Understanding Care Services: Intermediate Care

What Is Intermediate Care?

Intermediate care covers a range of short term care services including reablement. You can find out more about reablement by going to my article here. Intermediate care is short term support. It can last for a period of up to six weeks. It may, in certain circumstances, be extended beyond that six weeks’ period. Intermediate care is one part of an overall care package provided to you.

What Is the Purpose of Intermediate Care?

Intermediate care aims to keep you living in your home independently for as long as possible. By providing you with the right support you may be able to:

avoid having to go into residential accommodation

avoid having to be admitted to hospital,

be supported on discharge from hospital

recover more quickly from illness

Who Qualifies for Intermediate Care?

Intermediate care is an option for any adult who may benefit from it. An adult is anyone aged 18 or over. The aim of intermediate care is to help you to maintain, or regain, your independence to continue, or return to, living in your home. Therefore, you are likely to be offered intermediate care in the following circumstances.

To help you avoid admission to hospital. For example, you have a fall at home, with the right, timely support, it may be possible for you to avoid the need to be admitted into hospital

To support your discharge from hospital. If you have had a stay on an acute hospital ward you may need a little help to regain your confidence and skills to continue living independently at home. Intermediate care can allow this support to be provided in your home upon your discharge from hospital or in a rehabilitation home (sometimes known as bed-based accommodation) prior to your moving back into your home.

Before you move into long term residential care. Typically, intermediate care is offered as a stepping stone between hospital discharge and admission to long term residential care.

To support people who you have dementia or other mental health needs. In these circumstances, avoiding hospital admission in the first place is the ideal. If this is not possible, timely discharge should be the aim. Intermediate care may be available to support either of these goals.

End of life care. People who are being cared for at home during their last days may have the quality of their lives enhanced by some simple adaptations. This could involve, for example, helping carers learn different ways of doing things. In such circumstances, intermediate care may be available.

How Do You Get Intermediate Care?

In the ideal world, you would be automatically referred for intermediate care if ever you found yourself in one of circumstances outlined in the previous section. However, the world is not ideal and it may well be the case that you will need to prompt a health care professional to refer you to the intermediate care team. Suitable health care professionals to prompt might be your GP, a district nurse, the discharge team in a hospital, staff attending to you on an A&E ward, paramedics attending at your home or an out of hours GP. Alternatively you may refer yourself.

Once a referral has been made you will require an assessment from the intermediate care team. The contact details of Thanet’s intermediate care team are:

Westbrook Integrated Care Centre 
150 Canterbury Road 
Margate 
Kent
CT9 5DD

Telephone: 01843 254134

The East Kent Intermediate Care Team’s website address is: http://www.kentcht.nhs.uk/home/our-services/intermediate-care-east-kent/?entryid109=228837

What Is the Cost of Intermediate Care?

Intermediate care is free for up to six weeks. It may in certain circumstances be extended beyond this period.

What Does Intermediate Care Involve?

There are four types of intermediate care.

The first type is referred to as crisis response intermediate care. This is very short term care – usually for a period of up to 48 hours. A health care professional will make a referral to a crisis response team who can rapidly ensure that you receive an assessment and receive the support you need. The support can be provided in your home or in residential accommodation.

The second type of support available is called home-based intermediate care. So called for the simple reason that the support is provided in your home.

The third type is known as bed-based intermediate care. This involves support provided in a setting away from your home – for example in a residential home.

The final type is reablement. The approach underpinning reablement is aimed at helping you to live your life independently. Reablement workers are not charged with the responsibility of doing things for you; they are responsible for helping you become confident and competent in doing things for yourself. You can find out more about reablement by going to my article here.

Who Provides Intermediate Care Services?

There are many health and social work professionals who may be involved in supporting your intermediate care needs. These professionals include: doctors, nurses, occupational therapists, social workers and care and support workers.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Eight Things You Should Know about Community Care Assessments from Kent County Council

Introduction

In order to get financial help from Kent social services for your home care needs there are two assessments that social services must undertake.  

To take these in reverse order; the second assessment that is carried out is a means test. This determines whether you are entitled to have your home care provision paid for in full by social services; partly paid for by social services or not paid for at all by social services –  in this last case, in other words you have to pay for it yourself. There is, though, an assessment that comes before this.

The first assessment is one of your care needs. This is known as a community care assessment. You may also hear it referred to as a care needs assessment. This article deals with the community care assessment only.  

The information that follows applies specifically to adults. It is also aimed at people looking for domiciliary care (home care) although much of what is said applies to people seeking residential care.

Here are eight things you should know about community care assessments from Kent social services. 

1. Kent County Council (KCC) has a statutory duty to carry out community care assessments. 

Local authorities, like Kent County Council, often have statutory duties placed upon them. What this means is that there exists a law that has been passed by Parliament – a law contained in an Act of Parliament, also known as a statute – that places the local authority under an obligation to do something. When such a duty exists, it is something that a local authority cannot fail to do. Such is the case with community care assessments. Local authorities, like KCC, therefore, are under a duty imposed by law to carry out community care assessments.  

2. The Duty to carry out community care assessments is interpreted in such a way that means that in practice it is highly improbable that KCC can refuse to carry out an assessment of your care needs.

The law imposing the duty says that if it appears that you may need community care services that your local authority may be able to provide then your local authority has a duty to carry out an assessment of your care needs.  

Even in circumstances where the KCC believes that you have little chance of qualifying for community care services: it must still conduct the assessment. Even in circumstances where KCC believes that you will not qualify financially for social services help: it must still conduct the assessment.

If you are disabled Kent County Council has an additional duty imposed upon it by law to carry out an assessment. 

3. If you are a carer who looks after someone (your wife, husband, relative or friend), you are also entitled to have a community care assessment. 

If you look after someone, you can request a community care assessment when the person you care for is being assessed. You are entitled to an assessment even if the person you care for decides not to have an assessment of his or her needs undertaken. 

4. To get a community care assessment your first step is to make a referral to Kent social services. 

You can do this yourself. Alternatively, a relative, friend or carer can do this on your behalf. You can also be referred by your GP or another health or social care worker. To contact Kent Social Services you can telephone: 03000 41 61 61 (text relay 18001 03000 41 61 61) or email social.services@kent.gov.uk.  You can also drop into a Gateway Plus Centre. There are several of these in Kent and you can find their locations by following this link. 

5. To get an assessment takes about 28 days from the day of referral.  

Although local authorities have a duty to conduct community care assessments, there is no duty placed on them that dictates how quickly they must deal with referrals. There are guidelines; however, and the guidelines state that referrals must be processed within 48 hours and the whole procedure completed within 28 days. Kent County Council says that in most cases it completes assessments within a month. In an emergency, a local authority can put in place temporary care services.

6. Assessments usually take place in your home.

If you are seeking home care this is the best location for an assessment to take place. It is possible for alternative locations, like a GPs’ surgery, to be used. If you are a little unsure about explaining your needs to someone, you might like to have someone with you at your assessment. This person will sometimes be referred to as your advocate, that is, someone who speaks on your behalf. 

It is also possible for assessments to be done by telephone. This may be fine for simple assessments but it is not advisable if you have more complex care needs. Telephone assessments are controversial because they can be used as a means of screening out people before the formal assessment is conducted.  

You may also be asked to carry out a self-assessment of your care needs. This may help you focus your mind on what your needs are but in no way should it be used as a substitute for a formal community care assessment.

7. Your care needs will be assessed as falling into one of four categories. 

The community care assessments measures the risk to your independence and well-being if nothing more is done – in other words what is the risk to your independence and well-being if no care is provided. 

The four categories are referred to as eligibility criteria and they are called: critical, substantial, moderate and low.These criteria are a measure of how serious your needs are. 

In the first, and most serious, category your needs are judged to be critical. If your needs fall into this category then your life may be at risk, and/or you have significant health problems, and/or you are at risk of serious abuse or neglect if nothing else is done. 

In the second category your needs are deemed to be substantial, which means that if nothing more is done you will havelimited choice and control over your living environment and/or you will be at risk of abuse or neglect. You will not be able to carry out most of your personal care or domestic tasks. 

The third, moderate category, without more being done you are not able to carry out several tasks relating to your personal care or domestic tasks. You are not able to maintain a lot of contact with society or take an active part in family life. 

In the final, low category, will not able to carry out one or two tasks relating to your personal care or domestic tasks without more being done. 

Many local authorities will provide funding for care only where your needs fall into one of the first two categories. Kent County Council provides funding for care falling into the first three categories. 

If you qualify for funding you are said to have an eligible need or eligible needs. However, even though you have an eligible need you will still need to qualify on a means test. 

8. If you are assessed as not having eligible needs, or you feel the assessment of your needs is inadequate, you can appeal. 

You must ask for the decision in writing. You need to know the reason why you have been assessed as you have. Make sure that you are aware of the local authority’s complaints procedure. Kent County council has a complaints team at: Brenchley House, 123-135 Week Street, Maidstone, Kent ME14 1RF.  Telephone:  03000 410 410 or:  Brook House, Reeves Way, John Wilson Business Park, Whitstable, Kent CT5 3SS.  Telephone : 03000 410 410. Alternatively you can email them at: complaintsteamadults@kent.gov.uk.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 23591001843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

How to Get Financial Help for Home Care from Kent Social Services

What this Article Is About

The purpose of this article is to guide you through the procedure for gaining support from Kent Social Services for your home care needs. This applies to adults only. 

To qualify to have your home care paid for fully or in part by Kent Social Services you have to have two assessments. The first one assesses your care needs and is called a community care assessment.

The second assessment is a financial assessment that decides if you are entitled to have your home care paid for fully or in part by Social services.

Community Care Assessment

To receive funding from Social Services, the first step is to have your care needs assessed. This is called a community care assessment.  

The assessment can be done face to face or by telephone. You explain what your care needs are and Social Services use this information to decide if you are eligible for Social Services support. To arrange an assessment you need to contact Kent Social services on the following number:

03000 41 61 61 (text relay 18001 03000 41 61 61) or email social.services@kent.gov.uk.

Your needs are assessed as falling into one of four bands.

1. Critical

2. Substantial

3. Moderate

4. Low

You only qualify for Social Services support if your needs fall into one of the first three bands. If your needs are assessed as low you do not qualify for Social Services Support.

If your care needs fall into one of the first three bands, Social Services will then work out how much this will cost. This is called your actual personal budget. This is not necessarily how much you will get from Social Services. How much you get depends upon your financial circumstances.

Financial Assessment

This is a type of means test. First of all, you will be asked how much you have in savings. This does not include your home. If you have more than £23 250 you will be asked to pay for your care in full. 

If you have less than £23 250 in savings, Social Services then assess the amount of income that you receive each week. Income includes your pension and benefits. If your income is over a certain amount, you will be asked to contribute to the cost of your care. 

Everyone’s circumstances are different. However, for everyone there is a protected income level of £185.44 (in 2014-15) per week. There are various allowances that increase the amount that Social Services cannot make you use to pay for your care. Certainly if your income is below £185.44 you will not pay at all. For more information, you can take a look at this booklet. 

If you have savings between £14 250 and £23 250, Social Services assume that part of this makes up your income. For every £500 that you have above £14 250, Social Services will add £1 to you income.  

For example, if you have £16 250 in savings (that’s £2000 above £14 250), Social Services will add £4 per week to your income. So, if your income is £200 per week, the extra added on because of your savings makes your income £204 per week. 

The amount of money that you have left after Social Services have deducted all your allowances is called your available income. It is the money that Social Services assess you as having available to contribute to your care each week. Available income is your actual income less your protected income plus other allowances. 

An Example

Let’s say that you the following figures apply to you: 

Income: £250 per week

Protected income plus other allowances: £225

Therefore, your available income is £25 per week (£250 - £225) 

This means that Social Services will say that you can contribute £25 per week to your care costs. 

Now let’s assume that your actual personal budget is £150 per week. Remember that your actual personal budget is how much your care is going to cost based on how it has been assessed by social services. 

To meet this figure of £150 per week, you will have to pay £25 per week and Social Services will pay £125 per week. 

Direct Payments

Once you are receiving financial help from Social Services, make sure that you asked to receive you money by direct payments. Social Services should inform you of your right to direct payments.  

Social services can arrange everything for you. However, if you want to take control over who provides your home care you need to request to receive direct payments. If you receive direct payments it means that you are given a sum of money that allows you to purchase your care from whichever company you choose. And the importance of this cannot be overstated.  For more information about direct payments; go to this page. 

Direct payments work in a very straightforward way. KCC pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. You then use this money to buy your care from a provider of your choice. 

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.