faqs

Q: I am living in my own home, but think that I need a bit of extra help so I can cope. How do I arrange this and what do I need to think about?
A:

Assessing your needs
If you need some help in your home to enable you to remain there independently, you should first contact your local social services department to assess your needs. They will take your details and you may have to give them some brief details about your situation, so that they can decide whether they need to come and see you urgently. Social services will arrange for a social worker to visit you in your own home, and you will be asked questions about what sort of things you find difficult, and what you would like support with.

Providing you with support
When the social worker has visited you, they will provide you with a written statement of your needs. This will outline officially what your needs are, and will help social services provide you with support. It may be that your needs cannot be met by the council, either because they do not provide such services, or because you the support you need is not critical. If this is the case, they should provide you with details of other organisations you can approach who will be able to provide this care and support. You will probably have to pay for these services.

If your needs are high enough to be met by the council, the social worker will arrange for the services to be set in place. Social services usually provide home care services if you need help to get washed and dressed. In the past, they used to provide support with shopping and cleaning. However, this now depends on the local council's eligibility criteria as to what type of support they will now provide.

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Q: How are the services paid for?
A:

Council-provided services are not free of charge, and you will be expected to make a contribution towards the cost of any support you receive. In order to ensure that you are charged fairly, you will have a financial assessment from the social worker. Each local council has different charging patterns, but any money you pay towards services should be 'reasonable' and not put you in financial difficulty.

If you have concerns about what you are being charged for services, or are unsure about what services you might need please contact the Advice Service for information.

The above guides refer to England. Please click on the tabs below for information on assessment and services from your local council in [Scotland] or in [Wales].

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Q: My relative has been asked to pay a 'third party top-up' toward the cost of my care home fees. Is this correct?
A:

All council Social Services departments in England have a duty to allow an older person to choose which care home they would like to live in, provided this can meet their needs and provided they meet the appropriate standards of care set by the government.

If you prefer to move to a care home which is more expensive than the one that your local council Social Services has found for you, or which is more expensive than their standard rate, but which has a vacancy and can meet your individual assessed needs in full, you will be asked to find a third party top-up to pay the difference in cost. This means that a relative or friend will need to sign an agreement stating that they will pay the difference between what the care home charges and the council agree to pay. Local councils should not routinely ask for a top up towards the cost of care home fees.

Click on the tabs for information on third party top-ups in Scotland and how they are applied in Wales. Also, click on the following tabs for information on paying for a care home in Scotland and how it is arranged in Wales.

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Q: Can my relative be forced to go into a care home against their wishes?
A:

If your relative can make their own decisions
If your relative has the mental capacity to make decisions, they cannot be forced to go into a care home. However, if their needs mean that they need care in a care home, the council Social Services may ask them to sign a disclaimer to say that the risks involved in returning to their own home have been accepted. The council Social Services may agree to provide a package of care up to cost of the level of the care home fees they usually pay. If they do not agree to this, it should be made quite clear in writing why they were unable to provide these services.

If your relative cannot make their own decisions
If your relative has difficulties with mental capacity and is unable to make an informed choice about their living arrangements, the council Social Services could apply for a Guardianship Order in accordance with the Mental Health Act 1983. This would mean that the older person would need to remain in a place of safety, such as a suitable care home whilst the order was in place. The council Social Services would have to reapply for the Guardianship Order to be renewed after six months if it was assessed that your relative should stay there longer.

If your relative has dementia
If your relative has dementia and it is unclear how much they understand it may be difficult for the council Social Services and the relatives to come to the right decision about the older person's care needs. As with all Needs Assessments, it is particularly important to ensure that everyone involved in planning the care is consulted for their view or professional opinion. Regular reviews should take place so that the care can be adjusted and altered according to any changing needs. The older person could only be made to remain in a place of safety if the council Social Services were to take steps under the Mental Health Act 1983. This option should only be followed when all other possibilities to meet the care needs have been explored. Your relative may find that independent advocacy helps them to get their wishes and opinions heard. Some independence advocates are trained specifically to work with people who have dementia, who are often assumed not to be able to give their opinion about care. For more information, see our factsheet Independent Advocacy.
Download our factsheet:
Memory loss, 'confusion', depression and Dementia

For further information, please call Counsel and Care on 0845 300 7585 or email advice@counselandcare.org.uk.

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