If your care is paid for by your local authority social services or by the NHS then they will have a strong influence on the pattern of care and how many hours of care per week are allowable and in some cases they will also influence which care provider is used. Even so you can influence these factors as you will read further on in this article.
If you are paying for the care yourself then you have more or less complete freedom as to which care provider you use, how many hours per week you choose to buy and the pattern of care throughout the week.
It is especially important that if you are funding the care privately you have a copy of the contract to read in advance, before signing it, and a copy to keep after signing it.
COST OF CARE AT HOME
Costs of home care vary considerably depending upon which care provider you use, where you live in the UK, the nature of the care and level of training and qualifications which may be needed to support the care. Each care provider has a different approach to how they price care. Care which is delivered as part of a series of individual calls during the week is usually priced at an hourly rate. Some companies charge a standard hourly rate no matter what time of day or day of the week. In other cases the cost per hour may vary and is likely to be more expensive at night and weekends and bank holidays than at other times. Some care providers offer a ‘sleeping night’ which is charged at a set price with additional charges if there are more than an agreed number of waking periods during the night. There is also the possibility of a packaged price for a particular pattern of care. For example live-in care is usually offered at a price per week.
In general hourly rates might be expected to cost between £11 and £19 depending upon the pricing policy of the company and whether it is a weekday or weekend /bank holiday. However there will be exceptions and certainly the care will be more expensive if a qualified nurse is requested for private care.
PATTERNS OF CARE
The pattern of care during the day or week can be significant. If the care is made up of many individual short calls this can be more difficult for the care provider to plan and may involve several carers’ shift patterns and significant travelling and down time. Also, in our view, short calls are not conducive to high quality care when supporting certain conditions, for example dementia.
LOCAL AUTHORITY AND NHS SUPPORT
If you are considering that care at home may be needed you should speak to your local authority social services department in the first instance. Whether or not you think you may have to fund your care privately still speak with them. You are entitled to a care assessment and this should also take account of the needs of any family carer who might be involved in supporting you. If you are eligible for social services financial support you may also be given the option of a personal budget. This is part of the Government’s agenda to change the way care services are assessed, arranged and paid for. If you are eligible for local authority funding ask them about personal budgets and direct payments.
Benefits and support are often aimed at avoiding or reducing the possibility of moving into a care home and there may well be a range of support items that can be considered within a package of care for example meals delivery, equipment and adaptations to the building, assistive technology, the possibility of respite care for yourself and your carer or day-centre attendance.
It may also be possible to get funding from the NHS. Guidance from the Government has been issued which indicates that up to six weeks of rehabilitation care can be funded from the NHS in certain circumstances (usually following discharge from hospital) and it may be appropriate for this to be taken at home rather than in a care home setting. There is also the possibility of what is referred to as continuing care or continuing health care. This is also sometimes referred to as CHC or fully funded care. In simple terms people who may be eligible for this type of funding are those whose health needs completely dominate their overall care needs. This is subject to assessment by an NHS assessor. If you think you may be eligible for this care funding then it is important to get a proper assessment before your local authority carries out a means test for care support.
Generally speaking the Government's Fairer Charging guidance requires local authorities to follow similar guidelines for capital when assessing eligibility for social services’ funding for home care as they do when assessing for a care home. The upper limit in England and Wales is £23250 at January 2013 with slightly different figures in Scotland and Northern Ireland. Above this limit you might expect to pay for your care privately. Exactly how your local authority interprets the rules and applies its financial assessment is for them to decide and you should contact them directly.