YOUR FREE GUIDE TO HEALTH & SOCIAL CARE 2016/17
Please take one ...
Health & Social Care Signposting Directory Trafford
www.healthwatchtrafford.co.uk
Trafford
The Care Act
Care & Support for Adults in England
Know your rights ...
Well-being ...
Local councils must have services to meet different people’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 children’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 0161 912 4416. A trained assessor will work with you to carry out the assessment. They will consider a number of factors such as your needs and how they impact on your wellbeing and what is important to you. They 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 they can provide advice and signpost you to services who can provide support.
www.trafford.gov.uk
CONTENTS Healthwatch Trafford
1
Rate Your Care
2
Healthwatch Trafford - We Need Volunteers
3
Getting Involved
4
Carers Rights & the Care Act
5-6
NHS Hospital Services
7-8
Tell your GP You are a Carer
9 - 10
GPs, GP Surgeries & Pharmacies in Trafford
11 - 12
Dentists & Opticians
13 - 14
A - Z Social Care Jargon Buster
15 - 22
Taking a Break from Caring
23 - 24
Caring for Someone with Dementia
25 - 26
NHS Continuing Healthcare Funding
27 - 28
Imagine, Act & Succeed
29 - 30
Improving Safety & Wellbeing at Home
31 - 32
Care Home or Home Care?
33 - 34
Residential & Nursing Homes in Trafford
35
Care in Your Own Home 36
Disclaimer This Directory has been compiled to signpost primary health and social care providers throughout Trafford. 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 Trafford 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 Trafford 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 TRAFFORD What does Healthwatch Trafford do? Healthwatch Trafford is the Local Healthwatch for the Trafford local authority area. We help people get the best out of their local health and social care services; whether it’s improving them today or helping to shape them for tomorrow. Local Healthwatch is all about local voices being able to influence the delivery and design of local services. Not just people who use them, but anyone who might need to in the future. We have representatives on the boards, committees and project groups for Trafford commissioners and providers.
Healthwatch Trafford: • provides people with information and signposting about local health and social care services • gathers the views and experiences of local people on the way services are delivered and have the power to enter and view adult health and social care services to get a feel for how they are delivering • influences the way services are designed and delivered based on evidence from those who use services • influences how services are set up and commissioned by having a seat on the local Health and Wellbeing Board • passes information & recommendations to other local Healthwatch, Healthwatch England and the Care Quality Commission
What is the Healthwatch network? By making sure the views and experiences of all people who use services are gathered, analysed and acted upon, we can help make services better now and in the future. Healthwatch actively seeks views from all sections of the community, especially from those who sometimes struggle to be heard and not just from those who shout the loudest. We also encourage health and social care providers, regulators and planners to hear directly from people themselves. Healthwatch has two parts; the nationally focused Healthwatch England and 149 community focused local Healthwatch. Together we form the Healthwatch network, working closely to ensure consumers’ views are represented nationally and locally.
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What power does Healthwatch Trafford have? Healthwatch Trafford can request information from local organisations, commissioners and providers. They then have 20 working days to return the information requested. The trained members of Healthwatch (staff or volunteers) are authorised to perform ‘Enter and View’. These are powers to go to a service unannounced or announced and have a look at the work/standards in that practice. Healthwatch Trafford has worked very hard to create partnerships and collaborative relationships with local services and providers, in order to discuss issues openly and effectively. Once local people bring up an issue, it will be addressed by Healthwatch and the service provider/organisation together. Twenty working days is given to the organisation to respond as to how they will resolve the issue and improve. A report is then produced by Healthwatch and made public. The report will include recommendations both from the public involved in the Healthwatch and the steps taken by the organisation concerned. Service providers as well as health and social care organisations have a duty to the public to listen to issues that are brought forward and respond to/act upon them.
People need to feel that Healthwatch Trafford belongs to and reflects them and their local community It needs to feel approachable, practical and dynamic, and to act on behalf of local people • We’re helping you to shape and improve the services you use • We’re engaging with people in your community – if you haven’t met us yet, please get in touch! • We’re an open organisation and want to make it easy for you to talk to us • We’re inclusive and we want people from every part of your community to join us • Ask us what we’re doing and we’ll always tell you what’s happening • You can hold us to account • We’re here to help services to improve • We’ll notice the bad things they do, and the good - we use your evidence to build a true picture of your local services
RATE YOUR CARE So how can you get involved? There are a number of things that you can do to help us make things better, from things that take seconds and can be done from your living room to attending meetings, events or working with us in the office. From giving out leaflets, talking to the public in drop-ins, enter & view services to spreading news, stories and resources via social media. There are plenty of options to help us depending on your skills and time commitment.
Healthwatch Trafford Feedback centre All of the health and social care services in Trafford (as well as the major hospitals in Manchester, Salford and Wythenshawe) are listed on our website as part of our Feedback Centre. Over 600 people have shared their experiences of using these services with us and we would like to gather even more! We want to hear about your experience of using health and social care services, whether it’s at the hospital, your GP surgery, the dentist, chemists or opticians; whether you live in a residential or nursing home, receive home care or have a family member that does so, we want to know what is good and what could be improved. To find out more or to leave your comments on our easy to use feedback centre, visit our website at: www.healthwatchtrafford.co.uk Alternatively, you can phone us on: 0300 999 0303 or email: info@healthwatchtrafford.co.uk
Tell us your experience and help us use that to make services better for everyone in Trafford. Giving feedback takes minutes, but the impact could last a lifetime! North West Ambulance Service Patient Transport Service
Based on 3 reviews
Ladybridge Hall Headquarters, Bolton, BL1 5DD 01204 498400 www.nwas.nhs.uk/our-services/patient-transport-service
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Urmston Pharmacy
287b Stretford Road, Urmston, Manchester, M41 9NU 0161 864 3733
Based on 1 review
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Primrose Surgery
59 Old Crofts Bank, Urmston, Manchester, M41 7AB 01617472424 www.primrosesurgery.co.uk
Based on 11 reviews
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Primary Healthcare Dieticians Bridgewater Site, 1a Bridgewater Road, Altrincham, WA14 1LB 0161 716 4683
Based on 1 review
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Trust Care
Sale Point, 126-150 Wasway Road, Sale, M33 6AG Based on 1 review 0300 777 8777 www.traffordhousingtrust.co.uk/your-home/independent-living/
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Toll Altrincham
9-11 Ashley Road, Altrincham, WA14 2DT 0161 928 0566 www.optisavers-online.co.uk/toll-altrincham/ NHS Patients accepted
Based on 1 reviews
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Trafford General Hospital
Moorside Road, Davyhulme, Manchester, M41 5SL 01612761234 www.cmft.nhs.uk/traffordhospitals
Based on 104 reviews
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Turret Orthodontics Practice 258 Washway road, Sale, M33 4RZ 01619733501
Based on 4 reviews
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Partington Central Surgery
Central Road, Partington, Manchester, M31 4FY 0161 775 7032 www.partingtoncentralsurgery.co.uk
Based on 4 eviews
We want to hear about the treatment and care you have received. Whether you've had a positive experience or there is room for improvement, have your say on the Healthwatch Trafford website today. You can even leave feedback anonymously.
www.healthwatchtrafford.co.uk
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WE NEED VOLUNTEERS IN YOUR COMMUNITY Do you care about health and social care services in Trafford? Do you have a few hours spare and live or work in the borough of Trafford?
Whatever your skills or experience, as long as you are passionate about improving health services in Trafford we want to hear from you
If so, why not make a positive difference within your local community by volunteering with Healthwatch Trafford? By complementing the work carried out by our staff, volunteers play a vital role in helping Healthwatch Trafford achieve its objectives.
What do Healthwatch Trafford volunteers do? We offer a variety of interesting opportunities: • Community Contacts help us to promote Healthwatch Trafford within their own local area, building up links with local health and care services and people within their community. • Enter and View representatives visit health and adult social care services to see how they are run.
Why volunteer? The benefits of volunteering with Healthwatch Trafford include: • Making a change! Making a positive difference to health & social care services and to Trafford residents. • Meeting new people, being part of a friendly team and having fun!
• Champions support Healthwatch Trafford at drop-ins and other public events, gathering patient opinion and raising awareness of our organization.
• Learn new skills and gain new experience. Improving employability by getting valuable experience, proving your reliability and increasing your knowledge.
• Administration/Research Volunteers capture and analyse information in order for the findings to be published, or undertake specific administrative tasks which support the work of the staff team.
• Having your say and becoming part of decision making processes. • Learning about what’s happening in your area.
Under 18? We welcome applications from children and young people - please visit our website to find information specifically for young people: www.healthwatchtrafford.co.uk
Please get in touch with our Volunteer Coordinator, Katherine Bays Contact us by:
TELEPHONE: 0300 999 0303
EMAIL: info@healthwatchtrafford.co.uk
Our website has more information: www.healthwatchtrafford.co.uk/ get-involved/volunteer/
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GETTING INVOLVED Consultations In addition to this, we actively promote opportunities to get local people involved in consultations, promoting them at our drop-ins, group engagement, social media and via our website. Over the last 12 months we have promoted 16 consultations, including the Healthier Together transformation of services, Trafford Council’s budget, the patient consultation over the closure of Dr Ali’s GP surgery and wheelchair services in Manchester & Trafford. Find information about consultations on our website: www.healthwatchtrafford.co.uk
Our reports and recommendations
How we make change happen
In the past year we have produced a number of reports: • Getting it right for Deaf people in Trafford report. • Manchester Royal Eye hospital • Blind and Deaf / Deaf and Visually Impaired Residents. • Three Hospital Patient Experience reports (two Altrincham Hospital and one Trafford General Hospital) • Primary School Nurse report
An example of how the work we did has improved services for people in Trafford is the results of our report ‘Getting it right for Deaf people in Trafford’.
And in addition to the above, we have five enter & view reports and have been working on further reports due out this year (such as the report on access to services for people with ME/CFS). All our published reports can be found on our website at healthwatchtrafford.co.uk
We consulted with 36 Deaf residents, local health service providers, commissioners and British Sign Language (BSL) Interpreters to explore the issues faced by Deaf residents. We found barriers to contacting hospital & GP services to make appointments and collect test results for British sign language (BSL) users, problems with interpreters and a lack of deaf awareness amongst staff causing issues. The report made a number of recommendations, which have resulted in a number of actions, such as sharing of emergency text message service details and customer care information to be produced in plain English and easy-read formats.
Involving local people in our work As part of our commitment to involve local people in the commissioning and provision of health and care services, we are involved in a number of groups that allow us to have a direct input into the process. Several of our volunteers represent Healthwatch in local initiatives in order to help us achieve this, including a number on the Patient Reference Advisory Panel (PRAP). The PRAP is a Trafford CCG initiative which represents the views of the Trafford population and contributes to strategic thinking. They do this through debate, discussion, challenge, support and advice on clinical and commissioning decisions, policy and performance. We also have board members attending the Locally Commissioned Services Group, and on the Integrated Care Reference Group which are also Trafford CCG led. 4
CARERS RIGHTS & THE CARE ACT 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.
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.
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
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.
• have the assessment in private if you want to, at a convenient time and place for you
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.
• have a chance to identify the outcomes that you want; any services should be appropriate for you and meet your needs
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.
• get relevant information, including about welfare benefits you could claim and details of other services
• be given flexibility and innovation in identifying services that may meet your needs • have an opportunity to give feedback about the assessment
Request your Carer’s assessment Contact Trafford Initial Assessment Team Tel: 0161 912 5199 Email: IAT@trafford.gov.uk www.traffordcarerscentre.org.uk 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.
Request your Young Carer’s assessment Contact Trafford Carers Centre - Tel: 0161 848 240 Email: info@traffordcarerscentre.org.uk www.traffordcarerscentre.org.uk
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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
A specialist will only see you with a referral letter from your GP. The letter will give the specialist essential background information.
Choosing a hospital or consultant
However, if you see a private specialist without a GP referral, your GP is not obliged to accept the specialist’s recommendations.
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 • you are detained under the Mental Health Act • you are detained in or on temporary release from prison, in court, an immigration removal centre, or a secure children’s home • 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. 7
If you wish to see a private specialist, you are still advised to get a referral letter from your GP.
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.
Consent to treatment 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 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.
NHS HOSPITAL SERVICES 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.
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.
Help with travel costs If you are referred to hospital or other NHS premises for NHS specialist treatment or diagnostic tests by your doctor, dentist or other health professional, you may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme (HTCS). For further information visit: http://www.nhsbsa.nhs.uk/
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.
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TELL YOUR GP YOUR A CARER If they know you are a carer they will be able to offer advice and support. Your GP practice has a dedicated person who can help you by providing information and advice on: • any medical conditions including treatments for the person you care for. This may help you feel more confident in your caring role • services provided by the NHS such as continence services and patient transport to hospital appointments • carrying out home visits to you or the person you care for if your caring responsibilities make it difficult to attend appointments at the surgery • arranging appointments for both you and the person you care for at the same time to avoid having to visit the surgery twice • arranging for repeat prescriptions to be delivered to your local pharmacy to save you picking them up • providing supporting letters and information to enable you and the person you care for to access services and welfare benefits. Carers of people with serious/chronic health conditions or who are frail may also qualify for an annual flu vaccination. Your GP will also be aware of your caring responsibilities should you need treatment or hospitalisation.
Changing a GP You can change your GP at any time you wish without having to give a reason. If you tell your local Clinical Commissioning Group (CCG) that you want to change your GP, they must give you details of how to do so and provide you with a list of alternative GPs.
Did you know 51.4 million GP consultations are for minor ailments alone which would clear up by themselves, or with a little help from an over-the-counter remedy from a pharmacy, this is 18% of the GP workload nearly half of these consultations are generated by people aged 16 – 59 years. 9
A good GP practice should provide the following to all patients: • A professional and helpful team of GPs, practice staff and other healthcare professionals. • A practice that is accessible to everyone and provides a comfortable and organised environment. • A flexible and efficient appointment booking system. • 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.
Cancelling and missing appointments 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.
Did you know
Up to 40,000 GP visits per year are for dandruff. 20,000 go to their local surgery for travel-sickness. 5.2 million with blocked noses.
TELL YOUR GP YOUR A CARER Making an appointment
Keeping medicines organised
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.
Make sure medicines are all kept in one place in the home, preferably in a cupboard or drawer that can be locked. This is particularly important if children live in or visit the house. You’ll also need to ensure repeat prescriptions are dispensed in time so the person you’re looking after doesn’t run out of medication.
Managing medicines - tips for carers Managing medicines for someone you look after can be a challenge, particularly if they are taking several different types. Although the person you care for may appreciate your support with their medicines, bear in mind that they have a right to confidentiality. It’s up to them to decide how much of their health and medicines information is available to you as their carer If the person you care for has a complicated medication regime with different pills taken at different times of the day, you can ask your pharmacist to provide them in dosette boxes. These are plastic boxes with small compartments that show clearly which pills need to be taken at what time of day. Instructions for when and how to give medication should be clear. If you are experiencing any problems, ask a doctor, nurse or pharmacist to explain. It’s important to give medicines at the recommended time of day. Not doing this can make them less effective. You also need to know whether or not the medicines should be taken with food or in between meals.
Ask for a medicines use review If the person you are caring for is taking more than one medicine and has a long-term condition, such as arthritis or diabetes, they should be able to get a free medicines use review with their pharmacist
Did you know
Two million people who go to A&E could either self-care or have been treated elsewhere in the community. 12% of people admit to having used A&E in the past even when they knew there was nothing seriously wrong with them.
If you find you are spending a lot of time fetching prescriptions from the GP and picking up medicines from the pharmacy, ask the GP surgery if they can send prescriptions directly to the pharmacy. Some pharmacists also offer home delivery services for people who find it difficult to get out of the house.
Medicines safety for carers There are a number of things you and the person you’re looking after can do to make taking medicines safer: • Be aware over-the-counter medication shouldn’t be taken with prescribed medicines unless a doctor or pharmacist has confirmed it’s safe to do so. • Be aware that if a dose of the medicine is missed, it may not be safe to take a larger amount later on. • Return any surplus medicines to the pharmacist for safe disposal. • Never give medication to someone without their consent or try to force them to take it. People have the right to refuse medication. It’s not safe to crush tablets, or open capsules and mix them with food or drink Don’t forget most pharmacies offer a wide range of services including: • Stop smoking service • Weight management • Blood pressure checks • Flu vaccination service • Medicine check ups • Alcohol advice service • Sexual health advice
Did you know
The estimated cost of treating people who go to A&E but who could have either self-treated or gone elsewhere is £136 million a year. This is the equivalent cost of 6,500 nurses.
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GPs, GP SURGERIES & PHARMACIES GPs & GP Surgeries
Address
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Pharmacy / Chemist
Address
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Telephone
Supporting adults with disabilities to live independently in their own homes
Registered Charity Number: 1022680
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Supported Living • Shared Lives • Short Breaks • Community Support • Children & Family Centre Call us on: 0161 456 6502 or visit: www.independentoptions.org.uk
GPs, GP SURGERIES & PHARMACIES GPs & GP Surgeries
Address
Area
Postcode
Telephone
Pharmacy / Chemist
Address
Area
Postcode
Telephone
Data Correct with NHS Choices
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 12
DENTISTS & OPTICIANS
Dentists
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Opticians
Address
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Data Correct with NHS Choices 13
DENTISTS & OPTICIANS
Dentists
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Opticians
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Data Correct with NHS Choices 14
A - Z SOCIAL CARE JARGON BUSTER Some of the most commonly used social care words and phrases and what they mean ... Acute Care
Health care that you receive in hospital following an injury, operation or illness. It is different to any care you may receive for an ongoing health condition from your GP, community nurse or other professionals in the community where you live.
Adult Placement Scheme
Autistic Spectrum Disorder
A condition that someone is born with that affects their ability to communicate and interact with the world around them. It is also called autism, and covers a wide range of symptoms. It affects people in different ways, and some individuals need much more help and support than others.
When an adult with a disability or mental health problem lives in an ordinary home with an individual or family who provides them with a place to live and support. It is like a fostering arrangement for adults: adult placement carers must be checked and approved, and the arrangement is monitored by the local council. People may be placed in someone’s home for a short break or on a permanent basis.
Barred List
Adult Social Care
Behaviour Disorders
Care and support for adults who need extra help to manage their lives and be independent - including older people, people with a disability or long-term illness, people with mental health problems, and carers. Adult social care includes assessment of people’s needs, provision of services or allocation of funds to enable you to purchase your own care and support. It includes residential care, home care, personal assistants, day services, the provision of aids and adaptations and personal budgets.
Advocacy
Help to enable you to get the care and support you need that is independent of your local council. An advocate can help you express your needs and wishes, and weigh up and take decisions about the options available to you. They can help you find services, make sure correct procedures are followed and challenge decisions made by councils or other organisations. The advocate is there to represent your interests, which they can do by supporting you to speak, or by speaking on your behalf. They do not speak for the council or any other organisation. If you wish to speak up for yourself to make your needs and wishes heard, this is known as self-advocacy.
Appropriate Adult
Someone over the age of 18 who stays with you if you have a mental health problem or disability, or are perceived as ‘vulnerable’, and are held by the police for any reason. This person, who should not work for the police, is there to support you and help you understand what is happening.
Assisted Living
Housing for older or disabled people, usually privately owned, where you have your own apartment within a larger development, and support (such as help with meals or laundry) is provided to meet your own particular needs. 15
An official list of people who are unsuitable to work or volunteer with children or with adults who may be at risk of harm or abuse, because of their past record. If you employ someone regularly to provide personal care, you should expect them to have completed a Disclosure and Barring Service (DBS) check, which will show whether they are on the barred list or not. Health conditions such as attention deficit disorder that may lead to challenging behaviour, as well as to social and emotional problems. People with behaviour disorders may be treated with medicine and/or given psychological support.
Best Interests
Other people should act in your ‘best interests’ if you are unable to make a particular decision for yourself (for example, about your health or your finances). The law does not define what ‘best interests’ might be, but gives a list of things that the people around you must consider when they are deciding what is best for you. These include your wishes, feelings and beliefs, the views of your close family and friends on what you would want, and all your personal circumstances.
Capacity
The ability to make your own choices and decisions. In order to do this, you need to be able to understand and remember information, and communicate clearly - whether verbally or non-verbally - what you have decided. A person may lack capacity because of a mental health problem, dementia or learning disability
Care Plan
A written plan after you have had an assessment, setting out what your care and support needs are, how they will be met (including what you or anyone who cares for you will do) and what services you will receive. You should have the opportunity to be fully involved in the plan and to say what your own priorities are. If you are in a care home or attend a day service, the plan for your daily care may also be called a care plan.
A - Z SOCIAL CARE JARGON BUSTER Care Quality Commission (CQC)
An organisation set up by the Government to make sure that all hospitals, care homes, dentists, GPs and home care agencies in England provide care that is safe, caring, effective, responsive and well-led. If you are unhappy with the care or support you receive, you can contact CQC to let them know. Although CQC cannot investigate complaints about an individual person’s treatment or care, it inspects services and will use any information it receives from you to help it decide what to look at during an inspection.
Case Management
A way of bringing together services to meet all your different needs if you have an ongoing health condition, and helping you stay independent. If you choose this option, a single, named case manager (sometimes known as a ‘key worker’) will take the lead in coordinating all the care and support provided by different agencies, offer person-centred care and enable you to remain in your own home and out of hospital as much as possible.
Chargeable Services
Services that your local council may expect you to pay towards, such as day care or home care. The law says that the amount the council charges must be reasonable, and councils have to follow guidance from the Government, to make sure that you are not charged more than you can afford to pay. There are some services that the council is not allowed to charge you for, and these are called non-chargeable services.
Clinical Commissioning Group (CCG)
A group of GP practices in a particular area that work together to plan and design health services in that area. Each CCG is given a budget from NHS England to spend on a wide range of services that include hospital care, rehabilitation and community-based. Your local CCG should work with the council and local community groups to ensure that the needs of local people are being met.
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A - Z SOCIAL CARE JARGON BUSTER Cognitive Behavioural Therapy
Deprivation of Assets
Complex Needs
Deprivation of Liberty Safeguards
A type of therapy that can help you manage your problems by changing the way you think and act. It is often used to treat anxiety and depression and can help you think about how your thoughts, beliefs and attitudes may be affecting your feelings and behaviour. You may see a therapist face-to-face or take a therapy course online. You may have complex needs if you require a high level of support with many aspects of your daily life and rely on a range of health and social care services. This may be because of illness, disability or loss of sight or hearing - or a combination of these. Complex needs may be present from birth, or may develop following illness or injury or as people get older.
Court of Protection
An English court that makes decisions about the property, finances, health and welfare of people who lack mental capacity to make decisions for themselves. The court can appoint a ‘deputy’ to make ongoing decisions on behalf of someone who lacks capacity. It is also able to grant power of attorney.
Cross-border Placement
When your local council finds a place for you in a care home in another council area. This may be because you have requested it, in order to be nearer your family or friends, or because there is no suitable place available in a care home in your home area. You should be involved in any decision to move to a new area, and it cannot happen without your agreement. If you move, your council should let the other council know that you are there, and they should agree which council is responsible for your care.
Daily Living Costs
An amount you have to pay to cover things like rent, food and bills if you live in a care home. When the cap on care costs is introduced in April 2020, daily living costs will be excluded from your care account. When you reach the cap and the council is paying for your care and support, you will still be responsible for contributing to your daily living costs.
Day Services
Opportunities to do things during the day, while living in your own home. These may include social activities, education, or the opportunity to learn new skills. What your local council offers will vary, depending on what you need and what is available in your area. You may have to pay something towards the cost.
Delayed Discharge
When you are well enough to leave hospital after an illness or accident, but you have to stay there while the care you need in your own home or in another place is arranged. 17
When you deliberately reduce the amount of savings or property you have, in order to qualify for help from your council with paying for care costs or for various benefits. Your council may judge that you have deliberately reduced your assets if it believes that you knew you would probably need care and support. Legal protection for people in hospitals or care homes who are unable to make decisions about their own care and support, property or finances. People with mental health conditions, including dementia, may not be allowed to make decisions for themselves, if this is deemed to be in their best interests. The safeguards exist to make sure that people do not lose the right to make their own decisions for the wrong reasons.
Direct Payments
Money that is paid to you (or someone acting on your behalf ) on a regular basis by your local council so you can arrange your own support, instead of receiving social care services arranged by the council. Direct payments are available to people who have been assessed as being eligible for council-funded social care. They are not yet available for residential care. This is one type of personal budget.
Disabled Facilities Grant (DFG)
A grant you might be able to get from your local council in order to make changes to your home because you have a disability. Changes include things like widening doors, adding ramps or installing a downstairs bathroom. If the person with a disability is an adult, your household income and savings will be looked at, and you may need to pay towards the cost of the work. If the person is under 18, the family can get a grant without the parents’ income being taken into account. If you want to apply for a DFG, you should contact your local council
Discharge Planning
If you go into hospital, this is the process of planning when you will leave, where you will go, what you are likely to need once you are out of hospital, and how your needs will be met. You should expect discharge planning to begin as soon as you go into hospital. You should also expect to be part of these discussions and to know what is happening.
Disclosure & Barring Service (DBS)
A government organisation that checks people’s criminal records, in order to prevent unsuitable people from working with children or adults who may be at risk of harm or abuse.
A - Z SOCIAL CARE JARGON BUSTER Early Intervention
Action that is taken at an early stage to prevent problems worsening at a later stage. It may apply to children and young people, or to help that is offered to older people or people with disabilities to enable them to stay well and remain independent
Eligible Care and Support Needs
Financial Assessment
A discussion that your council may have with you to work out how much you can afford to pay towards the care and support you need. It involves looking at your income, savings and individual circumstances. This will take place after an assessment of your care and support needs.
The needs you have for care and support that your council is required by law to meet. Under the Care Act 2014, councils no longer decide for themselves what type of needs they will meet, and now have to follow the new national minimum eligibility threshold. You are likely to have ‘eligible needs’ if you need a lot of help to do things like washing yourself, getting dressed, getting in and out of bed, and keeping your home safe.
Gateway Worker
Extra-care Housing
Health and Wellbeing Board
Similar to sheltered housing, but with additional care and support available for people with illnesses or disabilities who wish to have a home of their own. Extra-care housing may be an option if living alone at home is difficult, but you do not wish to opt for residential care. It allows you to have your own home, either rented or bought, with personal care and domestic help readily available.
A mental health worker such as a nurse, social worker, occupational therapist or psychologist, who can help you with problems such as mild depression, anxiety or stress. Gateway workers work closely with GPs and can give you information and advice about support services in your area that may be helpful for you. You may see a gateway worker at your GP surgery or in your own home. Every council area in England has a Health and Wellbeing Board to bring together local GPs, councillors and managers from the NHS and the council. Their job is to plan how to improve people’s health and make health and social care services better in their area. Members of the public have the chance to be involved in the work of their local Health and Wellbeing Board through your local Healthwatch.
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A - Z SOCIAL CARE JARGON BUSTER Holistic Care
Care and support that treats you as a whole person and considers all your needs at the same time - physical, psychological, social and spiritual.
Impairment
A physical or mental problem, caused by an injury, illness or condition you were born with.
Inappropriate Care
Care that is not best for you and does not meet your particular needs, that is not in a place where you need or choose to be.
Integrated Care
Joined up, coordinated health and social care that is planned and organised around the needs and preferences of the individual, their carer and family. This may also involve integration with other services for example housing.
Intermediate Care
A wide range of services aimed at keeping you at home rather than in hospital, or helping you to come home early from hospital after illness or injury. It is normally made up of a specific programme of care for a fixed period of time, usually up to six weeks, and is free of charge.
Joint Assessment
There are two possible meanings to the term ‘joint assessment’: having the needs of the person who cares for you assessed at the same time as your own needs, or having an assessment carried out by more than one type of care professional at the same time.
Kinship Care
When family or friends care for a child on a full-time basis if their parents are unable to do so. This may be for a short period or permanently.
Learning Disability
A term that is used to describe a brain impairment that may make it difficult for someone to communicate, to understand new or complex information, or to learn new skills. The person may need help to manage everyday tasks or live independently. Learning disability starts in childhood and has a lasting effect on a person’s development. It can affect people mildly or severely.
Long-term Condition
An illness or health condition that you live with, that cannot be cured but can usually be managed with medicines or other treatments. Examples include asthma, diabetes, arthritis, epilepsy and other things.
Mental Capacity Act
A law that is designed to protect people who are unable to make decisions about their own care and support, property or finances, because of a mental health condition, learning disability, brain injury or illness. ‘Mental capacity’ is the ability to make decisions for yourself. The law says that people may lose the right to make decisions if this is in their best interests. Deprivation of Liberty Safeguards are included in the law, to make sure that people are treated fairly.
Motability
If you receive a mobility allowance from the Government, you can use the payments you receive to hire a car, scooter or powered wheelchair from a specially established charity, Motability. Your mobility allowance payments then go directly from the Government to Motability. The scheme includes the cost of insurance, breakdown assistance and repairs. You do not own the vehicle, and it is replaced every few years.
National Minimum Eligibility Threshold
The level at which your needs reach the point that your council, by law, has to meet them. From April 2015, every council in England will have to offer care and support services to adults who have a lot of care needs. This replaces the previous situation, where each council made its own decision about what level of need it would meet.
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A - Z SOCIAL CARE JARGON BUSTER Needs Assessment
The process of considering whether you need help or support because of your age, disability or illness. Anyone who appears to have a need for care or support - regardless of how severe those needs are or how much money they have - is entitled to a needs assessment, which can be arranged by contacting the adult social services department at your local council and requesting it.
Personal Care
Help with personal matters such as eating, drinking, washing, going to the toilet, getting up, getting dressed, going to bed, taking medicines and other things.
Personal Health Budget
When you are mistreated by not being given the care and support you need, if you are unable to care for yourself. It may include not being given enough food, or the right kind of food, being left without help to wash or change your clothes, or not being helped to see a doctor when you need to.
An amount of money to pay for your specific health needs, given to you - or managed for you - by the NHS. It is based on your own individual care plan, which sets out your health goals and how your budget will help you reach them. You can spend it on things like therapies, personal care and equipment. You cannot use it to pay for emergency care or care you usually get from a family doctor. Using a personal health budget is a choice: you do not have to have one unless you want to.
Non-chargeable Services
Primary Care
Neglect
Care and support services you receive in your home or in your community that the local council does not charge you for. The law prevents councils from charging for certain things, including assessments and advice about services. On other things (including day care, home care, domestic help and equipment and adaptations), each council makes its own decisions about which services it will charge for and how much the charge will be.
Occupational Therapist
A professional with specialist training in working with people with different types of disability or mental health needs. An OT can help you learn new skills or regain lost skills, and can arrange for aids and adaptations you need in your home. Occupational therapists are employed both by the NHS and by local councils.
Outreach
Support that you may be offered in your home or community, to help you with a particular condition or course of treatment or to help you take part in activities outside your home.
Palliative Care
Care that you receive if you have an advanced, progressive illness for which there is no cure. The aim is to manage pain and other symptoms and to help you have best quality of life you can. It may be provided in your home or in a hospital or hospice.
Personal Assistant
Someone you choose and employ to provide the support you need, in the way that suits you best. This may include cooking, cleaning, help with personal care such as washing and dressing, and other things such as getting out and about in your community. Your personal assistant can be paid through direct payments or a personal budget.
The first point of contact in the health service, usually your GP, practice nurse, local pharmacist, dentist or NHS walk-in centre. Primary care doctors deal with a wide range of health problems. They treat common illnesses, help you manage long-term conditions and refer you to a specialist doctor when necessary.
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A - Z SOCIAL CARE JARGON BUSTER Property Disregard
When your home does not have to be sold to pay for residential care. This applies if you are in a care home for a short time, and expect to go back to your own home. It also applies if you have moved permanently into a care home, and the house you own is lived in by your partner, a relative who is over 60, or a child under the age of 16 who you are responsible for. There is also a 12-week property disregard, when the council will not charge you - based on the value of your home - for the first 12 weeks that you are in a care home. You would still have to make a contribution to the cost of the care home based on your income or available capital.
Quality of Life
Your satisfaction with your life in terms of wellbeing and happiness. The way you define your own quality of life will depend on the things that matter most to you as an individual and make your life enjoyable and meaningful. The care and support you receive should make a positive difference to your quality of life.
Referral
A request for an assessment of a person’s needs, or for support from a social care organisation. A referral to adult social care may be made by your GP, another health professional or anyone else who supports you. You can also refer yourself, or a member of your family, by contacting the adult social care department at your local council.
Replacement Care
Care that replaces the care you normally receive from a regular carer, or would normally give to the person you care for. It may be needed either on a planned basis or in an emergency. Replacement care may be offered by your council, if the person needing care has had an assessment and is entitled to care and support services, or if the carer is entitled to help. Otherwise, you may have to pay for it.
Respite Care
A service giving carers a break, by providing short-term care for the person with care needs in their own home or in a residential setting. It can mean a few hours during the day or evening, ‘night sitting’, or a longerterm break. It can also benefit the person with care needs by giving them the chance to try new activities and meet new people.
Rights
What you are entitled to receive, and how you should be treated, as a citizen. If you have a disability or mental health problem, are an older person or act as a carer for someone else, you have the right to have your needs assessed by your local council. You have a right to a service or direct payment if your assessment puts you above the eligibility threshold your council is using. You and your carers have a right to be consulted about your assessment and about any changes in the services you receive.
Risk Assessment
An assessment of your health, safety, wellbeing and ability to manage your essential daily routines. You might also hear the term risk enablement, which means finding a way of managing any risks effectively so that you can still do the things you want to do.
Safeguarding
The process of ensuring that adults at risk are not being abused, neglected or exploited, and ensuring that people who are deemed ‘unsuitable’ do not work with them. If you believe that you or someone you know is being abused, you should let the adult social care department at your local council know. They should carry out an investigation and put a protection plan in place if abuse is happening. Councils have a duty to work with other organisations to protect adults from abuse and neglect. 21
A - Z SOCIAL CARE JARGON BUSTER Sensory Impairment
When one of your senses - sight, hearing, smell, touch, taste - does not work properly. It does not necessarily mean a total loss of one or more of your senses. You may be born with a sensory impairment, or develop it later in life.
Short Breaks
When a person with care and support needs spends regular short periods of time away from their main carer, in order to give the carer a break and to give the person with needs a chance to do something different. These breaks may take place in the person’s own home, in the home of an approved carer or in a place such as a hospice. Councils in England are required to provide short breaks services for children and young people with disabilities.
Signposting Pointing people in the direction of information that they should find useful. Your local council should signpost you towards information about social care and benefits through its helpline or call centre (if it has one), website and through local services such as libraries and health centres.
If you take it as a virtual budget, the council manages the money for you to arrange the services you choose, and you aren’t responsible for paying directly for the services you receive.
Vulnerable Adult
An adult who may need care and support because of their age, disability or illness, and may be unable to protect themselves from harm, neglect or abuse.
Wellbeing
Being in a position where you have good physical and mental health, control over your day-to-day life, good relationships, enough money, and the opportunity to take part in the activities that interest you.
Young Carer A young person aged 18 or under who looks after, or helps look after, a family member or friend who has an illness, disability or drug or alcohol problem. They may be responsible for cooking, cleaning, shopping, personal care or emotional support. Editorial courtesy of Think Local Act Personal www.thinklocalactpersonal.org.uk
Substance Misuse
Regularly consuming quantities of substances such as drugs or alcohol that affect your mental and physical health and your ability to do the things you need to do.
Third Party Top-up
If you are moving into a care home funded by the council, and you want to move into a home that costs more than the council believes is necessary to meet your needs, you will be able to move there if someone (a ‘third party’) agrees to pay the difference. The third party may be a relative, friend or charity, and they will need to have a contract with the council confirming the arrangement.
Transition
The process by which young people with health or social care needs move from children’s services to adult services. It should be carefully planned, so that there are no gaps in the care young people receive. Young people and their families should be fully involved in the planning process.
Universal Services
Services such as transport, leisure, health and education that should be available to everyone in a local area and are not dependent on assessment or eligibility.
Virtual Budget
When your council allocates an amount of money to you as a personal budget, you can take this either as cash through a direct payment or as a virtual budget (also known as a managed budget). 22
TAKING A BREAK FROM CARING If you provide care for a relative, friend or neighbour, there will be times when you need to take a break: to attend appointments or simply to take time out. Being a carer can be very demanding, taking up a lot of emotional and physical energy. Carers often feel worried or guilty about taking time off. But taking breaks from caring is very important, for both the carer and the person being cared for. It is important not to let your caring role take over your life. Ideally, you should find a balance between caring and looking after yourself, particularly if you have other commitments, such as your own home, family or a job. It is important to look after your own health too. You will be able to provide better care if you are not exhausted and run down. For your relative: respite care can also have positive benefits for the person being cared for. In some cases it can provide specialist medical care that you are unable to provide – for example, to help them recover from an operation or illness. Attending a day centre or going on a ‘respite holiday’ can be enjoyable, giving your relative the opportunity to meet new people and take part in different activities.
Planning ahead for respite care Remember that the need for respite care can occur suddenly, so there won’t always be lots of time to research and make decisions. So, it is worth checking what’s available in the area, before you need help. You might want to make a list of local agencies who can provide care at short notice or local care homes that offer respite care
Consider your relative’s interests: if you are trying to arrange day care or a short break for your relative, talk together about what they would enjoy. Try to match clubs to their hobbies and interests. Visit potential respite providers: before making any decisions, try to visit the day centres or care homes on your shortlist to get an idea of what they are like. If possible, take your relative with you and make sure they understand what is going on. If you are arranging emergency respite care, there may not always be time to visit. Check the room: if you are considering residential respite care, ask to take a look at the particular room your relative might stay in as well as any communal areas. Background checks: make a background check by checking the Care Quality Commission (or relevant regulatory body in your country) for information about the care provider Meet prospective carers: if possible, try to meet any carers that might provide care while you are away. Make sure that you and your relative are happy with them Respite care can have positive benefits for both you and your relative. But there are potential difficulties that need to be considered The benefits of respite care
Checklist for considerations when choosing respite care
A well-earned break for carers from the day-to-day responsibilities of caring.
If you are choosing respite care, there are some things you should do before making a decision on the provider.
Time for carers to focus on their children, jobs, home and personal health and wellbeing.
Ensure you make decisions jointly: any decisions about respite care should be made with your relative, wherever possible. Talk to them about their preferences and discuss the options. Explain why the respite care is needed and what is involved. Specific needs: make sure that any day centres or respite care can accommodate your relative’s needs. For example, if your relative is in a wheelchair, make sure that the chosen day centre is accessible. Or, if your relative has dementia, make sure that any staff employed to take care of them have the necessary experience and training to deal with this.
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A holiday or a trip to a relative’s house can provide a welcome change of scenery for your relative, particularly if they are stuck at home most of the time. Specialist care can be given to suit your relative’s needs. Help with funding is available in many cases. An opportunity to introduce alternative services or carers that may be needed in the future (for example, if the situation deteriorates or an emergency occurs).
TAKING A BREAK FROM CARING The drawbacks of respite care It can be difficult for carers to admit that they need or want time off. It might be difficult for some people, particularly those with dementia/Alzheimer’s to deal with changes to routine. In some cases, it might be easier for them to remain at home, with a substitute carer, than to move somewhere else. There may be additional respite care costs to consider that aren’t covered by local authority funding. Availability for respite care may be limited in some areas. There might be waiting lists for respite care. Care homes may not have space to accommodate short-term stays, particularly at short notice. Some benefits, such as carer’s allowance may be affected if you take breaks over a certain amount of time. The person being cared for may reject alternative forms of care. The person being cared for may become depressed or agitated if not being looked after by their usual carer.
When arranging residential or domiciliary respite care you should be given a contract stating the details of care and any other terms and conditions. This should include information about notice periods, cancellation clauses and (if applicable) bank holiday payments. It is important to read this carefully before signing. If you are not offered a written contract make sure you ask for one.
Financing respite care Local authorities will only pay for respite care for those that they have assessed as needing it. This can be determined by your relative having a needs assessment or you having a carer's assessment. Contact our Trafford Adult Social Care - Community Screening Team: 0161 912 5199 Email: IAT@trafford.gov.uk www.trafforddirectory.co.uk
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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.
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.
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.
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.
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• Turn up the lights or move to a well-lit area.
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.
CARING FOR SOMEONE WITH DEMENTIA 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.
Independent Life Solutions www.independentlifesolutions.co.uk
ILS can provide you with: • Advice & Support • Telecare Equipment • Installation • Assessment of daily living • Choice & Independence • Self Care • Medication Management • GPRS Locating Our aim is to provide you with the tools to help you maintain your independence whilst continuing to live at home.
There for you
365 days per year
For further information or to arrange a home visit please call 0161 748 1971 or email us at enquiries@indlife.co.uk
www.independentlifesolutions.co.uk 26
NHS CONTINUING HEALTCARE FUNDING Are you eligible for NHS continuing healthcare funding?
Funding varies by region, so you’ll need to check with your local Clinical Commissioning Group.
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
First of all, you’ll have an initial screening to see if you’re eligible for funding.
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. 27
It’s usually carried out in hospital or at home by a nurse, doctor, social worker or other healthcare professional. 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.
NHS CONTINUING HEALTCARE FUNDING What is a personal health budget? Personal health budgets are being introduced by the NHS to help people manage their care in a way that suits them. 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. 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. 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 for people with learning disabilities 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. 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.
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Imagine, Act and Succeed Listening with intent, acting with purpose
Imagine Act and Succeed (IAS) Imagine Act and Succeed (IAS) is a registered charity supporting people in Greater Manchester. We can support you on an individual basis in your life at home, in your family life, and in your community.
Support is available for: • Learning Disabilities • Autism • Physical Disabilities • Mental Health • Dementia • Elderly • Complex Health Needs • Extra Care We explore what we can do together to achieve better outcomes for people and that they are supported to be in control of their support and funding. We place a great focus on your health and well being and getting the support right for you. IAS has done a lot of work over the years to support people to live in the way they want to, in the right environment and with the right people. Whether this be living alone, being part of a small community sharing support with others also in their own places or sharing a house with others. Using a person centred approach, understanding and working in partnership with local authorities, and landlords means we can creatively find the right solution.
Statement of Purpose ...
People make things happen 29
We seek to develop a person centred organisation where everyone feels valued and sees that their contribution makes a difference. We aim to create an environment where everybody's energy and creativity is focused on getting better lives for people. We support people to live as valued and contributing members of their communities where they are part of a wide network of friends, neighbours and family. We do this through active listening, thoughtful practice, passionate commitment, and by working towards peoples dreams.
What's important to us ... People we support • Are encouraged and supported to dream. • Are given opportunities to demonstrate their capacity and resourcefulness. • Have a choice over where they live, who they live with and how they are supported. • Have the opportunity to direct how their service is delivered. • Have contributions to make to their communities. • Have opportunities to get to know and be known by as many people as possible. • Live as valued members of their communities, surrounded by a wide network of family, friends and neighbours.
Community • We strive to increase the community's ability to include everyone. • We create opportunities for people to get to know each other and develop friendships and relationships. • We promote equal and respectful relationships. • We highlight peoples gifts and qualities. • We counter discrimination through positive participation.
Dignity in Care IAS are proud to have achieved a Dignity in Care Award.
To achieve the award how IAS promoted and measured dignity across the organisation was examined and the support IAS provide at Fiona Gardens was observed. Fiona Gardens is an apartment complex with extra care where people’s health and wellbeing is a real priority, as is people having the right mix of independence and support. The complex has a sensory room, hairdressers, therapy room, lounges and a bistro amongst its facilities, making it a lovely community to live in.
Personal Health Budget Brokerage We can also support you as brokers to use your personal health budget As your broker IAS can provide you with information, give you advice that could be technical, practical and help you to manage your personal health budget. We can help you to develop a creative, innovative and person centered support plan with a focus on your health and well being, using your local community and building relationships and we will support you to meet your outcomes in a person centered way.
Community Support IAS also offers Community Support to people who live either with their family or in their own home and need some support to maintain their independence. This support can be for things such as health and wellbeing, shopping, finances or leisure interests.
IAS Community Support is ideal for those who would like one to one individual support and we can support you: • To be part of the community and build friendships and relationships • To seek employment or take part in further education • To attend medical appointments • To keep fit and healthy • With your personal care • With life skills For more information Please feel free to contact us about any of our services on
0161 748 2685
or you can visit us online at
www.imagineactandsucceed.co.uk Registered Charity Number: 1141823
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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.
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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. 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
IMPROVING SAFETY AND WELLBEING AT HOME • • • •
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 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. .
Safety in the bathroom 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.
Grants for bathroom adaptations 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.
Checklist to help prevent falls in the home 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
Getting dressed and undressed 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 32
CARE HOME OR HOME CARE? The most important decision to make when considering your care needs is whether you can remain in your own home or need to move into a care home. The decision will be based on what you want and what care you need, but you’ll also need to consider how much it will cost. 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 any minimum 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? 33
• 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
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 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. 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.
CARE HOME OR HOME CARE? • • • • • •
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. 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.
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.
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 34
RESIDENTIAL, NURSING HOMES & DOMICILIARY Residential Homes
Address
Area
Postcode
Telephone
Nursing Homes
Address
Area
Postcode
Telephone
Data Correct with CQC 35
Care at home
Address
Area
Postcode
Telephone
Data Correct with CQC
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