Chapter 1 Introduction

(Publication: Guide to Care at Home 2008-2009)

Welcome to the Guide to Care at Home

This Guide is for people who want to go on living in their own homes but, because of old age and/or disabilities, need help, information or specialist advice to do so.

Now in its eleventh year, this Guide has become the definitive reference source for thousands of people in Hampshire. It is relied on by those wishing to continue to live independently, their relatives and friends as well as carers, professional care staff and volunteers.

Finding the right care can be difficult and timeconsuming. You may need help from a variety of sources. Our aim here is to bring together details of the key organisations, such as the NHS, district councils, Home Improvement Agencies, charities and commercial companies, as well as Adult Services, that might be able to help you or the person you care for.

The production of this independent Guide is funded entirely by advertising revenue. None of its costs are paid for by Hampshire’s residents. This enables us to give copies free of charge to readers. You can get a copy in other formats, including large print and on audio tape, by calling 01962 8833046. It is also available online at www.hants.gov.uk/adultservices/care-at-home-publications.

We hope that you find the Guide helpful and that indexes such as the Quick & Easy Reference in the back cover flap make it easy to use. We would very much welcome your comments so please do fill in the enclosed questionnaire, call us on 01962 833046 or email us at adult.services.feedback@hants.gov.uk

Councillor Patricia Banks
Executive Member for Adult Social Care

Where to get help - overview

The Adult Services Department can provide information to all residents about the community care services that are available. Community care is the term for the mix of help, support and care that enables people to go on living in their own homes or supported housing rather than having to move either into a care home or to live with relatives. The Department will assist people who qualify for their help to identify which resources and support can be put into place to enable them where possible to retain or maintain their independence. To contact the department, see contact details on page 111.

If long-term care is necessary and if the person meets the Department’s eligibility criteria, there may be an initial 6-8 week period of intensive home care provided by the Department's Community Response Service. Thereafter, in most cases, the Department will contract with independent organisations to provide on-going care.

Your GP can advise you about health matters. The National Health Service (NHS) provides medical care and treatment and your doctor can refer you to a range of specialists for advice and care – see chapter 3.

Your nearest Department of Work and Pensions (DWP) office can give you information and advice about any state benefits or other payments you may be entitled to - see chapter 6.

Your local Citizens Advice Bureau (CAB) can give free, impartial advice and information about your rights, including benefits and how to apply for them. CAB staff can also help you put across your point of view when you are dealing with other organisations. See the Phone Book for your local branch, or the CAB website at www.citizensadvice.org.uk.

Your Borough, City or District Council can give information about affordable housing, including sheltered or supported housing. For contact details see chapter 9.

Your nearest Home Improvement Agency (HIA) can give information and advice about making alterations to your home to make it easier for you to live in, and about ‘care and repair’ schemes that help older or disabled people maintain their properties. See chapter 9

Your local Council of Voluntary Service (CVS) can give you details of local organisations and groups providing specialist services in your area, including carers support, help around the home and voluntary transport. For contact details see chapter 9.

Age Concern run an advice and information service for older people and their families, including help in applying for benefits. Tel 0800 328 7154, Monday to Friday 10am-3pm.

The Veteran’s Agency provides help and advice to former members of the Armed Forces and their families. Call 0800 169 2277.

The Yellow Pages gives details of local businesses that can help with cleaning your home (under ‘cleaning services – domestic’) and equipment to make life easier at home (under ‘disability’ and ‘mobility’). Details of gardening and taxi services, can also be found here. Additionally, www.yell.com allows you to search online for local businesses which offer the services that you need.

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Help in making decisions

The Mental Capacity Act (2005)

If you or the person you care for has a disability, injury or illness that makes it difficult to make decisions about medical treatment, care needs, finances and other aspects of everyday life, then the new Mental Capacity Act is designed to help you. It clarifies the circumstances in which other people can act on behalf of someone who lacks capacity to make decisions and sets out the limitations and safeguards that now exist.

The aim of the Act, fully in force since Autumn 2007, is to put individuals at the centre of any decisions made regarding their care, giving them the support and advice they need to make decisions for themselves where possible.

The Act introduces criteria to judge whether a person lacks capacity to make decisions because of an impairment or disturbance that affects the way their mind or brain works, e.g:

a learning disability
dementia
a mental health problem
a stroke or brain injury

The Act also creates a new criminal offence of the ill-treatment or wilful neglect of someone who lacks mental capacity.

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Advocacy

The new Independent Mental Capacity Advocate (IMCA) service is central to the working of the Act. Advocates will work with someone who lacks capacity to make certain important decisions and has no one else who can be consulted to try and establish their wishes. The IMCA service in Hampshire is coordinated by Hampshire Advocacy Regional Group (HARG).

Hampshire Advocacy Regional Group

HARG is a network of advocacy schemes which provide experienced advocates to work with people who have

mental health difficulties
physical or sensory impairments
a learning disability
older people, children and young people in transition.

They also work with people who lack capacity through other causes.

To find out more about the IMCA service please contact:

Independent Mental Capacity Advocate Service
17 New Road
Basingstoke
Hampshire
RG21 7PR

Tel: 01256 478999

Website: imca@hampshireadvocacy.org.uk

For schemes that specialise in learning disability see chapter 4.

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Making future decisions

You may wish to prepare for a time when you can no longer manage the running of your day-to-day affairs or deal with your paperwork yourself.

Powers of Attorney

From October 2007 you can apply for a Lasting Power of Attorney (LPA) and can choose one or more people you trust to deal with all or some of your property, finance or personal welfare affairs when, and if, it becomes a problem for you.

People often appoint more than one ‘attorney’ to act for them, as a safeguard against abuse of the wide powers over property and finance that the Power of Attorney gives and because people may have different skills relating to property, finance or personal welfare. Attorneys may act ‘jointly’ (where they must all sign all transactions) or ‘jointly and severally’ (where only one person needs to sign). If you change your mind later about the person or people you have chosen, you can revoke the document.

The Power of Attorney can take effect immediately, but more often it becomes active when people can no longer deal with their affairs. In that case the attorney’s powers are limited until the Power is registered by the Court of Protection.

You can use a solicitor to set up an LPA or, alternatively, fill in a form online on the Office of the Public Guardian website: www.publicguardian.gov.uk/arrangements/lpa.htm
Public Guardian helpline: 0845 330 2900

If you have already made an ‘Enduring Power of Attorney (EPA)’ or are acting on behalf of someone under an EPA, it will still be valid under the new legislation unless the person who made it decides to destroy it and replace it with an LPA.

The Mental Capacity Act allows you to make an ‘advance decision to refuse treatment’ if this is important to you.

The Court of Protection

The Court of Protection can make decisions about the finances and welfare of people who cannot manage for themselves, although it is not used for people on low incomes.

If your friend or relative:

is mentally incapable of managing their own financial or welfare affairs
has not made an Enduring or Lasting Power of Attorney (EPA) and is now mentally incapable of doing so
has assets that need to be used for his or her benefit or administered in some way, or
has complex welfare decisions that cannot be resolved in any other way,

then you should apply to the Court of Protection. The Court will appoint a Deputy to manage and administer the person's property and financial affairs if their assets exceed £16,000. If the assets have less value, the Court will issue a short order giving limited powers. If there is a one off welfare decision to be made, a short order will also be issued, but if there are a series of welfare decisions then a deputy will be appointed.

For forms and booklets about LPA or the Court of Protection call the Office of the Public Guardian Customer Services on 0845 330 2900 textphone 020 7664 7755
www.publicguardian.gov.uk/about/court-of-protection.htm

Office of the Public Guardian, Archway Tower, 2 Junction Rd, London N19 5SZ

Please note: They do not offer legal advice so for this, or for help in understanding the Powers of Attorney, you should contact a solicitor.

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What to do if you think someone is being abused or if someone is abusing you

People who need care and support have to trust everyone that they rely on for help. We know that abuse can happen and that it can take many forms, for example, physical, financial or emotional. It might be carried out by any one of a range of people including: family, friends, neighbours, paid staff, carers, volunteers, other service users or strangers.

Abuse is anything that harms another person.

Those who are vulnerable and are unable to protect themselves against significant harm or exploitation due to perhaps a mental ill-health, physical disability, a learning disability, age or frailty may be particularly at risk.

If you think someone is being abused, don’t assume that someone else is doing something about it. Make your concerns known to a person in authority that you feel comfortable speaking to, for example

The owner or manager of the domiciliary or nursing care agency
Your nearest Adult Services office for advice and help – phone numbers in Chapter 9
The local office of the Commission for Social Care Inspection tel 0845 015 0120
If you believe a crime has been committed, contact your local police on 0845 045 45 45.

If appropriate you could contact the following organisations that can give confidential advice and support

For older people:
Elder Abuse Response Helpline 0808 808 8141
Monday to Friday, 9am-5pm www.elderabuse.org.uk

For people with a learning disability:
Respond Helpline 0808 808 0700, Monday and Thursday, 2pm-7pm
Tuesday, Wednesday and Friday, 12pm-5pm
www.respond.org.uk

VOICE UK Helpline
0845 122 8695,
Monday to Friday, 10am-4pm
www.voiceuk.org.uk

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Using the internet

We’ve given the addresses of many useful websites in the Guide. Did you know that you can get free access to the internet in all Hampshire’s libraries? Staff at your local library can give you information, and help to get you started if you haven’t used the internet before. For details of your local branch, see the Phone Book or call 0845 603 5631 or see the website: www.hants.gov.uk/library

Telephone numbers

In this Guide, we give either local or national telephone numbers, as appropriate.

0800 numbers are normally free to call
0845 and 0844 numbers are normally those charged at local rates
0870 and 0871 numbers are normally charged at national rates

Be aware that some telephone numbers may cost more to call, especially those starting with 09.

If you get a request to call a number unfamiliar to you, you can call the operator for free on 100 and ask them to check the rate per minute for that number before you call it.

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