When you receive your care at home it is often referred to as Domiciliary Care. Care at Home is ideally suited to those people who want to retain their independence with some outside support. The care provided is usually help with a specific tasks, for example, help getting up and going to bed and/or help with bathing.

Demand for care at home is high and the situation is only likely to get worse as it is projected that nearly 40% of England’s population will be over 50 by 2029. The good news is that the majority will be active and able to cope independently. However, as people age, many will become more dependent and need this type of help from outside services to retain their independence.

Care at home is usually provided through the Local Authority Social Services, however, in the current economic climate, many people who need a little help are finding it increasingly difficult to get it. This is because many authorities are not able to find the extra funding required to keep up with the growing need for care. It means that those whose care is assessed as 'low level' often find that their services are limited or non-existent until they need a higher level of care and support.

Getting assistance

The need for care can happen at any time and can be triggered by an accident, such as a fall in the bathroom, or can happen over time such as when a person has a debilitating illness such as arthritis or dementia and finally cannot cope without help.

When the need for care arises, your first step is to get an assessment of needs done by your local social services. The Single Assessment Process combines the assessment for local authority social services with one for health care and is the gateway to any services that may be available. This assessment should be done for both the person who needs the care and the person who is doing the caring.

If you are providing care at home for someone, , you may be able to get assistance with your caring duties to give you some help. This could be from carers employed by the local authority or those engaged by the person you're caring for. There is no standard charging rate for domiciliary care and each Local Authority can set their own charging procedures, but in doing so, they must take account of the guidance under the 'Fairer Charging Policies' issued by the Department of Health.

Equipment and facilities that can be installed in the home are also available and can help the person being looked after to be more independent. You can access to this equipment through social services by getting a community care assessment for the person you're looking after; (or an assessment under the Children Act, if the person you're looking after is a child). The Local Authority's website usually provides details on any sources of support such as adaptations, Disabled Facilities Grants and how to get a parking bay outside your home.

The value of the home is disregarded in domiciliary care but all other assets may be included and following the Section 47 assessment, those who have been assessed as needing care from Social Services can either have it arranged through Social Services or people can opt to arrange their care themselves using funds allocated in their personal budget to pay for the care of their choice.

If you look after someone with an illness or a disability, you may need to help them move around. When providing Care at Home, it's essential that you know about safe moving and handling so you don't hurt yourself or them. The most common injuries that carers experience are back injuries, which affect more than a million people in the UK. Injuring your back will limit your movement and your ability to care for someone. It could take a long time for you to recover.

Lifting someone incorrectly can also damage fragile skin, cause shoulder and neck injuries, increase existing breathing difficulties or cause bruising or cuts. Your local authority may run training courses in manual handling and may provide you with equipment to make caring for someone safer and easier. Many charitable and independent carers' organisations can help you find training courses for moving and handling.

Your local authority has an obligation to help carers avoid health and safety risks. If your local authority doesn't offer manual handling courses, ask for a direct payment so you can pay for a course of your choice. You will find further information about moving and handling in the enclosed link. http://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/mobility-problems-carers.aspx

Preparing your home

If you are preparing to provide Care at home for someone who has limited ability to look after themselves, it is important to ensure that the accommodation is safe and warm. You need to remove items such as trip hazards and install grab rails in the bathroom and wherever else they are needed.

You may also need to consider getting a stairlift if stairs are a problem. You can source one yourself or your local authority should be able to advise you on what will meet your needs. The social services department will be able to help and advise on any other equipment that will help with day to day tasks and also on lifeline alarms or sensors that can be installed so that help is at hand in the event of a fall.

If you are providing the care for someone in their own home, it is important to follow the same rules on their accommodation but, as you are providing the care from a distance, it is even more important that lifeline alarms and sensors are installed so that you can be contacted by the system should an accident occur whilst you are not there.

Obviously when you have to travel to care, this makes things harder for you, as it makes it more difficult to fit some of your own work in between your caring duties which you would do if you were caring for your relative in your own home.

Where circumstances allow, many people provide Care at Home by converting or building an annexe to their home for their relative to move into. This solution has many advantages, in that the person can retain their independence but have help nearby when it is needed.

It also enables your relative to see and be part of the family and, if you have children, to take part in their lives. This is a benefit to them too as, with increasing job mobility, too many children grow up having very little experience of older people and their needs, as their grandparents often live miles away.

Finally, providing care at home and handling your own responsibilities is not an easy task and it is very important that you look after your own health too. Ensure that you investigate sources of help, take any that is offered and, if there are other members of the family that they take their share of the responsibility too.

Lasting Power of Attorney and Making a Will

It is also vitally important that you take care of the legal side of things. These are making a Lasting Power of Attorney and either reviewing an existing Will or making a new one.

A Lasting Power of Attorney (LPA) is an important document because it ensures that there is someone in place to make decisions if a person is unable to make these for themselves and a Will clearly sets out who is to receive their property and possessions, thus avoiding disputes between relatives and unnecessary legal costs.

You will find more information in the "Planning ahead" section of this site or, if you would like to speak to someone in person, email victoria.milsom@thenationalcareline.org or telephone 0800 0699 784.