Social care - Getting the Support you need at home

elderly man greeting a social care worker at his doorAs we get older more and more of us need support to go about our daily lives – not just so we can stay in our homes for longer, but also so we can take part in our communities and live our lives to the full.

If you have a disability, you may need support with your day to day routine at home, and Local Authorities have a major part to play in providing it.

You have a right to get the support you need but some Local Authorities are not as geared up to provide it as others. They are working hard at getting it right but it may take time for you to get what you need.

It can be frustrating but don’t give up. Your local authority, local disability organisations, the Thalidomide Trust and other agencies can all help you get the right support for you.

Read our advice below to find out how to get the support you need – it’s definitely worth fighting for!

Explaining social Care, how to apply for it and how it is funded

What is Social Care?

If you’re finding it difficult to look after yourself, and have specific care and support needs, you may qualify for your care to be organised by your local authority. Local authorities generally refer to it as Social Care.

What kind of social care is available?

The kind of social care support you can get depends on your needs - the type of condition you have, or the severity of your disability. For example, if you have trouble walking, you may simply need some equipment to help you stay mobile and independent; but if your condition seriously affects your mental capacity, or your ability to move and look after yourself, you are likely to need a much wider range of social care services.

It’s worth taking time to think about your specific needs and what you think will help you achieve the best quality of life you can.

Care and support services can include:
  • equipment
  • help in your home
  • community support and activities
  • day centres
  • home adaptations
  • residential care
  • financial support
  • information and advisory services, and advocacy
  • support for carers
  • other care support

How do I access social care?

Social care is accessed through your local authority. They have a legal obligation set out in The Care Act (2014) to provide you with an assessment of your care needs and a support plan. They can also organise your care for you, if you want them to.
If you feel you have a need for social care ask your local authority for a Care and Support Needs Assessment. Just contact your local authority Adult Social Care department to apply.

Anyone who needs care or support can have a needs Assessment, regardless of how much help they need, or their financial situation. Even if someone close to you, like a family member, or your partner, is providing all the care you need, you’re still entitled to an assessment.

Find your local authority

What is a "Care and Support Needs assessment"?

The assessment involves someone from your local authority adult social care team visiting you at home to review your needs against the National Eligibility Criteria. These consist of ‘Care Outcomes’ and ‘Well-being Principles’, explained below.
Your assessor will look at whether you’re able to meet, and continue meeting, your day to day care needs yourself to a particular level.

These are the Care Outcomes and the areas covered are:-

  • Managing and maintaining nutrition
  • Maintaining personal hygiene – for example, being able to wash yourself
  • Managing toilet needs
  • Being appropriately clothed - for example, being able to get dressed
  • The ability to make use of your home safely
  • Being able to keep your home in a habitable state
  • Developing and maintaining family or other personal relationships
  • Accessing and engaging in work, training, education or volunteering
  • Making use of necessary facilities or services in your local community such as public transport and libraries
  • Being able to care for any dependent children

If you’re finding it difficult to achieve two or more of these areas – for example you need help, or when you try to do it yourself it causes you pain or distress - you may be eligible for social care. This is not a judgement - it is intended to get you the support you need.

The assessment will then look at whether your difficulties have an impact on your wellbeing.

Wellbeing Principles:-

  • Dignity
  • Physical and mental health and emotional well-being
  • Protection from abuse
  • Control over your daily life
  • Ability to participate in work, training and education
  • Your own social and economic well-being, and that of your family or household
  • Contribution to society

If you are unable to meet 2 or more care needs to an acceptable standard AND your well-being is significantly affected in AT LEAST four well-being areas, you will be eligible for local authority care.

If you’re not sure how you measure up against all these factors, our Health and Well-being Co-ordinator (Social care) will run through the care outcomes and well-being principles with you to see whether it’s likely. Contact the Trust to arrange a session. If you meet the National Eligibility Criteria your local authority will have to provide the support services you need, whether you are funding them yourself or not.

If you are paying for the services yourself you should still be given information about what’s available and be signposted to sources of support and funding.

How is a Social Care Assessment carried out?

A Social Care Assessor will visit you at home to carry out the assessment. The questions you are asked may vary a bit, depending on where you live, as each local authority has a different approach.

You can have someone else with you to support you during the assessment, and your assessor will make sure they get to the heart of what your needs are and how they impact on your wellbeing.

The assessor should involve you all the way through the assessment and take the right amount of time to capture all your needs – so don’t be shy about speaking up, or giving more information.

The assessment starts the process of finding simple solutions to your care needs, like aids (say, devices to open jars and tins more easily), adaptations (things like handrails) or community support (like help with shopping, or lifts to appointments). It will also look at whether your needs are a bit more complex - which may mean getting someone in to help you at home.

If you have a friend or family member looking after you as an unpaid carer, they can have a carer’s assessment to see if they need support to carry on their caring role.

What Happens After the Assessment?

Your assessor will give you and the council a report saying whether you qualify for support and, if you do, how many care hours you’ll need per week to give you the help you need in the different areas. This will be written up in the form of a support plan.

Your local authority must give you a copy of your needs assessment/support plan or the relevant carer’s assessment.

You will also be provided with a Personal Budget by your local authority.

If you’re paying for your care yourself, you will still have a support plan, an assessment and information and advice to help you plan your own care.

What is a Personal Budget?

This is a sum of money which either wholly or partly covers your care and is worked out according to the authority’s view of what your care needs are and how they can be met.

How do Personal Budgets work?

Your personal budget is a statement of the cost of meeting the needs identified in your support or care plan.

You may have to meet these costs yourself if your income or savings are too high to make you eligible for local authority funding.

Even if you have to pay for your care yourself you will still be able to get the council to arrange your care through their approved providers - at a rate that will be cheaper than if you sourced your own care. This is known as Support Brokerage and most local authorities have brokerage teams to help you choose care. They’ll also assist you with recruiting and employing someone to look after you if you are self-funding. They sometimes charge a small fee for this service.

Read more about Support Brokers on the Disability Rights website.

If you are paying for your own care you are still entitled to an annual, local authority review of your care, or to call for a review if your needs change, giving you the peace of mind of having an experienced third party overseeing your care.

How you spend your personal budget is up to you. You can choose from commissioned care or a direct payment. 

What is Commissioned Care?

Commissioned care is care organised by the local authority through their approved local providers, at a pre-negotiated contract rate – which can save you money.

You can choose this option whether you’re funding your care yourself, or whether you’re a personal budget holder.
A bonus of having your care arranged for you is that your local authority has to make sure you get the right care and will review and monitor how well it is provided. They can hold care providers to account and have to arrange alternative support if there are any problems, like your carer not turning up.

What are Direct Payments?

Direct payment is when your Personal Budget is paid to you direct, and you arrange your own care.

You will have to account for the money and you will become your carer’s employer – with all the responsibilities that brings – but there is a lot of help available to support you. There are organisations that can help with recruitment, payroll and calculating employee national insurance contributions and holiday pay, for a small fee.

Direct payment rates are usually the same as the local authority hourly rate for commissioned care with an additional employee allowance. This means that they don’t always cover the hours of care that your assessment and support plan have stipulated in your budget – This means you may have to “top-up” the amount you pay for your care but you can use your Health Grant to do this.

What are the benefits of Direct Payments?

Many beneficiaries using Direct Payments have found that they give them greater flexibility and more control over their own lives, and therefore more independence.

Some of the good things people using Direct Payments say about them are:

  • you can choose who works for you, or what piece of equipment best meets your needs
  • they allow you to arrange care that really meets your needs
  • you can arrange for your carer to come in at times that suit you and your family and work in ways that work for you
  • it is easier to make changes as and when you need to
  • the same person can work with both you and your informal carers/family under your direction
  • there is less chopping and changing, avoiding different people coming at different times as sometimes happens with directly provided services
  • you can build up a small team of regular helpers who come at different times but who may also double up or temporarily increase their hours when more help is needed
  • if you’re not happy about something that the person helping you is doing you can sort it out directly with them rather than having to go through an agency
  • you can employ people with the right skills for the job you need doing – like someone sensitive for personal care, someone who can drive you places, someone who can help with overnight trips away or prepare your food for example
  • Direct Payments empower you – they put you in charge of your own lives.

In SOME local authorities you can employ live-in family carers. We can help you find out if this is available in your area, but you’ll need to be confident that this arrangement meets your needs.

How will my care be monitored?

Your care will be reviewed within the first three months, and then annually. If you or your local authority have any concerns you can call for a review earlier, to see if anything has changed. The review is like a mini assessment to see if any of your needs have changed. If there is a major change in your care needs, or one is expected, you can call for a complete reassessment. This should iron out any problems with your care package and, in some cases, could lead to an increase or decrease in your care hours.

Additional Information

If you want to know more about getting the right support at home you may find these links helpful:-

Description of the principles of well-being

Care Outcomes

Age UK - How to get care and support

Age UK - How to arrange care

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