The main part of the care planning process. This is an in depth discussion with you, your carer and/or family.
The assessment will identify your care needs at that particular time. We may with your permission, need to talk to other professionals such as your GP or District Nurse to gather further information.
You will receive a copy of the assessment report from your care co-ordinator.
When you feel your needs have changed in the future we complete another assessment, a reassessment and will adjust your care plan accordingly.
We will keep any information held about you in a safe place.
Researching local care services options.
Following your assessment and agreed care plan your care coordinator will research and source local care service options for you. We will look for the best available options for you that provide value for money.
Nothing will go ahead until you agree to using the service provider found and the final decision to use the service will be made by you and your family.
Monitoring of your well being and services provided.
At Age Care Advice out main areas of focus are your general well being and safety. To ensure your services contribute to both we will monitor the care you receive and will respect you if things do not go well. You might for instance become unwell you or you might not be fully satisfied with a service you are receiving.
Your Care Coordinator will be there for you when needed.
Long term care planning.
You may have reached a point where you need or would like to consider entering a residential or nursing home. Your personal Care Coordinator will identify your care needs by carrying out an assessment. You may want us to discuss this with your family or other representative.
Our Care Coordinators have many years of experience working alongside care homes and their clients. They will also escort you to view homes if possible. It is a big life changing decision and we can support you through it.
Once you have chosen the home of choice the care home will receive a copy of the assessment report.
When you are living in the care home we will monitor your progress with you and your family if you wish. We can help you address any issues that arise along the way.
You have the option to retain the same Care Coordinator who can continually monitor your well being and complete a formal review of your care service every six months. This service is especially useful for the family members who do not live close by and need an independent professional to oversee and continually monitor the care of their relative.
Care Coordinator Retainer Scheme.
If you would like your personal Care Coordinator to work with you and your family or other representative on an on going basis then this is an option for you. The benefits are your coordinator will get to know you and your needs, the care you receive and other professionals involved such as your GP etc. This really improves efficiency and communication when the coordinator needs to respond to any problems.
Social service departments cannot offer this service and you would have a variety of workers over time who all ask the same questions each time. This is no ones fault, it is a large organisation and just cannot guarantee such a personal service. Your Care Coordinator will also be easy to contact and you will not have to go on a waiting list.
The retainer includes all the services listed (excluding the escort scheme for special occasions). For a fixed monthly fee your Care Coordinator will as a minimum visit you once a week to review your well being and care services being received. That person will of course be able to respond to any crisis such as ill health, falls or hospital admission and can represent you.
Family members not living close by find the retainer invaluable as it is one person who knows their relative well that they can turn to for help, support and guidance. Please remember our Care Coordinators are very experienced and carefully chosen. They are even available at weekends. This scheme can offer you and your family peace of mind, 7 days, 12 hours a day, access to your personal coordinator.
Please contact us if you have any questions.
Hospital Discharge Package
Being admitted to a hospital can be an unpleasant time for you and your family. As well as being unwell you cannot guarantee that you will receive a good service. Your Care Coordinator will visit you in hospital and represent you. They will make sure your needs are met within the hospital environment and address any issues with the medical team. We have hospital social work experience so have frontline insight in to how things should be done. We will-
• Liaise with ward staff and when are ready to be discharged complete an assessment of your needs on the ward.
• Attend any discharge planning meetings if arranged.
• Arrange appropriate care services to start on the day of your arrival at home.
• Monitor your well being and the care arranged and avoid readmission.
• Always involve you and your family in decision making.
• Only close your case when you are settled and satisfied.
You will also have the option to retain your Care Coordinator for the future if you wish.
Hospital Consultant and GP appointment representation service.
Many older people can have problems getting to appointments due to a variety of reasons. They also may have difficulty remembering important information given to them by the GP or Consultant due to poor memory or because they feel worried about their future health.
Age Care Advice can attend with you to represent you and clarify points made. They can also help you to ensure that the best medical interventions are available and if you so wish they can feedback any important information to your family.
Continuing Health Care (free) NHS funding screening.
If your care needs are high and you require nursing interventions, you may qualify for support with funding your care, whether at home or in a care home.
Our Care Coordinators can assess you against the current Continuing Healthcare criteria and complete a report. This report with it’s evidence can be presented to the local Continuing Healthcare Team in order to request a full formal assessment which is carried out by an NHS assessor.
Reviews within the community or long term care homes.
Our Care Coordinsotrs are very experienced in completing reviews of care with clients and their families. Reviews are very important because they reveal if the person is satisfied with their care, if the care being provided is good quality and if an increase or decrease in the care is required.
The review is a meeting with you and any other representative you wish to involve and the care provider. The review might conclude with several action points which need to be addressed. Your Care Corodinator will make sure this happens.
If you are impressed with your Care Coordinator you do have the option to retain them. See our Gold Scheme.
Reviews are also essential for the provider as it enable them to identify areas of poor practise that the home or agency needs to change. If a client is assessed to be needing an increase in their care the Care Coordinator will gather the evidence for the review report which can be presented to the local authority to request an increase in funding.
Capacity and Best Interest Decision Making Assessments
If someones mental capacity to make a decision is in doubt then a formal assessment of that persons ability to make the decision needs to take place. If the person is assessed not to have the mental capacity or insight to make a specific decision then a Best Interest Decision is the next step. This involves research into peoples past, any written documentation, family and friends opinions etc of what the person more than likely said if they retained their capacity. A decision is then made for the person in their best interests. An example may be when a person who has dementia needs to go into long term care. Another example is when having to make a decision about your financial affairs or medical treatment.
This process is a legal process, you can read about this in more detail on www.doh.gov.uk.
Welfare Benefit form completion.
You may be entitled to claim welfare benefits which may really boost your income. For instance claiming Attendance Allowance if you need assistance with personal care for example will provide £200 to £300 extra a month. Carers can also claim Carers Allowance for looking after you.
Age Care Advice Care Coordinators have experience of completing the forms, which most people find to be quite a daunting process. The process involves registering your claim with the DWP (Department for Work and pensions) and then-
• Completing the form on line.
• Assist you to appeal if the application is refused.
Depending on where you live you may also be able to get the service free from Age UK or the CAB.
Tel: 01572 756666, 01476 552137 or 07772-992732
Age Care Advice currently operates in the following areas:
If you live outside one of these areas, still do contact us, we may be able to help you!