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19 Community care

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1. Introduction

2. Where do I start if I think I need help?

3. What kind of help is there?

4. Can I get help if I look after someone?

5. Who pays if I get care in my home?

If you are eligible for NHS continuing healthcare at home, the NHS pays for your care. If you are not eligible, you may have to pay for that part of your care provided or arranged by social services.

Councils can charge for services they provide. But in some cases they should pay for some or all of the costs of care in your home:

If you suffer from CJD (Creuzfeldt Jacob Disease), you shouldn’t pay anything.

If you have been kept in hospital because of a mental illness or disorder and you need care when you come out ('aftercare'), you may not have to pay for that care.

Any help you get as part of ‘intermediate care’ should be free.

Otherwise, you may have to contribute. However, you may be able to get financial assistance from the council, depending on your savings and income.

Councils must not take account of your financial circumstances when deciding what you will get, only when deciding what they will charge you for it. And your friends or family cannot be made to pay for your care – only the person getting the care can be charged.

Can I get any benefits to help pay for care?
You may be entitled to certain benefits related to your need for care, such as Attendance Allowance and Disability Living Allowance, or Carer’s Allowance if you are caring for someone. Your social worker may be able to help you with information on benefits, and you can ask your local Age Concern office or Citizens Advice Bureau to do a benefits check for you.

You can also get information about claiming benefits from:

  • your local social security office, Jobcentre or, if you are a pensioner, the Pensions Service;
  • the Department for Work and Pensions website (www.dwp.gov.uk);
  • the Gurkha Free Legal Advice leaflet, ‘Welfare Benefits’.

How much will I have to pay?
When working out how much to charge you for care at home, councils should take into account:

  • how much the service costs; and
  • how much you could reasonably be expected to pay. To work this out, they are allowed to ask you how much income you get and what savings you have.

They should also follow government guidelines on charging. These aim to ensure that councils are consistent and fair and do not leave people struggling to pay. If you feel you cannot pay, you can ask social services to review the charge. You should always do this if you think they haven’t taken into account any extra things you have to pay for because of a disability or other problem.

The council can’t stop your services if you don’t pay, but it can try to get you to pay what you owe.

Is there a limit on what the council will pay?
The council is entitled to provide care as cost-effectively as possible. So, for example, the council may want to move you into a care home because it believes this would better meet your needs and because it would cost much less than giving you the care you need in your own home. You would have the right to say you didn’t want to move into a care home. But if you chose to stay in your own home, you might not get all the help you needed.

For example, the council might have to pay £500 a week towards the cost of a place in a care home, and might believe that the care home would better meet your needs, but you would prefer to stay at home. The council might argue that it should give you care at home worth only £500, even if that wouldn’t be enough for your needs. In this situation the council would have to consider all your needs, including your psychological needs and your human rights, before it decided that it would not fund a full care package at home.

If you are unhappy with what the council has decided for you, you may be able to challenge its decision.

What are direct payments and how can I use them?
The council can provide the services in your care plan itself (or with, for example, voluntary organisations) but it must also offer you the option of ‘direct payments’ to buy your own care (if you meet certain conditions). If you are a carer, you may also be able to get direct payments.

Direct payments may give you more choice about who cares for you and how. You can use the funds to pay for almost any care you need. For example, if you can’t do your shopping alone, you could use a direct payment to help you do it yourself – for example, by paying for a taxi or a home delivery – or to pay someone to do it for you. Or you could pay for some care while your carer has a break.

You can’t normally use direct payments to pay for care provided for you by your husband, wife, civil partner or other partner, or a close relative who lives with you. And you can’t use direct payments to pay for a permanent place in a care home or to buy care from the council.

If you use direct payments, it may mean you have to become an employer. This involves having to sort out contracts and deduct tax and national insurance from the money you pay people. Your council should give you advice and help to deal with these things. The Department of Health also produces a guide to direct payments (see ‘Further help’).

You can decide at any time that you don’t want to get direct payments any more, and would rather have services arranged for you.

The council can stop direct payments if it thinks that:

  • your needs are no longer being met;
  • you can’t manage your payments; or
  • you aren’t spending the money properly.

However, it should warn you and give you the chance to discuss the matter and put right any problems you are having before this happens.

6. What if I have to go into hospital?

7. What if I need to move into a care home?

8. What if I need ongoing nursing care?

9. Will I have to sell my home?

10. Can I claim any benefits if I am in residential care?

11. What choice of care home do I have?

12. What if I want to move to a care home that costs more than the council will pay?

13. What if my move into a care home is temporary?

14. What rights do I have when I am in a care home?

15. What if I have difficulty getting the care I need?

16. Further help

17. About this leaflet

This leaflet is published by the Gurkha Free Legal Advice (LSC). It was written in association with Sue Bloomfield, a freelance consumer affairs writer.

Leaflet Version: May 2008