hospital care in england: what you need to know · 2018-10-04 · hospital care in england - what...

Factsheet

Hospital care in England: whatyou need to know

This factsheet covers three areas:

1. what you need to think about before you go into hospital

2. what happens during your hospital stay

3. what should happen after your discharge from hospital.

Last reviewed: April 2015Next review date: April 2016

Independent Age provides advice to help people claimbenefits, access social care and stay independent at home.Our local volunteers provide friendship visits and calls forlonely older people. To find out how Independent Age can helpyou, call us FREE on 0800 319 6789 or visit . Our free wiseguides and factsheets can be download from the website andordered by phone or via our online order form.

Hospital care in England - what you need to know - April 2015 2

ContentsIf you live in Scotland, Wales or Northern Ireland Page 3

Section one: Preparing for a hospital stay

Planned admissions Page 4

Emergency admissions Page 5

Concerns about the treatment you may receive Page 6

Managing your finances Page 6

Section two: during your stay

Benefits – what happens if you are in hospital? Page 8

Your legal rights in hospital Page 13

Food, hospital facilities, visitng hours, infections Page 13

Assessments in hospital Page 16

If you qualify for support Page 18

Section three: leaving hospital

Things to check when leaving hospital 5

Discharge from hospital – how it should work Page 26

Going back home - what help is available? Page 30

Moving to another home Page 36

Making a complaint about hospitals Page 41

Useful contacts Page 42


If you live in Scotland, Wales or NorthernIreland

The Care Act which took effect in England from April 2015does not apply to the other UK countries – the health andsocial care system works differently in different parts of theUK.

Some of the details provided in this factsheet may notapply if you live in Scotland, Wales or Northern Ireland (eg– your experience of hospital discharge, how a needsassessment is carried out, and what you pay towards anycare you need may be different). For up to date informationabout hospital care:

If you live in Scotland

Contact Care Information Scotland (0800 011 3200,careinfoscotland.co.uk).

If you live in Wales

Contact Age Cymru (08000 223 444, ageuk.org.uk/cymru).

If you live in Northern Ireland

Contact Age NI (0808 808 7575,ageuk.org.uk/northern-ireland).

http://www.careinfoscotland.co.uk

http://www.ageuk.org.uk/cymru

http://www.ageuk.org.uk/northern-ireland


Section one: Preparing for a hospital stay

Planned admissions

If you have a relative, friend or carer, you may find ithelpful to talk about your admission to hospital with themand consider what you need to do before, during or afteryour hospital stay. You have probably thought of these, butthey might include:

- ensuring your home is safe - turning off electricalappliances, turning off water at the mains and turningyour central heating down/off

- securing your property - checking windows and doors arelocked and consider installing timer switches on lights andradios

- leaving valuables/keys with family or neighbours

- asking family or neighbours to collect your mail or, if thisisn’t possible, perhaps paying for Royal Mail’s “Keepsafe”service where they hold your mail for up to two monthsand deliver it to you when you are home. For moreinformation on charges, contact Royal Mail (03457 777888, royalmail.com/personal/receiving-mail/keepsafeorask at your Post Office)

- arranging help with looking after your property (wateringplants etc)

- cancelling any deliveries, like milk or newspapers.

If you are a carer for someone

The person you care for will need alternative care arrangedwhile you are in hospital and while you are recovering. Toorganise this you may need to contact your council’s socialservices department to arrange for a needs assessment forthe person you care for. The council may provide

http://www.royalmail.com/personal/receiving-mail/keepsafe


replacement care either at home or in a care home – theperson you care for may be charged for this if they canafford it. You may also want to request a carer’sassessment for yourself if you have not already done so.This is an assessment of what support you need to help youcare for somebody else. For more information, please seeour factsheet Carers: what support is available (0800319 6789, independentage.org).

Good to know

Carers UK (0808 808 7777, carersuk.org)or Carers Direct (0300 123 1053,nhs.uk/carersdirect) can offer advice and

information to help you make sure that the person is caredfor while you are in hospital and recovering.

If you own a pet

If no one else can look after your pet while you are inhospital, you may be able to pay for a ‘pet-sitter’. Your localAge UK (0800 169 6565, ageuk.org.uk) or Age Concern, orthe Cinnamon Trust (01736 757 900, cinnamon.org.uk)may be able to offer practical help and advice about caringfor pets during your hospital stay.

Emergency (unplanned) admissions

It may not be easy to plan for an emergency admission tohospital, but there are still things you can do. If you areworried about anything at home, don’t hesitate to ask thestaff on your ward. If they can’t help directly, they shouldbe able to put you in touch with someone who can, such asyour family, friends or neighbours and any organisations

http://www.carersuk.org

http://www.nhs.uk/carersdirect

http://www.ageuk.org.uk

http://www.cinnamon.org.uk


you need to contact. The hospital will have a Patient Adviceand Liaison Service (PALS) who may also be able to help.

Concerns about the treatment you may receive

You may have concerns or questions about the medical careyou will receive in hospital, such as:

- what treatment will I be having?

- what effect will it have?

- how long will I be in hospital?

- how long will I take to recover?

- what follow-up treatment/support will I need to recover?

Some of this may have been covered in the pre-admissioninformation sent to you if your stay in hospital waspre-planned. For more information on these issues, you cancontact the following hospital offices:

- admissions office

- nurse liaison officer (not all hospitals have these, or theymay have a different title)

- Patient Advice and Liaison Service (PALS).

Managing your finances in hospital

If you don’t already have arrangements in place forsomeone to collect your pension or carry out other financialtransactions on your behalf, you may want to considersetting up:

- direct debits and standing orders

- an appointee – to receive your benefits on your behalf

- a third party mandate – you give your bank instructionsthat you want someone else to be able to deal with youraccount for you while you are unable to


- a Power of Attorney (POA) or Lasting Power of Attorney(LPA) – you appoint someone to be able to makedecisions for you.

For more information, see our factsheet Managing myaffairs if I become ill (0800 319 6789,independentage.org).


Section two: during your stay

Benefits – what happens if you are in hospital?

If you get welfare benefits, you must inform theappropriate benefit service if you are admitted to hospitaland when you are discharged.

A stay in hospital affects your benefits in the followingways:

Attendance Allowance (AA) You should stop receiving AAif you have been in hospital for four weeks or more. The‘linking rule’ means that if you are in hospital, return home,but go back into hospital within 28 days, the days spent inhospital on both occasions will be added together. If thisadds up to more than 28 days you would lose eligibility forthe benefit until you return home. You must tell the AAService Centre (0345 605 6055) as soon as you go intohospital, and when you come out.

Disability Living Allowance (DLA) You should stopreceiving both the care and mobility component of DLA ifyou have been in hospital for four weeks or more (pleasesee the linking rule set out above). You must tell the DLAhelpline (0345 712 3456). If you have a Motabilityagreement for a car, scooter or electric wheelchair beforeentering hospital, this will carry on being paid, but anyexcess from the mobility component usually paid to you willstop. You cannot begin or renew a Motability agreementwhile you are in hospital.

Personal Independence Payment (PIP) PIP is beinggradually introduced to replace DLA for people under 65. As


with DLA, PIP will be payable for your first 28 days inhospital. Please see the linking rule set out above, underAttendance Allowance, as this also applies to PIP. For moreinformation, you can contact the PIP helpline (0845 8503322).

Good to know

AA, DLA and PIP should still be paid if youare in a hospice and the benefit has beenawarded under the special rules for

terminal illness (see below).

Special rules for people who are terminally illNormally, you must have had the illness or disability forthree months before you can qualify for DLA or PIP, or sixmonths to qualify for AA. However, if you are diagnosedwith a terminal illness (and a doctor certifies that you arenot reasonably expected to live longer than six months)you can claim the highest rate of AA, DLA care componentor PIP enhanced rate of the daily living component, straightaway without meeting the normal time requirement. TheAA, PIP or DLA will usually be awarded for a fixed period ofthree years. If three years have passed, you will be askedto renew your claim. Your claim will not be reviewed on aregular basis, once you have been assessed to receive itunder special rules.

To do...

For more information about special rulesfor getting disability benefits, pleasecontact the relevant office at the DWP (see


details in sections above). You may also want to contact abenefits specialist at your local Citizens Advice (www.adviceguide.org.uk, 03444 111 444).

Carer's Allowance (CA) If you receive CA for caring forsomeone else and you go into hospital, it will stop after 12weeks. You must tell the Carer’s Allowance Unit (0345 6084321) as soon as you go into and come out of hospital. Ifyou need to arrange alternative care for the person youcare for while you are in hospital, please see section one ofthis factsheet.

If someone receives CA for looking after you, it will stopwhen you lose your disability benefit (ie after you havebeen in hospital for four weeks).

Council Tax Reduction Scheme (Council Tax Support)Council Tax Reduction has replaced Council Tax Benefit, andis paid by your council. Some councils may have kept theold rules of Council Tax Benefit, which allowed your benefitto be paid for up to 52 weeks after you had gone intohospital, as long as the other conditions of entitlement weremet. You will need to check with your council whether thisapplies for their Council Tax Reduction scheme (gov.uk/council-tax-reduction).

Housing Benefit For people over retirement age, you cancontinue to receive Housing Benefit provided your stay inhospital is unlikely to exceed 52 weeks or, in exceptionalcircumstances, unlikely to substantially exceed 52 weeksand the property has not been let or sub-let.

You may be able to continue receiving Housing Benefitbeyond 52 weeks by stating that you are not going to be in

http://www.adviceguide.org.uk

http://gov.uk/council-tax-reduction


hospital for substantially more than 52 weeks (but not ifthis will exceed a further three months). You may need helpand advice to make this argument. Certain premiums andallowances attached to your Housing Benefit are affected.

To do… If you think this may affect you,contact one of the organisations listedbelow for advice.

Pension Credit Pension Credit is paid for an indefiniteperiod as long as the other conditions of entitlement aremet. However, certain premiums and allowances areaffected:

- if your Disability Living Allowance, Personal IndependencePayment or Attendance Allowance stops, any SevereDisability Premium attached to your Pension Credit willstop after four weeks

- if your Carer’s Allowance stops, any Carers Premium youhave attached to your Pension Credit will stop after eightweeks

- if you have been in hospital for a continuous period of 52weeks and have no dependants living in your home, youare no longer eligible to receive Pension Credit housingcosts. If you are one of a couple and have been inhospital for 52 weeks, you and your partner are treatedas separate claimants. This will be the same for claimingCouncil Tax Support and Housing Benefit. However, thisshould revert back to a joint claim after you return home.

State pension

This should not be affected by a stay in hospital for anylength of time.


Organisations that offer benefits advice

For more information about benefits,contact one of the following organisations:

- Independent Age advice service (0800 319 6789,[email protected])

- your local Citizens Advice (03444 111 4444,citizensadvice.org.uk)

- your local Age UK (0800 169 6565, ageuk.org.uk)

- your local Age Concern branch.

mailto:[email protected]

http://www.citizensadvice.org.uk



Your legal rights in hospital

Some of your rights as an NHS patient are set out in theNHS constitution, such as access to health services andquality of care. You can see information about theconstitution on the NHS Choices website (nhs.uk/nhsconstitution).

The Equality Act 2010 means that you must not be treateddifferently by hospital staff because of your age, sexualorientation, gender or disabilities.

To do...

If you think this has happened, you canraise these concerns informally with theNHS staff involved in your care or make aformal complaint to the hospital (see

information in section three). You may also wish to contactthe Equality Advisory and Support Service (0808 800 0082,equalityadvisoryservice.com) who can advise you on how totake your issue further, but they are unable to representyou in any legal or court action.

Food

The hospital will provide you with all your meals on theward and you choose your meals in advance. There will bespecial food available for you if you have a medical need forit (eg, if you need a gluten-free diet) as well as options ifyou follow a special or reduced diet for cultural or religiousreasons (eg, if you are a vegetarian or do not eat pork).There may also be other choices, such as reduced fat and

http://www.nhs.uk/nhsconstitution

http://equalityadvisoryservice.com


reduced salt options or small portions, helpful if you have asmall appetite.

To do...

If you require a special diet and you knowyou are being admitted to hospital, youmay want to contact the hospital beforeyou are admitted to check that they can

provide you with the food you need. If it was an unplannedadmission, ask the nurse in charge of the ward to help you,or ask the person who comes round with the menu cardsthat you fill in to order your food.

It is also important to ask for assistance if you:

- need help filling in the menu cards for the next day (eg, ifyou have a visual impairment or can’t hold a pen)

- are having any physical problems eating (eg, if you arefinding it hard to sit up, hold cutlery or chew or swallowfood).

The staff on the ward may seem busy, but this should notstop you from asking for help when you need it.

If you would prefer any additional food or drink (eg, extrafruit, your favourite brand of biscuit or a bottle of softdrink), you can bring this in with you, or ask a friend orrelative to bring it for you. Bear in mind, though, that youmay not always be allowed to eat if (eg, if you have toabstain from food before an operation or test or if you arebeing asked to eat less sugary food as part of your medicaltreatment).


Good to know

A dietician or an occupational therapist willbe able to help you if you need a special diet

or any help to eat and drink.

Hospital facilities

In larger hospitals, there is usually a shop sellingnewspapers and groceries and/or a cafe that can be usedby staff and patients. Some larger hospitals also have asmall bank branch or a cash machine. You may want tocheck this before you go into hospital if you will be stayingfor a fairly long time, especially if you will not have manyvisitors in hospital.

Most hospital beds are now equipped with a service thatprovides a personal radio, TV, telephone and answeringmachine. The radio and answering service is usually freebut you have to pay to use the TV and telephone. You canusually buy cards for this from vending machines inside thehospital.

Visiting hours

Visiting hours vary from ward to ward, so you may want toask on the ward about this if you have not already beeninformed.

Hospital infections

Most people will not get infections such as MRSA inhospital, but if you want to find out more about what MRSAis and how it can affect people, you can contact MRSAAction UK (01337 841098, mrsaactionuk.net).

http://www.mrsaactionuk.net


Assessments in hospital

If it appears that you will need help and support at homeafter you have been discharged from hospital, you shouldhave a needs assessment arranged by a hospital orcommunity social worker, or a care manager. Thisassessment should include the opinions of any other healthprofessionals involved in your care (eg - the occupationaltherapist, physiotherapist etc).

To do...

You may have to ask the NHS staff involvedin your care to refer you to the hospital

social worker if you feel you will need some extra helpwhen you leave hospital.

Assessments in hospital and the law

The Care Act, which became law in England in May 2014and took effect from April 2015, includes new duties for theNHS. These new duties include the need to cooperate withlocal councils and other partner organisations whensomeone is being discharged from hospital.

If you are likely to need ongoing support after you leavehospital, the NHS must make sure that the council whereyou usually live is told, so that they can carry out a needsassessment. The NHS must also inform the council of thelikely date that you will be leaving hospital, giving them asmuch notice as possible. The council must then make surethe needs assessment happens before you are discharged.

You and any friends or relatives caring for you should beinformed of the discharge date at the same time or even


before the council. The NHS and the council must involveyou as much as possible in the assessment when it takesplace.

Good to know The council has ultimateresponsibility for carrying out a needsassessment.

What happens at the needs assessment?

The needs assessment checks whether you are able to docertain tasks (or achieve what the professionals call‘outcomes’) – eg, being able to wash and dress yourself,get enough food and drink, and stay in contact with friendsor family members. If you need help to achieve thesethings, then you should be seen as being unable to achievethose outcomes.

If you can achieve some tasks or outcomes without helpbut it causes you pain or anxiety, puts your or someoneelse’s safety at risk, or it takes you a lot longer than itwould normally take, you should also be assessed usunable to achieve those outcomes.

For more information about needs assessments, seeour factsheet Assessment and Services from your localcouncil in England (0800 319 6789, independentage.org).


Do you qualify for council support?

The needs assessment will show whether your care needsmeet the national eligibility criteria for access to support.You will qualify if:

- you are unable to achieve two or more of the outcomesthat all councils assess against, and

- you not being able to achieve these things is seen ashaving a ‘significant impact’ on your overall wellbeing.The council must make a judgement about this.

If your assessment shows that you have eligible careneeds, and you have capital and savings below £23,250,you will be able to receive care and support services fromyour council (see section three).

Good to know

The council can also choose to meet careneeds that have not been assessed aseligible if it decides to – eg, if they feel thatyour needs may quickly get worse if you do

not get the support you need. Whether or not you qualifyfor support, the council has a duty to tell you about localservices that can help support you, and perhaps stop yourcare needs getting worse.

If you qualify for council support

You should be given a care and support plan. This is awritten statement of:

- your individual assessed care needs – based on whichtasks or outcomes you are unable to achieve


- how these care needs will be met (who will meet them,which services will be used, where, when) – seeinformation about help available in section three

- how much money has been allocated to you to meet yourcare needs (this is called your personal budget). Seesection three for more information about paying for yourcare and personal budgets.

The needs assessment in hospital may show that you needadditional services, such as rehabilitation, physiotherapy,intermediate care or re-ablement as part of your carepackage when you leave hospital - see the section belowfor details.


Free short-term help you may be entitled to

- Rehabilitation

Once you are ready to leave hospital, you may receiverehabilitation services, allowing you to return and remain athome. This should be free of charge if you are clinicallyassessed by NHS staff as needing it. This would be decidedat your needs assessment. Services can include:

- physiotherapy to improve your mobility

- speech therapy for any communication or swallowingdifficulties

- occupational therapy to manage the risk any risk toyou when carrying out daily activities.

- Physiotherapy

This is often used to help restore your range of movementfollowing an injury or illness. It can help you to overcomeinjury or short-term health problems, or manage long-termdisability. Your consultant may recommend physiotherapyas part of the process of preparing you to return home.

There is no charge for physiotherapy on the NHS. If youfeel you need more treatment than the NHS will offer you,go back to your GP or consultant and ask to be referred formore sessions. If you would prefer to see a physiotherapistprivately, search for one through the Chartered Society ofPhysiotherapy (0207 306 6666, csp.org.uk).

- Intermediate care

Intermediate care is a range of services to help you:

http://www.csp.org.uk


- recover faster from illness

- return home safely from hospital and be as independentas possible when you get there

- stay out of hospital in the future

- stay in your own home for longer, rather than needing tomove into residential care.

Intermediate care should be provided free of charge,generally for up to six weeks.

- Re-ablement

The aim of re-ablement is to provide a mixture of services(social and health care - if you need them) to support youto retain or regain skills that support independent living athome. This is similar to intermediate care. The servicesprovided will depend on your care needs and what theperson carrying out your needs assessment felt mightsupport your wellbeing and help stop your care needsgetting worse.

Community equipment (eg, disability aids and minoradaptations for your home), which is sometimes providedas part of a package of re-ablement, should be providedfree of charge where the cost is £1,000 or less.

To do...

Ask the consultant, ward matron/manager,occupational therapist or social workerwhether you are being considered forintermediate care and/or a re-ablement

package after hospital discharge.

This could be either to:


- meet your eligible care needs

- stop any lower-level care needs that you have fromincreasing

- improve your wellbeing, by helping you to feel moreindependent.

All of these things should be considered as part of yourassessment. If you feel that you could benefit from thiskind of support, it should be included in your support plan.If it is not offered to you after you have raised it with thoseinvolved in your care, you could consider making acomplaint (see information about making a complaint insection three).

- NHS Continuing Healthcare

NHS Continuing Healthcare is a package of care arrangedand funded solely by the NHS. If you have complex healthneeds, and your main or ‘primary’ care need is forhealthcare, you may be eligible to have all your care paidfor by the NHS.

A primary health need is where most of the care is aimed attreating or preventing health issues as opposed to socialcare support needs – there is no legal definition and thisneeds to be assessed).

The decision about whether you have a ‘primary healthneed’ is made using a checklist of things that the healthprofessionals must consider as part of the assessmentprocess. They decide whether you are eligible for NHSContinuing healthcare funding by looking at howunpredictable and complex your health care needs are, as


well as how they interact together and affect you as awhole. The decision is not made just from looking at yourspecific health diagnosis (eg – dementia), or from lookingjust at the type of care needed (eg, 24 hour care or nursingcare).

Good to know

The assessment for this type of care isseparate from the needs assessment youhave in hospital. Local NHS ClinicalCommissioning Groups (CCGs) have overall

responsibility for the assessment for NHS ContinuingHealthcare, but a council social worker may be part of theassessment team.

For more information about NHS Continuing Healthcare, seeour factsheet Continuing Care: should the NHS bepaying for your care? (0800 319 6789,independentage.org).

- Palliative care and fast track for NHS ContinuingHealthcare

Palliative care services are designed to keep youcomfortable and ensure you have the best quality of lifepossible when nearing the end of your life. Palliative care isprovided free by the NHS in hospitals, hospices, carehomes and in people’s own homes.

Care needs resulting from a terminal illness may notnecessarily qualify for free NHS Continuing Healthcare; itdepends on whether you have a ‘primary health need’.


Someone with a terminal illness may be ‘fast-tracked’ forimmediate provision of free NHS Continuing Healthcare ifthey have a rapidly deteriorating condition and areapproaching the end of their life.

The referral should be accepted immediately and thefunding provided with an assessment to follow.


Section three: leaving hospital

Things to check when leaving hospital

It is very common to be concerned about various aspects ofleaving hospital, such as:

- what date and time will you be discharged and how willyou get home?

- what medicine do you need and will you be provided withsome until you can see your GP when you get home?

- will the hospital staff contact your GP to let them knowwhat treatment you have had, the outcome of it and whatfollow-up appointments you need at the hospital or GPsurgery?

If you have been assessed as needing support when youleave hospital, check that your care and support plan cananswer the following questions for you:

- will the care and support that you have been assessed forbe in place when you get home?

- who will provide the care you need when you returnhome?

- how can you contact these care providers?

To do...

If you have concerns about any of these orother issues, you may want to discuss themwith the hospital social worker, consultant or

ward manager.


Discharge from hospital - how it should work

The consultant in charge of your care (or their assessmentteam) will make the final decision about whether you aresafe to be discharged from hospital. Their decision will bebased on whether you are medically fit and on the care thatis available to you if you need ongoing care.

If you do need ongoing care, you should not be dischargedfrom hospital until your needs assessment is complete andthe care and support you need is in place.

Good to know

You should not be pressured into acceptinga move to somewhere you do not want togo to (eg, a care home). If this happens,you may want to make a complaint and

contact an advice service and/or an independent advocatefor more support. You have a right to refuse such aplacement if you have the mental capacity to mtake yourown welfare (care) decisions.

To do...

You should ask for further help in any ofthe following situations:

- you are being discharged from hospital before you feelyou are well enough to go home

- you feel you will not be able to cope at home, especially ifnot enough support has been organised for you at home

- you are going to be discharged on a Friday or during aweekend which might mean you may be unable tocontact care workers or other health professionals overthe weekend


- you are being pressured to accept a placement (eg, acare home) that you do not want

- you have not had a needs assessment and care plan (youwill only get a care plan if the council is going to meetyour care needs).

If this is happening to you, you can contact IndependentAge for advice (0800 319 6789, [email protected]).

Transport to get you home

If you need transport to get you home from hospital, thehospital should make sure that your relative, friend or thehospital transport is able to take you. If you have a medicalneed for transport and have no other means of gettinghome, you may have access to the Patient TransportServices.

To do...

If you feel that you could qualify for patienttransport, you may want to talk to theconsultant in charge of your care, the

hospital social worker/care manager or the ward manager.

Help paying travel costs

If you are on a low income or get benefits such as PensionGuarantee Credit, you may be able to get help with travelcosts for follow-up and future NHS appointments throughthe NHS low income scheme. You can ask about the NHSlow income scheme and get the application form (HC1) atthe hospital, at your GP surgery or pharmacist when youreturn home.



Help from charities

Some charities can offer escorted discharge from hospital.To find out if there is a volunteer transport scheme in yourlocal area you can contact Age UK (0800 169 6565, ageuk.org.uk), Age Concern or the Royal Voluntary Service(0845 608 0122, royalvoluntaryservice.org.uk).


http://www.royalvoluntaryservice.org.uk


Independent sector or private hospitals

If your care has been provided by a private hospital, thehospital discharge process might be different.

To do..

You may want to contact the hospital beforeyou are admitted to ask if they have anarrangement with the local social servicesdepartment to do a needs assessment

before you return home. If they do not, you may want tocontact social services before you are admitted to hospital,to tell them that you will require a needs assessment afteryour treatment and while you are still in hospital. Contactus if you are in this situation and would like moreinformation and advice about what to do (0800 319 6789,[email protected]).

If you are refused an assessment by the council you maywant to contact an advice service and/or Civil Legal Advice(0345 345 4 345, gov.uk/civil-legal-advice) as soon aspossible. They can advise on whether you could get legalaid and can signpost you to specialist solicitors who may beable to help challenge the refusal of the assessment. Somelegal challenges such as Judicial Review have time limits, soit is best to get advice quickly after you have been refusedan assessment. You can also make a complaint to thecomplaints officer at the council (you usually have 12months to do this).


http://gov.uk/civil-legal-advice


Going back home - what help is available?

Help from your local council

The support available from your council's social servicesdepartment can vary considerably in different parts of thecountry, so you will need to find out from your council whatservices are available in your area. The support you needshould be made clear during your needs assessment and/orin your care and support plan. For information on the typesof services that are available in most areas, seeour factsheet Help at home: what may be available inyour local area (0800 319 6789, independentage.org).

Paying for your support

If your capital (excluding your sole or main property if youown it) or savings are above £23,250, you may need tofund your own care and support services at home.

If you have capital or savings below £23,250 and youqualify for council support, you will get some help from thecouncil to pay for the care you need to meet your assessedneeds. Your needs should be set out in your care andsupport plan and you should receive a copy of this. Youmay have to make a contribution from your income to thecost of the care at home. And if you have savings between£14,250 and £23,250, you will have to contribute a bit ofmoney from your savings too. Savings under £14,250aren’t counted.

Direct payments and personal budgets

If you qualify for council support, the council should tell youwhat your ‘personal budget’ is. This is the amount of money


that the council has worked out is needed to meet youreligible care needs. This budget could be made up of someof your own money, and some money from the council. Insome cases it could also contain other money from theNHS.

You can choose to take the council’s contribution as a‘direct payment’. Direct payments are designed to give youchoice and flexibility about how your needs are met. Thecouncil gives you the money to buy your own servicesdirectly, instead of these services being provided for you.

If you prefer, this pot of money (including any contributionyou need to make) can be:

- held and managed as an account by the council – to bespent on services of your choice, or

- held and managed as an account placed with a thirdparty, such as a voluntary organisation or care serviceprovider (this is called an individual service fund), or

- a combination of these options.

Having direct payments could allow you to:

- employ someone of your choice to give you care at home,at a time that suits you best

- employ someone to help you attend activities outsideyour home, such as going shopping or attending a lunchclub

- employ someone to help you maintain your fitness bydriving you to a local exercise class or going on a walkwith you.


For more information on direct payments see our factsheetHome care: using Direct Payments and PersonalBudgets (0800 319 6789, independentage.org).

Adaptations to your home

If you find it difficult to get around your property afterreturning home from hospital, you may need to makeadaptations. This could be hand rails to help you get up thestairs, or having a ramp fitted if you will need to use awheelchair around the house. To get adaptations, your localsocial service department will refer you to an occupationaltherapist (OT) who will assess what adaptations you mightbenefit from. These are usually free if they are worth under£1,000. There is a means-test of your capital and incomefor major adaptations, when you apply for the DisabledFacilities Grant scheme.

For more information about getting adaptations, see ourfactsheet Housing: adapting your home to stayindependent (0800 319 6789, independentage.org).

Private care arrangements

If you are paying for your own care, or if you have directpayments and are arranging your own care services withfunding from the council, you may want to considercontacting the United Kingdom Home Care Association (0208661 8188, ukhca.co.uk). They can direct you to localprivate care agencies.

Please also see our factsheet Home Care Agencies: whatto look for (0800 319 6789, independentage.org).

http://www.ukhca.co.uk


Good to know

If you meet the eligibility criteria for careservices and have been assessed as able to

pay for your own care, the council still has a duty to helpyou to arrange services, if you are unable to do thisyourself and have nobody else able or willing to arrange thesupport you need. They may charge you an administrationfee for doing this.

Home care from voluntary organisations

Some voluntary organisations provide home supportservices at little or no cost. You can use these services inaddition to any care provided by social services or privatecare agencies. It could be ‘that little bit of extra help’ thatcouncils may not provide. If the service offered to you by avoluntary organisation is similar to a service that socialservices provides you with to meet your eligible care needs,social services may reduce the services they are offeringyou. This is because some of your care needs are being metby another agency.

Your local Age UK (0800 169 6565, ageuk.org.uk) or AgeConcern branch may provide support or may know of otherlocal organisations that provide such support. This supportmight include:

- a home visiting service

- home help service

- shopping service

- handyperson service

- benefits check

- gardening service.



They may charge for some of the services they provide.

Other services provided by voluntary organisations

- befriending schemes: trained volunteers visit you in yourown home, join you on an outing, or telephone you for achat. The Independent Age advice service can registeryou for face-to-face befriending, Telephone Buddies orour telephone-based book and discussion groups. We canalso provide you with the details for other national andlocal befriending schemes and social groups (0800 3196789, [email protected]). Your local Age UK(0800 169 65 65, ageuk.org.uk) or Age Concernbranch may also know of befriending schemes availableto you.

- 'Welcome Home' service: someone from a localorganisation, such as an Age UK (0800 169 6565,ageuk.org.uk) or Age Concern visits you at home the dayyou are discharged from hospital and can help withshopping, collecting pensions and prescriptions etc. Theymay also provide help with small household tasks.

Homeshare

Homeshare is a scheme which allows you to stay in yourhome with live-in help at no cost to you. You offeraccommodation in your home to a tenant (who is ‘matched’to you), in exchange for an agreed number of hours ofsupport per week. Homeshare is run through theorganisation SharedLivesPlus (sharedlivesplus.org.uk/about-us/homeshare). There arecurrently homeshare schemes operating in Bristol,Somerset, London, East Sussex and Cumbria.




http://www.sharedlivesplus.org.uk/about-us/homeshare


Benefits

If you have been discharged from hospital and you now findyou have difficulty with carrying out daily living tasksand/or getting around, you may qualify for a benefit suchas Attendance Allowance (AA) if you are over 65, orPersonal Independence Payment (PIP) if you are under 65.To qualify, you must have been experiencing the difficultiesfor the past three months (for PIP) or six months (for AA).

For more information on AA and PIP, see our factsheets:Attendance Allowance and Disability Living Allowanceand Personal Independence Payment (0800 319 6789,independentage.org).

To do...

Your local Age UK (0800 169 6565,ageuk.org.uk), Age Concern branch orCitizens Advice (08444 111 444,

citizensadvice.org.uk) can check you are claiming all thebenefits you are entitled to.

If you already receive any disability benefits, you will needto inform the appropriate benefits service as soon as youare discharged from hospital if any of your benefits need tobe restarted (see section two).

For more information about support available

You can find a wide range of information about the supportavailable to you in your own home in our Wise Guide: Extrahelp at home. Call 0800 319 6789 to order your free copy(or order through our website at independentage.org).


http://www.citizensadvice.org.uk


Moving to another home

The needs assessment in hospital (see section two) willlook at whether:

- you will be able to stay in your own home, with orwithout extra help

- you need to move to sheltered accommodation orextra-care housing

- you need to move into a care home.

Your views, wishes and rights should be taken into accountand you cannot be forced to move from your home if youdo not want to - as long as you have the mental capacity torefuse specific services and understand that decision. Theassessment in hospital will only make a recommendationabout where you should live; it is your choice on whether toact on it. More often than not, the assessment will simplyrecommend that you need help in your own home, eitheron a temporary or ongoing basis.

You may decide that being admitted to hospital, particularlyif this is not the first time, is the ‘wake-up call’ that yourcurrent home is no longer suitable for your needs. You maywant to investigate alternative housing options, such asmoving to a bungalow or housing with care provided and ifso you should ask for the needs assessment process toinclude this consideration.

Good to know

There are some exceptional circumstanceswhere a decision about your care could betaken by someone else – taking into


account your past and present wishes as far as possible.

This may happen if you lack the mental capacity to makedecisions for yourself. Any action without your consent willonly take place under the rules set out within the MentalCapacity Act (which allows others to make a ‘best interestsdecision’ about your care) or the Mental Health Act (whichcovers issues such as Guardianship).

To do...

You may want to contact the Office of thePublic Guardian (0300 456 0300, gov.uk/office-of-public-guardian) if youhave concerns about your, or someone

else’s mental capacity. If you have concerns about anymental health issues, you can contact Mind (0300 1233393, mind.org.uk) or Rethink (0300 5000 927, rethink.org).

Sheltered accommodation or extra-care housing

This is purpose built accommodation, usually in the form ofa group of bungalows or self contained flats, speciallydesigned for older people. Sheltered accommodation willusually have a community alarm system and a warden thatvisits daily to oversee the general maintenance of thebuilding and help with any housing issues. An extra-carehousing scheme will also have this, as well as care staff onsite (or on call) 24-hours a day. If you would like to moveinto sheltered or extra-care housing it’s important to have aneeds assessment (see section two). This is for tworeasons:

http://gov.uk/office-of-public-guardian

http://rethink.org

http://www.mind.org.uk


- to make sure that the sheltered or extra-care housing canmeet your care needs

- because some sheltered or extra-care housing is onlyavailable through the council (through a points-basedallocation system depending on your assessed careneeds), except where you are buying it privately.

FirstStop Care Advice (0800 377 7070, housingcare.org)can provide you with a list of sheltered accommodation andextra-care housing schemes in your area. There may bewaiting lists for such accommodation.

For more information on the different types of shelteredand extra-care housing schemes, who provides them andhow to find, access and pay for them, please seeour factsheets Housing decisions and options in laterlife and Extra-care housing (0800 319 6789,independentage.org).

Care homes

If, following the needs assessment, you and the socialworker agree you should move into a care home after beingdischarged from hospital, you can get a list of care homesfrom the social services department in the area you want tomove to. Or you can contact FirstStop Care Advice (0800377 7070, housingcare.org) or the Care QualityCommission (03000 616161, cqc.org.uk) for a list of carehomes.

Paying care home fees

If you have capital and/or savings over £23,250, you will beexpected to pay the full cost of your care home fees untilyou spend down to this amount. But, depending on the care

http://www.housingcare.org


http://www.cqc.org.uk


and support you need, you may be entitled to financialsupport towards the cost of your care home fees through:

- receiving Attendance Allowance (a disability benefit)

- a Registered Nursing Care Contribution

- NHS Continuing Healthcare funding.

If you have been assessed as needing a care home andhave capital and/or savings under £23,250, you will beentitled to financial help from the council towards the costof your care home fees. But, if the council contributes toyour care home fees, you will still have to pay towards thecost from your weekly income. Being council funded maymean you have less choice in which care home you canmove to. If you are funded by the council, they shouldprovide at least one option that meets your care needs atthe amount that the council is willing to pay.

Good to know

If you are receiving Attendance Allowance,your payments will stop after 28 days ofbeing in a care home if you are part-fundedby the council.

For more information about care homes, order a free copyof our Wise Guide : Choosing a care home(0800 319 6789,[email protected]).

/advice/factsheets/wise-guides/choosing-a-care-home/



Refusing a care home placement

If you have the mental capacity to make your own welfaredecisions, you have the right to refuse a care homeplacement. You cannot be forced to move into a care homeunless there are exceptional circumstances where you lackthe mental capacity to make decisions for yourself. This canbe very complex and you may want to get advice if thisbecomes relevant to you.

To do...

If you find yourself in a situation where youfeel that your rights and views are notbeing appropriately considered by thecouncil, you can speak to one of our

advisers in confidence (0800 319 6789,[email protected]).



Making a complaint about hospitals

Although many people do not enjoy being in hospital, formost their stay goes well and they are happy with the careand treatment they receive. Unfortunately, sometimes thisdoesn’t happen.

If you are unhappy with the service that the NHS or yourcouncil has provided, depending on the seriousness of thecomplaint, you can either:

- raise a complaint informally with the staff that providedthe service and/or

- raise a formal complaint using the council or NHScomplaints procedure.

For more information about the complaints process,including complaints relating to the standard of careprovided by a private care agency, see our factsheetComplaints about community care and NHS servicesin England (0800 319 6789, independentage.org). Thisfactsheet also explains how you can get support to makeyour complaint.


Useful contacts

For questions or concerns when you arein hospital

The hospital Patient Advice and Liaison Service (PALS) –ask on your ward or at the hospital reception.

For help with transport and settling back at homeafter a hospital stay

Age UK (0800 169 6565, ageuk.org.uk) or Royal VoluntaryService (0845 608 0122, royalvoluntaryservice.org.uk).

To find a local private home care agency

United Kingdom Home Care Association (020 8661 8188,ukhca.co.uk)

If you are looking for a care home or supportedaccommodation

FirstStop Care Advice (0800 377 7070, housingcare.org)

If you have questions about any of the information youhave read in this factsheet or need some support, call ouradvice service, Monday to Friday, 10am-4pm (0800 3196789, [email protected]).


http://www.royalvoluntaryservice.org.uk

http://www.ukhca.co.uk



This factsheet has been put together by Independent Age'sexpert advisers. It is not a full explanation of the law and isaimed at people aged over 60.

If you need this information in an alternative format (such aslarge-print or audio cd), call us on 0800 319 6789 or [email protected].

Tell us what you think

We’d love to hear what you think of our publications. Pleasewrite to us at the address below, phone us on 020 7605 4294or email [email protected].

We will use your feedback to help us plan for changes to ourpublications in the future. Thank you.

Supporting Independent Age

If you have found this information helpful and would like tosupport our work, there are lots of ways you can help:

- get fit - run, walk or cycle in aid of Independent Age- take part in our annual raffle- donate in memory of a loved one- remember Independent Age in your will and benefit from our

Free Wills offer to supporters.

If you would like to donate or raise money in aid ofIndependent Age, please visit our website, [email protected] or call our fundraising teamon 020 7605 4288.

© Independent Age

Independent Age18 Avonmore RoadLondonW14 8RR

T 020 7605 4200E [email protected] line 0800 319 6789

View our page on Facebook Follow us on Twitter @IndependentAge

Independent Age is the operating name ofthe Royal United Kingdom BeneficentAssociation Registered charity number210729




hospital care in england: what you need to know · 2018-10-04 · hospital care in england - what...

Documents