Healthwatch county durham north

Issue 1

Health & Social Care Directory 2014/2015 Covers services within:

3 Durham 3 Chester-le-Street 3 Derwentside

ContentS Contents Healthwatch County Durham Do you have a Complaint about the NHS? Healthy Living Choosing a GP GP Surgeries Pharmacies Dentists Opticians & Hearing Centres Complementary & Alternative Medicine Personal Health Budgets Advice on Funding for Healthcare Advice on Funding for Social Care Independent Living Are you a Carer?

Care in your own Home Choosing between Nursing & Independent Living Residential care costs Choosing the Right Care Home Residential & Nursing Care Help & Advice Disclaimer This Directory has been compiled to provide information about primary health and social care providers throughout Durham, Chester-le-Street & Derwentside.

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 County Durham nor Healthcare Publications can be held responsible for any errors or omissions.

All services are up to date as of September 2014.

A note on advertising: We offer businesses the chance to reach potential customers via this publication. It is our intention to clearly indicate that an advertisement is being displayed and no endorsement or approval by the promoters of any product, service or supplier should be implied.

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 CoUntY DURHAM What is Healthwatch?

Healthwatch is the new, independent consumer champion for health and social care in County Durham. Our job is to promote the consumer interest for everyone who uses health and social care services in the county.

Healthwatch County Durham is part of a network of 148 local Healthwatch organisations.

Healthwatch England has a national perspective, fed by local insight gathered by local Healthwatch organisations.

Healthwatch County Durham

There are two main ways in which Healthwatch County Durham can help you: 1. By having real influence with the people who provide local services; and 2. By helping you find the right services and providers to give you and your family the best possible care.

Speaking up for you

Healthwatch County Durham is independent and powerful; it influences the decision-makers in organisations that provide health and social care throughout the county.

• We gather the views and experiences of local people through a multitude of methods including surveys, research, and by listening to the concerns, comments and compliments of people we meet at events, drop-in points and workshops, and by monitoring calls to our office.

• Having collected evidence, we analyse and reflect on this and report our findings to the people who provide the relevant service, to the commissioners who pay for that service, and if the issue needs escalating, to the Care Quality Commission and Healthwatch England.

Pointing you in the right direction

The health and social care 'system' can seem complex and many people struggle to know exactly what is available to them, what choices they have, and what to do if they're not happy with something.

Healthwatch County Durham provides help and advice about all aspects of health and social care provision in the county. We can signpost you to what's available, help you make the best choice for you, and offer help and support if you experience any problems.

Healthwatch County Durham is the consumer champion for local health and social care provision.

We advise you

How to get the best health and social care for you and your family.

• Need help with making a complaint?

• Choosing a care home?

• Finding a pharmacist?

We provide help and information about all aspects of health and social care provision in the county.

We can signpost you to what’s available, help you make the best choice and offer help and support if you experience any problems.

We listen to you

To find out what you think of the health and social care services you come across.

• What needs changing?

• What works well?

• What services are missing?

We are always willing to attend or speak to community groups, health and social care support groups, schools, clubs etc. about our work and to invite people to tell us about their experiences of local health and social care provision.

Freephone: 0808 801 0384

Email: info@healthwatchcountydurham.co.uk Web: healthwatchcountydurham.co.uk Office line: 01325 375 960 Twitter: @HWCountyDurham Facebook: HealthwatchCountyDurham

HeALtHWAtCH CoUntY DURHAM Your place, or ours!

Drop-in sessions

tell us your experiences We’re listening

together we can make a difference

Any help gratefully received

Healthwatch County Durham is working towards becoming an independent social enterprise.

We rely on many volunteer members to help in our work - and we’re always keen to welcome new members. We have roles for people with a wide range of skills and experience and we would like to talk to you about how you could help if you can spare some time. We need help at events, talking to people, collecting views, putting up posters and giving out leaflets in the community.

Volunteer members of Healthwatch County Durham can be:

Friends who receive regular updates, news and e-bulletins, and invitations to take part in surveys.

Facilitators who get involved in ‘hands-on’ activities such as helping at events, with administration or being part of an ‘Enter and View’ team (training provided).

Partners who have ‘group’ membership, maybe as representatives of a particular sector of the population, or service providers.

Healthwatchers help us to promote Healthwatch in their local community using posters and leaflets, or by attending events and telling people about Healthwatch. They also help to gather views and comments from the public on health and social care services.

Call our office on 01325 375 960 for a membership application form, or complete one online at www.healthwatchcountydurham.co.uk

Members of the public are invited to call, without appointment, to talk to Healthwatch County Durham staff at regular ‘drop-in’ points held throughout the county. Whether it’s gripes or grumbles, singing someone’s praises, or asking where to go and who to speak to, we want to hear people’s experiences and help them get the best from local health and social care provision.

Find out where we are and when by looking at our website www.healthwatchcountydurham.co.uk by following us on social media or by calling our office on 01325 375 960.

Outreach in the community

Healthwatch County Durham staff are always willing to attend or speak to community groups, health and social care support groups, schools, clubs etc. to talk about our work and to invite people to tell us about their experiences, and their gripes, grumbles or positive praise of local health and social care provision.

Speak to a member of our team on 01325 375 960 if you’d like to arrange for us to visit your organisation.

Healthwatch County Durham office

Our office in Newton Aycliffe is open Monday to Thursday from 9am to 5pm and Friday 9am 4.30pm, and we’d be delighted to see you there.

And in the digital world, too . . .

Follow what we’re up to and join in our conversations, by following us on Twitter (@HWCountyDurham) or liking us on Facebook (HealthwatchCountyDurham).

Our website is at www.healthwatchcountydurham and you can contact us by email using info@healthwatchcountydurham.co.uk

HeALtHWAtCH CoUntY DURHAM Enter & View

Enter & View is one of the important powers that Healthwatch County Durham has. A team of highly specialised and trained volunteers, called Authorised Representatives, can go into publicly funded health and adult social care premises and conduct a visit. The aim of the visit is to talk to the patients and service users and gather their experiences, observing what happens whilst they are there.

This information is then gathered into a report that will document the findings along with any recommendations they may have. Enter & View is an engagement tool and not an inspection; it is about finding out the patients’ experiences to ensure they are receiving the best care possible.

Authorised Representative volunteers are supported throughout the Enter and View programme. Travel expenses are reimbursed and there is no minimum or maximum time commitment. Volunteering is a brilliant way of gaining new skills to add to your CV as well as meeting new people who share your interests.

If you are interested in this volunteer role, please call us on 01325 375 960 for an application form and details of the training.

What’s it really like?

We need help to gather evidence and prepare unbiased, objective reports on how the ‘consumer’ experiences local health and social care provision.

Do you tick all our boxes? q Good Listener q Compassionate q Team Player q Observant q Non-Judgemental q Accountable q Respectful q Objective

Healthwatch Couty Durham is recruiting for its ‘Enter & View’ team, which visits health and social care providers’ premises to observe the quality of service received by patients/service users.

All Enter & View recruits undergo free training in confidentiality, dignity, equality, diversity, report writing and safeguarding.

The role is voluntary, although expenses are paid.

If you are interested in helping to make a difference, please email info@healthwatchcountydurham.co.uk for an electric application form and please say where you saw this advert.

If you would prefer to speak to one of our team first, please ring 01325 375 960.

HeALtHWAtCH CoUntY DURHAM We’re making a difference!

It’s early days for Healthwatch County Durham, and of course our work is driven by what local people tell us is concerning them, but already we have influenced changes and helped people get better service.

• GP telephone numbers

We received reports that patients in County Durham still had to use ‘0845’ numbers to contact their GP surgery. Depending on what phone package the patient was using - for example whether it was a mobile or landline, and the time of day - in some instances this meant that the cost of the call was several pounds.

Healthwatch County Durham sought assurances that all GP surgeries would offer a ‘geographic’ or 0345 number to minimise the costs of patients contacting them. All surgeries in County Durham have committed to stop using 0845 numbers from April this year.

• Cardiac rehab pointers

We received a call from a member of the public who was looking for gentle exercises classes in their local area. They suffered from heart problems and had received treatment in the past for this. We contacted staff at their local leisure centre, who informed us that it would be likely that the caller would qualify for a cardiac rehab programme. The leisure centre staff then made arrangements to contact the caller to discuss the options available to them.

• Teething problems

Another caller had already submitted a complaint to their dental practice, as they were unhappy with the treatment received. They had been informed that a full investigation of their complaint was underway, but had received no further contact from the practice. The caller felt they were being ignored. We were able to inform the caller of the correct procedure that should be followed, in line with the NHS Complaint regulations. We also offered to refer this patient to the North East NHS Independent Complaints Advocacy (ICA) service for help and support with their complaint.

• Switching doctor

A visitor to one of our drop-in points wanted to change their GP surgery. We contacted NHS England on their behalf to find out which local GP surgeries were taking on new patients. We then were happy to advise the person about the procedures they needed to follow to register with a new GP.

Every voice counts when it comes to shaping the future of services and improving them. We want to know what health and social care issues are important to you and your family.

Please tell us:

1. Are you happy with the health and social care you are receiving?

2. Do you have a relative or a friend living in a care home? Are they/you happy with the care they receive?

3. Can you get an appointment with your GP (Doctor) when you need to?

4. Have you had to stay in hospital recently?

If so, what was your experience like?

5. Do you or a relative suffer from a long term illness; are you/they happy with the help and support you/they receive?

6. Do you know what services are available and how to choose the right one, when you need urgent care?

7. If you could wave a magic wand to fix one thing in health and social care what would it be?

With your support Healthwatch County Durham can make a difference to the quality of local health and social care services.

Do YoU HAVe A CoMPLAInt ABoUt tHe nHS? ICA stands for Independent Complaints Advocacy. We can help if you feel you have not had the service you expect from the National Health Service (NHS) and want to complain.

When your healthcare is provided by the NHS you are allowed to make a complaint using the NHS complaints process.

An NHS complaint might include something that happened during care or treatment at:

• The hospital • Your General Practitioner (GP) • The dentist • The pharmacist • The optician • An NHS funded care home

What is ICA?

ICA is Independent Complaints Advocacy. ICA provides practical support and information to people who want to make an NHS complaint.

This might mean giving information so you can pursue a complaint by yourself or giving you the support of an experienced worker who can help you to make your complaint.

In this area ICA is provided by the Carers Federation. We have directly supported over 27,000 people to make an NHS complaint in the last 5 years.

How does advocacy work?

ICA uses advocacy to help people to make their complaint.

Advocacy is a system that uses experienced workers to help people speak up for themselves and represent their own thoughts and feelings when things are difficult. Our specially trained and experienced staff are known as Advocates.

Because advocacy is about helping people to speak up for themselves, an ICA Advocate will not tell you what to do or act on the wishes of others.

Our Advocates are qualified and have many years of experience working within the NHS complaints process.

What does an ICA Advocate do to help?

ICA Advocates will help you explore your options at every stage of your complaint and can give you information that can help you to decide what to do.

Throughout the complaints process an Advocate might also do some or all of the following:

• Help you to compile all the issues you wish to raise in your complaint • Help you to write letters to the right people • Prepare you for meetings and go to these with you • Answer questions to help you make decisions • Give you the opportunity to speak confidentially to someone who is independent of the NHS • Where possible meet you face-to-face to discuss your complaint • Provide you with information about how the NHS complaints process works • Help you to monitor the progress of your complaint with the organisation or individual responsible • Help you to understand what you can expect to achieve from the NHS complaints process • Put you in touch with other people or services that might be able to help you

Do YoU HAVe A CoMPLAInt ABoUt tHe nHS? What if I only need information?

Not everyone needs the support of an Advocate to make their complaint. For example, some people just want to know how the complaint system works or know who they should send a letter of complaint to.

Everyone who contacts ICA for help with an NHS complaint is entitled to receive a free Self Help Information Pack.

The Self Help Information Pack includes:

• Information on how the complaints system works • Information on how to access your medical records • Guidance on how to put together your complaint letter • A leaflet containing useful addresses (including the General Medical Council and the Health Service Ombudsman)

This may be enough to enable you to make a complaint yourself. Anybody who starts a complaint by themselves is entitled to contact ICA at any stage in the process for more information or to request the support of an Advocate.

Can I complain on behalf of somebody else like a child, friend or relative?

If you have particular needs, please let us know what these are and we will do our best to meet them.

What next?

You can get in touch:

• If you want more information • If you want a Self Help Information Pack to help you make a complaint, or • If you want an Advocate to help you make an NHS complaint

When are we open?

Monday - Friday 9am - 5pm

North East NHS ICA Aidan House Sunderland Road Gateshead NE8 3HU

Contact us

Email: ica@carersfederation.co.uk Tel: 0808 802 3000 or visit www.nenhscomplaintsadvocacy.co.uk

You can complain on behalf of a child under 18 years of age if they are unable to make the complaint themselves. The organisation you are complaining to must be confident the child cannot complain themselves before they consider the complaint. You can also make a complaint on behalf of a friend or relative but they will need to agree to this in writing. If you want to complain on behalf of someone who lacks mental capacity then it is usual that the organisation you are complaining to will check the patient’s mental capacity before responding.

Meeting your needs

ICA can adapt the way we communicate with you depending upon your needs.

This might include any of the following:

• Using an interpretor or translator • Using alternative formats for written correspondence including larger prints, audio or braille • Using British Sign Language (BSL) interpretors • We can also supply our current information in different languages

Your health. Your voice

HeALtHY LIVInG The choices we make about how we live can have a significant effect on our health. Eating a healthy diet, doing regular exercise, not smoking and not drinking too much alcohol can help you stay well and enjoy a long life.

Keeping fit and healthy can be a challenge if you are living with a long-term condition, but it will make a big difference to your wellbeing. If you’ve been thinking about making changes to your lifestyle, such as stopping smoking, losing weight, eating healthily, drinking a little less alcohol, or doing more exercise, there’s plenty of help and support available.

Talking to your GP and other healthcare workers, including pharmacists, is the first step. They’ll help you look at your lifestyle and suggest changes that are suitable for your condition and any treatment you’re having. Your health or care worker can also let you know about local services that can help you.

For example, if you want to start exercising but you're unsure how to, your GP can put you on the Exercise on Referral scheme. These schemes are run with local gyms and fitness centres and can include swimming. Ask at your GP practice for more information.

Your GP can also help you if you want to stop smoking, for instance by enrolling you in a clinic where you’ll get support from other people who are also trying to stop. Nicotine replacement therapy and other stop smoking treatments provided by your GP can also help you resist cravings and boost your chances of quitting successfully.

You're never too young or too old to switch to a healthier lifestyle. Children who learn healthy habits at a young age will benefit from them throughout their life. And giving up bad habits can improve your health at any age.

Stop Smoking for good

Giving up smoking is probably the best thing you can do to improve your health. Research shows that smoking is responsible for almost one in five of all deaths in the UK. This means that smoking causes an estimated 110,000 deaths a year.

Smokers are almost twice as likely to have a heart attack as people who have never smoked. Smoking also increases your risk of developing many cancers and lung disease.

Get active, feel fitter, live longer

Whatever your age, there's strong scientific evidence that being physically active can help you lead a healthier and even happier life.

Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week. Young people (5-18) should do 60 minutes every day.

If you do this, it can reduce your risk of heart disease and stroke by up to 50% and lower your risk of early death by up to 30%.

Rethink your drinking

Drinking too much alcohol could increase your risk of getting 14 major diseases, including mouth and throat cancers, liver cirrhosis, strokes and mental health problems.

Alcohol is believed to be responsible for as many as 22,000 premature deaths in England and Wales every year. But it’s not just binge drinkers who are at risk: regularly drinking more than the recommended limit can cause significant health problems.

CHooSInG A GP Choosing a GP can seem a daunting task, especially if you have just moved into an area and don't know anything about the local health services. But there are some easy ways to find the doctor to suit you.

It's important to be registered with a doctor because you'll need them to refer you for specialist hospital and community treatment services.

A surgery may refuse an application to join its list of patients if:

You don't reside in the surgery area.

It has formally closed its list of patients, eg when a practice has more patients than it can deal with or not enough doctors - this is less common than it used to be.

If your application is refused, the surgery must write to you and give the reasons for this.

How do I find a surgery?

Most surgeries operate a fairly strict catchment area system, and only those who live within the area may be able to register.

This isn't to be awkward, but ensures a GP can visit a person at home in an emergency in reasonable time.

How do I register?

This is straightforward and far easier than most people realise. Simply take your NHS medical card along to your chosen surgery. You will then be asked to sign a registration form.

Not all NHS trusts issue medical cards. If you don't have one, the receptionist will give you form GMS1 to fill in.

Once you've completed and returned the forms, your local NHS will transfer your medical records to your new surgery and write to you to confirm your registration as a patient with the surgery.

Many surgeries ask a new patient to attend a ‘registration medical’ that checks your general health.

What if I can’t get an appointment?

If you can't get a doctor's appointment or have a non-urgent health problem or query, you can contact a nurse by ringing 111 at any time.

What if I have a complaint or concern about my 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 at 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

If you want to help improve services in your GP practice you can join a Patient Participation Group.

Ask at the practice for details of how to join yours.

GP SURGeRIeS The urgent care service has been set up to deal with patients who have medical problems that cannot wait, but that can't be managed by their GP (e.g., because they are closed) or which don't really need a visit to an Accident & Emergency department.

The urgent care service operates across the whole of County Durham and Darlington with most centres being open 24 hours a day, every day of the year. Services are available at the following locations.

Surgery

Address

Area

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Telephone

GP SURGeRIeS Durham University Hospital North Durham, North Road Durham DH1 5TW Available 6pm to 8am every night and all day weekends and Bank Holidays.

Surgery

Bishop Auckland Bishop Auckland General Hospital Cockton Hill Road DL14 6AD Entrance on Escomb Road.

Address

Peterlee Peterlee Community Hospital O'Neill Drive Peterlee SR8 5UQ

Shotley Bridge Shotley Bridge Hospital Consett DH8 0NB

Area

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Darlington Dr Piper House King St, Darlington DL3 6JL

Postcode

Telephone

PHARMACIeS Make sure you have repeat prescriptions

If you or someone you care for requires medicines regularly, make sure you order and collect repeat prescriptions in good time to ensure you or your family have enough medicine to last i.e. weekends, Bank holidays and breaks away.

Many of the calls to out of hours health services are for emergency repeat prescriptions when people have run out of their medication - a situation that could be avoided with some forethought and planning. By thinking ahead for your regular medication you are helping our busy out of hour’s doctors and nurses.

Pharmacy / Chemist

Address

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Telephone

PHARMACIeS If you have the symptoms of a cough, cold, or think you’ve got the flu a pharmacist is the best place to go, as they can usually provide you with the help and information you need on the spot. They can also offer help with healthy living issues such as losing weight or giving up smoking.

For opening times and NHS SERVICES available from your Pharmacy Please scan the QR code with your smartphone or visit www.nhs.uk

Pharmacy / Chemist

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DentIStS Dentist

Address

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Telephone

NHS DENTAL CHARGES Band 1 course of treatment

£18.50

This covers an examination, diagnosis (eg X-rays), advice on how to prevent future problems, a scale and polish if needed, and application of fluoride varnish or fissure sealant. If you require urgent care, even if your urgent treatment needs more than one appointment to complete, you will only need to pay one Band 1 charge.

Band 2 course of treatment

£50.50

This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth.

Band 3 course of treatment

£219.00

This covers everything listed in Bands 1 and 2 above, plus crowns, dentures and bridges.

NHS DENTISTRY

KNOW YOUR RIGHTS

You're entitled to have all clinically necessary treatment on the NHS. This means that the NHS will provide any treatment that you need to keep your mouth, teeth and gums healthy and free of pain.

If your dentist says you need a particular type of treatment, you should not be asked to pay for it privately. Your dentist is not allowed to refuse you any treatment available on the NHS but then offer the same treatment privately. Also, any treatment provided on the NHS has to be of the same high quality as treatments provided privately.

Depending on what you need to have done, you should only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it. You will not be charged for individual items within the course of treatment.

oPtICIAnS & HeARInG CentReS Opticians

Address

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Telephone

Hearing Centres

Address

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Telephone

DATA CO RRECT WI TH NHS CHO I CES - S EPTEM B ER 2014

Regular eye tests are important because your eyes don't usually hurt when something is wrong. A sight test is a vital health check for your eyes that can pick up early signs of eye|conditions before you're aware of any symptoms – many of which can be treated if found early enough.

What your eye test will show

A sight test will show if you need to get glasses for the first time or change your current glasses.

A sight test will also include a general health check that can pick up early signs of eye disease before you’re aware of any symptoms. Some health conditions can affect the eyes such as:

tell us your experiences We’re listening

Diabetes, Macular Degeneration or Glaucoma

Your Sight Test

It’s recommended that adults have their eyes tested every two years, unless their ophthalmic practitioner advises them to have a sight test more often than that.Your employer may pay for this test for you so ask for advice on this, and if you are over 60 your test is free of charge.

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together we can make a difference

CoMPLeMentARY & ALteRnAtIVe MeDICIne If you're thinking about whether or not to use a complementary or alternative medicine, the first step is to learn as much as possible about the treatment.

The availability of complementary and alternative treatments on the NHS is limited. Some, such as acupuncture, may be offered by the NHS. You should find out:

What is the evidence that this treatment is safe for you to take? For example, Ginseng has been associated with higher blood pressure and may be inappropriate if you already have raised blood pressure (hypertension).

If you are using complementary or alternative medicine to treat a health condition - what is the evidence that the treatment works for your condition?

Acupuncture

There is no one health condition or set of conditions that acupuncture is meant to treat.

Instead, Acupuncturists use the treatment for an extremely wide range of health conditions.

Sometimes, patients combine acupuncture with conventional treatments that have been prescribed by a GP or Hospital Consultant. If you are being treated by an Acupuncturist for a health condition, it is advisable to discuss this with your GP.

Acupuncture is often used to treat musculoskeletal conditions (of the bones and muscles) and pain conditions, including:

• • • • • •

Headache and migraine Chronic pain - including neck and back pain Joint pain Dental pain Post-operative pain Post-operative nausea and vomiting

Chiropractic

Chiropractic treatments are often used for musculoskeletal conditions (affecting the muscles, bones and joints).

Conditions commonly treated by chiropractors could include: • Lower back pain • Neck pain • Shoulder pain and problems

• Slipped discs • Leg pain and sciatica • Pain or problems with hip, knee, ankle and foot joints • Pain or problems with elbow, wrist and hand joints • Fibromyalgia

Homeopathy

Homeopathy is used for an extremely wide range of health conditions. Among the most common conditions that people seek homeopathic treatment for are:

• • • •

• • • •

Asthma Ear infections Hay fever Mental health conditions, such as depression, stress and anxiety Allergies, such as food allergies Dermatitis (an allergic skin condition) Arthritis High blood pressure

Osteopathy

Osteopathy is a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints.

Conditions commonly treated with osteopathy:

• • • • • • •

Lower back pain Neck pain Shoulder pain Arthritis Problems with the pelvis, hips and legs Sports injuries Problems with posture caused by driving, work or pregnancy

Hypnotherapy

Hypnotherapy is a type of complementary therapy that uses hypnosis, an altered state of consciousness.

When might it be helpful?

• • • •

Irritable bowel syndrome Losing weight and quitting smoking Skin conditions Anxiety, pregnancy and childbirth

PeRSonAL HeALtH BUDGetS Can I have a personal health budget as well as a personal budget for social care and support?

Yes. If you already have a personal budget for care and support from social services and your NHS team agrees, you can also have a personal health budget and ask for both to be combined.

Do I have to have a personal health budget?

No. If having a personal health budget does not work for you, your local NHS will provide the care you need as it has always done.

What is the difference between a personal health budget, a personal budget, an individual budget and a direct payment?

A personal health budget is for your NHS healthcare and support needs.

A personal budget is for your social care and support needs.

An individual budget includes your social care and support needs plus other funding, such as independent living.

A direct payment is one way of managing these budgets, where you get the cash to buy the agreed care and support you need.

Key Points

• Personal health budgets should help people get a better 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.

• You should have as much control over decisions as you want.

• NHS and social care organisations should work in partnership with you and with each other.

• 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

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

They have been piloted in a number of places across England and, from April 2014, anyone receiving NHS continuing healthcare will have a right to ask for a personal health budget.

What is a Personal Health Budget?

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.

Personal health budgets work in a similar way to the personal budgets that many people are already using to manage and pay for their social care.

Together with your NHS team (such as a GP) you will develop a care plan. The plan sets out your personal health and wellbeing needs, the health outcomes you want to achieve, the amount of money in the budget and how you are going to spend it.

You can use a personal health budget to pay for a wide range of items and services, including therapies, personal care and equipment. This will allow you more choice and control over the health services and care you receive.

You don’t have to change any healthcare or support that is working well for you just because you get a personal health budget, but if something isn’t working, you can change it.

Who can have a Personal Health Budget?

The first group to be able to ask for a personal health budget, from April 2014, are people getting NHS continuing healthcare, which is NHS-funded long-term health and personal care provided outside hospital.

Local NHS organisations can offer personal health budgets to other people if they think an individual will benefit. It is the Government’s long-term aim to introduce a right to a personal health budget for people who would benefit from it.

ADVICe on FUnDInG FoR HeALtHCARe There are several options for funding care and finding out which ones apply to you can be complicated. These options depend on your need for care and support, as well as your personal and financial circumstances.

The main sources of support are the NHS and your local Social Services Department.

NHS Care

The NHS is responsible for funding certain types of healthcare and equipment you may need. In some situations, the NHS is also responsible for meeting care needs. This is usually when someone’s need is mainly for healthcare rather than social care. NHS care could be provided in hospital but it can be in someone’s own home or elsewhere in the community.

When care is provided through the NHS there is no financial assessment and no care charges to pay.

However, people are only eligible for NHS care in certain circumstances.

NHS Continuing Healthcare

If you or the person you care for has very severe and complex health needs, they may qualify for NHS Continuing Healthcare. This is an ongoing package of care that’s fully funded by the NHS.

Nursing Care

If someone goes into a residential care home but needs some element of nursing care, they’ll get a payment from the NHS to help pay for their nursing care. This is called a registered nursing care contribution (RNCC) .

Intermediate Care

Some people can be eligible for intermediate care from the NHS. This is provided on a short-term basis and is intended to help people to recover from an injury or illness, and stay independent.

Intermediate care is often provided to elderly people who are being discharged from hospital, and may help someone to keep living in their own home rather than moving into a care home.

Aftercare

People who were previously detained in hospital under certain sections of the Mental Health Act will have their aftercare services provided free.

ADVICe on FUnDInG FoR SoCIAL CARe If someone isn’t eligible for free care from the NHS, their main source of support will be social services. In this case, there are rules that determine whether or not they have to make a financial contribution. These rules vary depending on whether the care is provided in a care home or in their own home.

Local Authority Community Care

If you or the person you're looking after has difficulty with their personal care, they should consider getting support from social services by having a community care assessment of their needs.

Your income (including any benefits) and capital will be taken into account when calculating whether you have to pay anything towards the care that you or they will receive.

In some cases a person may have a mixed package of care, including some that is NHS-funded and some that is provided by social services, for which they may be charged.

Normally, an assessment is carried out before a service can be provided by the social services department of a local authority. However, if the services are needed urgently, the local authority can provide a service without carrying out the assessment.

The local authority uses the community care assessment to decide whether a person needs a community care service and, if they do, whether it can be provided by the local authority.

The assessment considers what types of services are needed by the person being assessed.

A wide range of services could be needed, from aids and adaptations in the person's own home to care workers or residential care.

Where there are disputes about the process of the assessment or the care plan, there are ways that decisions can be challenged. For more information on challenging decisions, speak to your local Healthwatch team.

The local authority is obliged to carry out a community care assessment when they become aware that someone may be in need of community care services. This may mean that an assessment is offered even if you or the person you look after have not specifically requested one.

Direct Payments

If you are assessed has needing community care services and qualify for social services funding they must offer you direct payments as an option.

If someone isn't able to manage their own direct payments, it's possible for another person to manage the direct payments on their behalf.

Direct payments are part of a move towards ‘personalised’ social care so that people have more choice and control over the support they get, letting you choose and buy the services you need yourself, rather than having it arranged for you by social services.

It's important to know that if you receive a direct payment to pay a care worker or personal assistant, you become an employer and have legal responsibilities.

Direct Payments can be made to:

• Disabled people aged 16 or over (with short or long-term needs) • Disabled parents for children’s services

• Carers aged 16 or over (including people with parental responsibility for a disabled child) • Elderly people who need community care services

Choosing Direct Payments

The choice of direct payments is voluntary. If you decide to have direct payments, you can change your mind about this at any time. If you no longer want direct payments, contact your local social services and ask them to arrange services instead.

It's possible to try direct payments by asking social services for a direct payment for some of your support while you continue to get your other support directly from social services.

Direct payments can only be spent on things that will meet the assessed needs of the person getting them. If you spend a direct payment on something that doesn't meet your needs, social services can recover the money from you.

Everyone who gets support from social services should have their needs reassessed at least once a year.

To contact Social Care Direct for an assessment, to be re-assessed or for further information please call 0845 850 5010

InDePenDent LIVInG Suggestions for making life easy:

External Adaptations

• Handrail at front or rear entrance of dwelling • Provision of whirly clothes line or path leading to clothes line • Widening of paths around the property • Defining steps for people with visual impairments • Outdoor lighting • Paved areas for wheelchairs

Around one in five adults in the UK is disabled, and more than 1 million of those live alone. With the right support and facilities, leading an independent life with a physical or learning disability is now more achievable than ever.

Aids and Adaptations

If you or a member of your family has difficulty living in your home due to a long-term illness or disability, you may be able to get help by adapting your home to better meet your needs. You can apply to your local council for a disabled facilities grant. The grant helps you adapt your home to make it suitable for a disabled person. Depending on your income, you may need to pay towards the cost of the work to the property.

You could get a grant from your council if you are disabled and need to make changes to your home, for example to: • Widen doors and install ramps

• Improve access to rooms and facilities - eg stairlifts or a downstairs bathroom

• Provide a heating system suitable for your needs

• Adapt heating or lighting controls to make them easier to use

How can I find out more about the aids and adaptations that would help me?

Contact your social services department on 0845 850 5010 about what difficulties you are having at home. They will send an occupational therapist to carry out an assessment and provide advice on which equipment or housing adaptation needs suit you best.

General Internal Adaptations • • • •

• • • • • • •

Additional stair rail Changing door knobs to lever handles Lowering of Yale locks Re-siting of electrical sockets at a convenient level Additional power points Provision of intercom & door unlock systems Provision of rocker light switches Adjustments to or additional lighting Relocation of clothes hanging rails Accessible window openings Provision of letter cages or delivery shelves in entrance hall

Kitchens and Bathrooms

• Lowering or replacement of high wall hung cupboards • Additional storage space in kitchen • Lowering of cooker mains switch • Installation of extractor fan with accessible controls • Level access shower • Overbath shower • Provision of non-slip/tactile surface • Provision of storage space for wheelchair • Ramps • Special baths • Special toilets • Step in shower • Widening doors for wheelchair access

Major Adaptations

• Bathroom extensions (ground floor showers & W.C’s) • Bedroom extensions • Hardstandings • Major internal rearrangements • Re-design or re-organisation of existing kitchen • Stairlifts • Vertical through floor lifts

ARe YoU A CAReR? A carer is anybody who looks after a family member, partner or friend who needs help because of their illness, frailty or disability. All the care they give is unpaid and about one in ten of us is a carer. Many carers don't see themselves as carers and it takes carers an average of two years to acknowledge their role as a carer.

It can be difficult for carers to see their caring role as separate from the relationship they have with the person they care for, whether they are a parent, son, daughter, sibling or friend and many people do not see themselves as carers. They simply may think of themselves as a friend or family of the person they care for.

It is because of this that they often don’t realise there is help available to them as well.

Such as how to get:

• • • • •

Assessments Direct payments Home care Housing adaptations Funding for short breaks or respite

Some carers can suffer from poor health because of the demands of their caring role. For example, back pain can result from lifting or moving the person being cared for. It may also be difficult to maintain a healthy diet and exercise routine while caring.

Without the right support, being a carer can be an extremely stressful role.

• Ask for help: We all need help from time to time and carers are no exception. Help is out there, you only need to ask!

• Know your rights: It sounds simple, but knowing what you’re entitled to and what support is available can help a great deal.

• Tell your GP: Your GP practice can record that you are a carer to ensure you get your annual flu vaccination and additional support as a carer.

• Get an assessment: This can sound a little daunting at first, but ensuring that you and the person you care for get a assessment of your needs through the Local Authority can give you access to a whole host of additional practical help and support.

• Be a little selfish! We all need time to ourselves, but it’s particularly important for carers. This could be as simple as setting some me time aside for a relaxing bath or a night out.

Durham County Carers Support

Durham County Carers Support is an independent, charitable organisation providing information, advice and support to carers.

Durham County Carers Support aims to improve the health and wellbeing of Carers caring for someone in County Durham by providing practical and emotional support, advice and information such as.

• • • •

• • • • •

One-to-one support, including home visits Information and advice Informal advocacy support Carer training and support with employment issues Support to access other services Supporting carers’ health and wellbeing Social events and activities Local support groups Carer breaks

www.dccarers.org

Contact Us

Tel: 0300 005 1213 Text: 07624 818 403 Email: admin@dccarers.org

Bishop Auckland - Head Office 1 Hutton Close, South Church Enterprise Park Bishop Auckland, Co Durham DL14 6XG

Barnard Castle, Middleton in Teesdale & Newton Aycliffe Carer Surgeries – ring for details: 0300 005 1213

Chester Le Street, Bullion Hall, Bullion Lane Chester Le Street, Co Durham DH2 2ES

Peterlee, Community House, Yoden Road Peterlee, Co Durham SR8 5DP

Consett, Village Hall, Delves Lane, Consett Co Durham DH8 7BH

CARe In YoUR oWn HoMe Home care isn’t for everyone but frequent visits from carers and a few home modifications can help you retain your home comforts and independence.

Receiving care in your home is an increasingly common alternative to staying in hospital or moving into a care home.

Depending on your needs, you can receive help and support that allows you to stay in your own home as long as possible. Not only do you avoid any upheaval and stay in familiar surroundings, it can also be a more economical alternative to residential care.

How much you have to pay will depend on:

• Your health and mobility • What level of help and support you require • The value of your assets

What home care services are available?

• Regular visits from home care workers to help with daily tasks and personal care • Meals delivered to your home • Equipment and home modifications to help with mobility and accessibility, such as getting in and out of the bath, and getting up and down stairs • Personal fall and panic alarms that are monitored around the clock • Support for health needs, such as incontinence • Day care and transport to take you there • Gardening and handyman services

If you only need a few hours help a day and your house can be adapted to your needs, care at home may be the most practical and cost-effective solution.

Your local authority may pay some or all the costs, but you might also have to pay for all the services yourself. Make sure you claim all the benefits you’re entitled to – Attendance Allowance and Disability Living Allowance (or Personal Independence Payment) are the most common.

CARe In YoUR oWn HoMe Carers Direct helpline

Call the Carers Direct helpline on 0300 123 1053 if you need help with your caring role and want to talk to someone about what options are available to you. If you are busy at certain times of day, you can send us a message to ask us to call you back for free at a time that is convenient to you. The helpline is open from 9am to 8pm Monday to Friday, and from 11am to 4pm, at weekends. The helpline is closed on bank holidays. Calls are free from landlines and mobiles within the UK. Care Provider

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CHooSInG BetWeen ReSIDentIAL, There are many types of residential care homes available. These include permanent care homes for older people, homes for younger adults with disabilities and homes for children. They may be privately owned or run by the voluntary sector or local authorities. You may want to consider in detail the many options for residential care before you make a decision.

Older people

Care homes for older people may provide personal care or nursing care. A care home which is registered to provide personal care will offer support, ensuring that basic personal needs, such as meals, bathing, going to the toilet and medication, are taken care of. In some homes more able residents have greater independence and take care of many of their own needs.Some residents may need medical care and some care homes are registered to provide this. These are often referred to as nursing homes. Some homes specialise in certain types of disability, for example, dementia.

Adults aged 18-65

There are also residential care homes that provide care and support for younger adults with, for example, severe physical disabilities, learning disabilities, acquired brain injury, progressive neurological conditions or mental health problems.

Care can be provided for adults with more than one condition and some homes have expertise in providing care for adults with alcohol or drug dependency.

These homes offer permanent residence or provide care for a temporary period until the adult is able to live independently or move to a different type of accommodation.

Choosing between residential care and independent living

Social services normally encourage younger adults who they assess for support to be as independent as their circumstances allow. The care plan for adults with disabilities will consider what independent tasks they can carry out and how they can be helped to achieve more. Even if adults have very severe disabilities their needs are reviewed from time to time to check whether residential care or a very high level of support is still appropriate.Supported living may be an option for younger adults. This allows people to live independently in the community but with basic support. The support offered includes help with setting up a home and managing finances, and assistance with cleaning and shopping.

For older people there are various alternatives to residential care. These include sheltered housing and extra care housing schemes, which offer independence with an increased level of care and support.

For many people there is also the choice of living independently at home with community care support.

nURSInG & InDePenDent LIVInG Choice of accommodation

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.

Choosing a 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.

Respite and short term stays

Residential care home stays don't necessarily have to be permanent. Temporary stays can be arranged for respite care (in which you take a break from caring for somebody else), or as a trial period before a permanent stay.

Temporary stays can give you flexibility when covering unexpected events, such as:

• Palliative care (which manages or reduces pain) after a hospital stay or illness • Support for newly disabled people and their carers • Enabling someone to continue living independently if they live alone and suddenly require care • Giving someone a chance to try potential future homes

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 or scan the QR CODE WITH YOUR SMARTPHONE

ReSIDentIAL CARe CoStS In some cases the residential care needed by the person you're looking after may be paid for by the NHS under the NHS continuing care scheme. The care may also be provided free of charge because it is 'intermediate care'. It may be free because the person you're looking after has previously been a mental health inpatient. If this is the case, the services are funded under the Mental Health Act.

Residential care is also free if the local authority could charge but decides not to do so. This can occur if the stay in residential care is only temporary (normally less than eight weeks), or if the residential care is for a child. If none of the above applies, the person you're looking after will be given a financial assessment. This is also known as a means-tested assessment. They will be required to give information about their income and capital. There are rules that determine how income and capital are treated. Some types, including benefits, can be disregarded. The financial assessment will work out how much the person you're looking after will be expected to contribute towards the cost of their care home fees.

Owning Property

There are rules that explain how the property of the person you're looking after will be taken into account In some cases it can be disregarded, this is the case if a partner is still living in the property.

The capital limit for residential care is ÂŁ23,250.

Local authorities will investigate if they believe that the person you're looking after has deliberately reduced their capital to avoid paying care home fees. There is a scheme called the deferred payment scheme which allows someone who goes into care to keep their property and still get help from the local authority with paying care home fees. The local authority recovers the fees from the proceeds when the property is sold. This scheme can also be used if there is a delay in selling a property.

Self-funders

After the means-tested assessment, the person you're looking after may receive a decision that they will have to pay their own care home fees.

People paying their own fees are referred to as self-funders. Self-funders will still receive advice about the arrangements for residential care. Once a self-funder's capital reaches ÂŁ23,250 the local authority is responsible for helping out with the care home fees. This will require another assessment.

Get personal advice on care funding

The cost of care and support is likely to be a longterm commitment and may be substantial, particularly if you opt for residential care. If you or a member of the family need to pay for care in a care home, it’s important to seek advice tailored to your individual needs.

The cost of your care will vary depending on its type, intensity, specialisation, location and duration. For example, a place in a residential care home will cost hundreds of pounds a week.

Decisions that have such financial implications should be made with advice and only after considering the costs of alternatives.

For example, the cost of a care home needs to be weighed against the cost of care and support that may help you remain in your existing accommodation.

The costs of long-term care can be significant and how you may wish to arrange to pay for it is a big financial decision for most people. Cost can vary across the country and different care homes will charge different amounts based on the level of care needs, the quality of the accommodation, or the area of England it is in.

Few of us will have the income or ready access to the cash to pay for their ongoing care needs. Often people find that they need to sell or remortgage their home to pay for care or enter into an equity release scheme. Before taking such significant financial steps it is advisable to get proper independent financial advice. For advice on selffunding care, visit the Money Advice Service or the Society of Later Life Advisers. You may also have previously arranged an investment or insurance plan to fund your care. Again, it is worth taking independent advice on these potentially significant financial arrangements.

Find out more about paying for care on the websites of: www.ageuk.org.uk www.carersuk.org www.findmegoodcare.co.uk www.moneyadviceservice.org.uk

www.societyoflaterlifeadvisers.co.uk

CHooSInG tHe RIGHt CARe HoMe All care homes vary in their quality, and it can be hard to know what qualities to look for when choosing a home.

A good care home will probably do the following:

• Offer new residents and their families or carers a guide (in a variety of accessible formats) describing what they can expect while they’re living there. Ideally, residents of the home would have helped to produce the guide

• Have a majority of staff who've worked there for a long time. They know the residents well, and are friendly, supportive and respectful

• Involve residents, carers and their families in decision making, perhaps through regular meetings with staff

• Support residents in doing things for themselves and maximising their independence, including keeping contact with the outside community

• Offer a choice of tasty and nutritious food, which residents may have helped to prepare

• Take into account the needs and wishes of all residents, and provide a variety of leisure and social activities

• Be in a clean, bright and hygienic environment that's been adapted appropriately for residents, with single bedrooms available. A good environment encourages residents to personalise their room

• Have staff who respect residents’ privacy and knock before they enter someone’s room

• Be staffed by well-trained people, for example, nurses trained in dementia care • Respect residents’ modesty and make sure that they look respectable, while recognising residents’ choice about what they wear • Be accredited under the Gold Standards Framework for end of life care

A bad care home might do the following: • Have a code of practice and a set of aims, but doesn’t make them a priority

• Offers little opportunity to listen to residents, with most decisions made by staff

• Have residents’ care plans that are out of date, and don’t reflect their needs accurately. This means that some residents aren't getting the support they need with their healthcare and personal care

• Give residents little privacy. Staff often enter residents’ rooms without knocking, and they talk about residents within earshot of other people

• Have staff who don’t make an effort to interact with residents, and leave them sitting in front of the TV all day

• Be in a poorly maintained building, with rooms that all look the same and have little choice in furnishings

• Need cleaning, with shared bathrooms that aren't cleaned regularly

• Deny residents their independence, for example, by not allowing someone to feed themselves because it takes too long As a resident in a care home, you should expect: • The right to be treated politely and with dignity

• The right to privacy for yourself, and your relatives and friends when they visit

• The right to deal with your own finances and spend your money how you choose

• The right to eat food that's prepared in line with your faith, and to worship when and where you want to

• The right to choose the food that you eat, and to be given the time and space to relax and enjoy your meal

• The right to choose when you get up in the mornings and go to bed at night

• The right to complain if you're unhappy with your care

ReSIDentIAL & nURSInG CARe Residential Homes

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nURSInG & ReSIDentIAL CARe Nursing Homes

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HeLP & ADVICe NHS health trainers can help you change your lifestyle. With our FREE local service, we can support you on a 1:1 basis to help you reach your goals around making healthier food choices, increasing physical activity, stopping smoking or drinking less. With the right advice, tips and tools, we can help make it happen.

For more information, ring health trainers on 0191 5692841 or 01207 523666.

The Patient Experience Team at County Durham and Darlington NHS Foundation Trust welcome feedback such as compliments, comments, concerns and complaints from patients, relatives and carers, as they can be used to help us improve our services. We are committed to acting on issues raised, and use a variety of methods to elicit patient feedback including face to face interviews, surveys, website comments, NHS Choices and patient stories.

Tel: 0800 7835774 • Email: patient.experience@cddft.nhs.uk Web: www.cddft.nhs.uk

Talking Changes is a self-help and talking therapies service designed to help anyone living in County Durham and Darlington to deal with common mental health problems such as stress, anxiety or depression, as well as panic, phobias, obsessive compulsive disorder (OCD) and post traumatic stress disorder. It is a free, confidential NHS service and is open to anyone aged 16 and over who lives in County Durham or Darlington, who isn't already accessing adult mental health services.

Bede House, Unit 3, Belmont Business Park, Durham DH1 1TW Tel: 0191 3740044 Web: www.talkingchanges.org.uk

The Rethink Mental Illness Co Durham Advocacy Service provides advocacy to adults in Co Durham who are experiencing mental illness. We can also advocate for Carers of people with mental illness. We work in the community and in hospitals and we also provide IMHA advocacy to those detained under the Mental Health Act. Post Rethink Mental Illness Co Durham Advocacy Service, Unit 15 Crook Business Centre, New Road, Crook, Co Durham DL15 8QX Tel: 01388 766310 • Fax: 01388 764323 Email: countydurham.advocacy@rethink.org

Pioneering Care Partnership (PCP) is a leading third sector organisation supporting people in the north east to improve their health and wellbeing.

PCP is responsible for running a healthy living centre, the Pioneering Care Centre in Newton Aycliffe and a range of outreach projects and services out in the community. PCP has a huge range of activities, support and classes aimed at improving your health and making you feel better!

Find out more: Pioneering Care Centre, Carers’ Way, Newton Aycliffe, DL5 4SF Tel: 01325 321234 • Email: enquiries@pcp.uk.net • Web: www.pcp.uk.net or find us on Twitter: @PioneeringCare and Facebook: /PCPandCentre

We have several services in Durham which are to support stroke survivors and carers from the initial trauma of stroke right through their stroke recovery journey. We can provide, support, advice and information, signpost to local resources for all those affected by stroke. We have support services and groups for stroke survivors with aphasia, information hubs and peer support networks based throughout the County Durham area.

Contact any of our staff at our Bishop Auckland office on 01388 771524 Helpline: 0303 3033 100 • Textphone: 18001 0303 3033 100

HeLP & ADVICe Free, confidential, impartial and independent advice for all.

BENEFITS – We will find out if you qualify for benefits.

DEBT – We will look at the options for managing your debts.

JOBS – We will help you deal with your problems at work.

HOUSING – We will explain your housing rights and options.

RELATIONSHIPS – We will advise you on how to cope with family problems.

CONSUMER AND ALL OTHER ISSUES – We will look at your rights and advise you on how to tackle consumer problems, ranging from buying products and services to paying gas, electricity and water bills. We can also advise on a wide range of issues, from immigration to tax rebates.

LOCAL OFFICE CONTACT DETAILS or visit www.adviceguide.org.uk Citizens Advice (Consett) 77 Medomsley Road, Consett DH8 5HN • Tel: 01207 501234 Citizens Advice (Chester Le Street) 1a, Front St, Chester Le Street DH3 3BQ • Tel: 0191 3893001 Citizens Advice (Durham) 32 Claypath, Durham DH1 1RH • Tel: 0191 3746375

Citizens Advice (Stanley) Prince Bishops Community Bank, 25-33 Front Street, Stanley DH9 0JE Tel: 08444 111 444

Family Action delivers a range of support to young carers living in County Durham.

If you are Under 18 and are supporting a family member living with an illness, disability, addiction or a mental health need Family Action could help you in your caring role.

4 Red Hill Villas’, Durham DH1 4BA Tel: 0191 383 2520 Email durhamyoungcarers@family-action.org.uk

4Real is a free and confidential service for young people under the age of 18.

We offer services to young people who use drugs and alcohol.

• Do you live in County Durham?

• Are you under 18?

• Do you need to talk to someone about your drug or alcohol use?

If the answers are YES, then you need 4Real!

4Real advice, 4Real help, 4Real support, 4Real change, 4Real life

Tel: 03000 267 567 • Email: 4real@durham.gov.uk • www.4realcountydurham.co.uk

Help and support for victims of domestic abuse There are organisations within County Durham that can help and support you or someone you know regardless of age, gender and sexuality.

If you are in immediate danger please call 999. Your call will be dealt with confidentially and sensitively, you do not have to face your problems alone.

Harbour Support Services are a specialist domestic abuse service who can help people who live within County Durham. You could also go to your GP, health visitor, social worker, housing officer or the police who can get advice on your behalf.

Harbour Support Services Tel: 03000 20 25 25 • Email: durham@myharbour.org.uk