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Finding out what help someone
needs and who can provide it
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DISC Tel: 0845 120 4048 email: info@disc.org.uk |
This fact sheet offers information about why the person you care for might benefit from a community care assessment; how to obtain one; who undertakes the assessment; what it will contain and the grounds on which you may or may not receive a service. You may also find the following fact sheets helpful: ·
What is dementia? ·
Assessment and diagnosis ·
Treatment and therapy for people with dementia ·
Looking at your needs as a carer - having a
carer’s assessment ·
Making the decision about future plans for care ·
Getting help through financial benefits ·
How will the cost of a care home be paid for? ·
Visiting a care home Why ask for help? Caring for someone
with dementia is likely to affect every aspect of your life - your finances,
health and well-being, family life and any time you may have had to yourself. That is why it is so
important to find out what support is available – do not wait until you are
desperate before accessing help.
Someone with dementia will often have complex and varied needs. For example, as well as short-term memory
loss, they may be more prone to falls, have eating or swallowing
difficulties, continence problems, have mood swings or periods of extreme
confusion. As a carer you cannot be a
24 hour a day, 7 days a week, resource.
It is not unknown for the carer to become exhausted and ill as a
result of their caring role. It has
been shown that carers who access help and support suffer less with stress
and depression and may carry on caring for longer. Even though you may feel
able to provide care without any additional support at this time, it is worth
contemplating what would happen if a sudden emergency should arise, eg, you
were ill and could not look after the person you care for. Who would know about them, how could continuity
be maintained and what would you do? |
There are two good
reasons for planning help in advance:
·
Services
that exist to support people remaining in their own home for as long as
possible could be accessed more easily if someone is already known to them eg
respite care.
·
The
presence of a care plan will mean that the needs of the
person have been written down making caring easier.
What if I don’t want to go to social services?
There are services available
that you can access without having to contact your local authority (social
services). For example support groups,
lunch clubs, sitting services and day centres.
You can arrange
services directly yourself. Often there
is a charge for services, although some are free. This will depend on the area you live in. If you purchase the care yourself, make sure
you talk to the care agency about the help you feel is needed, the sort of
skill the person coming to provide care will need to have and how much the
service will cost. Make sure that the agency is a “registered care
provider”, this means that they have conformed to government legislation and
monitoring.
However, we would
advise that it is always worth talking to a care manager from social services
even if you don’t want to go through an assessment of need. The situation which exists now may not apply
in the future and you may require more help.
Going ahead with an assessment
If more structured help or “hands on care” is needed, you may want to
look at services provided by, or through, the local authority. In order to gain access to those services,
the cared for person should have a “formal assessment of need”, which is
undertaken by the local authority.
If the person you care for is assessed as needing certain services,
such as help getting up in the morning, then the local authority has the duty
to provide a service. The local authority has a duty to tell you that you have
a right to an assessment of your needs as a carer, and to consider your
assessed needs when providing services to the person you care for. You should be given a copy of the Government
Leaflet “How to get help in looking after someone: a carer’s guide to a carer’s
assessment”. Ask for a carer’s
assessment for yourself – this can be carried out at the same time as the
person you care for, or you can ask to have an assessment without the person
you care for being present.
These assessments are a right under section 47 of NHS and Community
Care Act, 1990 and the Carers Recognition and Services Act 1995 and are free.
Who do I contact to ask for an assessment?
Contact your local
authority that provides social services (sometimes called Health and Social
Care).
Tell them that you
want to make a referral. You will be
asked to give your name, address, telephone number, who you are phoning on
behalf of, their date of birth and the GP with whom they are registered.
If you do not want to make the contact yourself, then
anyone can make contact on your behalf, for example:
·
A
friend, relative or neighbour
·
Your
GP
·
A
local voluntary organisation such as the Alzheimer's Society
·
DISC
How long after asking for an assessment will one take place?
When you make contact ask
how quickly the assessment will take place.
This will depend entirely on how urgent the need is. The Local Authority social services will
prioritise.
There are no set
government timescales, but each social services department will say what they
expect their response time to be in a locally produced document called
"Better Care Higher Standards".
The department has to publish this document annually to say what
services they offer, how much they cost, and how long it will take before they
are available.
Assessments are
sometimes called by different names, for example Community Care Assessment or
Needs Assessment. There has recently
been a change which is designed to make assessment easier. This is called the Single Assessment
Process. The intention is that people
can be assessed for a range of health and social care services using just one
procedure. This may be just the initial
contact and assessment, or could be followed by more complex or detailed
assessments undertaken by other professionals eg physiotherapists and community
psychiatric nurses. This should mean
that information is shared, with your permission, by professionals involved and
an integrated care plan is produced giving a fuller picture of the person’s
needs.
This should be helpful
to people with dementia and their carers as they often have more complex needs
and a variety of support services are required.
Try to get a named
co-ordinator when the assessment is carried out as this means that one person
will have the overall responsibility for the process and you can contact
them. You have a right to a copy of any
assessment.
Who comes to carry out the
assessment?
Usually the assessment is carried out at the person’s home
by a designated officer - this may be a social worker, nurse or other
professional involved in the person’s care -they will contact all the people
who are already involved. You, as the
carer, and the person being assessed, should be encouraged to participate as
fully as possible in the assessment.
What will the assessment ask about?
The assessment is to find out how much help someone needs during the
day and/or night. If there is a typical
day for you and the person you care for, what would it be like? Try writing down what you have to do. What would the day and night be like for the
cared for person if they were on their own?
What do you do to help them?
What can they do for themselves?
The
following checklist may help in thinking about the amount of care and time that
someone needs:
·
Can
the person get out of bed without help?
Do you have to lift them at all?
·
Can
the person you care for, wash and dress themselves?
·
Can
they manage to get in and out of the shower or bath?
·
Can
they get drinks or meals for themselves?
·
Do they remember to eat and drink?
·
Are
they able to go to the toilet on their own?
·
Do
they need help going to bed?
·
What
happens if the person needs to get out of bed during the night?
·
Do
they need prompting with some or all of these tasks?
·
If
they take medicines can they manage to do this themselves?
·
Do
they need prompting?
·
Is
there a problem with continence?
·
What
is their mood like? Are they agitated, upset, angry?
·
Is
their behaviour difficult to cope with?
·
What
is their behaviour like? Does it change through the day / evening / night?
·
Is
the person safe to be left on their own?
Social Needs
·
Is
the person isolated living alone at home or alone for long periods? Would they
benefit from some form of stimulation during the day such as a day
centre?
·
Would
you benefit from a break if they attended a day centre?
·
Can the person communicate with other people or do
you have to be there to explain?
·
Does
the person's disability require any adaptations to the house?
·
Can
they manage the stairs? (You may have considered making changes, getting advice
on aids and adaptations from an Occupational Therapist could be helpful)
·
Are
they entitled to a Disabled Facilities Grant?
When the assessment is completed what happens next?
The assessor
completing your assessment will decide if the person you care for is eligible
for services, using a set Eligibility Criteria.
A local authority may
take into account their available resources when deciding how to respond to an
individual’s assessment. However once
the authority has indicated that a service should be provided it is under a
legal obligation to provide or arrange it.
It will not be possible for an authority to use budgeting difficulties
as a basis for refusing to provide services.
To help them decide
who gets a service local authorities have developed eligibility criteria. They are based on risk assessment principles
and have to be published by the local authority.
For example, the
eligibility criteria might show that people are categorised as follows:
High Priority – Someone is likely to suffer
serious physical harm within 72 hours if a service is not provided.
Medium / High – Someone is likely to suffer serious physical harm
within 28 days if the service is not provided.
Medium – Someone is likely to suffer measurable harm (which is not minor) within
3 months if the service is not provided.
Low
– Someone, although not at risk of physical harm, is likely to suffer serious
social isolation if a service is not provided. (In some areas people classified
as low priority may not receive a service).
What a care plan
should include
If the person is
eligible for services, the outcome of the assessment will be set down in
writing in an individual care plan. The
care plan should incorporate a range of services to make it easier for you to
continue caring. Your assessed needs as
a carer should be considered when providing services for the person you care
for.
What the care plan should say
·
What
services are going to be provided e.g. home care, day care, or respite care and
by whom
·
How
long they will be staying
·
How
much any service will cost
·
When
the plan will be reviewed
The local authority
must make it clear which services are for you and which are for the person you
are looking after. Services cannot be
withdrawn unless a re-assessment of their needs takes place.
Direct Payments
From April 2003 all
local authorities have to offer people receiving care at home money instead of
arranging services for them. This is
called a direct payment. The purpose is to give people more control, choice and
flexibility over the services they receive by purchasing the service themselves
with that money.
One essential
qualification is that the person receiving the service must be able to manage
the service themselves or with assistance from an advocate. This causes difficulties for people with
dementia. Discuss this option with the care manager or social worker. If an Enduring Power of Attorney (EPA) is
being considered and Direct Payment had been preferred in the past, this should
be specified when the EPA is being drawn up.
If you are using the
Direct Payment to employ home carers privately rather than through a care
agency, you may need to advertise a position, draw up a contract and arrange to
pay their tax and national insurance. It
can be complicated but if direct payments are offered in your area there should
be a direct payments officer who will be able to help and advise you. Your care manager will know about this
option.
Telephone: 020 7587 1663, text: 020 7587 1177 or visit the following
website: www.ncil.org.uk
for advice and information.
Who makes sure that the plan
happens?
The Care Manager.
How often will the plan be
reviewed?
A Care Plan should be subject
to regular review. You, or the person
being cared for, can ask for a review at any time.
This fact sheet can be made available in
large print.
We are constantly looking to improve our
information. It helps if you let us know
whether the information in this fact sheet was/was not useful and if there are
other fact sheets that you would have found helpful that we have not yet
provided.
While the information contained in this fact sheet is
believed to be correct, DISC does not accept liability for any error/s it may
contain.