If the person you care for moves into residential care

Making the decision

If you are considering the possibility of the person you care for moving into residential or nursing care, you should allow time to find out all the options open to you. Ask social services for a carers assessment, and for an assessment (or re-assessment) of the person you care for. There may be more help you can get at home, for example increased support from social care, medical equipment, adaptations to the house or more frequent short term stays in residential care for the person you care for.

You also need to talk with the person you care for about what is best for both of you. You may find that they accept the situation more readily than you expect. There may be ways you can reassure them, and yourself, about the move. For example, if the home is nearby, do you know anyone who already stays at the home?

Can the person you care stay there on a trial basis first?

If the person you care for is unwilling to discuss the situation, or you are finding it hard to handle the move, it may help to talk it over with a friend, family member, another carer, your GP or Social Worker. There are organisations that can offer support such as your local carers centre or the Relatives and Residents Association.

Other organisations produce information about finding and funding care, and may have information that can help, such as MS Society, Alzheimers Society, or Independent Age. 

Practical Matters

Are you still a carer: social care

When the person you care for moves into a residential care home, you may still be entitled to a carers assessment from social care. This will be the case if you are still providing necessary care to supplement the care provided by the residential care home. Some carers find that the time they spend caring actually increases as they spend all day at the home, e.g. helping with personal tasks such as feeding or bathing. Travelling to and from the care home does not count as time spent caring.

If you are no longer offering necessary care, the professional in charge of looking after the person you care for must still take into account your views and feelings when decisions are made. It is a good idea to discuss with staff how you will be involved, and what you can expect from them, as early as possible.

Are you still a carer: employment

If you are employed and care for someone, you can ask for flexible working. This can help you balance working and your caring responsibilities. You have the right to request flexible working if  you’ve been with your employer for at least 26 weeks, and haven’t made any other requests within the last 12 months.

For more information about carers rights at work, see the Carers UK’s factsheet ‘Your Rights at Work’ or visit the Advisory, Conciliation and Arbitration Service (ACAS) website

Making decisions about treatment

If the person you care for has the capacity to make decisions, and they continue to do so, the fact that they live in a residential home does not affect their right to make choices about their care and treatment. If the person you care for cannot make their own decisions, or may not be able to in the future, they may be able to nominate someone to make decisions for them (by giving them Power of Attorney), or the Court of Protection can make decisions on their behalf.

For more information or advice, contact the Office of the Public Guardian.

If the person you care for is at the end of their life and the expectation is that their condition will deteriorate and they may lose capacity to make decisions about their care, they should be offered Advance Care Planning. This is a process used by all professionals who work with people at the end of their life, to help them understand their illness, and make decisions about, and prepare for, the end of life.

Through Advance Care Planning, the person you care for can make an advance statement or decision about the treatment they wish or do not wish to receive. They can instead (or also) nominate someone to have Lasting Power of Attorney over their health and welfare decisions.

For more information about Advance Care Planning contact Compassion in Dying. 

Without having a Lasting Power of Attorney for the person you care for, you will not be able to make decisions about their care or treatment if they are unable to do so themselves. The professionals involved should ask about your opinions and wishes, but you cannot make decisions on their behalf, even if you are their next of kin.

If none of the above measures are in place, decisions about the care and treatment offered to the person you care for will be made in their best interest by medical and social care professionals.

Charging

Unless care is provided by the National Health Service (NHS), local authorities or individual care homes can charge for their services. In order to do this, they must carry out a financial assessment of the person you care for to determine how much they can charge.

Local authorities must follow statutory guidelines for charging (which includes any property owned by the person in care). Paying for care is a complex issue and it is important to seek specialist advice.  

Independent age produces information about paying for care. 

What happens to my benefits?

Some benefits can still be paid to the person you care for once they have moved into a residential home, and some will stop once the person you care for has been living in a residential home for a set period of time. If the person you care for is paying all of the fees themselves, they can still get the Disability Living Allowance care component, Personal Independence Payment daily living component or Attendance Allowance. 

If the fees are being payed in full or part by the local authority, NHS or any other public funds, payment of the above will stop after the person you care for has been in a care home for 28 days. Once the person you care for is in a care home permanently and their Attendance Allowance or Disability Living Allowance care component stops, or you stop caring for at least 35 hours per week, your Carers Allowance will also stop.

There may be other benefits that you may be able to claim. The Turn2Us website has lots of for information on income-related benefits, Universal Credit and tax credits.

Concerns or complaints about the care home

If you are not happy with the care home, in the first instance, talk to the manager of the service. All homes must have a complaints procedure.

If a referral to the home was made by social care, you should also speak to the social worker or care manager involved in the care package. All local authorities have a complaints procedure - this will offer three stages of complaint. If you have gone through all stages of the complaints procedure and you are still not happy, you may be able to take your case to the Local Government Ombudsman. 

To find out about care home standards or to make a further complaint about a service, contact the Care Quality Commission.

If the service is provided by the NHS, ask your local health authority for a copy of their complaints procedure. If, at the end of the complaints procedure, you are still unhappy, you may be able to take your case to the Health Service Ombudsman.

Healthwatch Dorset works to help local people get the best out of their health and social care services, either by improving them today, or helping to shape them for tomorrow. To share your experiences, good or bad you can contact Healthwatch Dorset.

Useful contact numbers (as mentioned throughout)

Finding and funding care

• MS Society - 0808 800 8000
• Alzheimers Society - 0300 222 1122
• Independent Age - 0800 319 6789 

Your rights in work

• ACAS - 0300 123 1100

Decisions about treatment and Advance Care Planning

• Office of the Public Guardian - 0300 456 0300
• Compassion in Dying - 0800 999 2434 

Concerns or complaints about a care home

• Care Quality Commission - 0300 061 6161
• Hospice Care - Hospice UK - 020 7520 8200