Who is eligible for home care services?

If you or a loved-one is struggling to cope with day-to-day tasks at home, such as washing, dressing, medication or getting around the house, support from a home care service can keep you at home living independently.

Home care, otherwise known as domiciliary care, home help or homecare, can be provided by CQC-registered care providers, self-employed people, or informally by family, friends and neighbours.

It covers a wide spectrum of support, from 15 or 30 minute visits through to 24/7 ‘Live-in Carers. Sometimes your local council will contribute to the cost, and we’ll discuss that later in this article.

Home care is unlike health care in the UK, in that it is not universally ‘free at the point of use’. Although there are national regulations around what councils need to provide to their residents, there is no central National Care Service, although that has been discussed previously.

When should I organise home care services?

Organising care at home might be beneficial if you or a loved one are:

  • Finding it difficult to move around your home on your own
  • Struggling with daily routines like washing and dressing
  • Not keeping up with medications due to memory issues, confusion or physical difficulties
  • Having difficulties with tasks around the home like cleaning, laundry, organising shopping, etc.
  • Wanting to stay in your own home, rather than move into a care home.

What can home care services help me with?

Home care providers can help with a wide variety of tasks, including:

  • Getting out of bed in the morning
  • Washing, bathing and dressing
  • Personal care such as toileting or helping with incontinence pads
  • Grooming, such as hair care, skin care, oral care etc.
  • Preparing meals and drinks
  • Ordering, collecting and administering prescribed medication
  • Doing your shopping
  • Getting out and about, such as to clubs, friends and appointments
  • Getting ready for bed

It’s worth mentioning that personal care and medication administration can only be done by home care services registered with the Care Quality Commission – the regulator for social care in England. You can find a list of registered providers on their website.

In contrast, what is often called ‘home help’ often covers domestic tasks that you might be needing help with, such as cleaning, laundry, gardening, shopping etc. Home help, because it’s less regulated and controlled, is often cheaper than regulated home care.

What Home Carers CAN’T help with

There are some tasks that home care services can’t provide to their clients without specialist training and expertise. These are generally invasive procedures and include:

  • Toe nail cutting
  • Ear syringing
  • Removing or replacing catheters
  • Bowel excavations
  • Bladder washouts
  • Lifting from the floor unaided

How to apply for home care services

Apply for home care services from the Council

If you want help from the Council regarding your home care services, you can apply for a needs assessment. Councils have a legal obligation to provide you with a needs assessment, even if you are not eligible for funding.

The Council will meet you to discuss:

  • What routines you can do yourself at home
  • What you can do with some help
  • What help you feel is needed
  • What help can be provided

If the council can help arrange and pay for your home care, they:

  • Discuss on the phone or meet with you
  • Agree a care and support plan with you
  • Work out how much the care and support will cost
  • Work out how much, if anything, you will pay towards it.

Who is eligible for home care services?

The Council will use the following criteria to assess if you are eligible for care:

You need to be an adult and have care and support needs as a result of a mental or physical condition, and due to this you can’t do at least two things on the following list:

  • Managing and maintaining nutrition (getting, cooking and eating food and drink)
  • Maintaining personal hygiene (keeping clean)
  • Being appropriately clothed
  • Being able to use your home safely
  • Maintaining a habitable (clean, safe and tidy) home environment
  • Developing and maintaining family or other personal relationships (meeting and keeping in touch with people who are important to you)
  • Accessing and engaging in working, training, education or volunteering (finding, getting and keeping a job or learning new skills)
  • Transport and recreational facilities or services (getting to places in your local area)
  • Carrying out any caring responsibility you have for a child and this has a big impact on your “wellbeing” (being comfortable, healthy and happy)

You will also be eligible if you are a carer and these needs arise as a result of providing necessary care for an adult and your physical or mental health is, or is at risk of, deteriorating and/or you are unable to achieve any of the following:

  • Carrying out any caring responsibilities you have for a child
  • Providing care to other people that you provide care for
  • Maintaining a habitable home environment in your own home
  • Managing and maintaining nutrition (getting, cooking and eating food and drink)
  • Developing and maintaining family or other personal relationships (meeting and keeping in touch with people who are important to you)
  • Making use of necessary facilities or services in the local community including recreational facilities or services (getting to the places you need to get to in your local area)
  • Engaging in recreational activities and this has a big impact on your “wellbeing” (being comfortable, healthy and happy).

Council Financial Assessment for home care services

Currently, if you have over £23,250 worth of money, property and investments, the council will still talk to you or meet you, agree a support plan and potential costs, but you will have to self-fund this support.

Savings in joint accounts will usually be treated as divided equally between the two of you.

If you are looking at a move into a care home, the Council will take into account the value of your property during the means test. If you are looking for home care services, they won’t.

Certain types of income, such as money from certain disability benefits, may not be counted in the means test. All other income can be taken into account.

It’s important to ensure you get all your entitlements and benefits, as the means test will assume you’re already claiming them, even if you’re not.

In review:

Capital over £23,250 – You must pay full fees

Between £14,250 and £23,250 – The council will fund some of your care and you’ll contribute to the rest

Less than £14,250 – This will be ignored and won’t be included in the means test.

If you’re not eligible for financial support for organising home care services:

It’s important to make sure you’re claiming all the benefits you’re entitled to. You can read our guides about the following non-means tested benefits here:

Self-Funding Your Home Care Service

So – you need care but aren’t eligible for support; what next? Apart from Continuing Healthcare Funding, which has high eligibility criteria for care needs, most people will need to pay for their own home care service.

There are two main ways of doing this: informal care, organised by employing your own care assistants and being responsible for pay, pensions, holiday etc, or a home care provider. Employing your own care assistants is a cheaper option, but more complicated and potentially risky. You can find out our pros and cons table of home care options here.

How to find a local home care service

  • CQC Website – you can search for home care services on their home page by choosing ‘services in your own home’ and entering your postcode. You can then see ratings and read inspection reports based around the CQC’s five Key Lines of Enquiries: is the service Safe, Effective, Well-led, Caring and Responsive.
  • Use ratings websites like homecare.co.uk – these show real-life user reviews with overall scores and can give you a good idea of the quality of the care provided.
  • Word-of-mouth – one of the most effective approaches is to talk to family and friends that have organised home care, and find out if they have feedback about particular companies.
  • Contact a few different companies – Once you’ve met a few companies you’ll be able to compare and contrast, and get a feel for which one will best suit your needs.

Most home care services will provide free initial assessments either at your home, or in hospital or a care home, depending on your current situation.

Questions to ask the home care agency

  • What is their capacity for taking on new clients? Some companies might be able to start at short notice, whereas some may have a waiting list or even not be taking on new clients at the moment.
  • What are the charges per care visit for different lengths of time? Often a 30-minute visit will cost more than just half the hourly rate, due to the fixed costs the company will have around travel time, mileage etc.
  • Are there any hidden costs? Some companies charge extra for mileage, or travel time, or there are extra costs at peak times.
  • How many people will be visiting each week? This will give you a good idea about the continuity of care – lots of different carers can be unsettling and less effective than a small team of dedicated carers.
  • What sort of training do the carers get? Do they use e-learning, or provide extra training above and beyond the minimum care certificate standards.
  • What is the notice period? Do you need to provide 4 weeks’ notice to end the package of care, or are they more flexible?
  • What is the out-of-hours support provision? It’s important to know how the service supports its’ carers and clients outside of the usual 9-5 office hours
  • Do I get a rota sent with a list of who is visiting me, and at what time? This is very helpful for being able to plan your week properly.

Complaining about Home Care Services

As with any service, you have a right to complain if you are not satisfied with the help at home you are getting. For example, you could complain if:

  • Carers consistently arrive at times different to scheduled times, or sometimes don’t arrive at all
  • Mistakes are made with your medication
  • Carers aren’t doing all the tasks you’d like them to do
  • You are getting poor care, such as not getting as much choice as you’d like.

The first place to complain to is the company directly. You can contact their Registered Manager (a manager personally registered with the Regulator and responsible for the care delivered) and they should be able to solve most issues.

If you are still not satisfied, you can complain to the local council if they are funding or organising your home care.

You can also give feedback to CQC and they will use this information to guide their inspections and monitoring activity, but don’t actively investigate each complaint.

Next steps for organising home care services

  1. If you think you might be eligible for care funding, contact your council for a needs assessment
  2. Start researching care providers in your area
  3. Meet your top two or three providers for more info and to get a feel for what they offer
  4. Choose the one you have most confidence in, and regularly review how it’s going (the company should also be regularly reviewing the situation).

If you want to find out more about the care services we offer at Good Oaks, get in touch with us today.

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