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Last updated on 21/04/08
Return to the Fact Sheet Contents Page Information to assist those returning home after a stay in hospital, particularly those who may require long-term care perhaps relating to some form of temporary or permanent disability. WHILE IN HOSPITAL While in hospital, you will have a 'named nurse' who will be responsible for organising and planning your care and discharge home. This nurse, or the ward manager can give you information on the hospital's discharge procedure and what happens if you need care after leaving hospital. You should not be discharged until the appropriate support is in place. Your GP should be advised by the hospital of your admission and, on admission, the hospital should set in motion its plans for your discharge so that a confidential written plan can be provided. In addition to identifying your 'named nurse', this plan should give information on who to talk to about any aids, adaptations, etc., which will be needed on return home and on who to contact - for example GP, District Nurse, Social Worker, after returning home. If the hospital or Social Services think you would benefit, you may be offered rehabilitation before returning home. This might involve special exercises or practice in everyday tasks. Treatment or advice might be given by Physiotherapists, Occupational Therapists or Speech Therapists. You may even spend time at a Social Rehabilitation Unit. CARE ASSESSMENT and CARE PLAN You and, usually, your closest carers and family will be included in the review discussions so that your views can be made known. Such involvement should help you to understand and hopefully agree with the outcome of the assessment. If a care assessment identifies that you will require ongoing care and support, you will be provided with information to enable you to make important related decisions. Prior to discharge from hospital, you will be given details about the ongoing support, from Health and Social Services, that needs to be provided once you have left hospital. If you do not agree with the proposals for ongoing inpatient care, you can ask for it to be reviewed. There are established procedures for a review to be undertaken. A relative, friend or neighbour who will be providing you with a lot of care or support is also entitled to assessment of their needs as a carer. They do not have to live with you to get this. CONTINUING HEALTH CARE It is the hospital's responsibility, before you are discharged from hospital, to ensure that proper arrangements are in place for your return home and for any continuing health care which may be necessary. COMMUNITY CARE
Your needs in these respects will have been identified within the care plan, drawn up in accordance with the care assessment. RESIDENTIAL/NURSING CARE A nursing home is, basically, a residential care home which, additionally, provides care needing the constant involvement of or supervision by a qualified nurse. The person in charge has to be a registered nurse or doctor and the home must be registered with the District Health Authority. You may state your preference for a particular home, but it will not always be possible to meet your preference; your Social Worker may be able to identify another home that you will be happy with. If you are offered a place, you or your carer can ask to visit the home before making a decision. You will be charged for residential or nursing home care. The amount you have to pay will depend on how much money you have, which will include things like building society accounts, pension, premium bonds or savings certificates and maybe the value of your home. Generally, at the current time, if you have more than £22,250 worth of assets you will be expected to pay the full cost of care yourself. You can expect to pay between £342.87 to £490 per week in a residential home and over £420 in a nursing home (* For more information see end of Factsheet). In some cases, Social Services may help with your payments, up to their "contract fee" level. The costs of any nursing care you need in a nursing home will be paid for you. An assessment will be made of the level of care which you need and this will be used to determine that part of the costs which will be met by the NHS. Some of the arrangements for financial support for people in residential or nursing home care have changed with effect from 1st October 2007 New national guidance from the Department of Health provides, for people in care homes who require continuing health care, for the NHS to pay the full cost of nursing, care and accommodation, just as in hospital. For those who require some care from a registered nurse, the NHS will pay a flat weekly rate towards nursing costs. This payment is expected to be £101.00 per week and there are transitional arrangements in place to protect those who were benefiting from a higher rate under the old arrangements. In general, the arrangements for those who require only social care - means testing and level of capital assets - will continue. BENEFITS/FINANCIAL SUPPORT Carers Allowance It is not payable to someone in full-time education or who earns, currently, above £95 per week. Recent legislation enables carers aged over 65 to claim Carers Allowance for the first time. Most carers over 65 won't be able to receive it in full because it overlaps with the state retirement pension. Before claiming, you should be aware of how this benefit affects other benefits. It is fully taken into account as income for means-tested benefits and overlaps non-means-tested benefits. Carer Premium WARNING! Attendance Allowance Disability Living Allowance The two components of this benefit are care component, for help with personal care needs, and mobility component, for help with walking difficulties. DLA is for you, not for a carer or parent, and is payable to you whether or not you actually have someone helping you. What counts are the effects of your disability and the help you need. The care component is payable at three different levels and the mobility component at two. You could be paid either component on its own at the appropriate level or both components at the same time. The benefit can be paid indefinitely but your first claim must be made before your 65th birthday. After this birthday, you may claim Attendance Allowance. Travel to/from Hospital The travel expenses of an escort can also be met if you need to be accompanied for a medical reason. You should claim at the hospital - ask for the office which deals with claims. Disabled Facilities Grant The maximum mandatory grant, in England, is £25,000. Discretionary grants can be paid toward adaptations to make the property more suitable. The Independent Living Fund (ILF) The maximum weekly payment from the Independent Living Fund is normally £455. Direct Payments Scheme Managing Another Person's Affairs You must ensure that money is spent in the best interest of the person owning the money, and protect the person's other property. What is an appointee? What is a receiver? What is a Lasting Power of Attorney (LPA)?
Property and Affairs LPA Personal Welfare LPA Enduring Power of Attorney HOME CARE This kind of help can also be provided as a form of respite care, to allow your carer a well-earned break to help them then continue with their demanding role. Sometimes it might be better to decide exactly what is needed when you are back at home, rather than this being determined through the procedures of a care plan whilst you are in hospital. If you need equipment or adaptations to your home to help you manage, then an Occupational Therapist will be responsible for deciding what is needed. COMMUNITY ALARMS There are various means - telephone, pull-cord, alarm button, etc. - by which this can be achieved. These can activate a call to a carer, friend, neighbour, or relative, or to a response centre from where information will be passed to a voluntary helper nominated by you, or to a visiting warden, so that a quick response can be made to your call for help. There are various makes and types of alarm available and they can be obtained from numerous different sources. The choice needs to be made very carefully. Within the Doncaster Council area, a dispersed alarm system is available, through a Community Alarm Service Centre which operates round the clock every day of the year. You will need an existing telephone and an operator can be contacted by simply pressing a button on the telephone or on a pendant. If there is an emergency, a mobile warden will visit your home. There is a small weekly fee for this service. CARERS When you leave hospital, you may need help from a carer or carers. This may be the first time that you have needed such help or it may be continuing care. In any case, your carer should be informed when you will be leaving hospital in good time for preparations to be made for your return home. If your carer is in employment, there is now provision for time off work to be taken should an emergency arise which means that you need their help. There is sensible guidance as to what counts as an emergency and as to how much time off can be taken. Your carer's employer does not have any obligation to pay for the time taken off. Carers, themselves, may need outside help or advice and there are a number of organisations, both local and national, which can be contacted. It may be that a carer's needs can be best identified and appropriate help provided through a carer's assessment undertaken by the local Social Services Department. Some people spend so much time and energy in caring that they need regular breaks. Such needs can often be met by the provision of what is known as respite care whereby the carer is relieved of the responsibility of providing care, for a period varying between an hour or two, for a day, or even for a period of weeks. Access to this kind of care is possible through your GP, the Local Health Authority, Social Services, or Voluntary Organisations such as Age Concern. Or it can be provided on an informal basis by, say, another member of the family. Sitters, Minders and Care Attendants can come into your home for a few hours a day to give the regular carer the chance to get out. If your carer needs to go to work or have some time alone, etc., day care can be provided for you at a local day centre or hospital. For longer periods, say between a weekend and six weeks, it might be possible and helpful for you to go into short-term residential care. And this could be repeated on a regular basis. More information on this is given elsewhere in this Factsheet. SOME USEFUL CONTACTS
Benefits:
Carers:
Community Alarms:
Homes:
Hospitals:
BENEFIT RATES AS AT APRIL 2008
Carer Premium
Attendance Allowance
Disability Living Allowance
* FINANCIAL INFORMATION as at APRIL 2008 Residential/Nursing Care
Benefits/Financial Support
Independent Living Fund
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