Lewis@triangle.care
Thurrock, Essex and surrounding areas Mandy Lennox • 01375 656010 Mandy.Lennox@triangle.care
Malvern, Worcestershire and surrounding areas Anna Kirk • 01684 897797 Anna.Kirk@triangle.care
Head Office query
Jessica Stone • 0743 658 4050 Jessica.Stone@triangle.care
www.triangle.care
As a Care Select customer we are also able to offer a 10% discount on your first month’s care if you quote “Careselect16” when you speak to us about how we can support you.
REHABILITATION & HOME CARE
REHABILITATION AND HOME CARE IN YOUR HOME COVERING SURREY AND SURROUNDING AREAS
Honeydew Healthcare aims to provide high quality compassionate care and support to people who are unable to look after themselves in their own homes, at a time convenient to them. Our services include: Home care • Live-in care • Respite care
For more information call 0116 201 4433 or email info@honeydewhealthcare.co.uk
• The provision of personal care or treatment of disease, disorder or injury including nursing care • Specialist / complex care / Live in care • Alzheimer’s & dementia care • Care for the terminally ill • Short or long term rehabilitation
This innovative approach allows us to: • Maintain people in their own homes for longer • Help prevent unnecessary admissions / readmissions to acute hospital services • Facilitate early discharge from hospital in conjunction with health & social care teams CONTACT US TODAY FOR YOUR NO OBLIGATION ASSESSMENT
www.honeydewhealthcare.co.uk
01483 801 810
www.waverleycaregroup.co.uk
enquiries@waverleycaregroup.co.uk
Call the Care Select Helpline - 0800 389 2077 - for more information
33
to know you all. This will significantly enhance your parent’s experiences when settling in. There are also quality ratings of care services. Further information on care homes is on page 53 and care inspection, regulation and quality ratings are explained on page 58.
Setting out a plan Getting a full assessment of needs is vital – but just as important is how the service will translate that into a plan for daily living. Everybody living in a home or being supported by a home care service should have an individual plan outlining how those providing the service will go about meeting their needs – not just care or health matters, but their overall wellbeing, their likes and dislikes and any other information you are willing to share with staff. The plan should be a living document, reviewed regularly by all parties and revised to take account of any changes in circumstances. Further information on care needs assessments is on page 12.
Who runs care services? Care services are now predominantly in the hands of either privately-run businesses made up of nationwide corporations or small traders, and local or national charities, with local authorities retaining only a very small number of services. Your parent may have a connection to a charity, benevolent society or religious group that runs services and this may trump all other factors. For some, a small local business may have established a reputation in the neighbourhood that makes it the obvious choice, while for others, a national chain may be familiar precisely because it is a nationwide brand. You or another relative may have visited a
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friend in another of their homes or know of someone who has used their services and know how well-run they are and perhaps that they invest a significant amount of time and money encouraging their staff to improve performance. The choice of care provider is a very personal one. As such, it is important to visit a few to get a feel for them, their ethos, staff and the quality of their service.
What standards do they have to meet? All care providers in the country must be registered with the Care Quality Commission (CQC). The CQC is also responsible for checking that any care provided meets essential standards of quality and safety. All services are inspected by the CQC, which reports on its findings and gives each provider a quality rating. These inspection reports and ratings are available from the provider or from the CQC (www.cqc.org.uk). Reports of inspections are intended to provide the reader with an overview of all elements of the organisation’s operation, management and policies. In addition to these statutory inspections, some providers, especially those which are part of a larger group or chain, are likely to have internal quality checking systems that aim to set and maintain the provider’s compliance with nationally agreed rules and the ethos that the group promotes. The CQC has recently established a system of quality ratings (in addition to a range of industry-led schemes that should not be confused with the statutory system). The CQC’s system is intended to make it easier for laypeople to form opinions and make judgements that will assist them in their search for care. Providers who receive a rating must display it prominently in its premises. However, not all providers have been inspected with this new inspection
Visit www.careselect.co.uk for further assistance with your search for care
Questions on elderly care? We’re only a phone call away. If you’re thinking about long or short-term care for an elderly loved one, it can be difficult to know where to start. Whether it’s advice on choosing the right care, or covering the costs, our trained care advisers are here to talk through your options, whether you’ve got our health insurance or not. For friendly advice about your options, call our Elderly Care Support Line free on:
0808 256 4573 Lines are open seven days a week. We may record or monitor our calls. Q116273 2450 2016 BPR00881
CARE HOMES FOR LOVED ONES Excellence in residential, day, respite, nursing, dementia & younger disabled care With over 30 years experience we have continued to grow with our dedicated team in understanding the needs of our residents. We ensure that you can begin a new chapter in your life. We also take care of your wellbeing, and help you feel part of something special. Contact us: Derbyshire Tel: 0845 602 2059 Nottinghamshire Tel: 01623 441 130 Web: www.ashmere.co.uk
DEMENTIA STANDARDS
AWARD DERBYSHIRE County Council
Improving life for local people
Codnor Park: 88 Glass House Hill, Codnor, DE5 9QT The Firs: 90 Glass House Hill, Codnor, DE5 9QT Smalley Hall: Main Road, Smalley, DE7 6DS King William: Lowes Hill, Ripley, DE5 3DW
Valley Lodge: Bakewell Road, Matlock, DE4 3BN Kidsley Grange: 160 Heanor Road, Smalley, DE7 6DX West Hallam: Newdigate Street, West Hallam, Ilkeston DE7 6GZ Sutton Court, Lodge & Manor: Sutton-in-Ashfield NG17 2AH
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regime and don’t yet have a rating to display in this way. As a result, it may be confusing to rely on such a partial review of the field. Where no rating has yet been awarded you can nevertheless use a combination of past inspection reports, conversations with management, staff, clients and their relatives to form an opinion on the provider. Professionals involved in finding care for people after a hospital stay are likely to have extensive experience of providers registered in their locality and may, therefore, be a good source of information. However, be warned, they may be reticent about appearing to recommend a particular service. Checklists outlining what to look for can be found on pages 46, 65 and 75.
Try before you buy As with many other decisions around buying key items, it may be possible to ‘test drive’ some options before making a commitment. This is more likely to be possible with home care or a care home than with, for example, a retirement flat, enabling all parties to experience the benefits of formal care and support. Care homes offer personal space adapted to make life easier for someone who is slowing down and finds it more difficult to support themselves. They also have easily accessible toilet facilities close to lounges and dining rooms. A really important element of even a short stay in a care home is that it gives you and your relative the opportunity to talk to other residents and their family visitors about the pros and cons of living in a home, to observe the way in which staff go about their work – and to taste the cooking. This will provide you with valuable insights into how a care home functions and may well challenge some of the pre-conceived ideas held about what goes on in homes.
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Daily challenges However, it may be that your relative does not need the degree of help that a care home provides, and you should avoid taking ‘a sledge hammer to crack a walnut’. Some of the commonplace risks associated with everyday activities like using cookers, kettles and other household equipment – very often a concern due to physical frailty or memory lapses – could be eliminated. Hot drinks and nutritious meals could be provided by care staff calling at home or by the in-house services of sheltered housing or extra care housing that also provide varying degrees of support. Some difficulties that present risks, for example getting in and out of the bath or shower, can be ‘designed out’ by a adaptations or equipment, providing all of you with improved peace of mind. Not all of the challenges being faced will be associated with the physical environment. Some, and these are even more sensitive, may arise from living alone with nobody to prompt your relative to wash themselves or their clothes as frequently as they had done before. Early signs with men may be in a failure to shave – as a sign perhaps of other failures of personal hygiene – and women as well as men may change their clothes less frequently, perhaps displaying what they had for their last meal encrusted on a blouse or jumper. Support in managing household cleanliness can be a springboard to dealing with more intimate issues of personal cleanliness and may be discussed more openly with someone outside the immediate family, rather than through a shaming and guiltprovoking approach, however innocently intended, that can lead to entrenched positions, with your relative declining help and deteriorating as a consequence.
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We’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 Call the Care Select Helpline - 0800 389 2077 - for more information 37
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?
Care and support at home Each individual will need different types of support to help them live as independently and safely as possible. The number of services available to you may seem daunting at first glance, but actually once you have sat down with your relative and made a list of exactly what they are finding difficult to manage on their own, the right type of support should feel easier to find.
Whilst the realisation that they need extra help may feel hard for them to accept, receiving care and support in their own home can actually be a positive step towards more confident living, all whilst still being surrounded by the comforts of their own home. Once support has been set in place, however, it is worth bearing in mind that there may come a point where help at home is no longer the best option and additional care is needed around the clock.
What types of home support are there? Home help Home help can come in lots of different forms to assist with small, household jobs which your relative may need help keeping on top of. Typically, you can find someone will come into the home to offer support with the following things: • Cooking, shopping or light gardening.
Legal issues surrounding needing care
• Help with pet care, such as taking the dog for a walk.
Essential contacts
• Companionship and help with getting to and from social activities or doctors’ appointments.
Region-byregion care providers Advertisers’ index
• Small DIY jobs such as changing light bulbs or putting up shelves. Home help doesn’t include personal care
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or helping your relative get around with the aid of hoists and other equipment as these are more specialist tasks.
“However much, or little, your loved one decides they need help, it is important to establish a routine as soon as possible.” However, if they would benefit from some help maintaining their home or just having someone to share a cup of tea with a couple of times a week, then home help could be the right support system for them.
Home care Also known as domiciliary care, home care involves trained staff going into your loved one’s home and assisting them with personal care tasks. These can include: • Help with morning and evening routines; showering or bathing and getting dressed or ready for bed. • Preparation of meals and help with eating these meals, if needed. • Help to remember important tasks, such as taking medicine. • Help moving around the home – this will usually involve the use of hoists and specialist handling. >
Visit www.careselect.co.uk for further assistance with your search for care
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.
Visit us www.bluebirdcare.co.uk
Elmbridge & Runnymede Epsom & Kingston Guildford & Waverley Reigate Rushmoor & Surrey Heath
(01932) 567593 (01372) 822875 (01483) 761000 (01737) 247111 (01276) 683577
> The number of home care visits your relative may have will depend entirely on their needs. Trained care workers can visit a few times a week or come every day and the length of their visits can vary from 15 to 30 minutes or longer. However much, or little, your loved one decides they need help, it is important to establish a routine as soon as possible. Visits should be arranged between the agency, your parent, you and anybody else who can advise on your loved one’s care needs. These conversations will lead to a care plan being drafted so that everyone involved is clear on what will happen on a daily basis. Home care can also provide short breaks for an unpaid family carer and these can be arranged as and when they are needed. Commonly, home care services are available from 7am until 10pm; outside these times, services may be available by special arrangement. There is also the option of night-sitting, which can be very helpful if your loved one has difficulty sleeping or needs to get up multiple times in the night and a family carer is tired from helping them
throughout the day. The hourly rates for this type of service vary depending on the type of support your relative needs, the time of the visits and the location that the care worker will need to travel to. If your loved one lives in a more remote location then travel costs may be added to the hourly rate. Remember to ask for a written breakdown of all costs and ask if these are reviewed annually before signing any contracts. You and your loved one are entitled to find and employ the services of an independent home care agency. This means that finding one and paying their charges are completely down to you and your relative. Home care agencies have a responsibility to vet their staff by checking their references and carrying out Disclosure and Barring Service (DBS) checks before they are employed. These have replaced CRB checks. However, whilst home care agencies can take away the burden of being an employer, you or your relative may prefer to be directly responsible for the staff coming in and out of their home.
WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE?
VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE?
VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? 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 CARE SELECT FOR MORE INFORMATION:
0800 389402077 Visit www.careselect.co.uk for further assistance with your search for care
Employing your own staff Care assistants or personal assistants (PAs) can be a great option to helping someone live independently in their own home. If you are considering employing and paying staff, there are a number of factors to consider. First off, you can choose to use an agency or recruit a PA directly. You may also consider taking on a selfemployed PA. However, few PAs are legitimately considered self-employed and if you get this wrong you could be liable for fines and paying tax retrospectively. Although it may sound daunting, the benefits of having domestic assistance in the home can far outweigh any initial fears or uncertainty. It can work very well as long as you are wellinformed. The option of employing staff is open to everyone.
Advantages of employing directly An advantage of employing directly is that it gives you the option to choose somebody who is a good fit for your parent, perhaps even somebody they know personally. Another advantage is that you will have direct control over their hours and duties, whereas agency staff may need to fit you around other customers if you do not need somebody full time. Furthermore, you can decide how much to pay your employee rather than paying an agency’s set fee.
Responsibilities of being an employer Employing a care assistant or PA directly involves taking on a number of responsibilities. Employers have a duty of care towards employee(s) and a number of legal obligations:
• The employee must be provided with a Contract of Employment. • Whoever is the employer, you or your relative, you must register as one with HM Revenue and Customs (HMRC) and pay the National Minimum Wage or National Living Wage, depending on the employee’s age, (unless your employee is live-in). You must provide your employee with payslips and pay any liabilities to HMRC. All of this is encompassed in Payroll. • You will need to have Employers Liability Insurance, which may be included in your home insurance or available as an add-on from your home insurance provider. • As a safeguard, it is recommended that any potential employees have a current Disclosure and Barring Service (DBS) check before being employed in the home.
Help available to employers If recruiting staff is the best option, you may want to use a payroll company. A good, specialist domestic payroll company will do the following: • Issue a Contract of Employment. • Register you as an employer with HMRC. • Calculate how much the employee should be paid. • Provide payslips. • Tell you how much tax and National Insurance needs to be paid and how to pay it. • Help with getting DBS checks done.
Call the Care Select Helpline - 0800 389 2077 - for more information
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Live-in care If your loved one requires care around the clock but would like to remain in their own home, 24-hour live-in care may be a suitable support system for them. It is understandable that most people would prefer to live in their own home rather than move into a care or nursing home but if your relative is feeling increasingly isolated or lonely then this will have to be considered alongside their physical needs and, at that stage, a care or nursing home may be the
better option. Live-in care can be a useful service to offer short-term respite to carers who may want to have a holiday or just need a break. Live-in care can also be useful when an urgent need for care is placed upon families and hospital discharge relies on having the right amount of care and support in place in your loved one’s home. In this regard, a live-in carer would help with recuperation and rehabilitation whilst working alongside professionals in the community, but this may only be for a limited period of time.
Specialist support for Geoffrey and Judy Geoffrey and Judy live in Surrey. Judy has been caring for Geoffrey for some years now. He has Parkinson’s Disease and his care needs have progressed to the point that Judy needs some support. Initially, Judy advertised for someone to come and help her around the house. Light cleaning, the washing and ironing. The arrangement worked well. However, as Geoffrey’s needs increased so did the support Judy required. Their son, Jon offered to help them find a care agency. There were a
Choosing the right service It may feel like there is a lot of information to digest when you start to look into the different types of care and support available in the home. This is because there is a lot to consider initially. However, once you have sat down with your relative and pinpointed the exact things they need help with, this should help steer you in the direction of the right choice.
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number in the area so they arranged for a few to visit them. After speaking with a few different providers, they found one that had supported other people with Parkinson’s. Judy, Geoffrey and Jon worked with the agency to set out a care and support plan and detail the type of support Geoffrey needed and when. Judy was happy to have skilled staff come in and help Geoffrey every day. It gave her the opportunity to take some time for herself and resume her role of wife and partner, not carer.
Being as informed as possible about all the options available will help to make the process feel easier and more straight-forward. 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 contact several different providers that could help support your relative. Do not just go
Visit www.careselect.co.uk for further assistance with your search for care
New 2016 website:
www.kimara-support.com
KIMARA
SUPPORT
Tel: 0203 291 3436 • Fax: 0203 727 0836 • Email: info@kimara-support.com We are a family owned and managed Home Care Company and 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.
Our services include but are not limited to: • Personal care • Keeping safe at home and out in the community • Developing independent living skills • Accessing employment, education or training • Social Companionship • Accessing social, religious or cultural activities including holidays • Activities of daily living (shopping, laundry, cleaning, gardening, filing and general organisation) • Managing finances
We work with a broad range of people, older adults, younger adults who have many different support and care needs. We work with you to ensure that your wishes and choices are primary in the support that we provide to you.
Independent Social Work for people who fund their own care. • Professional needs and support planning. • Hospital discharge planning. • Specialist dementia services. • Continuing Healthcare funding (CHC) services. • Self-funded end of life services. • Reviewing in care homes, enhancing your care. • Providing services in Worcestershire and surrounding counties.
01905 67 65 65 • info@clearguide.co.uk www.clearguide.co.uk Call us and speak to a qualified social worker about your situation. We only offer services to those who we feel will benefit.
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for the first company you come across. Though it may feel like a lot of work, doing your research will help to ensure that the settling in period feels smoother and eventually confirm to you that the type of support you have chosen is the right one. Speak to your relative about what they feel the right fit for them would be. Always consider that the role care staff take on is a very personal and sometimes intimate one, so make sure your parent plays a central role in the decision and feels comfortable with the people supporting them. 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. 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 assessment from their local authority, this will form a good starting point for conversations with any care agencies. You can request a ‘Service User’s Guide’, which you can take away and read in your own time and ask to see a copy of the care providers’ most recent inspection report and ask whether they have been awarded a quality rating. 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, it is an important area to familiarise yourself
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with whilst making your decision. The standards cover all aspects of the operations, including 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 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.
Careful consideration Care in the home, however it is delivered, is a natural first step when someone’s needs progress to the level where they need formal, trained support. Be considerate of the fact that your relative’s needs are likely to shift and change over time, as such ensuring that the right level of support is available at all times is vital. This could include increasing the amount of in-home care or even recognising that the time has come when home care is no longer suitable and a housing with care or care home setting may be necessary.
Visit www.careselect.co.uk for further assistance with your search for care
THE LEADING PUBLISHER OF CARE INFORMATION WITH TWENTY YEARS’ EXPERIENCE IN THE SECTOR
New 24 hour care in the UK
We are here to help your parents stay at home in their later years. • Regional Care Services Directories
Independence enhances quality of life, especially as we get on in years. So what should we do if, for instance, our parents are no longer able to manage on their own at home?
advice and information on all aspects of seeking care and support, available in printed or e-book format. Care Choices publishes over forty regional care services directories across England and Wales. A full list can be found at www.carechoices.co.uk/ publications/regional-directories
Don’t worry. We arrange reliable, in-home care workers from Eastern European EU-member countries.
• Care Select the handbook for relatives when looking for care and support for a loved one. Care Select provides additional guidance and delves into the practical and emotional issues facing families and carers when the time comes to find care. For a free copy of Care Select call the Care Choices helpline on 0800 389 2077 or visit www.careselect.co.uk
Your advantages: ✔ 24 hour live in care ✔ High quality standards ✔ Dedicated assistants with additional diplomas ✔ ✔ Years of experience ✔ Large pool of applicants
• Care Choices website The Care Choices website is a comprehensive information source for people looking for care. www.carechoices.co.uk has details of all CQC registered care homes and home care providers and displays CQC inspection results at a glance with links to recent inspection reports.
Call us or visit our homepage www.inpetto24.co.uk Katharina Denbury Tel.: 0208 014 4499 E-Mail: office@inpetto24.co.uk
E: enquiries@carechoices.co.uk T: 01223 207770
www.carechoices.co.uk 02_gb_90x264mm_uebersetzt_190216.indd 1
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19.02.16 09:27
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?
© Care Choices Ltd 2016
• 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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Visit www.careselect.co.uk for further assistance with your search for care
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
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47 Hitchin, Hertfordshire SG5 2EN Pirton Road,
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
Specialist housing with care schemes Housing with care schemes are on the rise in the UK and there’s good reason for this. If your loved one is unable to live independently at home but doesn’t necessarily require the support that a care home might offer, they could consider moving into a housing with care scheme.
They offer a mid-ground for people with care and support needs, with a combination of services and independent living. This can promote a person’s wellbeing, giving them back independence they may have feared lost.
Who would use housing with care? The great thing about housing with care schemes is that there are many different types offering all levels of support. Some schemes will be more suited to people with lower care and support needs while others can cater for people with more complex needs requiring high levels of support. Usually, schemes are aimed at people over the age of 55, but some will accommodate younger people with support needs as well.
“The great thing about housing with care schemes is that there are many different types offering all levels of support.” Typically, your loved one will buy or rent a property on the site and will have their care and support services provided by a contracted company. A scheme manager may be based on- or off-site, and a 24-
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hour emergency response service could be available through a community alarm system. Your loved one will have their own home but can access services such as meals on wheels and domiciliary care. Schemes may have facilities onsite, such as a laundry, a hairdresser or a communal lounge. The amount of support your loved one receives in a housing with care scheme can change, depending on their level of needs. For example, if your loved one’s needs increase, they can arrange to have more support.
Different forms of housing with care There are various different types of housing with care; although the name is a catch-all term and schemes may be variations on this theme. None are particularly classed as ‘better’ than others as each scheme varies and your loved one’s needs, plus the options available in the local area, will play a big part in how appropriate the scheme is for them. Listed here are the most common types of housing with care.
Sheltered housing Sheltered housing, sometimes known as retirement housing, is usually provided by local authority housing departments and housing associations. It is designed
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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
The Royal Alfred Seafarers’ Society Providing the highest standards of residential, nursing, dementia and respite care, including sheltered flats, for former seafarers and their dependents. Set in a 14 acre estate, our Surrey based care home provides like minded companionship and support for seafarers and a safe haven for those in old age.
IF YOU KNOW SOMEONE WHO NEEDS OUR HELP, PLEASE CONTACT US T 01737 353 763
E enquiries@royalalfred.org.uk
www.royalalfredseafarers.com
Reference code: FULL Call the Care Select Helpline - 0800 389 2077 - for more information
Registered as a Charity No. 209776
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for older people who would like to remain independent but prefer the added security and reassurance of a scheme manager and an alarm call service. A scheme manager is either based at the site or visits regularly. Many sheltered housing schemes also have communal lounges, laundry facilities, lifts, door entry systems and specially-adapted facilities. There may also be a communal garden.
Extra care housing Extra care schemes are similar to sheltered housing, but may provide personal care onsite. This is the same type of care that a home care agency would provide, for example assistance with washing and dressing, and does not include nursing care. Extra care allows your loved one to live independently, in their own self-
contained accommodation whilst still having their care and support needs met by a designated team of care and support workers. This may include a night time on-site member of staff who can be available in an emergency. This makes it popular with people who are unable to live independently in traditional housing but still don’t want or need to move into a care home. The complex is often linked to a central control centre for security and emergencies. There are also communal facilities, as in sheltered housing, and lunchtime meals are available at most schemes. Your loved one may be able to buy, part-buy, rent or lease the property, depending on the scheme they choose.
Very sheltered housing Very sheltered housing is essentially another form of extra care housing.
WHAT ARE THE CARE OPTIONS? WHAT ARE ITHE CARE OPTIONS? HOW WILL KNOW WHICH TO CHOOSE? HOW I KNOW WHICH TO CHOOSE? WHATWILL IF MUM DOESN’T AGREE? 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
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It is normally provided by the private sector and can enable your loved one to maintain their independence for as long as possible. Schemes may also provide 24/7 housekeeping staff cover.
Assisted living Assisted living is, again, very like extra care and sheltered housing. It is commonly provided by the private sector and offers care and support services for older people who can no longer live on their own but don’t need complex supervision. Schemes may also be able to offer your loved one ‘hotel services’ such as cleaning, laundry, meal provision and hairdressing.
Retirement/care villages Retirement villages tend to be larger developments than other schemes. This means that there can be a wider range of services, catering for more of a variety of needs. Your loved one may be able to buy or rent their property or have it on a shared ownership basis. Retirement villages can offer your loved one a combination of independence and security, as well as an active social life, even if they have a higher level of support.
Close care Close care refers to any type of housing with care scheme that is linked to or has a care home on-site and the care home provides support to the rest of the scheme. This type of housing with care can be popular with couples, where one person needs to be in a care home and the other person is still able to live independently in their own home. It allows couples to remain near to each
other and can make visiting easier. It may also be useful for people who have a diagnosis of a deteriorating illness, as they can move into a property on the site and as their needs increase, receive more support there until, if necessary, they move permanently into the care home. It’s important to check how much support is available on the site, as this can differ from scheme to scheme.
How to make the right choice There are many considerations when choosing a housing with care scheme, as they are all quite different to each other. It may be helpful to think about what it is about particular schemes that you like and don’t like, for example, do you like the scheme because of the facilities it offers or because of the style of the housing? Consider the following when you are looking at choosing a scheme: Location – It’s really important to consider the location of any scheme that you are looking at. Depending on your loved one’s needs, you want to make sure that they are close enough to local amenities. If they enjoy going to the cinema, is there one nearby? What is the local public transport like? Cost – Make sure that you weigh up the cost against the suitability of the services the housing with care scheme can provide. The cost will be determined by the level of support that your loved one requires. Tenure – If your loved one would like to buy their home, is this available as an
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option? Are they able to rent or part-buy it? If they are renting, it is important to consider the terms of the contract and what you might do if your loved one suddenly needs to move into residential care. Size – The size of a scheme will vary with each one you visit. Make sure your loved one considers the number of other people who are likely to be around – would they prefer to be in a large
scheme, which is likely to have more amenities, or would they prefer a smaller, more neighbourly atmosphere? When you visit the schemes it might be worth asking the manager whether your loved one would be able to come for a trial stay. This would give your loved one a good idea of whether they might like to live there for the foreseeable future and whether the scheme is appropriate for their needs.
To purchase or rent Purchase
Market rent
If the scheme your loved one picks offers homes for purchase, your loved one may want to use the money from the sale of their house to buy a property on the scheme.
Your loved one would rent their property from its owner at a fixed price.
Shared ownership This is where your loved one purchases part of the property and the rest is owned by the developer, housing association, local authority or managing company. You will need to speak to the scheme manager if you are considering this as an option as it will work differently at different schemes.
One size doesn’t fit all Housing with care can be a perfect option for many people with social care needs as it provides an opportunity to remain independent, maintain or renew a social life, whilst still ensuring that care and support needs are met. However, as with all social care options, it is important to ensure that a housing with care scheme is the right fit for your loved one. You will need to carefully consider your loved one’s
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Social rent This is generally only offered to extenants of local authority or social housing who do not have sufficient funds to purchase, part-purchase or rent their property themselves. In this instance, the rent is subsidised by benefits. Options vary from site to site, so it is important to ask about what may be available at the sites you are considering. Also, get specialist advice to help you with the decision.
needs and whether these can be met by the services available in the scheme. Think about whether your loved one’s needs are likely to increase or become more challenging. Make sure that you and your loved one have visited more than one scheme so that you know you are making an informed decision and carefully consider other options as well as housing with care. This ensures that you and your loved one have made the right choice and that their needs will be met.
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Residential care options Many people feel that moving their relative into a care home is the absolute last resort. Residential homes do not receive the most positive coverage in the news, and it is often only the most negative stories that make their way into the wider public eye. However, many care homes can provide safety, security and peace of mind to residents and their loved ones.
Care homes should treat their residents with respect and friendliness. The staff want to help the residents to have a better quality of life and want their families to know that their loved one is happy. A great care home will offer personalised support to its residents, ensuring that people are making decisions about their own lives. This could range from deciding what they want to wear or do each day and whether they prefer baths or showers, to how they want their care delivered, plus their plans for end of life.
What is a care home? All care homes are very different to each other. They can be large or small, their dĂŠcor can be modern and hotel-like or more traditional and homely. Usually, residents will all eat together in a dining room, in larger homes there may be more than one dining room. However, given personal preference, some people may choose to eat in their room. There will also be communal areas where residents can sit together in the daytime. Some care homes may have entertainment rooms or bars, coffee areas and other activity rooms. Some might have gardens, which
residents can walk around and may even be able to do some gardening.
“A great care home will offer personalised support to its residents, ensuring that people are making decisions about their own lives.� Many care homes will offer activities for residents to join in with, such as tailored exercise classes or arts and crafts sessions. Bedrooms will usually be individual and your loved one should be able to bring in their own things to decorate the room. Care homes are split in to two main categories. These are care homes that provide personal care only and care homes that provide nursing care. Some homes might specialise in particular areas, such as dementia care.
Personal care The time may come when your loved one starts to need more help than can be provided at home; they might need help getting around the home or
Call the Care Select Helpline - 0800 389 2077 - for more information
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intensive support that can no longer be provided there. You may have been using home care agencies to support your loved one, but as their needs increase the time may come for more intensive, round-the-clock support. If this is the case, you might want to consider a care home offering personal care. This would be a good option if your loved one needs a lot of support but doesn’t have any needs that require nursing care. A care home providing personal care can offer assistance with tasks such as: • Washing. • Dressing. • Eating. • Drinking. • Toileting. This sort of home may offer your loved
one more security and companionship and will provide you with peace of mind that they are well cared for. Many residents find that they are happier in a care home than at home, as they have company and may find that there are more activities they can join in with.
Nursing care A care home that provides nursing care will operate very similarly to a care home offering personal care only. However, care homes with nursing must have registered nursing staff on duty at all times of the day and night. There may also be a higher number of staff due to the more complex and increased needs of the residents. If your loved one has a condition that requires nursing care from a registered nurse, then consider a care home with nursing.
Care needs assessment The best way to determine what sort of care your loved one needs and whether a care home or care home with nursing might be suitable for them, is to request a care needs assessment from their local council. The assessment will look at what your loved one can and can’t achieve by themselves or with assistance, and will consider the impact that this has on their wellbeing. The assessment is free, and is available to anyone who appears to have social care needs. The council may also offer a financial assessment, which will look at your
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loved one’s financial circumstances and see whether they might be eligible for any financial assistance from the council. Having a care needs assessment could reassure you that you are making the right decision about care for your loved one and should help to narrow down the type of support they require. Care needs assessments are covered in more detail on page 86. Financial assessments are covered on page 87. Carers are also entitled to a free care needs assessment, which is explained further on page 84.
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THE ANGELA GRACE NORTHAMPTON’S PURPOSE BUILT PREMIER CARE FACILITY Cheyne Walk, Northampton The Angela Grace is a new purpose-built, luxury care centre located right in the heart of Northampton, close to amenities and opposite the Hospital. It is the latest home from care providers A.G.E Nursing Homes Ltd, a group who draws on 30 years of experience to provide top quality care. The Angela Grace cares for people with a wide range of needs including residential care, dementia and nursing, as well as end-of-life care and respite. Facilities within the centre include a cafe, cinema, hair & beauty salon, reminiscence kitchen & a light and airy conservatory overlooking a private courtyard garden.
For all enquiries: Tel 01604 – 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
Care homes as a short-term solution A care home may not have to be a permanent arrangement. Your loved one may only need to go into a care home for a short period of time.
Short break or respite Sometimes carers need a break from caring. There is a number of options available to carers who want to take a short break. You may arrange for another carer to come into your loved one’s home to look after them while you are away, or your loved one might go into a care home for a short period of time. This will allow you to have a longer break than if your loved one stayed at home. A short break can be a good experience for both parties. Your loved one can meet new people and participate in different activities, whilst getting to know the staff in the care home of choice. You then have a break from your caring role and could go on a holiday or just enjoy some time to yourself, knowing that your loved one is well looked after.
“The short stay will give them a chance to get used to their surroundings and will help them to decide whether it is something that they would like long-term.” This sort of stay can also be useful if your loved one is considering moving into a care home permanently. The short stay will give them a chance to get used
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to their surroundings and will help them to decide whether it is something that they would like long-term.
Intermediate residential care This type of care home stay may be appropriate if your loved one has been in hospital and needs some extra support before they are able to return home. This allows your loved one to rest and recuperate before returning to living independently, without having to stay in hospital to do so. They would usually be transferred straight from the hospital to the care home, and this will typically be arranged by the local authority, hospital and other professionals with you and your loved one involved. Your loved one will need to be assessed by the local authority and/ or hospital social work team to ensure that this service will be appropriate for them. If it is, it may be called reablement of intermediate care. It may be offered for up to six weeks, by which time any further care and support required should have been arranged. This could include a home care package or a permanent move to a care home.
Choosing the right care home Making sure that you and your loved one choose the right care home can be daunting. You will want to consider the quality of the care home, the suitability of it in terms of your loved one’s specific needs, and how easy it is for you to visit, amongst other things. For more information on choosing care, see page 30. You may find it helpful to look at the services within this publication. >
Visit www.careselect.co.uk for further assistance with your search for care
Rosebery House Residential Home in Eastbourne specialises in dementia care for the elderly. Our philosophy is centred on the individual’s right to achieve and maintain privacy, dignity, independence, choice and fulfillment regardless of their physical or mental capabilities.
Services Include: Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
Community services available on request: Dental Optical
Chiropody Dietician
Tel: 01323 501026 E: info@rosebery-carehome.co.uk www.rosebery-carehome.co.uk
> Care Select also has a companion website: www.careselect.co.uk where you will find the ebook version of this edition, as well as a list of useful contacts. This website also links through to a fully searchable database of all care providers in England, with the option to search by postcode, region or county. Your loved one should feel able to choose whichever home they wish, as long as it can meet their needs. If they are going to be self-funding their care home placement, they have the freedom to choose any home, anywhere in the country, but you should make sure that they can continue to afford living there, or they may have to move if they run out of money.
Inspecting and regulating care services To help regulate the quality and safety of care providers, all care homes and home 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. This system is administered by the Care Quality Commission (CQC).
“The CQC registers, inspects and reviews all adult social care and healthcare services in England in the public, private and voluntary sectors.”
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 national essential standards of quality and safety. The CQC also rates services as: Outstanding, Good, Requires Improvement and Inadequate. When considering a care service, it’s always a good idea to check its inspection report and rating on the CQC’s comprehensive website: www. cqc.org.uk or ask the care provider you are considering for a copy of their latest inspection report.
Care home contracts If your loved one is funding their own care, they should make sure they sign a contract with their care provider. The contract should include: • Details of any fees and their increases. • Details of services included in these fees. • How medication will be administered. • Your loved one’s rights. • The obligations of the care provider.
The 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
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• The complaints procedure. • How the contract should be cancelled. It is sensible to get a solicitor to look over this contract for you to ensure that you and your loved one have understood it in its entirety.
Visit www.careselect.co.uk for further assistance with your search for care
BECKET HOUSE BE
CK E T H O US
E
Nursing Home
Becket House Nursing Home specialises in Dementia Care and Nursing for the elderly. The Home is situated in the prestigious village of Loughton Opposite Loughton Church, having ample car parking and large mature gardens attracting varied wildlife. It is also close to Milton Keynes Centre, Railway Station and shops.
Services Include: Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
Community services available on request: Dental Optical
Chiropody Dietician
Tel: 01908 231981 E: info@beckethouse-carehome.co.uk 59 www.beckethouse-carehome.co.uk
Call the Care Select Helpline - 0800 389 2077 - for more information
Important considerations There will be many things that you want to consider when choosing a care home. These will differ for each person, but main considerations will include things like: can your loved one still access the community easily? Is there plenty of outdoor space that your loved one can walk around? How the care home is designed – is it easy to navigate and is the décor to their tastes? You and your loved one should visit each home that you are considering; you may find it useful to take a checklist with you so that you remember to ask important questions. Write down things that you and your loved one do and don’t like about each home and make sure that your loved one is as involved as possible in the decision-making process. There is a checklist in this handbook to help with this, see page 65.
the other residents are behaving. Do they seem happy and stimulated? Are staff engaging with them or are the residents left to amuse themselves? You might want to see whether the care home allows for day-to-day traditions to be observed – if your loved one is used to having a gin and tonic before dinner or taking a hot water bottle to bed, will the care home be willing to facilitate this? You might want to consider the type of atmosphere of the home. Would your loved one prefer somewhere lively and energetic or somewhere more gentle and quiet? Whatever sort of care home you are looking for, your loved one should not have to give up their dignity, freedom or right to personal choice to live there. The staff should encourage your loved one to maintain and improve their quality of life wherever possible and all parties should come away from your visits confident that your loved one will be happy in their chosen home.
“Whatever sort of care home you are looking for, your loved Who’s who in a care home? one should not have to give up There are a lot of different types of staff in care homes, and it might be confusing their dignity, freedom or right to know who does what. Listed here are to personal choice to live there.” some of the staff you will find in a care home. Any care home you choose should have friendly and engaging staff. You will want to make sure that your loved one is treated with dignity and respect, so it is worth watching the way staff interact with them. Are they speaking to them directly? Does your loved one feel patronised? The staff should be approachable and cheerful. When you are visiting, observe how
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Registered manager Every care home should have a registered manager. This person oversees the day-to-day running of the care home and must also ensure that the home meets national essential standards. They will have a high level of training, be registered with the CQC and have completed a full DBS check.
Visit www.careselect.co.uk for further assistance with your search for care
CARLETON COURT CA
RL
ETO N C O U
RT
Residential Care Home
Carleton Court Residential Care Home for the elderly stands in it’s own spacious grounds with mature gardens and lawns. Built around 1900 as a family home it was for many years Christ Church Vicarage. A beautiful, period home, with many unique original features, it has been recently extensively refurbished to provide comfortable accommodation for twenty-four residents in tastefully decorated and furnished surroundings.
Services Include: Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
Community services available on request: Dental Optical
Chiropody Dietician
Tel: 01756 701220 E: info@carletoncourtskipton.co.uk 61 www.carletoncourtskipton.co.uk
Call the Care Select Helpline - 0800 389 2077 - for more information
Care assistant
Ancillary staff
Care assistants will be those staff that provide the everyday care for your loved one. This will include a lot of personal care, such as help with bathing and dressing, so they should be friendly and approachable. A good care assistant will also be supportive and patient and will form a friendship with your loved one. They should be DBS checked and have completed or be working towards the Care Certificate. They may also be working towards, or have, other relevant qualifications.
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.
“Sit down with everyone involved, including your loved one, and talk about what everyone thinks is the best way forward. Try to be understanding and supportive of each other.� Activities co-ordinator Not all homes will have a dedicated activities co-ordinator, but if they do, this is the person who will organise and arrange all of the activities for residents within the home. This gives your loved one an opportunity to join in and engage with others. The activities co-ordinator will provide a range of meaningful entertainment that will stimulate residents. They should encourage all residents to join in with the activity but should not force anyone to participate. The activity can be anything, from arranging gentle exercise classes, to gardening or encouraging someone to participate in household chores if they want to.
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Give it time Thinking about moving a loved one into a care home is a big decision. Even if you know for certain that it is the right thing to do, you may feel like you are letting them down in some way or that there is more that you should do. Your emotions may tell you it is the wrong choice and other family members and friends are all likely to have differing opinions. It is important, where possible, not to rush the decision of permanent residential care. If you can, try a short stay before making a permanent decision. Sit down with everyone involved, including your loved one, and talk about what everyone thinks is the best way forward. Try to be understanding and supportive of each other; negativity will only make it harder for your loved one to adapt to their new surroundings. Make sure that your loved one is involved as much as possible in all decision-making, even when those decisions only concern minor details – such decisions will have the biggest impact on them and they should be encouraged to contribute their thoughts. The process might feel long and frustrating, but, with effort and time, you should feel confident that your loved one is well cared for and is living somewhere that they can be happy.
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Welcome home... We care for you as we would our own mums, dads, brothers and sisters. • Residential, nursing and respite care • Sheltered housing • Day centre • Compassionate and stable team
• Light and airy rooms • 3 acres of beautiful grounds • Immaculate interiors • Vibrant community
“I was bowled over by the wonderful community that you have at Peterhouse. So warm, friendly and vibrant.” Charlie Parkin
CALL NOW OR COME TO VISIT US. WE ARE IN THE OLD TOWN AREA OF BEXHILL-ON-SEA. 01424 730809 or email info@peterhousecare.com
A caring way of life, where you come first
www.peterhousecare.com Minehead
Westcliff on Sea
Our Westerley Christian Care Homes aim to
provide the best in time of need for people
looking for actively Christian residential care
in their retirement.
Woodhall Spa
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, 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 Call the Care Select Helpline - 0800 389 2077 - for more information
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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: ffch.admin@ffchltd.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: ncch.admin@ffchltd.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: lnh.admin@ffchltd.com • Web: www.littleovernursinghome.co.uk
“Warm, friendly and professional residential homes”
WHAT ARE THE CARE OPTIONS? WHAT ARE ITHE CARE OPTIONS? HOW WILL KNOW WHICH TO CHOOSE? HOW WILL I KNOW WHICH TO CHOOSE? WHAT IF MUM DOESN’T AGREE? 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
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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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• Are staff warm, friendly, polite, clean and respectful?
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• What arrangements are there for religious observance? (e.g. are places of worship nearby/Is there a prayer room)?
• 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?
• 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?
© Care Choices Ltd 2016
First impressions
• Are all procedures clearly spelt-out?
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Was it the right decision? Once the decision has been made about the right type of care and support for your parent, it should feel like a weight has been lifted from everybody’s shoulders. You want your loved one to feel happy and for you and your family to feel confident that they are receiving the right type of care that they need.
As with all major changes in life, there is a period of adjustment and settling in. Whilst all you want to feel is reassured that you have made the right decision, in some cases this may not be immediate. This won’t mean that you have made the wrong decision, it’s just a case of understanding the difference between teething problems and more serious concerns.
Settling in After long consideration, your loved one should be receiving support which will offer them a personalised service tailored around their assessed needs. The first few weeks, in particular, may feel uneasy for everybody involved. If they seem unhappy when you visit them at home or in their new setting, or worse, distant or angry with you, how are you supposed to know that this isn’t a knee-jerk reaction to sudden change or fear of a new situation? How can you be sure that the pleas from your parent to take them home with you each time you leave are more for effect and that they are, in fact, fairly happy once you have left? The truth is that you won’t know straight away but the following things may make it easier to help you step back from this emotional situation slightly and assess it with more clarity.
Talk to the staff Was it the right decision?
How your relative acts when you are visiting them may be vastly different to
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how they act when you are not there. The only way you will know this is to talk to the people who are responsible for supporting them. The member of staff who has been appointed as their ‘key worker’ may be the best place to start as they are likely to have spent the most amount of time with your loved one. If you are not able to speak to them, speak with the manager of the service. Good care providers will happily offer their time to talk through the concerns you have. They will want to see their clients happy too. It is likely that they will have seen this type of behaviour before and they may be able to give you some advice about how long it typically lasts. Just like dropping your child off at nursery and having to leave them with tears running down their face, the guilt you are likely to feel may be difficult to deal with.
Delving deeper After the settling in period, things will either calm down and you will start to see your relative return to their old self again or things may continue or start to get worse. Striking a balance between professional reassurance and gut instinct is important in this situation. If your loved one’s cries for help continue to worsen or they begin to target specific people supporting them or care tasks which cause them distress, you will need to pursue things further. If your parent tells you that a particular member of staff refuses to
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help them when they ask for it or that they don’t like to be left alone with somebody who doesn’t respect their wishes, you will need to know if there is a more serious underlying issue. Something may have happened in the first few days which they can’t get past or they associate with a particular member of staff. It is important that everybody involved keeps communicating so that a breakdown of trust does not start to occur. Your relative trusts you to listen to them and respect what they are saying and you, in turn, trust the members of staff who are responsible for looking after your parent. Not addressing concerns straight away will only lead to them festering and turning into something more serious. Once this has happened, you may find yourself doubting your decision of choosing this particular support for your loved one in the first place. Managers would always prefer you to raise your concerns, so take advantage of their professional experience and use it to form your own opinion.
If the problem persists If it appears that your relative is not settling after a lengthy amount of time, the most extreme outcome would be deciding to remove them from their current home or care provider and find alternative support. This is a dramatic step and, just as you took time to consider all the options before, you should think seriously about whether this is the best decision for your relative. If your parent is struggling with their loss of independence and what they see as a lack of control over their own life, these feelings will arise whichever support they receive or care setting they are in. For some, staying in their own home is more important to them than
others. If they can’t do this, they may resist any form of alternative support. As well as listening to your loved one, it is important that you try to maintain a similar relationship with the provider and the staff who support your relative. A good provider will want to keep the lines of communication open to ensure the best possible outcomes for everybody. This may make you feel like you are being pulled in two different directions at the same time but, as difficult as this will feel, it is necessary. However, if the provider is not forthcoming in its attempts to help you and listen to your concerns, then this is likely to be a warning sign that they may not be the best organisation for your relative. Ensure you keep talking to all the family members who have been involved in this process from the beginning. If they can help to judge whether your loved one seems happy or not, the burden of responsibility will be shared.
Trust your instincts Making the decision to move care provider can be a tricky one. If a relative is very frail there are risks involved with moving care home. However, you might find a move to a new provider or home, with a different atmosphere or different staff could make a marked difference to your parent. Sometimes people, places or approaches to support just aren’t the right fit for someone, however, you’ll need to take some time to figure out the real reason for any concerns and the best possible solution. Choosing formal care and support is emotive and can be difficult. You may not get it right the first time. Consider all elements of what may or may not be working and carefully explore the options with clear communication involving all parties.
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Foreword Starting your journey
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Understanding their needs Dealing with family pressures Support to live independently at home
Dementia and dementia care Dementia is often oversimplified and thought to mean someone is losing their memory so they can’t recognise their loved ones. It’s more complex than that however, it can start years before it becomes severe and early signs can be as unassuming as losing the thread of a conversation.
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-byand regionDementia care dementia care providers Residential Advertisers’ index dementia care checklist
It’s a growing issue, which is increasingly on the Government and media’s agenda. An estimated 850,000 people are thought to be living with dementia in the UK today and, in England, about one third of those remain undiagnosed. Many people consider dementia to be an older person’s condition but 42,000 people with dementia are under the age of 65.
What is dementia? Dementia is an umbrella term which 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. Alzheimer’s disease is the most common form of dementia, other types include: vascular dementia, frontotemporal dementia and dementia with Lewy bodies. The condition does not only affect the person who is living with it – it affects families and friends too. There are 700,000 people caring for people with dementia, and the total cost of dementia each year is £26.3 billion – including unpaid care, health care, state-funded social care and care paid for by the individual – that’s enough to pay the
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annual energy bill of every household in the country.
Spotting the signs of dementia Spotting the signs of dementia isn’t always easy. Many people may notice they are becoming forgetful as they get older, and it can be tricky to tell whether this is nothing serious or a sign of an underlying condition. Talking about dementia can be frightening, but seeking help early offers the best chance of getting the right support, advice and treatment. Memory problems can occur for a number of reasons. It happens to most people from time to time – forgetting a name, popping upstairs and forgetting what you went for or struggling to find the right word. More often than not, such slips are a nuisance rather than a sign of something more serious. Many notice that their memory becomes less reliable as they get older. This could be down to stress, depression, certain physical illnesses, or medication, but sometimes memory loss can be an early sign of dementia. Symptoms may point to dementia if they are so significant they begin to affect daily life. This is especially true if people:
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• Struggle to remember recent events, although they can easily recall things that happened in the distant past. • Find it hard to follow conversations or programmes on TV. • Forget the names of friends or everyday objects. • Regularly lose the thread of what they are saying. • Leave objects in unusual places (eg keys in a bathroom cabinet).
Try to focus on meeting the individual needs of the person at that time, rather than to focus only on which stage they are in. Generally, in the early stages of the condition, people can be supported through simple changes such as memory aids around the house. However, as the condition develops, people often need increasing amounts of support. They may need help getting up in the morning, getting washed, preparing and eating meals or going to the toilet.
• Have problems thinking and reasoning. • Feel confused even when in a familiar environment or get lost on familiar journeys. • Find that other people start to comment on their forgetfulness. If anyone is worried about their memory, they should make an appointment to see their GP. The GP will talk about any concerns and possibly arrange for further investigation. They will likely make a referral to a local memory clinic or hospital specialist where further assessments will be performed and a formal diagnosis can be made. Receiving a dementia diagnosis can be a huge shock – Alzheimer’s Society can provide information and support which allows many people who have the condition to continue to lead active, fulfilling lives.
Identifying the need for care and support Each person experiences dementia in their own way, but the way the condition progresses can be seen as a series of stages (early, middle and late stage). While it can be helpful for planning ahead to have some awareness of the likely progression of a person’s dementia, it is important to realise that everyone’s experience will be different.
Supporting dementia at home Two thirds of people with dementia live in the community – and people with dementia tell us they want to remain in their own home and stay independent for as long as they are able.
“Spotting the signs of dementia isn’t always easy. Many people may notice they are becoming forgetful as they get older, and it can be tricky to tell whether this is nothing serious or a sign of an underlying condition.” There is a wealth of local initiatives and services provided by the voluntary sector that can help people with dementia to live well at home – these include dementia cafes, dementia advisers and support workers. There are even courses for family carers to help them to better understand dementia, cope day-to-day and learn more about legal and money matters. Your local Alzheimer’s Society and Age UK will have more information on what’s available in your area. With the right support and assistance, people can live well at home with
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Burcot Grange “Your home, within a home�
With a unique blend of luxury country house living and quality care, Burcot Grange is the perfect place to enjoy an active lifestyle. Approached by a tree lined drive, Burcot Grange is set in five acres of beautifully maintained lawns, traditional and contemporary planting, pools and an arbour. Burcot Grange offers the best in quality residential care and assisted living. A full complement of knowledgeable and experienced staff offer support, encouragement and preservation of personal choice, independence, dignity and privacy, creating an environment of dedicated holistic care. The aim of Burcot Grange is to maintain a caring and enjoyable environment for our residents. This is achieved through a constant endeavour to create close personal contact among both residents and team members. One of the many benefits of life at Burcot Grange is the on-site hairdressing salon, Tranquillity. With its beautiful outlook over the fountain and gardens, the smart salon always offers a caring and welcoming atmosphere where residents can relax.
Tel: 0121 445 5552
Burcot Grange Residential Care Home: 23 Greenhill, Burcot, Bromsgrove, Worcestershire B60 1BJ
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dementia. However, as with all aspects of care and support, it’s not one-sizefits-all. While there are many benefits to living at home, including familiar surroundings and support networks, it can be isolating if people live alone and those with dementia can struggle to access the support they need. Extra support should be available from the local council’s adult social care team. As with other conditions, a local authority assessment will establish whether Adult Social Care has the responsibility of providing support. For a person with dementia 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 respite care. Alzheimer’s Society research has found that nearly two thirds of people with dementia experience loneliness and almost half report losing friends after their diagnosis. It can be a difficult subject to talk about and, in turn, stigma can create a huge barrier for people being able to live well in the community. Alzheimer’s Society’s Dementia Friends initiative was launched as part of the Prime Minister’s Challenge on Dementia in 2013, to address the stigma and lack of understanding which has resulted in many people with the condition facing social exclusion. Already, there are close to 1.5 million Dementia Friends making it the biggest ever social action movement to change perceptions of a condition. The aim was to get one million people from all walks of life to understand a little about dementia and to turn this understanding into action to improve the lives of people affected by dementia. The initiative encourages a spectrum of social action, from changes in everyday behaviour and how people respond to dementia, to people taking sustained action, working to make their communities dementia-friendly.
The initiative combines face-toface information sessions and online videos to help people learn more about dementia and the small things they can do to make a difference. To get involved, visit www.dementiafriends.org.uk
Innovation and technology in the home Having dementia can make day-today 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.
“When a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support.” 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’s factsheet ‘Assistive Technology’ may help.
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Everyday worries and concerns When a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support. Equally, their loved ones may worry as the person with dementia’s behaviour changes. At the first sign of concern, it’s best to seek help immediately, as the right support and information often offers an answer to the issue. People with dementia may experience changes in behaviour. For example, they 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 why they are doing it and how they can
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Specialist independent social work dementia services for · Supporting people to remain at home · Need alternative accommodation? · Accessing or appealing Continuing Healthcare (CHC) · Reviewing in care homes, enhancing your care · Mental Capacity, Best Interest and Deprivation of Liberty assessments Providing services in Worcestershire and surrounding counties. Call us and speak to a qualified social worker about your situation. We only offer services to those who we feel will benefit.
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do it safely. 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 – to find out more read Alzheimer’s Society ‘Top Tips for Carers’ or join Alzheimer’s Society’s online forum ‘Talking Point’ for peer support.
Identifying increasing needs 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. 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
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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 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. Consider how any family carer can continue to be involved in the care of their loved one when deciding whether a care home is the right solution.
Supporting dementia in care homes Good quality care that preserves dignity, treats people with respect and promotes independence can improve the lives of care home residents with dementia. It’s estimated that seven in ten care home residents have dementia. As a result, many care homes are well-equipped to cater for the complex needs of people with dementia and meet the individual needs of each resident. This is not always the case however, and some care homes are not suitable for people with dementia. Well-trained staff with experience of dementia care are essential. It is important to note whether staff are friendly and caring towards residents and whether they treat residents with respect. A good care home will focus on the individual rather than their dementia – an approach known as ‘personcentred care’. It takes into account the
individual’s unique qualities, interests and needs. 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.
“Good quality care that preserves dignity, treats people with respect and promotes independence can improve the lives of care home residents with dementia.” The environment of the care home should be as comfortable and homely as possible. People with dementia often need to have things to stimulate their interest and so an overly tidy environment is not always helpful. A home with pictures and objects on tables, and with opportunities for residents to do household tasks such as dusting or folding towels, will give an indication that residents are welcome to get involved in the community of the home. Spaces should be clearly sign-posted and laid out to minimise any of the confusion or distress that people with dementia may sometimes feel. Residents should also be able to spend meaningful time outdoors. Some residents with dementia who don’t live on the ground floor might not have easy access to the outside, so extra requirements may be needed so that they can spend time outdoors. Regular exercise, fresh air and natural light are important for a person’s wellbeing. For more information read, Alzheimer’s Society’s ‘A guide to choosing a care home.’
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Helping Pearl and John John, 77, lives with his wife and carer Pearl, 60. John was diagnosed with mixed dementia (vascular dementia and Alzheimer’s disease) over three years ago. Pearl was determined to look after her husband at home so when she knew John needed full-time care, she gave up work to look after him. Pearl does everything for John – getting him
“He’s my husband so, of course, I don’t begrudge it – I love him and only want the best for him, but there needs to be more support for carers.” up in the morning, washing him, shaving him,
giving him his medication, helping him on the toilet, and feeding him. It’s only at 10:30pm when Pearl gets to sit down herself when she’s put John to bed, but often John wakes at night too. It’s a 24/7 job. Pearl says, ‘He’s my husband so, of course, I don’t begrudge it – I love him and only want the best for him, but there needs to be more support for carers.’ After realising she needed more support, Pearl got the local authority to make an assessment of John’s needs. Now, as John’s dementia is in the later stages, care assistants come in three times a day to wash John in the morning, check on him in the afternoon and put him to bed at night. Over time as John’s needs have changed, Pearl has needed more support which has been provided by the home care assistants.
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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 65.
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? •D o 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?
© Care Choices Ltd 2016
Residents
• I s there a full assessment at home before a resident is admitted?
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Thinking of end of life care Every minute someone in the UK dies. Yet for many of us talking about dying, and our own mortality and that of the people who are important to us, remains something people tend to avoid discussing.
People deal with the prospect of someone important to them reaching the end of life in different ways. You may be aware of the fact that your loved one is nearing the end of their life, but other family members may not agree or may have conflicting views on whether or how to approach this. 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. Talking about end of life, and doing it early on, gives people the opportunity to share their hopes, fears and wishes for the end of life. This control over the process can be very powerful and help to deal with any fears your loved one may be experiencing.
“Talking about end of life, and doing it early on, gives people the opportunity to share their hopes, fears and wishes for the end of life.”
Thinking of end of life care
It might be that your loved one has advanced dementia and does not have the mental capacity to contribute to planning and conversations around their care. If this is the case, you, your family and any support staff should make decisions that are in the person’s best interests, in conversation with all those involved in their life and care. As people approach older age there
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are some important considerations. The need for care and support and discussing getting older and possible end of life may prompt conversations around: • Making a will. • Planning and sharing funeral wishes. • Writing down preferences for care and support at the end of life – including their preferred place to die. • Communicating wishes with partners and close relatives.
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. Without communication and understanding, terminal illness or approaching the end of life can be a painfully lonely and stressful experience for the person dying and for their friends and family. Addressing the subject of dying, 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 easier for everyone.
Broaching the subject Few of us want to be the first person to start a conversation about death and dying, but many people find it a relief to talk openly about the subject, and by starting the conversation it gives other
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people space to do this. Try to choose the right place and the right time to start the conversation. Avoid stressful situations and gauge how comfortable the person is talking about their future. Maybe use discussions about care and support needs 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:
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.
Consider • Though 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 gloomy and humour can be a real help.
• If the person 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. Or suggest they write down their thoughts and wishes instead. There may also be other opportunities for them to have conversations around death and dying. For instance, a local ‘Death Cafe’ might be taking place where people can meet to discuss death over tea and cake. For more information visit www.deathcafe.org • Don’t be so worried about saying the wrong thing that you don’t say anything.
Planning ahead • Don’t leave it too late to have important conversations about life and death. • For those with a terminal illness, or approaching the end of their life, it is much better to make plans for care in advance. • Thinking and talking about wishes for how your relative is cared for in the final few months of life 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 the person, you are ensuring that you don’t have to make the difficult decisions on your own later on.
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Planning for end of life 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 • Write a will, setting out your wishes for your personal effects and financial affairs in order to avoid difficult legal problems for your family – and make sure you take legal advice if needed. • If you need to, make financial plans to ensure the people you care about are protected. • Record your funeral wishes so your family know what you would like, and consider how funeral costs would be met. • Plan for your future care and support, for example by setting up a Lasting Power of Attorney (LPA) for Health and Welfare as well as an LPA for property and financial affairs, in case there comes a time that you are unable to make health, wellbeing or financial decisions for yourself. Also consider writing an advance care plan setting out your wishes for care and support at the end of life.
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2. Make a plan for what you want when you die • The type of care you would like towards the end of your life. • Where you would like to die. • Whether you have any particular worries you would like to discuss about being ill and dying. • Whether you want to be resuscitated or not.
3. Save other lives – through organ donation • If 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, for example to help with dementia research.
4. Consider how you would like to be remembered • What would you like people to know before you die? • Messages, memory boxes, videos for loved ones. • Consider your digital legacy – would you like to be remembered online, and what do you wish to happen to any social media accounts?
5. Prepare for bereavement • If you need help or advice, find out where to go for support. • Find out what to do about legal and financial matters after death.
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As the end approaches Wherever your relative is being cared for, in their own home or a care home, you should be confident that the people responsible for 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 and support the care staff should be able to ensure this happens.
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 “A good understanding care assistants provide the highest possible standard of care for of someone’s wishes can everyone who may be in the last help to avoid unnecessary years of life. Many care homes have completed admission to hospital. Most GSF training and some have received people would prefer not to GSF accreditation. GSF accredited die in a hospital and with care homes are twice as likely as other care homes to care for people good planning and support in the home up until the end. the care staff should be able GSF encourages doctors, nurses and care home staff to help families to ensure this happens.” and carers too, so they can work together to avoid ‘crises’. Better Care staff should assess the person and planning of people’s care means be familiar with their specific wishes. a last minute prescription panic Each organisation should have its own or something more major can be end of life care policy – ask your loved averted. one's care provider for their policy ARE THEWhilst CARE OPTIONS? Speak to your loved one’s care andWHAT training on the subject. HOW WILL ITHE KNOW TO CHOOSE? provider about GSF and how they being professional, should alsoWHICH be OPTIONS? WHAT AREstaff CARE approach end of life care. sympathetic and understanding of the HOW WILL I KNOW WHICH TO CHOOSE? situation andTHE the emotions it. VISIT NEWsurrounding CARE SELECT WEBSITE WWW.CARESELECT.CO.UK
WHAT ARENEW THE CARE CARE SELECT OPTIONS? VISIT THE WEBSITE WWW.CARESELECT.CO.UK HOW WILL I KNOW WHICH TO CHOOSE? VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK CALL CARE SELECT FOR MORE INFORMATION:
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Palliative care Palliative care 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.
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, in 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.
“The goal of palliative care is to improve quality Team delivery of life, by increasing In palliative care, decisions about comfort, promoting treatment and care should be made dignity and providing a with the help of the members of a support system.” multidisciplinary team and in line with Palliative care is appropriate for anyone of any age who is facing lifelimiting 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
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, these misconceptions grow. Don’t let the myths get in the way of planning properly for what you want for yourself or the person you love 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; or, in the words of the Dying Matters
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the person’s personal 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.
coalition, ‘Talking about dying won’t make it happen’. If we think about it a little in advance, we can plan for the kind of death we’d actually wish for. Encouraging your loved one to make a will, 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 for or supporting them.
Myth 2: Most of us will die in hospital – it’s inevitable In the UK, currently, more people die
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in hospital than elsewhere, but 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 the person 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 with those you love about illness or dying 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, particularly for those who are left behind.
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 help manage symptoms, including morphine which is often prescribed when pain is severe.
Myth 5: Everyone is vulnerable and powerless at the end of their life Whilst there are always aspects of death that cannot be controlled, many people remain in control of lots of aspects because they’ve prepared for a time when decision-making won’t be as
easy. It is possible for people to leave 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.
“Facing illness together can bring people closer, take away unanswered questions and make the situation easier for all to cope with.” Practical help There is a range of organisations that can help you and your loved one 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 website (www.nhs.uk/Planners/ end-of-life-care) are useful starting points. You can also find information about a range of practical services to support people approaching the end of life, their family and their carers through the ‘Find Me Help’ directory at www.help.dyingmatters.org/ To find out more about the dying process and the care available in the last days of life, see ‘What to expect when someone important to you is dying’ published by The National Council for Palliative Care, Hospice UK and Sue Ryder. It can be downloaded from www.ncpc.org.uk My Home Life supports good care in care homes, and contains lots of useful information, visit www.myhomelife.org.uk
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Are you a family carer? An unpaid carer is anyone who cares, without payment, for a friend or family member who, due to illness, disability, a mental health condition or an addiction, cannot cope without their support. There is an estimated 7 million unpaid carers in the UK.
People can become an unpaid carer at any time, and three in five people will become an unpaid carer at some point in their lifetime.
What does caring involve? Some people spend a lot of time caring; some people become a carer for a shorter period of time to support someone following an accident, at the end of their life or during an illness, for example. The type of support unpaid carers provide varies according to the person or people who need care. It might include: • Personal care (helping someone to wash, dress or go to the lavatory). • Supporting someone to take medication. • Practical support (supporting someone to go to a doctor’s appointment or collecting a prescription). • Emotional support (listening to how someone is feeling, supporting someone who is having a panic attack. Emotional support may also include things like prompting someone to get up, encouraging someone to go for a short walk, or distracting someone who is having intrusive or unwanted thoughts).
Are you a family carer?
Support might also include taking on a higher proportion of domestic chores if the person cannot do this for themselves.
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All unpaid carers feel differently about their caring role, and there is no one way or right way to feel. Carers may also feel differently about their role from day-today, or over time. You might find that helping your loved one get by day-to-day gives you a sense of happiness and fulfilment. However, many carers will find caring demanding and tiring, and you may feel that it changes the dynamic of your relationship with your loved one. You might find that support with some aspects of your caring can help you to still feel like your loved one’s husband, wife, or partner, daughter or son, relative or friend. You may feel that you do not want to care for your loved one for whatever reason, but that you have no choice because no-one else can help. You may feel you have to give up work or things you enjoy and there may also be an impact on your finances. However, caring for a loved one is not all doom and gloom and there is support available for all unpaid carers, no matter why you are caring, who you are caring for, or how you feel about your caring role.
Finding support Many areas have independent local services for unpaid carers of all ages. These can provide breaks for carers, offer advice, or just be a forum where you can share a pot of tea with people in a similar position to yours. You can find
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services that are part of Carers Trust’s network at www.carers.org Services on offer in the local community, or by Carers Trust Network Partners, vary but can include: • Emotional and practical support for unpaid carers including providing care in the home to enable you to take a break. • Carers’ emergency services, offering help in a crisis. • Outreach work in GP surgeries, hospital wards and schools to reach carers who haven’t come forward for support. • Information and advice on issues such as benefits, grants and other financial help available. • Giving unpaid carers a voice so that they are listened to by local decision makers. • Helping unpaid carers to share experiences though group support and social activities. The Carers Trust website, www.carers.org is for adult carers, with users aged from 18 to over 80, with a focus on sharing knowledge and finding solidarity, backed by access to expert and authoritative welfare information. As one member of the website said, ‘Anyone could have created a website but it takes the people who work at it to make it an extended, supportive, loving family.’ You might also find it helpful to get information or support from a local service that supports people who have the same condition as the person you care for, such as a local Mind association, or a local Alzheimer’s
Society. It’s also really important to keep in touch with friends and other family members to ensure you have a solid network of support around you.
Support and time off A carer’s break gives you the opportunity to step out of your caring role for anything from a few hours a week to a week or two on a regular basis. This might include time without the person you care for, or time together outside of your normal routine. Your local carer’s service or council can provide more information about breaks. Some charities, such as Revitalise, provide carers’ breaks as well, visit www.revitalise.org.uk Alternatively, search online for short breaks or respite services in the area. It is important, if you can, to try to take breaks, so that you can carry on with the things you enjoy, or that make you feel like ‘you’. These could be things that happen regularly each week, like going to the pub to see your friends on a Friday, or making sure that you get to your Scrabble group once a month; or things that you would like to do as and when, such as going for a walk, or meeting your friend for coffee. There are numerous ways for you to take a break and for your loved one to be supported while you do so. This can include your loved one visiting a day service for a few hours, a home care worker supporting them at home, even a stay with another family member or in a care home could be an option. Your loved one may also find it easier to manage with some aids and adaptations to the home, and this could
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help you so that you don’t have to worry about your loved one so much. This could be something like a stool that they can sit on in the shower, so you know they are less likely to slip or fall. Ask your local council or carers’ centre about this or see page 26 for more information. This should also be covered as part of your carer’s assessment – see below for more information.
Looking after you It can be difficult to make time for yourself and sometimes carers can ignore their own health problems. You must remember that it is imperative to look after your own physical and mental health as you would your loved one’s. If you don’t, you might put yourself at risk of serious illness and may not be able to continue your caring role effectively.
up any screening appointments that are offered to you – this could include a mammogram, bowel check, or prostate check. Remember that your mental health is just as important as your physical health. As a carer you may be at a higher risk of developing mental health issues, such as depression, due to the impact that caring can have on a person’s emotions. Stress, worry and feelings of sadness are common amongst carers and these feelings may pass. If they don’t, or if you find you can’t get on with everyday tasks as usual, or that you don’t enjoy things like you used to, you should speak to your GP. Other signs that you might be need some support may include sleeping and/or eating more or less than usual and drinking alcohol more than usual. Your GP will take your concerns seriously and there may be counselling support available, or more support may be suggested for you and/ or your loved one. You should mention your emotional or mental health in the carer’s assessment if this affects you.
“You must remember that it is imperative to look after your own physical and mental health as you would your loved one’s.” Carer’s assessment If you can, try to take exercise, eat well, and keep alcohol consumption to a minimum. If your sleep is affected by your loved one getting up in the night, for example, try to rest whenever you can, and mention this during your carer’s assessment as there may be night-time support available. It is also important that you look after your own physical health. Make sure you see your GP if you are unwell and see if you are able to take a short break from caring if you need extra rest to fight an infection. In many areas, unpaid carers can have a free flu jab, as well as health checks; these are important as they will help to protect you and your loved one. Also ensure that you take
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All carers in England are entitled to a free assessment of their own needs for support from the local council. If the assessment shows you need support, you may have to pay for this. More information is available on the Carers Trust website www.carers.org/carersassessment/ Your loved one is also entitled to an assessment of their own needs – for more information, see page 12. If you are their carer, you and your loved one may have your assessments together or separately. You may find that you would prefer to have your assessment separately as it can be hard to discuss how you feel about caring in front of the person you care for. If your loved one is in hospital, the
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council should assess their needs, and yours, before they are discharged so that any care and support, or aids and adaptations, are in place before they come home. It is a good idea to ask the council who you can contact for support after your loved one returns home, in case the care and support isn’t set up as you and your loved one might like. Your carer’s assessment should consider your caring role and how you want to balance that with your life.
“All carers in England are entitled to a free assessment of their own needs for support from the local council.” You may wish to discuss your caring situation with your employer, as they may be able to offer alternatives so that you can stay in work, perhaps working different hours or working patterns, or taking on different responsibilities. Some employers have a carer’s policy. If you are worried about taking time off work to look after your loved one, it is important to be aware of the Employment Rights Act 1996. The Act states that all paid employees in England, Wales and Scotland are entitled to a ‘reasonable’ amount of time off work, so that they can support a ‘dependant’ in an emergency. Your employer does not have to pay you while you take this time off, although some may choose to, and you need to let your employer know you need this leave as soon as possible.
Benefits Benefit entitlements are a complex area and you might want to get some
support from your local authority or a financial adviser about what you might be entitled to. Carer’s allowance is for people who regularly spend at least 35 hours a week caring for someone with a disability who receives a Disability Living Allowance (Middle or Higher Rate for Personal Care), Personal Independence Payment, Attendance Allowance or Constant Attendance Allowance (paid as an addition to a War Disablement Pension or industrial disablement benefit). To qualify for this benefit, carers must not be in full time education or earning above a certain amount. Other benefits may be affected (reduced or stopped) if you get Carer’s Allowance. It is taxable. You qualify to apply if: • You are 16 years old or over. • You look after someone for at least 35 hours a week. • The person you look after receives a qualifying disability benefit. • If you work, you must not earn more than £110 a week net pay, although this figure is revised every April, so be sure to check. • You must be living in the UK when you claim Carer’s Allowance. • You must not be a full-time student. This is defined as supervised studying for 21 or more hours per week. Talk to your local carers’ service or local Citizens Advice Bureau about what else you may be entitled to. Caring can be rewarding but also tough. If you are a carer, make sure you access all the support you may need. This will help you to support the person you care for and enable you to balance caring and your life. Looking after yourself is as important as looking after the person you care for.
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How is care funded? Understanding the way care is financed can be difficult. Social care is not free at the point of delivery, like NHS services. It is a paid-for service only for those who meet specific social care needs and financial eligibility criteria set by the Government.
To understand eligibility, the person with care or support needs must have a care needs assessment and then a financial assessment. The outcomes of both of these assessments will determine their eligibility and how much they will need to contribute, if anything, towards the cost of the care considered necessary.
Care needs assessment
How is care funded? Legal considerations
As mentioned, the starting point for someone with perceived social care needs is a care needs assessment. This will be conducted by the local council. Not all councils have social care responsibilities so you may need to check with your parent’s council and, if they don’t, they should point you to the right authority. The care needs assessment is free to everyone who appears to have a social care need. It sets out to establish your loved one’s physical care needs and any specific personal needs they may have related to promotion of their wellbeing. It will consider the correct level of support needed to achieve identified personal outcomes and will take account of your loved one’s preferences as to the best location for that support to be delivered. It should take into account the social need to
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maintain family relationships and links with friends, as well as your loved one’s desire to stay in their own home.
“To understand eligibility, the person with care or support needs must have a care needs assessment and then a financial assessment” There is a national minimum threshold for eligibility for services which is applied across England and care needs should be assessed first, independently of dealing with the issue of means to pay. Unpaid carers, who may be family members or friends, also have an optional but absolute right of their own to have their support needs assessed using slightly different eligibility criteria and subject to the same means-test rules. See page 84 for more information on carers and carers’ assessments. Not everyone wants an assessment of their needs, however it can help to define the types and level of support needed and what help may be available locally. If your parent agrees to the care assessment and this reveals eligible needs, then
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the council will, with permission, undertake an individual financial means assessment. This assessment will consider capital, income, and savings, applying relevant disregards, to determine the level of your parent’s contribution to funding the care package they are assessed as requiring.
Financial assessment The financial assessment will generally explore all of your parent’s finances. The assessment process can be complicated, involving looking back at gifts and purchases that may be considered to have been made to intentionally reduce your loved one’s resources. You may, therefore, feel the need for independent financial advice before or during the process. If you’re confident your parent wouldn’t qualify for financial support, then you may even feel that a financial assessment should not be undertaken. However, once your loved one is assessed as having eligible social care needs, and after a financial assessment, the local authority will provide details of the amount of money they consider needed to cover the cost of meeting your loved one’s core care needs (without any top ups). This information may help you decide how best to arrange the support needed. Even if the local authority won’t be contributing towards the cost of care, it may offer information on where to find care and support. In some cases the authority may help to arrange suitable services, however there will be a fee for this. It is worth considering undergoing assessment as soon as perceived needs arise. Ensure a continuing record of your loved one's own contributions to the cost of care are kept and that you review them periodically. This will help to ensure appropriate care arrangements are in place and best value is achieved.
Good signposting to useful organisations and providers with whom you can discuss your parent’s support needs and how they can best be met is essential. The care providers in this handbook can be a good place to start. Alternatively, the publisher of this handbook, Care Choices has a searchable database of all care providers in England. Access it through the Care Select website www.careselect.co.uk or www.carechoices.co.uk or call the helpline on 0800 389 2077.
Funding thresholds Presently, the Government has a set upper capital limit of £23,250 and a lower capital limit of £14,250. Someone with capital, including savings, above the upper limit will be classed as a self-funder. They will not receive any financial support towards the cost of meeting their care needs. Self-funders are free to choose any care provider that can meet their needs. Self-funders will pay all fees from their own resources. Your parent will want to ensure that the care arrangements remain affordable so as to avoid a move later.
“Even if the local authority won’t be contributing towards the cost of care, it may offer information on where to find care and support.” If your parent has eligible care needs and capital, including savings, below £23,250, approach the local authority for a financial assessment, as it may be able
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to offer assistance with meeting the cost of eligible care needs. Your parent is still likely to have to contribute towards the cost of their care – this will be explained in more detail at the time of assessment.
Property disregard Many people have concerns about the family home when a loved one requires care. If your parent owns their own home and is assessed as requiring home care, the value of their home will not be taken into account in their financial assessment. The value of your parent’s home will, however, generally be taken into account in any financial assessment if they are assessed as requiring residential care on a permanent basis. There are some exceptions, most notably related to whether any other person has a qualifying right to occupy your loved one’s property. Also, if your loved one goes into residential care temporarily, to try out this option, or for respite or reablement, then the local authority will disregard the value of their property. Consider independent advice about the circumstances that may lead to the property being disregarded as well as all other aspects of paying for care. You may also need advice concerning the process involved in valuing your parent’s property. Aside from enabling wellinformed choices, taking steps to ensure you have received advice related to your loved one’s specific circumstances may help to avoid misunderstandings, which can be costly and time-consuming to resolve later.
12-week property disregard If your loved one is eligible for a financial contribution from the local authority, has been assessed as requiring care in a care home and moves into a care home
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permanently, the value of their property may be disregarded for the first 12 weeks. This can give you time to decide what to do with the property. The local authority will take its value into account after 12 weeks, or sooner if the property is sold within that time. This is called a 12-week property disregard.
Deferred payment agreement If your parent qualified for a 12-week property disregard, after 12 weeks in residential care, the sale of their property may be deferred. This is called a deferred payment agreement. It is an arrangement between your parent and their local authority that enables the value of your parent’s home to be used as security for a loan from the council. If entered into, it means the council will pay care home costs on your parent’s behalf, subject to your parent accepting a charge on the property to cover the amount of the costs being paid on their behalf, plus interest. There is usually also a fee associated with this sort of arrangement. The scheme is now universally available throughout England, meaning that councils are required to offer deferred payment agreements to anyone who is eligible, provided their home is considered adequate in value to cover the amount of loan and interest. Your parent may be eligible if: • They are receiving care in a care home (or are going to move into one soon) because of their care needs. • They own their own home (unless their partner or certain others live there). • They have capital, including savings, of less than £23,250 (not including the value of their home or their pension). The issue of selling a home is emotive. Such an agreement will only delay
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requirement to sell the family home. Deciding to defer sale may restrict your loved one’s care choices as the local authority will usually limit the amount it will loan to cover only the costs of your parent’s core care needs. Your parent’s welfare benefit entitlements may also be affected adversely if their home is not seen to be on the market. You should seek independent financial and legal advice before any agreement is signed.
Income disregards The council will ignore 50% of income from an occupational pension or retirement annuity used to support a partner living in your relative’s home. There are other types of income excluded from consideration in the financial assessment process, the local authority will inform you of these.
and services which may be charged for as ‘extras’. Figures mentioned here may change over the lifetime of this publication.
Benefits The local authority should undertake a full benefits check when your parent has a financial assessment. Other local support organisations may also be able to help with benefits checks. Age UK has an online benefits calculator which can be a useful starting point. It’s worthwhile having a benefits check to ensure that your parent is claiming everything they are entitled to. This may include: • Attendance Allowance. • Disability Living Allowance. • Personal Independence Payments. • Pension Credit. • Winter Fuel Allowance.
“The local authority has a duty to provide details of suitable care available at the personal budget limit detailed within your parent's care and support plan.” Once the local authority has all the information about your parent’s finances, it will calculate how much your loved one should contribute towards the costs of their care, making sure that, if they are in permanent residential care, they are left with a weekly Personal Expense Allowance currently set at £24.90. It is important to be aware that the council may expect your parent to use their Personal Expense Allowance to cover costs known as ‘extras’ which includes things such as receipt of newspapers, hairdressing and purchase of clothing or incidentals like sweets. Your parent will need clarity about items
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• Council Tax reductions. Changes of circumstances, needs or even a move into residential care can affect benefit entitlements, so make sure you have another check if anything changes.
Top up payments The local authority has a duty to provide details of suitable care available at the personal budget limit detailed within your parent’s care and support plan. Each local authority has a fee rate that it pays for care. This means that if the local authority is contributing towards your parent’s care costs then this rate will be the fee the authority will pay. Any difference between the level the authority will pay and the cost of the home will need to be paid by a third party. This is called a top up, or third party contribution as someone will be
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required to 'top up' the cost. Your parent is not generally permitted to pay their own top up. Presently, self (first party) top up payments may only be made by those whose property is subject to the 12-week property disregard, or who have entered into a deferred payment agreement, or those receiving accommodation provided for mental health aftercare. A top up can be made by a friend, family member or charity. The use of a top up by an authority does not mean that councils can set arbitrary limits on the amount they will pay so as to require a third party top up in order to meet the cost of the care home. According to the Local Government Ombudsman, when arranging care, councils must offer eligible people the option of a nursing or care home placement which does not need a top up fee. Before anyone agrees to make additional payments, they should be aware that the amount could change, usually increase, once a year. The person who will make the payment must sign a contract with the council before any contract with the home is signed. In doing so, the person must confirm that they have the financial means to make the payments (including any future increases) for the whole time your parent lives at the care home. If they are unable to maintain the payments, and there is nobody else able to meet this cost, your parent may have to move to a cheaper home within the local authority’s funding levels. If they are already resident in a care home and no third party payment was required at the time they became a resident, the home may seek to introduce a third party payment at a later date. This
should be arranged in conjunction with the local authority. If the additional payments stop being paid for any reason, then your parent should seek help and advice from the local authority.
Funding of primary healthcare needs If, at the assessment, it is decided that your relative needs nursing or medical care, then the local authority will involve a multi-disciplinary team in a joint assessment of needs. The local NHS clinical commissioning group (CCG) will have responsibility for any healthcare funding.
NHS-funded Nursing Care If your relative is assessed as having nursing care needs, the NHS will pay for nursing care provided in a care home with nursing. Funded Nursing Care (FNC) or a Registered Nursing Care Contribution, as it can be known, is a set amount of money that will usually be paid directly by the CCG to the care home with nursing that employs the registered nurse. In care homes without nursing, or your loved one’s own home, the community nursing service may provide the required care as part of their rounds. Even if your relative is not eligible for financial support from the council, but has assessed nursing needs, they should still be eligible for the FNC contribution of £112 per week, which should be deducted from their fees. This figure may change over the lifetime of this book. In some cases, the need for nursing care may mean your parent has to move from the family home to a care home,
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or from a care home to a care home with nursing. An assessment indicating need for nursing care may also initiate an assessment for an NHS Continuing Healthcare package. Speak with your parent’s current care provider, GP, if they are involved in discussions, or the local authority if they have been involved in their care and support.
NHS Continuing Healthcare If your parent is assessed as having ‘primary healthcare needs’ and is deemed eligible for Continuing Healthcare, then the NHS will pay for your loved one’s healthcare and associated social care needs. If care is provided in a care home, then the NHS will also pay the fees. There are strict eligibility criteria for NHS Continuing Healthcare, so contact your local authority or CCG for more information if you feel your loved one has a primary healthcare need.
Other funded social care Social care may also be free if your relative is receiving intermediate NHS care or reablement to facilitate recovery, or to avoid hospital admission or premature entry into long-term residential care. However, this may vary across the country and depend on specific local policy so please check.
Financial and legal advice As mentioned above, the rules around paying for care can be complex. Understanding fully the assessment 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. Councils have an obligation to signpost you and your loved one to appropriate
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sources of information and independent advice. Seeking advice is recommended, if possible well of ahead of needing any care, because sound financial and legal advice may help your loved one to cover the cost of care and facilitate passing on legacies to the next generation. For more information you can contact the Money Advice Service at www.moneyadviceservice.org.uk or call 0800 138 7777. To find an independent financial adviser, contact the Society of Later Life Advisers at www.societyoflaterlifeadvisers.co.uk or call 0333 202 0454. The Law Society will provide help with finding a solicitor to assist you and there are a number of specialists mentioned in this directory able to provide a free first interview or telephone advice. Figures mentioned here may change over the lifetime of this publication.
The cost of care The cost of care, wherever it is delivered, will vary from provider to provider and depend on your parent’s specific care needs, the type of service on offer and even their location. It is important to ask about, and explore, the fees of the different providers you and your parent are considering. Care fees will also increase, usually annually and if your parent’s needs change or they ask for a change of service, such as upgrading their room. It is important to take this into account with all planning and financial considerations. Your loved one will also enter into a contract with the provider of the service or the local authority, so it is recommended to seek specialist financial and legal advice.
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Unrivalled Health & Care expertise Get in touch with Freeths for your Health Check and find out how you can save money and reduce your risks. All work types covered 24/7 by top 100 experts working for you in 11 locations nationally.
Liz Mulvaney Consultant National Head of Health Mobile: 07790 407992 liz.mulvaney@freeths.co.uk
Unrivalled Private Client expertise Our experienced team shows real commitment to delivering the right quality of service at the best price. • Wills • Trust formation, administration and taxation • Lasting Powers of Attorney • Probate and Administration of Estates • Court of Protection Applications
Natasha Molloy 0845 077 9679 natasha.molloy@freeths.co.uk
Unrivalled Safeguarding expertise Freeths team provides sensitive solutions and support in complex safeguarding situations. • Mediation and dispute resolution • Deprivation of liberties • Advice on covert surveillance and human rights • Financial abuse and fraud investigation • CQC and regulatory statutory compliance
Paul Burnley 0845 017 8381 paul.burnley@freeths.co.uk
Birmingham • Derby • Leeds • Leicester • London • Manchester Milton Keynes • Nottingham • Oxford • Sheffield • Stoke on Trent
www.freeths.co.uk
Legal considerations Ageing and requiring care and support can bring to the fore a number of legal considerations. These can range from estate considerations, to capacity to make contractual arrangements around formal care and support services. It can be hard to prepare for every eventuality but getting the right legal advice sooner rather than later can help ensure well-informed decisions.
What do I do if my relative might chosen by your relative. Your parent can also place restrictions on the powers not have mental capacity? As a relative ages they may find themselves in need of assistance with their financial affairs. Nobody is automatically entitled to take over the management of another person’s financial affairs, even if they are the closest relative. If you are concerned that your relative is developing dementia, or might lose the ability to make decisions for themselves, the first thing you should consider is whether your relative has a power of attorney.
What is a power of attorney? A power of attorney is a document that your relative can use to appoint someone to manage their financial affairs should they no longer wish to do so themselves, or if they become incapable of doing so. This person is called an attorney. These used to be called ‘Enduring Powers of Attorney’. However, since 2007, a newer version called ‘Lasting Powers of Attorney’ has been used. If your relative has an Enduring Power of Attorney, it will still be valid as long as it was prepared properly before October 2007. Your relative will have to choose someone to become their attorney. They can appoint more than one attorney and these people can act together or independently, depending on the terms
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of the attorneys, such as which assets attorneys 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.
“Nobody is automatically entitled to take over the management of another person's financial affairs, even if they are the closest relative.” In order to use an Enduring Power of Attorney, where a person 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
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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 where they can understand what the 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. Someone else can sign on their behalf as long as they are able to understand what they are doing and can communicate their understanding in some way. Sometimes, it is just too late to take this route, for example if your relative no longer has 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’.
How is a deputy appointed? In order for someone to be appointed as deputy for a person, they will have to submit an application to the Court of Protection detailing their suitability for the role and information about their 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 the person making the application 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? Around 60% of us have not made a will. If your elderly relative is told that they need care, they may well start to think about what happens next. This may involve making a will if they have not done so. 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 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 look through their papers or contact local solicitors to see if they have one. However, if there is no trace of a will or if the terms of the will are out of date, there are options. 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 your elderly relative is told that they need care, they may well start to think about what happens next. This may involve making a will if they have not done so.” 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. In many cases, following this process 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, it can be an incredibly stressful and confusing time for those left behind. The law ensures that spouses, civil partners 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, this can be a lengthy process, during which family members may not know where they stand in terms of legal rights and inheritance. If someone is not married or registered as a civil partner then the law will view the partner or cohabitee as a friend and they may not receive any provision, leaving them in financial difficulties. If your relative still owns the family home it is wise to put a plan in place regarding it before your relative enters care or passes away. The home can hold a lot of memories and emotional attachment. If your loved one has been living in their own home before entering long-term care, they or you, if you are
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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 source of great anxiety for some people. A major concern is whether or not your relative will have to sell their home to pay for care. For more information on this see the paying for care chapter on page 86.
Contractual considerations There are also contractual considerations associated with care and support. A good, specialist solicitor should be able to advise you on any care contracts you may have to enter into. If you do not have a solicitor, there are organisations that can help you to find one with specialist knowledge. There are specialist later life advisers. See page 92 for information on how to find one.
“If your relative dies before making a will, it can be an incredibly stressful and confusing time for those left behind.” Exploring legal considerations before your loved one requires care and support is important. If there hasn't been a chance, consider seeking advice at the time that care needs are identified. It’s never too late to get sound advice and it is important that your parent’s wishes are adhered to and their best interests are at the heart of all decisions. A specialist solicitor can advise on many aspects of the law around ageing, care and support.
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Essential contacts Action on Elder Abuse (AEA) Helpline: 0808 808 8141 Web: www.elderabuse.org.uk Works to protect, and prevent the abuse of, vulnerable older adults. Age UK Advice line: 0800 169 2081 Web: www.ageuk.org.uk Information on issues affecting older people and their carers. Alzheimer’s Society Helpline: 0300 222 1122 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.
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Care 4 mum Tel: 01223 511487 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 616161 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. Carers UK Advice line: 0808 808 7777 Web: www.carersuk.org Provides support to anyone who is a carer.
Call the Care Select Helpline - 0800 389 2077 - for more information
Essential contacts
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Disabled Living Foundation (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: 0800 021 4466 Web: www.dyingmatters.org Aims to change public knowledge, attitudes and behaviours towards dying, death and bereavement. Elderly Accommodation Counsel Tel: 0800 377 7070 Web: www.housingcare.org Helps people make decisions about where to live and any support or care they need. FirstStop Advice Advice line: 0800 377 7070 Web: www.firststopadvice.org.uk Advice and information on finance and rights for older people. 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. Gov.uk Web: www.gov.uk Information portal for Government services and information. Housing Options for Older People Online Web: hoop.eac.org.uk Online questionnaire to help consider the most suitable housing for your parent’s needs.
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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. National Activity Providers Association (NAPA) Tel: 0207 078 9375 Web: www.napa-activities.com Works to create new opportunities for community involvement and activity in care settings. National Care Forum (NCF) Tel: 0247 624 3619 Web: www.nationalcareforum.org.uk Represents the interests of the not-forprofit care sector. National Council for Palliative Care (NCPC) Tel: 0207 697 1520 Web: www.ncpc.org.uk Umbrella organisation for all those who are involved in providing, commissioning and using hospice and palliative care services in the UK. Pension Service, The Web: www.gov.uk/dwp 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
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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: 0333 202 0454 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. SFE (Solicitors for the Elderly) Tel: 0844 567 6173 Web: www.sfe.legal 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 KNOW WHICH TO CHOOSE? WHATWILL ARE ITHE CARE OPTIONS? WHAT IF MUM DOESN’T AGREE? HOW WILL 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 Call the Care Select Helpline - 0800 389 2077 - for more information
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Region-by-region care homes
North West
Yorkshire and the Humber
East Midlands
East of England
West Midlands
London
South West
South East
> East Midlands
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Derbyshire, Leicestershire, Lincolnshire and Northamptonshire.
> East of England
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Essex and Hertfordshire.
> North West Region-byregion care homes Advertisers’ index
Berkshire, Buckinghamshire, East Sussex, Hampshire, Kent, Surrey and West Sussex.
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108
Bournemouth, Gloucestershire, Somerset and Wiltshire.
> London
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North, South, East and West London.
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Cheshire East.
> South East
> South West
> West Midlands
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Solihull, Staffordshire, Warwickshire, Wolverhampton and Worcestershire.
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> Yorkshire and the Humber North Yorkshire.
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East Midlands Derbyshire
Aspen Court Care Home Aspen Drive, Spondon, Derby DE21 7SG Nursing Respite Palliative Parkinson’s Residential Day care Huntington’s Convalescence Young Physically Disabled
You don’t need to be a Bupa member to stay here. To find out more about Aspen Court Care Home call:
01332 896 212
90 Glass House Hill, Codnor, DE5 9QT Tel: 01773 743810 Web: www.ashmere.co.uk
a shmere
88 Glass House Hill, Codnor, DE5 9QT Tel: 01773 741111 Web: www.ashmere.co.uk
A purpose built care home Codnor Park Aispurpose built careroad home, Codnor Park is set off the main through Codnor setand off we the benefit main road through Codnor, from extremely goodand webus benefit extremely good links to links from to nearby Ripley andbus Heanor nearby and and Heanor as well as Derby as wellRipley as Derby Nottingham. and Nottingham.
CARE HOMES FOR LOVED ONES
Lines are open seven days a week. We may record or monitor our calls.
THE FIRS
CODNOR PARK
a shmere
KIDSLEY GRANGE
a shmere
160 Heanor Road, Smalley, DE7 6DX Tel: 01773 769807 Web: www.ashmere.co.uk
A purpose built care home Codnor Park The home hasmain retained original warmth is set off the roadits through Codnor and whilst having been developed andcharm we benefit from extremely good to the that all bushighest links tospecifications, nearby Ripleyensuring and Heanor residents have the amenities necessary to as well as Derby and Nottingham. enjoy our high quality care.
A purpose built care home Codnor Park We provide hourroad personalised care along is set off the24main through Codnor with wide range from of services and facilities and a we benefit extremely good tailored to your needs.Ripley As a resident you can bus links to nearby and Heanor beassure will continue to have access to wellyou as Derby and Nottingham. health, leisure and community services.
CARE HOMES FOR LOVED ONES
CARE HOMES FOR LOVED ONES
KING WILLIAM
Lowes Hill, Ripley, DE5 3DW Tel: 01773 748841 Web: www.ashmere.co.uk
a shmere
410 Burton Road, Derby, Derbyshire DE23 6AJ Email: rvnh.admin@primushc.com Telephone: 01332 365 240 • 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
A purpose built care home Codnor Park The residential home Codnor itself has is set28offbed the main road through plenty of benefit character, having once good been a and we from extremely public house. specialize all aspects bus links to We nearby Ripley with and Heanor of caring for the elderly and physically as well as Derby and Nottingham. disabled.
CARE HOMES FOR LOVED ONES
SMALLEY HALL
Main Road, Smalley, DE7 6DS Tel: 01332 882848 Web: www.ashmere.co.uk
RYKNELD VIEW NURSING HOME
“Premier nursing home”
www.rykneldview.co.uk
“Warm, friendly and professional nursing homes”
a shmere
SUTTON COURT, LODGE & MANOR Priestsic Road, Sutton in Ashfield, Nottinghamshire, NG17 2AH Tel: 01623 441130 Web: www.ashmere.co.uk
A purpose built care home Codnor Park is set offHall theismain through Codnor Smalley a 27 road bed residential home on and we benefit from village, extremely good the outskirts of Smalley Derbyshire. bushome links to nearby Ripley and Heanor The is full of character having once as well Derby andto Nottingham. been the as coach house Smalley Hall.
A purpose built care home Codnor Park Our up the Ashmere Care is sethomes off themake main road through Codnor Centre. With our Sauna pool, and we benefit from hydrotherapy extremely good Jacuzzi, physiotherapy rooms regular bus links to nearby Ripley andand Heanor activities, care centre is ideal for rest and as well asthe Derby and Nottingham. relaxation.
CARE HOMES FOR LOVED ONES
CARE HOMES FOR LOVED ONES
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a shmere
East Midlands
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Derbyshire continued VALLEY LODGE
a shmere
Bakewell Road, Matlock, DE4 3BN Tel: 01629 583447 Web: www.ashmere.co.uk
WEST HALLAM
8 Newdigate Street, West Hallam, Ilkeston, DE7 6GZ Tel: 0115 9440329 Web: www.ashmere.co.uk
A purpose built care home Codnor Park Valley is located on the outskirts is set Lodge off the main road through Codnor of Matlock the A6 Bakewell Road. and we on benefit from extremely goodThe home is set stunning bus links to within nearby Ripley andcountryside Heanor with panoramic views the River Derwent as well as Derby and of Nottingham. and the High Peak Railway.
A purpose built care home Codnor Park West was opened in 1988. Within is setHallam off the main road through Codnor easy from Ilkeston, and travelling we benefit distance from extremely good Derby andto Nottingham. Home is bus links nearby Ripley The and Heanor situated in a quiet residential area only as well as Derby and Nottingham. minutes away from Shipley Country Park.
CARE HOMES FOR LOVED ONES
CARE HOMES FOR LOVED ONES
Leicestershire
a shmere
Lincolnshire
Honeydew Healthcare aims to provide high quality compassionate care and support to people who are unable to look after themselves in their own homes, at a time convenient to them. Our services include: Home care • Live-in care • Respite care T: 0116 201 4433 E: info@honeydewhealthcare.co.uk
www.honeydewhealthcare.co.uk
Westerley Woodhall Spa offers… · A person centred environment for permanent residential, respite or day care · A Christian ‘family’ with daily acts of worship · High quality en-suite rooms with comfortable lounges, inspiring gardens 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 Westerley,The Broadway,Woodhall Spa, Lincolnshire, LN10 6SQ Call 01526 352231 or e-mail at woodhallm@lwpt.org.uk or visit www.lwphomes.org.uk
Northamptonshire
Brockfield House 01933 625555
Villa Lane, Stanwick, Wellingborough NN9 6QQ
THE ANGELA GRACE
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.
WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE?
PURPOSE-BUILT, LUXURY CARE CENTRE
Cheyne Walk, Northampton
The Angela Grace is a new purposebuilt, luxury care centre located right in the heart of Northampton, close to amenities and opposite the Hospital. It is the latest home from care providers A.G.E Nursing Homes Ltd, a group who draws on 30 years of experience to provide top quality care.
For all enquiries: Tel 01604 – 633282 or email admin@theangelagrace.co.uk
Nursing Homes Limited Caring Since 1984
VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? 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
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Visit www.careselect.co.uk for further assistance with your search for care
East of England Essex
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Hertfordshire Hertfordshire Luxury Care Home
Premier Court Care Home
Stunning 3D virtual tour on your smartphone /desktop at www.foxholescarehome.com
Thorley Lane East, Thorley, Bishop’s Stortford CM23 4BH
Pirton Road, Hitchin, Hertfordshire SG5 2EN
Nursing Residential Convalescence Palliative Respite Parkinson’s You don’t need to be a Bupa member to stay here. To find out more about Premier Court Care Home call:
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.
01279 888 451 Lines are open seven days a week. We may record or monitor our calls.
North West
South East Berkshire
Cheshire East
Hazelmere Care Home
BECKET HOUSE BE
Pinewood Road, Wilmslow SK9 2RS Nursing Residential Respite Palliative Convalescence You don’t need to be a Bupa member to stay here. To find out more about Hazelmere Care Home call:
01625 839 514 Lines are open seven days a week. We may record or monitor our calls.
CK E T H O US
E
Nursing Home
Specialising in Dementia Care and Nursing for the elderly. The home is in the prestigious village of Loughton with large mature gardens and close to Milton Keynes Centre, Railway Station and shops.
Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
T: 01908 231981 E: manager@beckethouse-carehome.co.uk W: www.beckethouse-carehome.co.uk
Call the Care Select Helpline - 0800 389 2077 - for more information
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South East
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Berkshire continued
Buckinghamshire
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.
Highclere Care Home KIMARA
SUPPORT
We work with a broad range of people, older adults, younger adults who have many different support and care needs. We work with you to ensure that your wishes and choices are primary in the support that we provide to you.
Our services include but are not limited to
• 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
K I M A R A SUPPORT
Tel: 0203 291 3436 • Fax: 0203 727 0836 • Email: info@kimara-support.com
To find out more about Highclere Care Home call:
01908 886 544 Lines are open seven days a week. We may record or monitor our calls.
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.
Weedon Hill, Hyde Heath, Amersham HP6 5UH Tel: 01494
1 Chapman Avenue, Downs Barn, Milton Keynes MK14 7NH Nursing Respite Residential Parkinson’sConvalescence Palliative Huntington’s Residential Dementia You don’t need to be a Bupa member to stay here.
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.
773606
Email: admin@careatrayners.co.uk
www.careatrayners.co.uk
East Sussex
Welcome home...
We care for you as we would our own family.
Specialising in Dementia Care for the elderly, our philosophy is centred on the individual’s right to privacy, dignity, independence, choice and fulfillment regardless of their physical or mental capabilities.
• Residential, nursing and respite care • Sheltered housing and day centre • Vibrant community and gardens • Compassionate and stable team CALL NOW OR COME TO VISIT US. WE ARE IN THE OLD TOWN AREA OF BEXHILL-ON-SEA. 01424 730809 or email info@peterhousecare.com
A caring way of life, where you come first www.peterhousecare.com
Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
Tel: 01323 501026 • E: info@rosebery-carehome.co.uk www.rosebery-carehome.co.uk
NURSING HOME
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Care Home with Nursing
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Alverstoke House
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Hampshire OC IATIO
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Established in 1978, a family run home offering 24 hour nursing care, good food, comfortable accommodation, extensive grounds and excellent facilities and services
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 end of life care and provide care for those needing nursing after leaving hospital before returning home. • Excellent reputation in the Alverstoke Area • 30 beds, most 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" Website: www.alverstokehouse.com • E-mail: info@alverstokehouse.com Telephone: 02392 510254 • Office: 02392 529908 • Fax: 02392 503054 20 Somervell Close, Alverstoke, Gosport, Hampshire PO12 2BX
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London Road, Hillbrow, Liss, Hampshire, GU33 7PD Telephone: 01730 895125/892711 • Email: wenham.holt@btconnect.com www.wenhamholt.uk
Visit www.careselect.co.uk for further assistance with your search for care
South East
continued
Hampshire continued
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
Kent
84-86 Shorncliffe Road, Folkestone, Kent CT20 2PG
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.
Tel: 01303 254019 www.ashwoodhealthcare.co.uk
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22 Cornwallis Avenue, Folkestone, Kent CT19 5JB
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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.
Tel: 01303 252394 www.ashwoodhealthcare.co.uk
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Country Country House House Living Living for for the the Elderly Elderly with with 24 24 Hour Hour Care Care 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.
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 NEL_199_LV_90Wx53H_AD.indd 1
Call the Care Select Helpline - 0800 389 2077 - for more information
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Surrey
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Abbey Chase Nursing Home
www.abbeychase.co.uk
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
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Tel: 01932 568090
Email us at: info@abbeychase.co.uk
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Surrey continued
Emberbrook, Thames Ditton
A New Approach to Residential, Nursing, Dementia and Palliative Care for Older Ladies and Gentlemen
Call 0203 553 8043 Emberbrook Care Home 16 Raphael Drive, Thames Ditton KT7 0BL www.brighterkind.com/emberbrook
Grandpa’s laughing again. New in the UK www.inpetto24.co.uk
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.
KIMARA
SUPPORT
We work with a broad range of people, older adults, younger adults who have many different support and care needs. We work with you to ensure that your wishes and choices are primary in the support that we provide to you.
We provide reliable domestic care workers from the Eastern European member states of the EU. Inpetto24. To ensure your parents are well cared for in their own home. Tel. 0208 014 4499 office@inpetto24.co.uk
Our services include but are not limited to
• 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
K I M A R A SUPPORT
Tel: 0203 291 3436 • Fax: 0203 727 0836 • Email: info@kimara-support.com
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The Royal Alfred Seafarers’ Society Providing the highest standards of residential, nursing, dementia and respite care, including sheltered flats, for former seafarers and their dependents. Set in a 14 acre estate, our Surrey based care home provides like minded companionship and support for seafarers and a safe haven for those in old age.
IF YOU KNOW SOMEONE WHO NEEDS OUR HELP, PLEASE CONTACT US T 01737 353 763
E enquiries@royalalfred.org.uk
www.royalalfredseafarers.com
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Whiteley Village Care Centre hiteley Village 01932 857821 www.whiteleyvillage.org.uk
The best possible care... In Whiteley Village’s 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.
Call the Care Select Helpline - 0800 389 2077 - for more information
Reg Charity No. 1103056
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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
Care homes, home care and wellbeing day facilities in West Sussex. Please contact 01903 327327 or enquiry@guildcare.org Charity 1044658 established 1933
Established in 1978, a family run home offering 24 hour nursing care, good food, comfortable accommodation, extensive grounds and excellent facilities and services
WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE?
London Road, Hillbrow, Liss, Hampshire, GU33 7PD Telephone: 01730 895125/892711 • Email: wenham.holt@btconnect.com www.wenhamholt.uk
VISIT THE NEW CARE SELECT WEBSITE WWW.CARESELECT.CO.UK WHAT ARE THE CARE OPTIONS? HOW WILL I KNOW WHICH TO CHOOSE? CALL CARE SELECT FOR CARE MORE INFORMATION: VISIT THE NEW SELECT WEBSITE WWW.CARESELECT.CO.UK
0800 389 2077
South West
CALL CARE SELECT FOR MORE INFORMATION:
0800 389 2077 Bournemouth
Meyrick Rise, Bournemouth
A New Approach to Personal and Nursing Care for Older Ladies and Gentlemen Call 01202 065 319 Meyrick Rise Care Home 11-13 Branksome Wood Road, Bournemouth BH2 6BT www.brighterkind.com/meyrick-rise
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Gloucestershire
Chapel House
Woodstock
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.
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 500005
Horton Road, Gloucester GL1 3EY info@coatewatercare.co.uk | www.coatewatercare.co.uk
t: 01452 616291
North Upton Lane, Gloucester GL4 3TD info@coatewatercare.co.uk | www.coatewatercare.co.uk
honeybourne gate
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.
Luxury living in a landmark retirement complex
1 bed apts from £198,000 2 bed apts from £295,000
Tel: 0800 4714793 www.honeybournegate.co.uk Somerset
Wiltshire
Enabling the best in time of need... ... at the Westerley in Minehead
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
01643 702066 email at mineheadm@lwpt.org.uk or visit www.lwphomes.org.uk
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 42 full-time residents.
t: 01793 496827
261 Marlborough Road, Swindon SN3 1NW info@coatewatercare.co.uk | www.coatewatercare.co.uk
Church View
Downs 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.
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 820761
Rainer Close, Stratton St Margaret SN3 4YA info@coatewatercare.co.uk | www.coatewatercare.co.uk
t: 01793 740240
Badbury (Near Chisledon), Swindon SN4 0EU info@coatewatercare.co.uk | www.coatewatercare.co.uk
Call the Care Select Helpline - 0800 389 2077 - for more information
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London North
South
The Arkley Care Home 140 Barnet Road, Barnet EN5 3LJ Nursing Respite Parkinson’s Palliative Convalescence Young Physically Disabled You don’t need to be a Bupa member to stay here. To find out more about The Arkley Care Home call:
0208 003 3796 Lines are open seven days a week. We may record or monitor our calls.
A beautiful, small, family-run home
Tel: 020 8660 6646
A Home away from Home
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47 Foxley Lane, Purley CR8 3EH
02/12/2015 Tel: 020 8688 7022
84 Coombe Road CR0 5RA
Situated in Purley, south east London, Heatherwood Nursing Home provides high quality nursing, residential and palliative care to 22 residents. We are a family-run Home that focuses on individual care and attention.
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
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www.lloydparknursing.org • info@lloydparknursing.org
Lyle House 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!
t: 020 8878 3806 e: lylehouse@countrycourtcare.com w: www.countrycourtcare.com
East
Looking for home care you can trust? • Personal & post-op care • Housekeeping and companionship • Specialists in dementia, end-of-life and complex disabilities ✔ CQC approved Contact us for a chat today and arrange a free assessment
Tel: 01708 548250
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www.lodgegroup.com
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West
Marling Court Care Home 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
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West Midlands Solihull
The Priory Care Home 1 Shelly Crescent, Monkspath, Shirley B90 4XA Nursing Residential Respite Palliative Convalescence You don’t need to be a Bupa member to stay here. To find out more about The Priory Care Home call:
0121 667 3543 Lines are open seven days a week. We may record or monitor our calls.
Staffordshire
Aston Court Care Home
Hammerwich Hall Care Home
Little Aston Hall Drive, Little Aston, Sutton Coldfield B74 3BF
105 Burntwood Road, Hammerwich, Burntwood WS7 0JL
Nursing Respite Palliative
Residential Respite Convalescence
Residential Convalescence Parkinson’s
You don’t need to be a Bupa member to stay here.
You don’t need to be a Bupa member to stay here. To find out more about Aston Court Care Home call:
0121 667 7534 Lines are open seven days a week. We may record or monitor our calls.
To find out more about Hammerwich Hall Care Home call:
01543 887 987 Lines are open seven days a week. We may record or monitor our calls.
Call the Care Select Helpline - 0800 389 2077 - for more information
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West Midlands Warwickshire
Alveston Leys Care Home Kissing Tree Lane, Alveston, Stratford-upon-Avon CV37 7QN Nursing Residential Convalescence Palliative Respite Parkinson’s Huntington’s Day care You don’t need to be a Bupa member to stay here. To find out more about Alveston Leys Care Home call:
01789 868 276 Lines are open seven days a week. We may record or monitor our calls.
Wolverhampton
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
Worcestershire
Burcot Grange
Anville Court Care Home 188 Goldthorn Hill, Penn, Wolverhampton WV2 4PZ Nursing Respite Palliative Parkinson’s Residential Day care Huntington’s Convalescence Acquired brain injuries You don’t need to be a Bupa member to stay here. To find out more about Anville Court Care Home call:
01902 267 178
“Your home, within a home”
Approached by a tree lined drive, Burcot Grange is set in five acres of beautifully maintained lawns, traditional and contemporary planting, pools and an arbour. Burcot Grange offers the best in quality residential care and assisted living. A full complement of knowledgeable and experienced staff offer support, encouragement and preservation of personal choice, independence, dignity and privacy, creating an environment of dedicated holistic care.
WWW.BURCOTGRANGE.COM
Lines are open seven days a week. We may record or monitor our calls.
Burcot Grange Residential Care Home: 23 Greenhill, Burcot, Bromsgrove, Worcestershire B60 1BJ
Yorkshire and the Humber
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
Tel: 0121 445 5552
North Yorkshire CARLETON COURT CA
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Residential Care Home
The recently refurbished care home for the elderly provides comfortable accommodation for residents in tastefully decorated and furnished surroundings.
Long and short stay Respite and convalescence Local GP service Varied menus and special diets Personal laundry service
Regular activities and outings Visiting clergy No restrictions on visiting Visiting hairdresser Visiting chiropodist
T: 01756 701220 E: info@carletoncourtskipton.co.uk W: www.carletoncourtskipton.co.uk
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Advertisers’ index A
F
Abbey Chase Nursing Home 106 Abbotsleigh Care Centre 4, 105 AGE Nursing Homes Ltd 55, 102 Alverstoke House Care Home with Nursing 104 Alveston Leys Care Home 112 Angela Grace, The 55, 102 Anville Court Care Home 112 Arkley Care Home, The 110 Ashbury Lodge 109, Inside back cover Ashmere 35, 101, 102 Ashwood Healthcare 3, 105 Aspen Court Care Home 101 Aston Court Care Home 111
Far Fillimore Care Home Firs, The Foxholes Care Home Freeths
B Becket House Nursing Home 59, 103 Bluebird Care 39 Brighterkind 10, 107, 108 Brockfield House 55, 102 Bromley Park Care Centre 110 Brotherwood 23 Bupa 35, 101, 103, 104, 111, 112 Burcot Grange 70, 112
C Care Choices 45 Carleton Court Residential Care Home 60, 112 Chapel House 109, Inside back cover Church View 109, Inside back cover Clear Guide 43, 72 Coate Water Care 109, 112, Inside back cover Codnor Park 101 Country Court Care 37, 111 Cumbria House Care Home 3, 105
G Grange Care Home, The Guild Care
3, 105 108
H Hammerwich Hall Care Home 111 Hazlemere 103 Heatherwood Nursing Home Inside front cover, 110 Hengist Field Care Centre 70, 105 High Hilden 105 Highclere Care Home 104 Honeybourne Gate 109 Honeydew Healthcare Ltd 33, 102
I Inpetto 24
45, 107
K Kidsley Grange Kimara Support King William
101 43, 103, 107 101
L Littleover Nursing Home 64 Lloyd Park Nursing Home 110 Lodge Group Care 110 Loose Valley Care Centre 105 Lukestone Care Centre 106 Lulworth House Residential Care Centre 106 LWP Homes 63, 102, 109 Lyle House Care Home 110
D
M
Downs View 109, Inside back cover
Marling Court Care Home Meyer House Care Centre Meyrick Rise Care Home
E Emberbrook Care Home
107
64 101 47, 103 93
Call the Care Select Helpline - 0800 389 2077 - for more information
111 111 108
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Advertisers’ index continued
Nellsar 4, 70, 103, 105, 106, 107, 110 Nicholas James Care Homes Outside back cover Nightingale Court Care Home 64
Smalley Hall Sonya Lodge Residential Care Centre St Winifreds Residential Care Centre Stafftax Sutton Court, Lodge & Manor
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Mockley Manor 112, Inside back cover
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Old Downs Residential Care Centre, The
101 106 106 89
Triangle Community 106
P Peterhouse 63, 104 Premier Court Care Home 103 Princess Christian Care Centre 107 Priory Care Home, The 111
R Rayners 104 Regal Care Homes Outside back cover Rosebery House Residential Care Home 57, 104 Rotherbank 105 Royal Alfred Seafarers' Society, The 49, 107 Rykneld View 101
S 103
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. ISBN 978-1-910362-94-5
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W Waverley Care Group 33 Wenham Holt Nursing Home 104, 108 West Hallam 102 Westcliffe on Sea Care Home 63 Westerley Christian Care Homes 63, 102, 109 Westerley in Minehead 63, 109 Westley Court 112, Inside back cover Whiteley Village Care Centre 49, 107 Woodhall Spa Care Home 63, 102 Woodstock Residential Care Centre 106 Woodstock 109, Inside back cover
Publisher: Robert Chamberlain. Director of Sales: David Werthmann. Head of Editorial: Emma Morriss. Editor: Angharad Jenkins. Content Editor: Emma Cooper. National Sales Manager: Paul Leahy. Regional Team Manager: Russell Marsh. Senior Sales Executives: Mark Dalton, Debbie Feetham, Elaine Green, Vanessa Ryder.
Ref. No: 4001/CareSelect05/16. 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, Bobbie Johnson.
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V Valley Lodge
Silverpoint Court Residential Care Centre
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Studio Manager: Jamie Harvey. Designer: Holly Cornell. Marketing Administrator: Leah Calaghan-Fowler.
Visit www.careselect.co.uk for further assistance with your search for care
Your loved ones are guaranteed a warm and safe environment at Coate Water Care — Coate Water Care is a family-run business that provides a high quality care service in all our Nursing, Residential and Dementia care homes.
Fully Secure Homes Fresh Home Cooked Meals Friendly Helpful Staff
We provide 24-hour nursing, residential and specialist dementia care, as well as specialist care for clients with end of life and palliative needs. Respite and day care services are also available. All these services are provided by our friendly and fully qualified care staff.
We care because you care —
CQC Regulated Full Activity Programme Specialist Care Services Specialist Trained Staff On-site Hair & Beauty
Let us help you find the right care for your loved ones. Please contact our ‘Welcome Team’ to arrange a visit to your local Coate Water Care home.
Call: 01793 821200 or Email: info@coatewatercare.co.uk
Ashbury Lodge | Chapel House | Church View | Downs View | Mockley Manor | Westley Court | Woodstock
Our homes in Kent and Sussex have Coastal and Woodland views. For more info please... Call: 0845 873 1234 Email: info@njch.co.uk Web: www.njch.co.uk
We are passionate about person centred care, your smile is our reward Our homes can be found throughout the UK. Each home is unique with its own individual character. Set in beautiful locations either in the Countryside, with woodland views, on quiet leafy residential streets or with stunning Coastal views.
We provide high quality and person centred Nursing, Dementia and Residential care which can be accommodated on a Long Term: Short term: Respite, Convalescence and Day Care basis.
Our Ethos‌.. We aim to provide a Person Centred and Resident Led, Happy and Secure Environment where promoting Independence, Dignity and Individuality is our priority.
When you visit one of our homes and meet our warm, friendly staff you will find the home from home you and your loved one is looking for.
Making new and happy memories are our business!
Our homes are located nationally. Why not pay a visit to one of our care homes... For more info please... Call: 0208 668 1500 Email: info@regalcarehomes.com Web: www.regalcarehomes.com