Frequently asked questions
I have several disabilities and am struggling to cope – what can I do?
Your Local Authority has a duty to assess your needs for community care wherever it appears that you may have such a need. You do not have to show you have a need, just that you may have a need. Once you have been assessed, the Council then has to make a decision on whether to provide care services. These services can be anything from providing equipment, making adaptations to your home and / or providing you with care. The Council’s decision depends on whether it feels that you meet the criteria under the Fairer Access to Care Criteria. Councils apply the criteria differently and often the way you are measured will depend on the quality of the assessment that has been done. This means that decisions can often be challenged.
I have been told I have to sell my home if I go into care. Is this right?
This is an extremely complicated area. Some people will have to pay for their own care in full. However, many others will not for a variety of reasons. Even when a person owns a property there are a number of exemptions which means that the property’s value may be disregarded in assessing a person’s means to pay for their care. Even where these exemptions do not apply there are other options for funding care. These include schemes such as Deferred Payment Agreements and the NHS Continuing Care fund. The rules are complex and sound advice is essential. Advice on the rules depends very much on the individual situation.
My disabled son gets lots of help at school and social services have been wonderful in supporting us. However, he is now 17 and I have been told that he will not receive all the help and support he gets now, when he becomes an adult. Why is this?
This is a perennial problem. Local Authorities generally split the administration of their social services functions into different departments and teams. The budgets are also split along the same lines. Your son will be currently under Children’s or Younger Person’s services. Generally, because of government policy, Children’s services are relatively well-resourced. The demands on Adult Services are usually much wider and greater, and as a consequence we often find that service provision when a child is much better than as an adult. Basically, the Council squeezes more out of its adult budget than it has to for children. However, this should not really happen. The duty to assess, plan and provide Community Care Services is placed on the Local Authority as a whole (and not simply on one department or another). Similarly, the legal duty to meet eligible needs is just as strong for an adult as a child. There are also duties which have to be met in terms of planning the transition from child to adult. Unfortunately, such duties to plan are often incomplete, are rushed through, or sometimes do not exist at all. Advice on all these aspects is vital. Early intervention can often secure smooth transition.
I have been told about a scheme where I can be paid for looking after my mother, who is disabled and elderly. I have done this for years and because I also have a job, I am finding the role increasingly difficult. When I asked about the scheme at the Town Hall, they said I couldn’t do it because I am related.
The scheme you are talking about is the Direct Payments Scheme. It is a scheme whereby community care services which would traditionally be provided by the Council’s own carers or by an agency contracted by the Council can be provided by carers of the service user’s own choice. Your mother would be assessed in the normal way and an offer of a regular weekly or monthly amount of care hours would be recommended to meet her needs. A sum of money to cover the hours would then be decided and paid to mum to choose her carer or carers (she could choose several). A common misconception is that close relatives cannot be paid a direct payment to provide the assessed care. Council staff themselves often get this wrong. There are exceptions to the Direct Payment rules. Normally a close relative living in the same household cannot be paid a direct payment. But even this rule has exceptions. When it can be shown that the only satisfactory way to meet community care needs would be for the care to be provided by a close relative living in the same household, then it should be allowed. It is not difficult to see that many people could show that having a carer who is closely related and knows them well, and is on hand at all times is a satisfactory way to provide care. If the service user also has emotional and psychological needs in this aspect (an aspect of need often ignored by assessors) then a case can be made. In any event, the use of direct payments has advantages and disadvantages depending on individual circumstances. A service user in essence becomes an employer when paying direct payments, and is responsible for such things as insurance, tax and national insurance. However, the Council should have teams dedicated to assist in this. The advantages of choice are clear. However, the person receiving the direct payment (the carer) will also have to consider the effect of the payment on their own circumstances (for example if they themselves claim means-tested benefits). Detailed advice is essential.
My father is in a nursing home and has to pay for his care. I have sold his house and am his appointee for his pensions etc. It is costing thousands each month to pay the care home. Surely with someone so ill he should not be paying for his care?
The difference between those people requiring residential care services and those requiring nursing care services can be wide. It is very confusing as some residential homes call themselves nursing homes and vice versa. It is also confusing because some residential homes have areas or units which provide nursing care. Essentially, if a person is in need of nursing care then it is worth considering whether the NHS should be paying for the care. This would be under the NHS Continuing Care funding scheme. The rules have always been that where the care provided is essentially and predominantly nursing care, it should be free at the point of use. Many legal challenges have been brought over the years to establish that this principle applies. This has led government to introduce a National Framework to assess for continuing care funding. Basically, a person is assessed in eleven differing areas of need including all aspects of mobility, behaviour, cognition, treatment, therapy, nutrition, continence, emotional need, etc. A level of need in each area is assessed and then a decision made based upon that level. You do not need to score highly in every area and indeed some people are eligible simply because they have a priority need in just one area or severe needs in just a couple of areas. The rules are complicated and – as with all such decisions – the accuracy and scope of the assessment is vital to making the right decision. Many decisions and assessments have been successfully challenged.
