If an adult you care for needs additional help because of disability, ill health or old age, you should first consider the range of community based services that may provide the support you are looking for. See Help in the Community.
At some point these local options for support may not be enough or become too costly. Also carers under a great deal of pressure may find it too difficult to set up and coordinate a support package themselves.
In these circumstances speak to your local council’s adult care services to see how they can help. The sorts of things they can arrange support with are;
- aids and equipment, including assistive technology
- home care – personal care and some daily living tasks
- day services – attending a day centre or having a support worker to accompany you to places
- short stays (or a permanent move) in a residential setting when a home support package is not enough
How will the council decide if it can help?
Care needs assessment
Aids and equipment
What is a direct payment?
Help with managing a direct payment
How could a direct payment work?
Find a care agency
What will I have to pay?
Help available after a hospital stay
Watch a video about how the care system works
If an adult appears to have a need for support and wants assistance from the council, they must be offered a care needs assessment. This is a process that looks at the impact on wellbeing if care needs are not met and determines whether or not a person is eligible for help from the council.
If the care needs assessment identifies that a person has eligible needs, the council representative will draw up a support plan and put a figure on what the support package will cost. A financial assessment will establish how much the person with care needs must contribute and the council will pay the balance.
A person with savings of more than £23,250 is not entitled to any financial help from the council. If this is the case, the council may suggest that, rather than go through the assessment process they should contact care providers directly. Bristol City council and South Gloucestershire council have information about local care and support providers on their websites.
Their adult care duty desks can also help call Care Direct in Bristol on 0117 922 2700 and if you live in South Gloucestershire call 01454 868 007.
See find a care agency for more information.
A care needs assessment is for the person who needs on going care and support. It looks at how they manage with everyday activities, such as washing and dressing, cooking, housework and getting out and about. It considers the risks and the impact on their wellbeing if they do not get the support they need. The intention is to focus on what is important to the individual, so that they can be helped to achieve the outcomes they want.
From when you first request the assessment, there may be a wait of six months or more for the appointment. If the needs are urgent or there is a significant change whilst waiting, make sure that you tell the council and they will be given greater priority.
The assessment will usually take place in the person’s home. However, some people are asked to complete a self-assessment form to send into the council. This is followed up with a phone call to complete the assessment over the phone.
From the information gathered, all councils use a national eligibility criteria to decide whether they have a duty to provide support to that person. There is information about the criteria on the NHS website.
If a person with care needs is eligible for help the council should arrange for someone to help draw up a care and support plan.
As a carer you should be included in the assessment. Your views, and the level of care you feel able and willing to provide, should be taken into account. It’s important to think about what you want to say in advance and not to underestimate what you do.
To request a care needs assessment, the person in need of care and support should contact the council. If they are unable to do this, you can do it on their behalf as their carer.
Ask for a Bristol assessment using the contact form or call 0117 922 2700.
South Gloucestershire information and online forms on the South Gloucestershire council website or phone 01454 868 007.
WECIL has a Care Assessment Advocacy service, if you need support through the care needs assessment process.
The care needs assessment may identify that some equipment or adaptations would make life a lot easier and increase independence. See our equipment section for more information.
Many day centres have closed and many of the few that remain cater for people with higher level needs. A placement at a day centre is usually arranged through referral from a social worker or another professional although some day centres will also accept people who self refer. Places are generally allocated to people who cannot access other mainstream activities, even with support. They will also take into consideration the carer’s need for a whole day’s break from caring.
Here is a list of day centres we know of that are currently operating in Bristol and South Gloucestershire.
South Gloucestershire Council runs day centres through the Promoting Opportunities service.
Age UK South Gloucestershire operate activity clubs in the South Gloucestershire area.
In Bristol there is information on Bristol City Councils website.
Age UK Bristol run a day centre in Withywood.
Humphry Repton House is a specialist care home which offers a day service for people with dementia.
Milestones Trust have day opportunities for people of all ages with varying support needs.
Tynedale Circle Day centre runs weekly and is located on Whiteladies Road for people with some memory loss and also has a carers group.
St Monica’s provides a day service available to people with dementia.
Ablecare offers lunch clubs and respite care to people in Bristol and South Gloucestershire. The lunch clubs take place at their care homes but are open to non-residents.
Brunelcare has a day centre for people with mild to moderate dementia which is located in Lawrence Weston and runs four days each week.
Dhek Bhal offers day services and support for carers to the South Asian community living in Bristol and South Gloucestershire.
Bingham Day Centre is for people with learning disabilities.
Dementia Wellbeing service website lists local day services.
Paul’s Place provides a day facility five days a week that meets the needs of physically, cognitively and sensory impaired adults. They also provide services for carers.
The Hive is a drop in centre is for adults with learning disabilities in Bristol and South Gloucestershire.
Silvacare runs outreach services for people with learning disabilities in Bristol.
Cambrian Green Day Centre is especially for people with dementia and also hosts events for carers.
If the local authority agrees to fund care, they are likely to offer a direct payment so the person you care for can buy their own care. Direct payments are a way of having more control and choice but they also give more responsibility. Find out about having a direct payment in Bristol and South Gloucestershire. Most people either:
- employ a care agency
- employ a person privately, often known as a personal assistant (PA) or a paid care worker
Employing an agency means that there will be a contract with the agency and they will sort out all the employment related matters. Employing a person privately gives the most flexibility and choice but there will be more responsibility as the person you care for would become an employer. Disability Rights UK has produced a factsheet on employing personal assistants.
If you choose to employ a personal assistant or individual care worker, you become an employer with the responsibilities this brings. That includes arranging pay, complying with annual leave legislation, checking references and entitlement to work in the UK and arranging insurance.
This may sound daunting but there are several organisations that offer support to disabled people who choose to employ someone directly. You can find out more about the direct payment support in Bristol on the Bristol City council website. You can find more information out about the direct payment support in South Gloucestershire on the South Gloucestershire council website.
A direct payment can be used to employ a personal assistant for the person with care needs. They might accompany a person to activities of their choosing or assist with daily living tasks to maintain their independence.
Mike cares for his 20 year old son Tom who is keen to be as independent as possible. Tom is visually impaired and needs someone with him when going out shopping and to some social events. He also needs some help at home. This was all put down in his care and support plan and a personal budget agreed. Tom contributes to the budget out of his Personal Independence Payment and the council gave Tom a direct payment to make up the rest.
Mike and Tom looked into employing a personal assistant and decided that this would be a good option as it gives Tom more control. Setting it up was quite hard work but once they had done this it worked well. Tom recruited a person of a similar age to himself who he got on well with. They paid a recommended agency to help with the recruitment process and they use their payroll service.
If you decide to buy in care from a care agency using the direct payment, the agency will deal with all the administrative and employer related tasks. This will be more expensive than employing someone privately but is less responsibility for you. The agency would also usually be responsible for arranging replacement care for holiday and sick leave.
Choosing the right care will affect the quality of your life, family life and the person you care for, so it’s essential to choose the provider who will give the best all round service for all of your needs — this Carers Trust guide may help you.
There is lots of useful information on NHS choices about care and support providers. You can find out about things to think about and search for a care agency.
Which also produce useful information and a directory of care agencies
You can check the rating of any provider you are considering on the Care Quality Commission website.
For those with under £23,250 in savings, the council will work out the personal budget. This is the amount that they think that the care and support will cost. More about personal budgets from Disability Rights UK.
Then they will carry out a financial assessment to work out exactly how much the person with care needs must contribute. Most people have to pay something towards the care that they receive and the council will make up the rest of your personal budget. There is sometimes a delay in having the financial assessment and the service may start before you know how much it is going to cost. When your contribution has been worked out, if there is a significant backdated sum to be paid, the council must offer a repayment plan.
A person who has over £23,250 in savings will have to pay for all their care. The carer’s income and savings should not be taken into account but the council may ask for details. There is more information about paying for care on the NHS website.
South Gloucestershire council and Bristol City council have produced information about how they work out how much someone will have to pay towards their care at home. There is more detailed information about the way Bristol works out charges on the Bristol City council website.
With the right support many people are able to regain their confidence and ability to do things after a crisis or illness.
In South Gloucestershire the Promoting Independence Service can help people regain confidence and the skills needed for everyday living after a stay in hospital. This service lasts up to 6 weeks and can also help people find voluntary or community services that may help with practical tasks like shopping or local social or activity groups. Ask to speak to a member of the Promoting Independence Team.
If you live in Bristol you can view the equivalent service on the Bristol City council website. If you think that the person you care for will need help when they go home ask to speak to a hospital social worker.
The Red Cross offers a service called First Call, which is available to anyone aged over 18 needing short term help. Volunteers provide telephone support and home visits for light domestic duties including shopping for essentials and collecting prescriptions. This service may help people needing a bit of support when they come out of hospital.
This animated video by the NHS explains how the adult care and support system works, from the cost of services and the role local authorities play, to finding out where you can get further information and advice.