Healthwatch Cheshire East 2016 / 17 by Healthcare Publications

YOUR FREE GUIDE TO HEALTH & SOCIAL CARE 2016/17

Please take one ...

Cheshire East

www.healthwatchcheshireeast.co.uk

Cheshire East

Cavendish Court

Providing Exceptional Care Throughout Cheshire

Bowerfield House

Bowerfield House Care Home 1 Broadwood Close, Disley, Stockport SK12 2NJ. Tel: 01663 721465

Cavendish Court Care Home Horseshoe Lane, Alderley Edge, Cheshire SK9 7QP Tel: 01625 242263 • Nursing Care • Residential / Personal Care • Palliative Care • Respite Care / Holiday Breaks • Day Care

Bowerfield Court

Bowerfield Court Care Home 3 Broadwood Close, Disley, Stockport, Cheshire SK12 2NJ Tel: 01663 721464

• Dementia Nursing Care • Day Care • Short Breaks

• Nursing Care • Residential / Personal Care • Care for the Physically Disabled • Palliative Care

The Belvedere

Clarendon Court

The Belvedere Care Home Horseshoe Lane, Alderley Edge, Cheshire SK9 7QP Tel: 01625 242261

Clarendon Court Care Home Beechwood Close, Stapeley, Nantwich, Cheshire CW5 7FY Tel: 01270 861298

• Dementia Nursing • Day Care • Palliative Care • Respite Care

• Dementia Care • Residential Care • Nursing Care • Respite Care • Short Breaks

The Westbourne

Birch Heath Lodge

The Westbourne Care Home

Birch Heath Lodge

Cricketers Way, Holmes Chapel, Cheshire CW4 7EZ Tel: 01477 551371

Birch Heath Lane, Christleton, Chester CH3 7AP Tel: 01244 434321

• Dementia Care • Residential Care • Palliative Care • Respite Care • Short Breaks • Day Care

• Nursing Care • Residential Care • Respite Care • Short Breaks

www.mmcgcarehomes.co.uk

Contents Healthwatch Cheshire East - You Said ... We Did ...

1-2

NHS Hospital Services

3-4

Do You Really Need to See Your GP

5-6

Patient Choice of GP Practice

GPs & GP Surgeries in Cheshire East

Pharmacies in Cheshire East

9- 10

Dentists in Cheshire East

11 - 12

Opticians in Cheshire East

13 - 14

Your Right to Social Care & Support

15 - 16

The Care Act - Know Your Rights

Support for Carers

Being a Young Carer - Your Rights

Caring for Someone with Dementia

21 - 22

Improving Safety & Wellbeing at Home

23 - 24

Disability Aids & Equipment

25 - 26

NHS Continuing Healthcare Funding

27 - 28

Planning for your Future Care Needs

29 - 30

Choosing the Right Home Care Agency

Choosing the Right Care Home

Care in Your Own Home in Cheshire East

Residential Homes in Cheshire East

Nursing Homes in Cheshire East

Disclaimer This Directory has been compiled to signpost primary health and social care providers throughout Cheshire East. Whilst we have taken every care in compiling this publication, the publishers and promoters cannot accept responsibility for any inaccuracies. All listings are supplied via the Care Quality Commission (CQC) and NHS Choices. Neither Healthwatch Cheshire East nor Healthcare Publications can be held responsible for any errors or omissions. All signposting services are up to date as of August 2016. This Directory contains advertising from businesses who are offered the opportunity to reach potential customers through inclusion. However, any information provided by a company or organisation does not carry endorsement or approval of any product or service by Healthwatch Cheshire East or Healthcare Publications.

Another quality publication by Healthcare Publications If you require extra copies of this directory or are interested in advertising in future editions please email Healthcare Publications on admin@healthcarepublications.org or visit www.hcpublications.org

Healthwatch Cheshire East Helping you get the best out of your local health and social care services Healthwatch Cheshire East is the patient and public champion for health and social care services, which include: • GPs and practices • Mental health services • Hospitals • Social care • Community health services • Carers services • Children and young people services Our aim is to listen to the local community, consumers and stakeholders, and use what we hear to challenge and scrutinise existing services. We’re here to work on your behalf, to ensure your views and experiences are heard by those who run, plan and regulate local health and social care services. We consult with patients and the public, ask questions and provide information, through our website, over the phone, by post or at one of the many community events we attend.

Living with Autism in Cheshire East We listened to over 200 carers at groups and events over five months in 2015. Within this group, most people were telling us about their experiences of caring for their children (some of whom were over 18) who were on the Autistic Spectrum (including Asperger’s Syndrome and ADHD).

You said ... In our conversations with carers: • There seemed to be a disparity across the region in relation to the timescales for diagnosis of autism and asperger’s in children. In particular there were significantly longer delays in diagnosis of autism and asperger’s in Eastern Cheshire, with some families waiting for over 5 years for assessment appointment. • A disparity in schools’ approach to children with autism and asperger’s • Lack of crisis care and support for families • A feeling of a ‘blame culture’ from the professionals by parents • Problems with appointments and everyday life • Lack of knowledge of the support available to families • Lack of support for adults living with autism and asperger’s

We did ... Healthwatch Cheshire East 81 Park Lane, Macclesfield SK11 6TX Tel: 03300 882 843 Email: info@healthwatchcheshireeast.co.uk Follow us on Twitter: @HealthwatchCE Facebook: facebook.com/healthwatchcheshireeast www.healthwatchcheshireeast.co.uk

• Raised with the providers and commissioners that there was a disparity faced by carers in Eastern Cheshire. We shared our conversations with carers with professionals working in the Children and Adolescent Mental Health Services (CAMHS) and Eastern Cheshire Clinical Commissioning Group (CCG). • Gathered recognition by both the Commissioner and the provider that there were current problems within the system and that there was a desire to make improvements for the carers and their children. • Worked with and supported the Commissioning Manager at Eastern Cheshire CCG feeding into a redesign of the service. This has been implemented and should address many of the concerns highlighted, particularly around waiting times. • Raised the concerns around support for families within the education system with Cheshire East Council and will be working with them to gather more information and evidence in this area. • Shared the voice of Carers as evidence in the Westminster Commission on Autism in March 2016.

You said ... we did ... Tongue Tie Project:

Areas of improvement include:

We held focus groups with Cheshire’s Really Useful Breastfeeding Support (CHERUBS) groups in selected children’s centres, where the mothers meet and get support for their young ones. The focus groups gathered the views and experiences of what the problem had been, how long the baby had been struggling with breastfeeding, who they had gone to see and their experience thereafter.

• Identify activities to meet individual resident’s needs

The data was then analysed and the results showed that the mothers’ negative experiences were common across Cheshire East. In our conversations with mums around Tongue Tie

You said ... Some of the themes found were: • Conflicting information that parents get from the various health care professionals that leave them confused about what to do with a baby who is struggling to feed. • There are different tongues ties that require different methods of diagnosis and treatment and the inability of some professionals to diagnose the posterior mucosal tongue-tie. • The waiting times for tongue-tie procedures that range from 3 to 8 weeks. There were challenges and barriers regarding referral and diagnosis of tongue tie pathways

We did ... Produced a report which made recommendations for improvements to the diagnosis and procedure, by working with Cheshire East Infant Feeding Team. Some of the breastfeeding teams were interviewed as well to get an understanding of their work and how they support the parents. The report will feed into the training plans that are currently underway by the breast feeding coordinator.

Scrutiny The Scrutiny team have carried out an extensive scrutiny programme. 37 Care Homes were visited in 2015 with each care home being observed in the following areas: • Independence for residents • Mobility both inside and outside the home • Stimulation and social activity

• Completion of activity passports to enable participation • A few homes would benefit from more community involvement Healthwatch shared reminiscence programme activity ideas in order for care homes to support residents to enjoy new past-times. Full reports for each care home visited can be found on the Healthwatch Cheshire East web site: http://healthwatchcheshireeast.co.uk/carehome-scrutiny-0 19 ‘Enter and View/Mystery Shops’ took place across wards in Leighton and Macclesfield Hospitals in 2015 and all reports can be viewed at: http://healthwatchcheshireeast.co.uk/hospitalscrutiny

2015/16 Ongoing Projects GP Access To understand patient experiences of accessing GP Practices, results of which will be fed into further work carried out across Cheshire East to help make improvements to access services. Report will be finalised in April 2016.

Care in your Own Home We are listening to the views of people who receive care in their own home, in order to help them remain independent; by holding focus groups and visiting various supported housing complexes, as well as distributing surveys for completion to get service users views on the quality of their care. Final report expected May 2016.

Young People’s Mental Health Working with schools to gain an understanding of young people’s experiences of mental health illnesses and support services, with a recommendation to stakeholders for improvement to service provision. Report due April 2016.

Future Focus Healthwatch Cheshire East is interested in hearing your experiences on the following topics: • Use of ambulances • Cancer treatment • Use of pharmacies

NHS Hospital services Hospital services fall under secondary care and with the exception of emergency care you’ll need a referral to access treatment. In England, hospital services are commissioned by clinical commissioning groups (CCGs). Hospitals themselves are mostly managed by NHS trusts, which ensure high-quality care is provided and that money is spent efficiently

Choosing a hospital or consultant If you are referred to a specialist, you have the right to choose which hospital or clinic to go to for your inpatient /outpatient appointments. You are also able to choose which consultant-led team will be in charge of your treatment, as long as that team provides the treatment you require. Therefore, if you wish to be treated by a particular consultant for a procedure, you can choose to have your inpatient/outpatient appointments at the hospital where the consultant works, and to be treated by that consultant’s team – but this doesn’t necessarily mean you’ll be seen by the consultant themselves. This choice is a legal right, if you are not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options. If you are still not offered, or refused, a choice, contact your local CCG. If you still don’t get a choice, you can complain to the Parliamentary and Health Service Ombudsman. You do not have a legal right to choice if: • you need urgent or emergency treatment • you are serving in the armed forces • you are accessing maternity services

NHS Waiting Times Emergency treatment If you have chest pains and heart disease is suspected, you should be seen at a specialist (or rapid access) chest pain clinic within two weeks of being referred. Cancer When cancer is suspected, you have the right to be seen by a specialist within two weeks from your referral date. Most people referred like this don’t have cancer, but it’s important to see a specialist as soon as possible, so that a cancer diagnosis can be confirmed or excluded. Non-emergency treatment For non-urgent matters, you have the right to start treatment within 18 weeks from the date your GP, dentist or other healthcare professional refers you (unless you want to wait longer or waiting longer is clinically right for you). As well as deciding what health services a local community needs and providing funding for them, your local clinical commissioning group (CCG) is responsible for deciding whether or not which treatments are available on the NHS. If you think that you would benefit from a certain treatment, contact your GP or local CCG to check if it’s available on the NHS in your area.

• you are detained under the Mental Health Act

Consent to treatment

• you are detained in or on temporary release from prison, in court, an immigration removal centre, or a secure children’s home

For some procedures, including operations, you will be asked to sign a consent form. It’s up to you whether you give your consent for a treatment. So you can make an informed decision, you should ask as much about the treatment as possible before giving your consent

• if you are referred to high security psychiatric services or drug and alcohol misuse services provided by local authorities

GP Referrals Access to NHS specialist treatment is via your GP and is based on need.You will need to see your GP if you wish to be referred to a specialist in a particular field If you ask your GP to refer you to a specialist, they will probably suggest that you try various tests or treatment options first to see whether your condition improves. You cannot usually self-refer to an NHS specialist, except when accessing sexual health clinics or treatment in an accident and emergency (A&E) department. A specialist will only see you with a referral letter from your GP. The letter will give the specialist essential background information. If you wish to see a private specialist, you are still advised to get a referral letter from your GP. 3

However, if you see a private specialist without a GP referral, your GP is not obliged to accept the specialist’s recommendations.

Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are explained below: Voluntary – the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family. Informed – the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment doesn’t go ahead.

Capacity – the person must be capable of giving consent, which means they understand the information given to them, and they can use it to make an informed decision. If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. This is still the case even if refusing treatment would result in their death, or the death of their unborn child. If a person doesn’t have the capacity to make a decision about their treatment, the healthcare professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests. However, the clinicians must take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions

Being discharged from hospital Once you are admitted to hospital, your treatment plan, including details for discharge or transfer, is developed and discussed with you. A discharge assessment will determine whether you need more care after you leave the hospital. You should be fully involved in the assessment process. With your permission, family or carers will also be kept informed and given the opportunity to contribute. If you need help putting your views across, an independent advocate may be able to help

If the assessment determines you’ll need little or no care, this is called a minimal discharge. But if you need more specialised care after you leave hospital, your discharge or transfer procedure is referred to as a complex discharge. If you need this type of care, you’ll receive a care plan detailing your health and social care needs. You should be fully involved in this process. A care plan should include details of: • the treatment and support you’ll get when you’re discharged • who will be responsible for providing support, and how to contact them • when, and how often, support will be provided • how the support will be monitored and reviewed • the name of the person co-ordinating the care plan • who to contact if there’s an emergency or things don’t work as they should • information about any charges that will need to be paid (if applicable) You’ll also be given a letter for your GP, providing information about your treatment and future care needs. Give this letter to your GP as soon as possible.

Do you really need to see your GP Common health complaints, such as coughs, colds and headaches, account for one out of every five GP appointments in England. Many of these can be treated quicker and just as effectively at home using self care, advice from your pharmacist and over-the-counter medicines bought from pharmacies or supermarkets. Below are the top 10 conditions, listed in decreasing order, that account for 75% of GP consultations for minor ailments. 1. Back pain

5. Constipation

One in five people visits their GP in any given year because of back pain. Most cases of back pain can be treated with over-the-counter medicines and self-care aids and techniques.

If you are having difficulty passing stools (going for a poo), changing your diet may be all that’s needed to ease your constipation without taking medicines.

Self-care tips:

• If your constipation is causing pain, take a painkiller, such as paracetamol.

• Use paracetamol or ibuprofen for pain relief. • Use hot or cold compression packs. • It’s important to remain mobile by, within reason, carrying on with your day-to-day activities, including work. Take care when lifting objects.

2. Dermatitis Dermatitis, which includes conditions such as mild eczema, happens when your body comes into contact with a substance that irritates your skin or causes an allergic reaction. Self-care tips: • Avoid scratching. Scratching may damage your skin and allow bacteria to get in, leading to infection. It may help to keep your nails short. • Try to identify the irritant or allergen so you can avoid coming into contact with it.

3. Heartburn and indigestion Digestive complaints like heartburn, indigestion and bloating are very common. They’re usually treatable with simple changes to your lifestyle. Self-care tips: • Diet, excess weight, smoking, alcohol and going to bed on a full stomach can all contribute to indigestion. •

Make a note of any food or drink that seems to make your indigestion worse, and try to avoid them. This may mean eating less rich, spicy and fatty foods, and cutting down on drinks that contain caffeine.

• Add more fibre to your diet, such as fruit, vegetables, wholewheat pasta, wholemeal bread, seeds, nuts and oats. This may take a few days to have an effect. • Make sure you’re drinking enough water. Cut down on caffeine, alcohol and fizzy drinks. • Regular exercise will greatly reduce your risk of getting constipation.

6. Migraines A migraine is a reoccurring headache that’s strong enough to stop you from carrying on with daily life. Self-care tips: •

Ask your pharmacist for advice. They may recommend over-the-counter painkillers. These are usually more effective if taken at the first signs of a migraine attack.

•

Combination medicines, which contain painkillers and anti-sickness medicines for migraine, can be bought without prescription. Always get your pharmacist’s advice first.

• If your migraines are severe, you may need stronger migraine-specific medicines that are only available only on prescription from your GP.

7. Coughs Coughs are usually caused by viruses such as the common cold or flu. They usually clear up without treatment once your immune system has beaten the virus. Antibiotics won’t help with coughs caused by viruses.

4. Nasal Congestion

Self-care tips:

In most cases, a blocked nose will clear within a few days without treatment once the body fights off the underlying infection. If you’ve got a virus, such as a cold or flu, your GP can’t offer you anything more than a pharmacist can provide. Antibiotics won’t help.

• Drink plenty of fluids – water is best. Make sure you drink something non-alcoholic at least every hour.

Self-care tips: • 5

Self-care tips:

Inhaling steam from a bowl of hot (but not boiling) water may soften and loosen the build-up of mucus in your nose. Adding menthol crystals or eucalyptus oil to the water may ease your blocked nose and catarrh.

• Make your own homemade cough mixture by mixing honey and lemon in hot water. • Some over-the-counter medicines can help to relieve cold or flu symptoms, such as a blocked nose, fever and headache. •

If you smoke, try to stop smoking. Get advice from your pharmacy team about over-the-counter products that can help you stop smoking, or visit an NHS stop-smoking service.

8. Acne Acne consists of spots and painful bumps on the skin. It’s most noticeable on the face, but can also appear on the back, shoulders and buttocks. Self-care tips: • Avoid picking or squeezing spots as this can cause inflammation and lead to scarring. • Use a mild face wash, which can be bought from a pharmacy. Bear in mind that over-washing can aggravate acne. • There’s no evidence that wearing make-up or that certain foods, such as fried foods or chocolate, can cause or aggravate acne. • Acne is caused by bacteria building up on your skin. The less you touch your skin, the less bacteria will spread on your skin.

9. Sprains and strains

• Try to keep your sprained joint mobile, unless the sprain is severe. The injury will heal quicker if you move the joint as soon as you’re able to. •

Your recovery time from a sprain or a strain will depend how serious the injury is. Get medical help straight away if your joint looks different than usual, is difficult or impossible to move, or you feel numbness or tingling.

10. Headaches Most headaches aren’t serious, and are usually relieved by medicines, relaxation techniques and lifestyle changes. Self-care tips: •

For pain relief, paracetamol usually works well to relieve a tension-type headache. It’s best to take a full dose as soon as a headache starts. Anti- inflammatory painkillers, such as ibuprofen, can also help with headaches.

Most mild to moderate sprains and strains can be treated at home. Self-care tips: • For the first 72 hours after a sprain or muscle strain you should avoid heat – such as hot baths – alcohol, running and massage.

Patient choice of GP practice Following changes to GP contracts, all GP practices in England will be free to register new patients who live outside their practice boundary area from January 2015. This means that you are able to join practices in more convenient locations, such as a practice near your work. The idea is to provide you with greater choice and to improve the quality of GP services. These new arrangements are voluntary for GP practices.

A good GP practice should provide the following to all patients: • A professional and helpful team of GPs, practice staff and other healthcare professionals.

The involvement groups can have many functions and each group and practice sets its own terms of reference. Groups can represent patients through collecting patient feedback, sharing best practice by working with other similar groups and working with the practices to improve patient services. They also help to run courses within the practice, volunteer support services and awareness events and provide newsletters and information directories.

• A practice that is accessible to everyone and provides a comfortable and organised environment.

To find out about your local patient involvement group or to get one started you should ask at the reception desk of your practice.

• A flexible and efficient appointment booking system.

Cancelling and missing appointments

• Assurance of systems to monitor and improve the safety and quality of care. • Appropriate, respectful and legal management of patient information. • A private consultation room that provides reassurance and builds a patient’s confidence and trust. • A referral or ongoing treatment process that is clear and well managed. • Access to a wide range of healthcare services to help address local health needs and inequalities. • An open and welcoming patient feedback policy with services continually improved or enhanced as a result of the feedback given. • Opportunities for patients to get involved and have their say.

Patient involvement groups Most GP practices have patient involvement groups. These groups are made up of individual patients who take an active interest in patient healthcare and are sometimes known as Patient Participation or Partnership Groups (PPGs).

Please always try to let the GP practice know when you are unable to attend an appointment. It is your responsibility as a patient to cancel any appointment you have made in reasonable time so that another patient can benefit from the appointment slot.

Making an appointment Be polite to receptionists. They are busy people who often have to deal with unhappy patients. Being polite to them will encourage them to help you.

If you have a complaint or concern about your GP or Practice? First raise it with the staff member concerned or the Practice Manager. It may just be an issue of poor communication. Ask your practice for a copy of their Complaints process to follow. If you are not happy with how they respond to your concerns then you can write to NHS England and they will allocate someone to look into your complaint. Write to: NHS England, PO Box 16738, Redditch, B97 9PT. Tel: 0300 311 22 33 Email: england.contactus@nhs.net

GP Out of Hours Service

Knutsford District Community Hospital NHS Choices provides an award-winning, comprehensive health information service with thousands of articles, videos and tools, helping you to make the best choices about your health and lifestyle, but also about making the most of NHS and social care services in England.

your health, your choices www.nhs.uk 7

The GP Out-of-Hours Service provides assessment, advice and treatment as required for urgent healthcare problems that cannot safely wait until the next time GP surgeries are open. Opening hours are: Monday to Thursday 18.30pm to 08.00am Friday 18.30pm to Monday 08.00am 24 hours on bank holidays

Patients should contact the GP Out-of-Hours Service via NHS 111. Knutsford District Community Hospital Bexton Road, Knutsford, Cheshire WA16 OBT

GPs & GP Surgeries GPs & GP Surgeries

Address

Area

Postcode

Telephone

GP Out of Hours Service

MINOR EMERGENCY CARE

If it's not a life-threatening emergency but you need immediate medical care or advice you can visit the Congleton Minor Injuries Unit Opening times Monday to Friday - 10am to 6pm Saturday and Sunday - 8am to 4pm Bank holiday opening times for the Minor Injuries Unit are the same as Sunday opening times

Macclesfield District General Hospital

Patients should contact the GP Out-of-Hours Service via NHS 111. Macclesfield Ditrict General Hospital Victoria Road, Macclesfield, Cheshire, SK10 3BL

Congleton Minor Injuries Unit

Telephone: 01260 294828

Congleton War Memorial Hospital Canal Road, Congleton, Cheshire CW12 3AR 8

Pharmacies

Pharmacy / Chemist

Address

Area

Postcode

Telephone

Data correct with NHS Choices

SUSAN PATTISON THERAPY SERVICES Physiotherapists and Occupational Therapists Home visits and Clinic sessions from our satellite services in Warrington & MacclesďŹ eld available

Tel: 0161 764 3799

www.neurologicalphysio.co.uk 9

Pharmacies

Pharmacy / Chemist

Address

Area

Postcode

Telephone

Data correct with NHS Choices

Dentists

Address

Area

Postcode

Telephone

Data correct with NHS Choices

Looking for an NHS Dentist? visit www.nhs.uk 11

Dentists

Address

Area

Postcode

Telephone

Data correct with NHS Choices

DAVID PROFFITT DENTAL LABORATORY • Quality Dentures • Cobalt Chrome & Valplast Flexible Partials • Denture Repairs • Mouthguards • Anti Snoring Devices • Collection & Delivery Service Locally Call us now on: 01625

500366 or visit www.davidproffittdental.co.uk 12

Opticians

Address

Data correct with NHS Choices

HIS IS A TEST

I F YO U C A N

R E A D

T H I S

A L L T H E WAY D OW N TO HERE DOESN’T MEAN T H A T YO U D O N ’ T N E E D A N E Y E T E S T

Area

Postcode

Telephone

Opticians

Address

Area

Postcode

Telephone

Data correct with NHS Choices

MOBILE EYE TESTS If you qualify for a free NHS sight test, you may be entitled to NHS-funded mobile services where the ophthalmic practitioner comes to visit you:

At Home At a Residential or Care Home At a Day Centre Call 111 to find out who provides mobile sight tests in your area 14

Your right to social care and support Local authorities have a duty to assess anyone who appears to have care and support needs. Your care plan should help you to: • live independently • have as much control over your life as possible • participate in society on an equal level, with access to employment and a family life • have the best possible quality of life keep as much dignity and respect as possible

Your local authority should: • assess your needs and give you advice, whatever your financial circumstances • provide information about services and support options available to you in your area • give you a carer’s assessment if you are an unpaid/ family carer The assessment by the local authority is important because it helps them work out what your difficulties are and what services will help you most. Often, only minor assistance is needed – such as meals on wheels and help with washing or dressing, yet these services could make a big difference to your life If your local authority decides you are eligible for social care support, they will carry out a financial assessment to determine how much you will need to pay towards your care, if anything. If you are assessed by social services and are found to be eligible for support, the next stage is to draw up a care and support plan, or in the case of a carer with eligible needs, a support plan.

Understanding the national eligibility criteria for care and support? The eligibility threshold for adults with care and support needs is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing.

What is a Care Plan? A care plan (sometimes called a care and support plan, or support plan if you’re a carer) sets out how your care and support needs will be met. You should be fully involved in the preparation of your care plan, and you and anyone else you request should also get a written copy. The care plan must set out: • the needs identified by the assessment • whether, and to what extent, the needs meet the eligibility criteria • the needs that the authority is going to meet, and how it intends to do so • for a person needing care, for which of the desired outcomes care and support could be relevant • for a carer, the outcomes the carer wishes to achieve, and their wishes around providing care, work, education and recreation where support could be relevant • the personal budget • information and advice on what can be done to reduce the needs in question, and to prevent or delay the development of needs in the future Your care plan should be individual to you, and you should be allowed to have as much involvement in the development of your plan as you wish.

Local authorities must consider whether the person’s needs: • arise from or are related to a physical or mental impairment or illness • make them unable to achieve two or more specified outcomes • as a result of being unable to meet these outcomes, there is likely to be a significant impact on the adult’s wellbeing

An adult’s needs are only eligible where they meet all three of these conditions. The specified outcomes measured include: • managing and maintaining nutrition, such as being able to prepare and eat food and drink • maintaining personal hygiene, such as being able to wash themselves and their clothes • managing toilet needs • being able to dress appropriately, for example during cold weather • being able to move around the home safely, including accessing the home from outside • keeping the home sufficiently clean and safe • being able to develop and maintain family or other personal relationships, in order to avoid loneliness or isolation • accessing and engaging in work, training, education or volunteering, including physical access • being able to safely use necessary facilities or services in the local community including public transport and recreational facilities or services • carrying out any caring responsibilities, such as for a child

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Local authorities do not have responsibility for providing NHS services such as patient transport, but they should consider needs for support when the adult is attending healthcare appointments. The local authority should not refuse to meet eligible needs on the grounds of cost, although if there is more than one option, it is allowed to choose what it believes is the most cost effective one. If your needs do not meet the national eligibility criteria, the local authority still has to give you information and advice on what support might be available in the community to support you If you need help from Cheshire East Council due to ill health or a disability, or you are struggling to cope with your everyday needs, you can contact us to tell us about your circumstances. We will discuss what is going on in your life and how we can help you. We have a responsibility to assess the needs of any person aged 18 or over, if they appear to be vulnerable. Anyone providing regular care for a vulnerable adult may also request an assessment.

Vulnerable people may be in one or more of the following groups: • Older people • People with physical disabilities • People with a hearing and/or visual impairment • People with learning disabilities • People with mental health problems • People with long-term conditions • People who misuse substances For initial enquiries relating to adult social care please call 0300 123 5010 Monday to Thursday 9.00am 5.00pm and Friday 9.00am - 4.30pm www.cheshireeast.gov.uk Report a Safeguarding Concern Cheshire East Safeguarding Adults Board Call: 01625 374753 and speak to someone about your concerns or visit: www.stopadultabuse.org.uk Email: LSAB@cheshireeast.gov.uk Cheshire East Safeguarding Adults Board First Floor, Macclesfield Town Hall, Market Place, Macclesfield, Cheshire SK10 1EA

The Care Act

Care & Support for Adults in England

Know your rights ...

Well-being ...

Local councils must have services to meet different peopleâ&#x20AC;&#x2122;s needs. They must always think about your wellbeing.

Prevention ...

Stopping problems before they start. Local councils must think about services that stop problems before they start, or stop them from getting worse as early as possible.

Information and advice ...

Local councils must have good information to help people choose the right care and support. Councils must give information and advice to everyone who wants it, not just people who have their care and support paid for by the council.

Having all the services people need ...

Local councils must make sure there are lots of different care and support services in their area.

Independent advocacy ...

Councils must involve you in assessments and in planning and checking your care and support. If you find it very difficult to be involved and there is no-one else to speak for you, they must find you an independent advocate.

Care when you leave hospital ...

If you need care from the council to stay safe when you leave hospital this needs to be ready on time.

Work and having a job ...

Councils must think about education, training and work when they look at the care and support you need.

Moving from childrenâ&#x20AC;&#x2122;s services to adults services ...

Before someone is 18, councils need to help them and their carers plan for the future and the support they might need as an adult.

Ask for an assessment ...

If you have (or someone you care for has) a health condition or disability and are finding it difficult to cope with everyday living tasks, then you may need some additional support to help you. You can request an assessment from Adult Social Care on 0300 123 5010. A trained assessor will work with you to carry out the assessment. We will consider a number of factors such as your needs and how they impact on your wellbeing and what is important to you. We will identify if you have any needs that are eligible for care and support to be arranged by the council. If you are not eligible for help from the Council we can provide advice and signpost you to services who can provide support.

www.cheshireeast.gov.uk

David Lewis is a registered Charity providing outstanding education, residential, medical and therapeutic support for people with learning disabilities, epilepsy and autism.

Day Services ...

Our popular ‘Day Services’ provides a supportive and flexible approach that enables people with learning disabilities access to a wide range of life and vocational training opportunities; all of which are aimed at meeting a range of different personal needs. We have locations across Cheshire including Warford, Alderley Edge, Macclesfield and our newest centre in Crewe. We welcome all external referrals and offer a range of attendance options to suit individual needs and personal budgets.

To find out more or to arrange a visit please contact our friendly team on

01565 640002 or email enquiries@davidlewis.org.uk

Day Services include: Horticulture • Woodwork Animal Care • Printing IT • Work Experience Sports • Sensory Activities Community Trips Arts & Crafts • Cookery Dance • Music.

www.davidlewis.org.uk Mill Lane | Warford | Alderley Edge | Cheshire | SK9 7UD

Registered Charity Number 1000392

Support for carers There are 6.5 million carers in the UK which is one in 10 of the population. Ask for a Carers’ assessment

Your decision to be a carer

The Care Act 2014 makes carer’s assessments more widely available to people in caring roles Local authorities now have a legal duty to assess any carer who requests one or who appears to need support

When your carer’s assessment is done, no assumptions should be made about your willingness to be a carer. This can be a very sensitive area, because many of us feel that we have a duty to those we care for. We sometimes rule out other options because we feel we have no choice. You have the right to choose: • whether to be a carer at all • how much care you are willing to provide • the type of care you are willing to provide When assessing your needs, social services must consider whether your role as a carer is sustainable. The assessment is about your needs and therefore you should: • have a reasonably detailed discussion about all the matters relevant to you • have the assessment in private if you want to, at a convenient time and place for you • get relevant information, including about welfare benefits you could claim and details of other services • have a chance to identify the outcomes that you want; any services should be appropriate for you and meet your needs • be given flexibility and innovation in identifying services that may meet your needs • have an opportunity to give feedback about the assessment

If you provide care and support to an adult friend or family member, you may be eligible for support from your local council. This support could include being offered money to pay for things that make caring easier. Or the local authority might offer practical support, such as arranging for someone to step in when you need a short break. It could also put you in touch with local support groups so you have people to talk to. A carer’s assessment is a discussion between you and a trained person either from the council or an organisation working on behalf of the council. The assessment will consider the impact the care and support you provide is having on your own wellbeing, as well as important aspects of the rest of your life, including the things you want to achieve day-to-day. It must also consider other important issues, such as whether you are able or willing to carry on caring, whether you work or want to work, and whether you want to study or do more socially. A carer’s assessment looks at the different ways caring affects your life, and works out how you can carry on doing the things that are important to you and your family. It covers your caring role, your feelings about caring, your physical, mental and emotional health, and how caring affects your work, leisure, education, wider family and relationships. Your physical, mental and emotional wellbeing should be at the heart of this assessment. This means that you can tell the council how caring for someone is affecting your life and what you want to be able to do in your day-to-day life. A carer’s assessment should also look at your own interests and commitments to see if and how they are disrupted by your role as a carer. One of the most important parts of your carer’s assessment will be a discussion about your wishes concerning going to work, training or leisure activities.

Being a young carer A young carer is someone aged 18 or under who helps look after a relative who has a condition, such as a disability, illness, mental health condition, or a drug or alcohol problem Most young carers look after one of their parents or care for a brother or sister. They do extra jobs in and around the home, such as cooking, cleaning, or helping someone to get dressed and move around. Some children give a lot of physical help to a brother or sister who is disabled or ill. Along with doing things to help your brother or sister, you may also be giving emotional support to both your sibling and your parents.

Supporting adults with disabilities to live independently in their own homes Registered Charity Number: 1022680

Supported Living • Shared Lives • Short Breaks • Community Support • Children & Family Centre Call us on: 0161 456 6502 or visit: www.independentoptions.org.uk

Being a young carer – your rights Your choices about caring Some people start caring at a very young age and don’t really realise they are carers. Other young people become carers overnight. If someone in your family needs to be looked after, you may really want to help them. But young carers shouldn’t do the same things as adult carers, nor should they be spending a lot of their time caring for someone, as this can get in the way of them doing well at school and doing the same kinds of things as other children or young people. It’s important you decide how much and what type of care you’re willing or able to give, or whether you should be a carer at all. You need to decide whether you’re the right person to offer the care that the person you look after needs. All disabled adults are entitled to support from their local authority, depending on their needs, so they should not have to rely on their children to care for them. It’s important for social services to ensure the whole family feels supported and comfortable with your role.

It should also explain what you can do if you or your parents disagree with the assessment. Provided that you both agree, the local authority can assess both your needs as a young carer and the needs of the person you care for, at the same time. If you’re 16 or over, and you’re not in full-time education you may be eligible for help finding work as well as help with your family’s finances, for instance through benefits such as Carer’s Allowance. Your assessment is the best place to find out about what is available in your situation.

Request your Young Carer’s assessment

There are organisations across Cheshire East who can support you as a young carer: Cheshire Young Carers’ network www.cheshireyoungcarers.org Carers trust 4 all www.carerstrust4all.org.uk Email: cheshireeast@carerstrust4all.org.uk

Young carers’ rights

Tel: 01260 292850

As from April 2015 a social worker from your local authority must visit to carry out a “young carers needs assessment” to decide what kind of help you and your family might need if you or your parents request this.

Request your Carer’s assessment

If the local authority has already carried out one of these assessments before, they must carry out another one if you or your parents feel that your needs or circumstances have changed. A young carer’s needs assessment must decide whether it is appropriate for you to care for someone else – and this includes taking into account whether you want to be a carer. The local authority must also look at your education, training, leisure opportunities and your views about your future. When assessing a young carer they must always ask about your wishes and involve you, your parents and anyone else you or your parents want to be involved.

Contacting our Adult Social Care Team at Cheshire East Council - Tel: 0300 123 5010 http://www.cheshireeast.gov.uk/care-and-support/ carers-information/carers_assessment.aspx Alternatively, if the person you care for is being assessed by a social care practitioner, speak to them about how you can have your needs assessed and they will be able to offer you information and advice about this.

All these people should receive a written record of the assessment. This should include whether the local authority thinks you need support, whether their services could provide you with that support, and whether they will give you that support.

Supporting adults with disabilities to live independently in their own homes Registered Charity Number: 1022680

Supported Living • Shared Lives • Short Breaks • Community Support • Children & Family Centre Call us on: 0161 456 6502 or visit: www.independentoptions.org.uk 20

Caring for someone with dementia People with dementia can feel vulnerable as their condition progresses and they increasingly rely on other people to do things for them. It is important that people who have dementia feel reassured and supported, while retaining some level of independence People with dementia live in your area, probably on your street, possibly amongst your friends and close neighbours. People with dementia may visit your shop, business or workplace. Common signs of dementia are confusion, forgetfulness, struggling to find words and repetitiveness. This can make everyday situations stressful. A person with dementia may need extra assistance to help them use your services or help them with everyday things.

Speak clearly • Speak clearly, calmly and slowly to allow the person time to understand information. • Use simple, short sentences and avoid direct questions. • Keep choices to a minimum and don’t raise your voice. • Where possible, talk in a non-distracting place or find a quiet corner.

Think about your body language • •

People with dementia may find it difficult to understand what is being said, but can be quick to interpret the message on people’s faces and may still be aware of body language. Make sure you are at the person’s level, use a friendly tone and respect personal space.

Show respect and patience • Adapt what you are saying if the person with dementia does not understand. • Don’t rush, and try to go at their pace.

Listen • •

Listen carefully to what the person has to say, giving plenty of encouragement, whilst looking out for other clues of what they might be trying to communicate. Allow them time to find the words to tell you what they want.

Noise • A person with dementia may have difficulty listening if there are a lot of different noises around them.

Lighting • Make sure the lighting is sufficient so the person with dementia can see you and everything around them clearly. • Turn up the lights or move to a well-lit area. 21

Finding the way • People with dementia may have forgotten where things are or they may not recognise everyday objects. • Sometimes people with dementia may forget where they are going or become disorientated. • They may not be able to follow simple directions and may need you to go with them to where they want to go.

Feeling lost • Sometimes people with dementia may feel lost in familiar places or forget where they live.

Maintaining good health and nutrition • It's important that the person you care for has a healthy, balanced diet and gets some exercise. • The longer they stay fit and healthy, the better their quality of life will be.

Recognising and finding things • • •

People with dementia may have forgotten what they came into the premises or room for. They may have a list but have problems finding the things they want. Help them choose the right amount of things, particularly if they seem to be buying an unusually large amount of something.

Making choices • • •

While choice is good, for someone with dementia too much choice can be confusing. Ask what the person would like, e.g. a coffee, and then suggest two or three likely options. You could describe these options and remember to give a pause between each option to allow them time to think and make a decision.

Whose reality • •

Past memories can often be stronger than present reality. The person may be confused and say something that does not makes sense to you.

Being predictable • •

The person with dementia may be confused if things have been rearranged, or by new people they meet. Try to keep things the same or offer additional assistance if things have changed.

Every day can be different • For some people with dementia what they can do changes from day to day, so how you help them may need to be different every time. • Look out for signs and offer to help when needed, bearing in mind the privacy of the person.

Dealing with incontinence in someone with dementia A person with dementia may simply forget to go to the toilet, or may forget where the toilet is. They may also have lost the ability to tell when they need the toilet. How you can help It’s important to be understanding, retain a sense of humour and remember that it’s not their fault. You may also want to try the following: • Put a sign on the toilet door, such as a photo of the toilet. • Keep the toilet door open and make sure that the person you care for can access it easily. • Make sure they can remove their clothes – some people with dementia can struggle with buttons and zips.

• Look out for signs that they may need to go to the toilet, such as fidgeting and standing up and down. • Get adaptations to the toilet if necessary

Helping someone with dementia with their personal hygiene People with dementia can become anxious about certain aspects of personal hygiene and may need help with washing. For example, they may be scared of falling when getting out of the bath, or they may become disorientated in the shower. The person you care for may not want to be left alone or they may resist washing, because they find the lack of privacy undignified and embarrassing

Helping someone with dementia sleep well People with dementia often experience disturbed sleep. They may wake up during the night or be restless. These problems may get worse as the illness progresses Some medication can cause sleepiness during the day and interfere with sleep at night. Sleeping pills can be used with care in people with dementia. However, “sleep hygiene” measures are best for people with dementia – for example, no naps during the day, regular bedtimes, and avoiding alcohol or caffeine at night.

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Improving safety and wellbeing at home There are lots of things you can do to help the person you care for live in as safe an environment as possible. Daylight and fresh air are essential to health and wellbeing. If the person you care for finds it difficult, or impossible, to go outside regularly. Open a window for one or two hours a day which will help to recycle the air inside the home. This should only be done if it does not significantly lower the temperature inside.

Heating Thermometers can help to ensure that rooms do not fall below a certain temperature. For living rooms, the recommended temperature is between 18 and 21°C. For other rooms, the recommended temperature is not less than 16°C. Service the gas appliances – fires, ovens, boilers and central heating systems – regularly, employing a professional who has been certified by the Gas Safe Register.

Lighting Many accidents can be avoided simply by having clearly-lit rooms and spaces. The right lighting can also make a dramatic difference to comfort and emotional wellbeing In addition to main lights, consider having lamps within easy reach of frequently-used spaces: for example, next to a favourite reading chair in the living room or on a bedside table. Wall-mounted, batteryoperated lights can be a good (and cheaper) alternative to installing new electrical wiring. These come in a variety of styles and are operated by switch, pull cord or even movement sensors

Furniture Consider re-positioning furniture – or taking away unimportant furniture – if this will make it easier to enter, exit or move around certain rooms. This may be particularly sensible if a walking aid is being used. Remove any rugs or replace any carpet that could prevent the safe use of walking aids, or which could potentially cause falls.

Sitting comfortably and safely It’s likely that the person you care for is going to be sitting down for increasingly long periods of time, so it might be good to check on the comfort of his or her furniture. Unfortunately, many sofas and armchairs are often the wrong shape for a good sitting position, and people can be uncomfortable for a number of reasons – more often than not because the length and depth of the seat is not correct for them. This may be due to the style of the furniture, such as chairs too narrow or too wide, but it may also be that the furniture is old and the filling in its upholstery has compacted. A ‘wrong’ sitting position can become uncomfortable quite quickly, potentially making it harder to get out of the chair again – for example, if certain joints have become stiff or cramped. 23

Over time, sitting in the same, wrong, position could lead to more serious physical problems with posture, balance and flexibility. For the safest ways to get in and out of a chair, remember the following tips: • When sitting down, always feel the chair or seat on the back of your knees before lowering into the seat. • Reach for the arms and lower yourself down gently and evenly; don’t be tempted to use a walking aid for support. • To get back up again, wriggle forward so that your feet are directly under or behind your knees. • Make a wide base with your feet. • Sometimes, rocking forwards and backwards will help you find the momentum to get up. • Ensure that you look up, and lead with your head. • Use the chair arms, and push up evenly with both your arms. • Give yourself a moment to find your balance before walking away from the chair.

Use Assistive Technologies There are many electronic products and systems that use technology to promote health and wellbeing in the home, by monitoring activity, managing risks, increasing security, helping the person you care for manage the important tasks within their daily lives, and bringing support more quickly when things go wrong.

Telecare Telecare systems can be linked to a call centre or to a mobile phone of a carer. Call centres are by far the most common option for home users of telecare, their primary advantage being that a call centre is staffed 24 hours a day, 365 days a year. Carers who have asked for an assessment should always be made aware of the benefits of telecare

Types of sensors • • • • • • • • • • • • •

Fall detectors Bed or chair occupancy sensors Movement detector Flood detector Property exit sensors Enuresis (incontinence) alert Smoke detector Heat/temperature analyser Gas detector Nocturnal epileptic seizure detector Hypothermia alert Medication dispensers Door opening sensors (to detect someone leaving the property, or a door left open)

Free Home Fire Safety Checks

Checklist to help prevent falls in the home

The Person you care for should be eligible to have free smoke alarms fitted in their home. Contact the local fire department for further information. . Slippery floors are a safety hazard, so think about installing grab rails and using slip-resistant mats and flooring. If a conventional bath or shower are no longer suitable, there are several different types of bath and walk-in showers to choose from. It’s a good idea to consult an Occupational Therapist (OT) and/or visit a Disabled Living Centre (DLC) before adapting a bathroom to make it safer.

 Make sure any rugs and mats are attached to the floor and are non-slip  Arrange cupboards and shelves so important things are within easy reach  Make sure that any spillages, particularly liquid spillages, are cleaned up as soon as possible  Be aware of the obstacles that unnecessary clutter can cause  Use high-wattage light bulbs and make sure there are replacements available  Take care of their feet, by having their toenails trimmed regularly and wearing well-fitting shoes

Grants for bathroom adaptations

Getting dressed and undressed

If the person you care for has a chronic illness or other form of disability that prevents them from getting into and out of the bath easily – and they intend to live in the current property for the next five years – they may be eligible for a Disabled Facilities Grant (DFG). Its worth looking into as the average cost of a new bathroom suite is around £3,000 but specialist adaptations can increase this amount substantially.

For people with disabilities and issues such as less flexibility in their fingers, everyday tasks such as getting dressed and undressed can become challenging. Many aspects of getting dressed can simply be made easier by choosing certain clothes and footwear. For example, zips and velcro are both easier to fasten than small buttons or shoelaces; easier still are clothes that don’t require fastening

Safety in the bathroom

From fitting a stairlift to building an extension, Care & Repair can help. We support older and disabled people with repairs and adaptations, keeping them safe, warm and independent in their own home.

Disability aids & equipment Get expert advice An occupational therapist or physiotherapist can advise you on whether a particular piece of disability equipment or adaptation is likely to meet your needs. Many more retailers are now entering the market for disability aids and adaptations. The market is no longer restricted to specialist providers so be careful of buying products online as bigger products like wheelchairs and scooters will need some type of assembly Buying locally can have some advantages. For example, you might not have to pay for delivery and if there’s a problem with the equipment when you get it home, it can be quicker and easier to resolve it face-to-face. Alongside personal needs, you might want to consider some of the following: • Does the company you are buying from offer an ‘after-sales service’? • Does the product come with a guarantee? • Can you get hold of spare parts easily and cheaply? • Does it need to be serviced regularly? Who will you use to do the work and how much will it cost? • Does it comply with the necessary British Standards? If it’s been tested and approved it will have the BSI (British Standards Institute) Kitemark. • What is the company’s returns policy? Do they offer a buy-back guarantee if your needs change?

Don’t forget to claim VAT relief If you have a long-term illness or you’re disabled, you don’t have to pay VAT on equipment designed to help with daily living. The supplier needs to be registered for VAT and you have to sign a form declaring that you have a long-term illness or you’re disabled.

Buying second-hand disability equipment Buying second-hand can be cheaper, but always check that what you are buying is in good working order. Second-hand items must be accurately described by whoever is selling them, including details of any faults. Some mainstream magazines and several disability organisations publish journals that contain Advertisements for second-hand equipment. If you are buying second-hand from a private individual, you must make sure that: • the equipment has been regularly maintained; • that you also receive accompanying literature, for example a care manual; • that batteries have been regularly charged (usually once a month is sufficient if the equipment is not being used); and that you receive instructions on how to use the equipment properly and safely. You may also need to find a local company able to service the equipment and carry out future repairs. 25

Minor adaptations and equipment – what help is available? Your local authority in England will normally provide you with disability equipment and small adaptations costing less than £1,000 free of charge, as long as you’ve been assessed as needing it and you are eligible

Complaining about care products When you buy something, the law gives you certain rights that protect you if it’s faulty or not fit for purpose – that includes equipment or aids to help with mobility or daily tasks. If your council arranged for and purchased a care product for you, report it to them and they should replace it. If you bought a care product directly, go back to the retailer to ask for a refund or replacement. If you don’t get a satisfactory result, contact your local Citizens Advice Bureau for help in taking matters further. If you bought a product or service with a credit card, and the retailer is being difficult, you may get help from your credit card provider. Contact them directly to see what they can do.

Mobility scooters A mobility scooter is a medical device as well as a lifestyle choice. It’s important to get the right one - for example, with a tiller and controls you can operate if you have arthritic fingers. Otherwise you could waste money or buy a scooter that isn’t the safest or most comfortable. Take advice from a mobility shop or by contacting an occupational therapist before you make a final decision on what to buy. Choosing a mobility scooter - top five things to consider  The types of journeys you plan to make  The types of terrain you’ll cover  Your storage facilities  Your body weight and size  Your budget

Choosing a wheelchair or scooter If you need a wheelchair, the main decisions you’ll have to make about your chair are: • whether it will be self-propelled, pushed by someone else, or electric-powered • for permanent or occasional use • for indoor or outdoor use • whether you need it to go in and out of a car There are pros and cons for each type of chair, so the choice depends on your needs. There are a large variety of wheelchairs and scooters available, so expert independent advice is essential. Some of the things to consider when choosing the right equipment are:

Your physical ability - For example, if you’re unable to stand up, a scooter may be difficult to manage. Stability and balance may also affect what you can use. How the equipment will be used - For example, do you need to get up stairs or through narrow doorways? Practical considerations - such as access to a power point if the equipment needs to be charged up, or having a secure place to store the equipment when it’s not in use.

NHS wheelchairs The NHS wheelchair service offers assessments to determine what type of wheelchair or mobility equipment you may be entitled to. In most cases, you’ll be referred to the service by a hospital, doctor, consultant or occupational therapist. However, the specific criteria to determine who is eligible are decided locally, and will vary depending on where you live. Many wheelchair services have a waiting list for assessment appointments, so you may have to wait several weeks after referral to have an assessment.

Did you Know ... The Motability Scheme enables disabled people to lease a new car, mobility scooter or powered wheelchair. You may be eligible to join the Motability Scheme if you get certain disability benefits www.motability.co.uk The Blue Badge Scheme provides a range of parking benefits for disabled people who have difficulty walking. For example, you can park for free in pay-anddisplay bays and also on double and single yellow lines. www.gov.uk/apply-blue-badge Car tax exemption. If you’re getting certain disability benefits you are exempt from paying Vehicle Excise Duty (car tax, or road tax).If you’re on the Motability Scheme you don’t need to do anything. If you own your car you have to apply for the exemption. www.gov.uk/vehicle-exempt-from-vehicle-tax The Disabled Persons Railcard gives you a third off most rail fares. The discount is for two people – so you can save money for a friend or a carer too. You have to buy the railcard but it can pay for itself after just one journey. A Disabled Persons Railcard costs just £20 for a whole year www.disabledpersons-railcard.co.uk

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NHS continuing healthcare funding Are you eligible for NHS continuing healthcare funding?

First of all, you’ll have an initial screening to see if you’re eligible for funding.

If the person you care for as a disability or complex medical problem, you might qualify for free NHS continuing healthcare (CHC). Not many people know about it, so it’s important to find out if you’re eligible and get an assessment

It’s usually carried out in hospital or at home by a nurse, doctor, social worker or other healthcare professional.

If you need a lot of nursing support, the NHS can fund your care for you. NHS continuing healthcare (adults) or NHS continuing care (children) helps you with healthcare needs resulting from disability, accident or illness. If you qualify, it should meet the full cost of your care including care at home, in a nursing home or hospice. In England, the NHS can arrange care for you or you can choose to receive funding for your care as a direct payment, known as a personal health budget

Who is eligible? The only sure way to know if you’re eligible is to ask your GP or social worker to arrange an assessment. There’s no clear-cut list of health conditions or illnesses that qualify for funding. Most people with long-term care needs don’t qualify for NHS continuing healthcare or NHS continuing care because the assessment is quite strict. Being frail, for example, isn’t enough. But don’t let that put you off. Free healthcare could be worth thousands of pounds each year, so it’s important to find out where you stand.

What are eligible health needs?  complex medical conditions that need additional care and support  long-term medical conditions  physical or mental disabilities  terminal illnesses  rapidly deteriorating health  mobility problems  behavioural or cognitive disorders

What costs are covered? NHS continuing healthcare or continuing care covers personal care and healthcare costs, such as paying for specialist therapy or help with bathing or dressing.  It may also include accommodation if your care is provided in a care home, or support for carers if you’re being looked after at home.  If you need nursing care as an adult, you might get NHS funded nursing care. You might get this even if you don’t qualify for NHS continuing healthcare or NHS continuing care. Funding varies by region, so you’ll need to check with your local Clinical Commissioning Group. 27

They’ll assess your general health and care needs with a simple checklist that will cover:  behaviour  cognition (everyday understanding of what’s going on around you)  communication  psychological and emotional needs  mobility  nutrition (food and drink)  continence  skin (including wounds and ulcers)  breathing  symptom control through drug therapies and medication  altered states of consciousness  other significant care needs If your health, or the health of someone you care for, is getting worse rapidly, ask about a fast track assessment to bypass the initial screening.

The assessment If the initial screening shows that you may be able to get free NHS Continuing Care, you’ll need to have another assessment. Even though the assessment process can be complex, most people and families who’ve been through it say the benefits are worth it. The Assessment team will mark each of your care needs as:  priority  severe  high  moderate  low If you have at least one priority need or two severe needs, you should qualify for funding. If you have one severe need and a number of other high or moderate needs, you may also be eligible. Circumstances change, so even if you were turned down for funding at first, make sure you have your situation regularly reviewed. Your GP or Local Carers Centre can help you.

What is a personal health budget?

 If you are not able to have a personal health budget, you can still speak to your NHS team about how your needs can be met in another way that is more personal to you.

Personal health budgets are being introduced by the NHS to help people manage their care in a way that suits them.

Personal health budgets for people with learning disabilities

Since October 2014, adults receiving NHS Continuing Healthcare and children in receipt of continuing care have had a right to have a personal health budget.

Personal health budgets offer a real opportunity to enable people with learning disabilities to live in their own homes or with their families, rather than in institutions. Across England the NHS has already begun to offer personal health budgets and joint health and social care budgets to people with learning disabilities who have complex health needs or challenging behaviour.

A personal health budget is an amount of money to support your identified health and wellbeing needs, planned and agreed between you and your local NHS team. The aim is to give people with long-term conditions and disabilities greater choice and control over the healthcare and support they receive.

Key points  Personal health budgets should help people get a more personalised service from the NHS. They should not make things worse.  You do not have to have a personal health budget if you do not want one.  They enable you to have more choice and control over the care you receive.  NHS and social care organisations should work in partnership with you and with each other.

People with learning disabilities eligible for NHS Continuing Healthcare now have a right to have a personal health budget. Anyone else whose support is funded by the NHS, including those with jointly funded packages could also benefit. From April 2015, all CCGs are being asked to develop plans for a major expansion of personal health budgets, and to ensure that people with learning disabilities are included by April 2016.

Home visits and Clinic sessions from our satellite services in Warrington & Macclesﬁeld available Please contact us for further information: 28

Planning for future care needs If you think the person’s mental capacity you care for is going to decline, it’s a very good idea to encourage them to make a power of attorney which won’t stop working if they lose mental capacity. It means they’re still in control, but if they do lose mental capacity someone else will be able to step in. Types of lasting power of attorney

Setting up a power of attorney

The big differences between the types of power of attorney are the decisions they cover – financial ones, or ones about your health and welfare.

You can get the forms and guidance you need to create a lasting power of attorney online at: www.gov.uk/government/collections/lasting-powerof-attorney-forms

There are two types of lasting power of attorney. You can set up one or both. A property and financial affairs lasting power of attorney lets someone manage all your financial affairs – for example, running your bank and savings accounts, managing your tax affairs, and buying and selling investments and property. A health and welfare lasting power of attorney lets someone make decisions about your health, care and welfare – for example, what medical treatment you receive and whether you move into a care home. If the person you want to help has already lost mental capacity, you will need to apply to a court to get the permission to manage their money for them.

Setting up a power of attorney is a big step. You should make sure you understand all the implications, and you may want to get advice from a solicitor.

Make sure there is a will in place for both yourself and the person you care for Your will tells everyone what should happen to your money, possessions and property after you die (all these things together are called your ‘estate’). If you don’t leave a will, the law decides how your estate is passed on – and this may not be in line with your wishes. Your will tells people two very important things: • who should have your money, property and possessions when you die •

Free and impartial money advice, set up by government Advice and guides to help improve your finances Tools and calculators to help you keep track and plan ahead Support in person, over the phone and online Give us a call for free and impartial money advice.

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who will be in charge of organising your estate and following the instructions you leave in your will – this person is called your ‘executor’, and you can name more than one person if you want to

You can also use your will to tell people about any other wishes you have, like instructions for your burial or cremation. Your executor will do their best to make sure your wishes are followed, as long as they don’t involve breaking the law. Writing a will is especially important if you have children or other family who depend on you financially, or if you want to leave something to people outside your immediate family If you think the person’s mental capacity you care for is going to decline, it’s a very good idea to encourage them to make a power of attorney which won’t stop working if they lose mental capacity. It means they’re still in control, but if they do lose mental capacity someone else will be able to step in.

Preparing for Residential or Nursing Home Costs Care home fees are a big financial commitment, and the decision to go into a care home is often made at a moment of crisis or urgency, such as when being discharged from hospital.

This can make finding the money to pay for fees (usually several hundred pounds a week) challenging for people funding their own care depending on where in the UK you live, care homes can cost an average of: • £28,500 per year for a residential care home • £37,500 per year if nursing is required. Remember, you may have to pay extra for things like trips out, hairdressing and some therapies. Registered Nursing Care Contribution is a tax-free, non-means-tested benefit, paid by the NHS to cover nursing or medical care. It’s paid whether you’re selffinancing your care or your local authority is paying for it. To be eligible, you must: • need nursing care • stay in a care home or residential home that can provide nursing care Registered Nursing Care Contribution should still be paid if your stay in the care home is temporary. If you’re staying for six weeks or less, you won’t have to be formally assessed. Instead, your need for nursing care will be based on information provided by the care home or your GP. This can be quite a useful contribution towards costs if you need regular periods of respite care.

How to apply for Registered Nursing Care Contribution If your care needs are being assessed by your local authority ask them to assess you for Registered Nursing Care Contribution at the same time or contact your local Clinical Commissioning Group: NHS Eastern Cheshire CCG - Tel: 01625 663477 There are independent financial advisers that focus specifically on care funding advice, often referred to as specialist care fees advisers. They are regulated by the Financial Conduct Authority (FCA) and must stick to a code of conduct and ethics and take responsibility for the suitability of any product they recommend. A specialist care fees adviser will go through a factfinding process with you to assess and understand your needs and circumstances. This will include questions about: • the level of your care needs and the attitude of your family • the care that’s currently available and what care will be required in the future • the potential cost of nursing care or the care home you’ve chosen

• current income (including unearned income) and benefits • your marital status • the location of family and friends • your assets, in particular shares or other investments liable for Capital Gains Tax • your property ownership • liabilities that could reduce the value of your assets or your estate • your attitude towards risk

Where to find a specialist care fees adviser You can use The Money Advice Service Retirement Adviser Directory to find a specialist care fees adviser in your area. www.directory.moneyadviceservice.org.uk You can also visit the Society of Later Life Advisers (SOLLA) website: www.societyoflaterlifeadvisers.co.uk/ SOLLA advisers undertake extra training and professional development before becoming full members.

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PERSONAL & FAMILY LAW

Do you or your family need legal advice? SAS Daniels’ Elderly, Care and Mental Capacity team specialise in managing the property and affairs of individuals. We can assist with:

• Care fee funding advice

What people say about our team:

• Acting as trusted deputy or attorney

They are a really lovely team

• Advising on powers of attorney

Chambers UK 2016

• Court of Protection matters

Your key contact: Justine Clowes 01625 442142 justine.clowes@sasdaniels.co.uk

Solicitors for the Elderly Accredited

Macclesfield | Stockport | Chester | Congleton

Choosing the right home care agency If you find it difficult to carry out personal care routines – such as washing or dressing – home care services can provide the extra support that you need. Home care services (also known as domiciliary care) provide carers or personal assistants who can visit you at home to help with a wide range of tasks If you are considering using a home care agency Here is a list of questions you should ask a home care agency; ensure you get all the answers that you need.

About the carers • Will I have a regular carer? • What will happen if my regular carer is off sick? • What happens if a carer is unable to get to me because of adverse weather conditions or a traffic accident? • How many different carers are likely to visit me? • What sort of training do the carers receive? Do they have an induction period? How often is their training updated? • What qualifications do they have? • Will carers keep written records of the care that has been given, and accurate timesheets for me to sign? • Can copies of the records be sent to me if I want them?

About your needs • How will you match the most suitable carer to my needs?

• • • •

Will you be able to find carer(s) that can visit at the time I need care? What happens if a carer and myself are incompatible? Could a different carer be requested? What happens in the event of a medical emergency? Will the agency carer stay with my relative until help comes? Will they notify me of any problems? How will carers get into my home if I cannot answer the door? How will that information be kept secure?

About the agency • Do you have a standard contract for work with private clients? Can we see a copy? • What are your hourly charges? Are there anyminimum charges (such as a minimum number of hours per week)? • What happens on weekends and bank holidays? Is care provided? Is there an additional charge at these times? • How is payment required – by cheque, direct debit or some other way? How often is payment required? Monthly or weekly? • What insurance do you have to protect my home, for example, in the case of damage to property, the carer making a mistake, or the carer having an accident in my home? • How do you ensure quality of care is maintained? What are your quality assurance policies and procedures? • Who should I contact if I have problems with a carer or the service provided? • Is it possible to try you for a short trial period initially, to see how it works out?

Care Home & Home Care CQC Ratings By law, all care homes and home care agencies have to display the ratings the (CQC) Care Quality Commission gives them. They must display them in the places that people who use their services can easily see them. They must also show their ratings on their website, if they have one. • Outstanding: The service is performing exceptionally well. • Good: The service is performing well and meeting our expectations. • Requires improvement: The service isn’t performing as well as it should and we have told the service how it must improve. • Inadequate: The service is performing badly and we’ve taken action against the person or organisation that runs it. Read their latest report: www.cqc.org.uk/content/findservices-your-local-authority-area 31

Choosing the right care home Care homes may be arranged through the local authority but many people will want to arrange them independently. It is a good idea to visit several homes before making a choice. Make sure you spend enough time in each home to get a good idea of what it is like. Choosing the right care home

Choice of accommodation

Choosing a care home is one of the most important decisions you’ll ever make. You need to make sure it’s got everything you need, in a place you’ll be happy, at a price you can afford.

The law says that where the local authority is funding accommodation it must allow the person entering residential care to choose which care home they would prefer. Social services must first agree that the home is suitable for the person’s needs and that it would not cost more than they would normally pay for a home that would meet those needs. If the person chooses to go into a more expensive home, a relative or friend may be able to ‘top up’ the difference in cost.

When choosing a care home you need to recognise that your care needs are likely to increase over time. Choosing a care home • Make a shortlist of suitable care homes in your area that fall within your budget. • Request an information pack from the homes on your shortlist. • Request a copy of their contracts and/or terms and conditions. • Make sure they have vacancies or establish how long their waiting list is. • The cost of care varies from region to region – you could save money by relocating. • Don’t forget to take into account additional costs that may not be covered in your residential fees, such as meals and day trips.

What your choices are A list of all nursing and residential care homes within your locality can be found on the following pages. Every care home in England must be registered with the national regulatory body Care Quality Commission (CQC). They inspect each care home on a regular basis and write an inspection report for you to read. It is advisable to read this report before making a final decision. To check up-to-date information on the Nursing and Residential care homes within your locality visit: www.cqc.org.uk

• Check how much notice you need to give if you move out and how much notice you will be given if the home is to close. • If your funding is local-authority assisted, check that you pay the same rates as self-funders and find out whether a top-up payment is required. Check the care home’s official inspection report

How much is it going to cost? Care-home fees vary considerably around the country, but on average you should expect to pay approximately £28,500 a year for a residential care home and £37,500 if nursing care is required. Your local council may be able to help with costs depending on your circumstances. Before visiting any care homes in person, you need to be very clear about what it is you’re looking for. Make a checklist of the things that are important to you, along with a list of questions to ask the managers and staff. Don’t be embarrassed – you’re about to make a lifechanging decision.

Care in your own home Care Provider

Address

Area

Data correct with CQC 33

Postcode

Telephone

Residential Homes Residential Homes

Address

Area

Data correct with CQC

Postcode

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Nursing Homes Nursing Homes

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Area

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The independent regulator of health and social care in England

Providing information and support to people with dementia and their carers/families across Cheshire East Springbank Centre, Victoria Road, Macclesfield Cheshire SK10 3LS Tel: 01625 503 302

www.alzheimers.org.uk

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care. Weâ&#x20AC;&#x2122;re the independent regulator of health and social care in England.

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Evolving Care Ltd. CQC o verall rating

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