One of the questions we are most frequently asked is, “we think that mum, or dad, needs care, but how do we go about arranging it, what steps do we need to take?”
There are a number of factors you need to address when considering care, from having the type and amount of care assessed, through financial means testing, identifying the appropriate location, or setting, i.e. home or care home, choosing the provider and then arranging for the care to be put in place. For details of the different types of care available, see our blog post, ‘YOUR CARE OPTIONS EXPLAINED’
As part of our series of blogs, helping people understand the complexities that are an inevitable part of making care arrangements today, we provide some guidance here on what are probably the most important steps you need to take. If you would like to have an informal, and confidential chat about your requirements, please either request a call back here, or telephone us on 0345 853 0300.
Care needs assessment
If you, or a loved one need social care, whether it’s home adaptations, home care or a care home, the first step is to arrange a care needs assessment. There is no charge for a care assessment and you’re entitled to one regardless of your income and savings, and regardless of what your needs are.
Your local council’s adult social services department will carry out the assessment, whether it is for you, a family member or friend. You can arrange an assessment for a relative or friend, but the person has to agree to have one, unless they don’t have the capacity to make or communicate that decision themselves.
What does the care needs assessment involve?
A social care professional will come to see the person requiring care to find out how they’re coping with everyday tasks, including:
- the emotional and social side of their life
- their skills and abilities
- their views, religious and cultural background and support network
- any physical difficulties they may experience, or any risks
- any health or housing requirements
- their needs and wishes
The assessor will also talk to the other professionals who are providing care, such as their GP or nurse. This is to make sure everyone agrees with the kind of support that is needed.
Your local council must do their utmost to help. They should consider what support is needed right now, and what might help in the future.
How can you prepare for the assessment?
Think about the kind of help that is needed. Be specific, for example:
- help with getting up and dressed in the mornings
- help to shower, or wash regularly
- to be reminded to take medication
- cultural, social, religious and emotional needs
If the assessment is for you, ask a friend or carer to be there for the assessment if you can. If it is a family member, or friend, attend the assessment yourself, or arrange for someone else to do so if you can’t.
Will they be eligible for help from social services?
Each local council will have their own assessment procedures, but they follow a national set of criteria to decide who is eligible for care and support. Questions they will have to consider in making their decision:
- Is the person being assessed unable to achieve two or more desired goals or outcomes as a result of their care and support needs?
- Is there, or is there likely to be, a significant impact on their wellbeing?
The desired goals and outcomes may include being able to:
- eat properly
- look after personal hygiene
- go to the toilet
- dress themselves
- be safe at home
- keep their home clean and safe
- see family and friends
- go to work, volunteering, education or training
- use services in their local area
‘Not being able to achieve’ an activity means that:
- they need help to do it
- when they try to do it themselves, it’s painful or makes them feel distressed or anxious
- it’s dangerous for them or others
- it takes them a much longer time than it should.
If they have eligible needs, their local council has a legal duty to meet them. As part of the assessment they should receive appropriate advice about how their needs should be met.
If you’re a carer, you are entitled to a carer’s assessment too. A carer’s assessment is the council’s way of working out whether you qualify for support from them in your role as an unpaid carer. The assessment is a chance for you to discuss how your caring responsibilities affect you. It will look at:
- whether you’re willing and able to carry on providing care
- whether your caring responsibilities have any impact on your wellbeing
- whether you need any support
- what you’d like to achieve in your day-to-day life. For example, you might want more time to take part in activities you enjoy
- whether you qualify for any help from the council
If you’re looking at arranging help at home, home adaptations or residential care, such as a nursing home or care home, then you may have questions about how to pay for it.
After the assessment, a care plan should be agreed with you and a copy given to you. This will detail the care needs and what could help to meet those needs. Then, as care arranged by your local council isn’t usually free, there will be a means test the local council will ask about the finances and income of the person requiring care, to work out how much may need to be contributed towards the cost of the care.
What does the means test involve?
The local council looks at income, savings and property to calculate how much the person requiring care will need to contribute towards the cost of their care and support.
If the care is needed to enable the person to stay in their own home, the means test won’t include the value of their property.
If they need to move permanently into a care home, the test will usually include the value of their property.
Current financial support thresholds
Payment of home care and care home fees, the upper savings threshold in England and Northern Ireland (above which the person has to pay all their costs) is £23,250.
The lower savings threshold in England and Northern Ireland (below which a person’s savings are no longer taken into account, (although all other income including benefits and pensions is still counted) is £14,250.
How will income be treated in the means test?
Certain types of income, such as money from certain disability benefits and pensions, may not be counted in the means test. All other income can be taken into account. In some cases, the local council may also assume that your capital generates an income, which will also be taken into account. If they and someone else jointly hold capital, such as a savings account, it’ll be treated as divided equally between the two of them.
Benefits and entitlements
Make sure that all of the benefits and entitlements that the person qualifies for are being claimed. That’s because the means test will assume the person is receiving all the benefits they are entitled to, even if they aren’t already claiming them.
Will the person receiving care have to sell their home to pay for the care?
Their property will be included in the means test at its present market value, but less any mortgage or loan they may have on it and less 10% of its value where there would be expenses to sell it.
In some situations, their home won’t be taken into account in the means test. There are a few circumstances where this applies:
- If they need temporary or short-term care only, their home won’t be included in the means test.
Their home also won’t be counted if it’s still occupied by:
- their partner or former partner, unless they are estranged
- their estranged or divorced partner if they are also a lone parent
- a relative who is aged 60 or over
- a child of theirs aged under 18
- a relative who is disabled
In the means test the local council must take into account joint owners who own different amounts of the property. They shouldn’t assume that joint owners have equal shares, although you may have to provide evidence to prove this.
Giving their home away
Some people consider giving their property to someone else, such as a child or relative, so that it won’t be counted in the means test. However, this may count as deliberate deprivation of assets, meaning they’d still have to pay the same level of care fees as if they still owned their home. It’s important to take appropriate advice about how deprivation of assets would apply if this is something they are thinking about.
There is a system where people don’t have to sell their homes immediately to pay for their care. This is called the deferred payment system. This is where they can delay paying the costs of their care until a later date.
This could last until they die, after which the costs will be paid from their estate, or could be a temporary arrangement to give them time to sell their home when they choose to do so. The local council must offer them this option if they are eligible.
If there is an identified need to have care and support after the care needs assessment, a care plan will be prepared, setting out the help you can expect.
The care plan should cover:
- outcomes the person wishes for, or needs to achieve
- what the assessed needs are
- which needs the local council will meet and how they will meet them
- information and advice on how to prevent, reduce or delay future needs for social care
- the personal budget figure – the amount of money to arrange the care and support needed
- details of any direct payment that is agreed
What support can be included in the care plan?
Each care plan is personalised, and what is in it will depend on the person’s needs. The support could include:
- adaptations or equipment to make their home safer and easier to live in
- help from home carers or a personal assistant
- a personal alarm to call for help
- help to regain your independence and confidence after an illness or injury
- an opportunity to meet people and socialise, such as at a day centre
- a permanent place in a care home
How often is the care plan reviewed?
If the local council has arranged support, they must review it within a reasonable time frame (usually within three months). After this, the care plan should be reviewed at least once a year or more often if needed.
What if I’m not happy with the care plan?
You should be involved in putting together the care plan, so it’s important that you raise any concerns at this time in order to reach an agreement with your local council. If at any time you feel your care plan doesn’t support your needs, contact the adult social services department of your council to ask for a review.
However, if you have any problems or questions, you should also be given a named person you can contact to help resolve any issues. If you’re still unhappy, you can make a complaint to your local council.
Finding the right care
Once you have prepared all the groundwork, with the care needs assessment, means test and care plan in place, the next step is to research and choose a suitable care provider, who can meet the care needs which have now been identified.
The process we have outlined above assumes that you have the benefit of sufficient notice of the need for care to be able to have all your arrangements in place. In many cases this is possible, however, as you will see from our blog ‘WHEN IS THE RIGHT TIME TO MOVE INTO A CARE HOME?’ it could just as easily be an urgent, or emergency situation.
Whatever the situation you are faced with, Care Home Finder is here to help. Please request a call back here, or call us on 0345 853 0300 for an informal and confidential chat, without obligation.
Care Home Finder offers a Care Review Service to ensure that the right care solution is in place for people already receiving care, whether at home, or in a care home. In some instances, the need for this can arise where a family are becoming concerned about the care their relative is receiving.
The Care Review Service is also of benefit to professional advisors, such as solicitors or attorneys, who have already arranged a package of care for a client and have a responsibility to ensure that the individual for whom they have made arrangements is receiving the right care provision.
For more information on how our Care Review Service can help you, please request a call back here, or call us on 0345 853 0300.