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Community care

community care

Many people living with a long-term health problem such as HIV lead active lives and need little support, but sometimes it can be hard to cope.

Direct Payments

Community care services are mainly provided to adults with care needs by the Local Authority through Direct Payments.

Direct Payments are made to a person by a Local Authority, to allow them to arrange and buy their own services. If a person lacks mental capacity or needs children's services, the Local Authority can make direct payments to someone else on their behalf.

Community care services include:

  • Activities such as those provided in a day centre. These activities can be cultural, educational, occupational, recreational, social or for the purpose of rehabilitation. 
  • Providing, arranging and paying for accommodation in a care home when someone is no longer able to live independently. 
  • Adaptations to the home and equipment.

Adaptations to your home or equipment:

You may be entitled to adaptations to your home and/or equipment to help you in your home or to increase your mobility outside the home. Adaptations can be big or small and can allow you to remain in your home.

A major adaptation could be the installing of a stair lift, a downstairs lavatory or the lowering of worktops in the kitchen.

A minor adaptation could be, for example, putting grab rails in the bathroom.

The equipment provided by a local authority could include:

  • alarms and communication equipment
  • bathing aids 
  • beds 
  • cushions 
  • equipment to access documents eg, a magnifier or computer programme 
  • hoists and lifts eg, for getting out of bed or up and down stairs 
  • speech aids 
  • car equipment such as car hoists.

Other ways community care can help:

Holidays: you may be able to get help with paying for a holiday, a place in a holiday home or information on holidays suitable for disabled people.

Home care services: home care is for help with personal care and involves someone coming to the home at agreed times. This could involve daily visits or even 24 hour care if needed. It could include occupational therapy services. Home care can make it possible for you to stay in your home.

Home care can include help with:

  • bathing and washing
  • cleaning 
  • cooking 
  • eating and drinking 
  • getting up and going to bed 
  • shopping 
  • laundry 
  • helping someone to manage their finances.

Intermediate care: temporary care (usually no more than six weeks) to help you keep or regain the ability to live independently in your own home. It can be provided by the Local Authority or the NHS and is meant to avoid unnecessary admissions to, or long stays in, hospitals or care homes. It can involve therapy or treatment or can give you time to recover your ability to manage at home.

Meals on wheels and lunches outside the home: you may be entitled to the delivery of a meal each day or, in some areas, the delivery of a weekly or monthly supply of frozen food. You may be entitled to meals 'elsewhere', which will usually be at some kind of day centre or lunch club.

Night sitting services: you may need someone to watch over you during the night or to be on call if needed. This may be to allow your carer to have a break. The night sitter will not be medically trained but will usually just be there in case anything goes wrong and to call other assistance if necessary.

Radios, televisions and library services: you may be able to get a radio, television, library services and/or talking books.

Respite care: respite care is temporary care to give a carer a break from caring, or to give you a break from your carer. It can mean temporary accommodation in a care home or temporary home care services in your own home. It can also mean a holiday to help you to recuperate or a period of NHS-funded care to help with rehabilitation after you have been discharged from hospital.

Telephones: you may be entitled to a telephone and/or any equipment necessary to use it, for example an amplifier or a textphone.

Travel to participate in services: you may be entitled to transport to and from services, for example, to a day centre.

Will I have to pay for community care?

Community care services are separate to those provided by the NHS or by housing authorities, although they can include some health and housing services.

You may be entitled to have all of your care paid for by the NHS. This is known as NHS continuing healthcare.

If you’re entitled to NHS continuing healthcare, the NHS and not the Local Authority should provide and pay for your care.

The process for getting community care services has three stages:

  1. The Local Authority will carry out a Community Care Assessment.
  2. It will then decide what services the client is entitled to.
  3. It should then make a Care Plan and decide how the services will be provided.

The Local Authority can charge for some services. A Local Authority must normally charge for residential accommodation which it provides or arranges, including those providing personal care or nursing care and for hostel accommodation.

Services and the way they are provided differ between Local Authorities. You may need to contact your Local Authority or an adviser for specific information.

Challenging community care decisions:

If you want to challenge a community care decision there are five possible ways of doing this:

  • Use the Local Authority complaints procedure.
  • Contact the Local Authority's monitoring officer.
  • Contact the Local Government Ombudsman in England or the Public Services Ombudsman for Wales.
  • Use judicial review proceedings.
  • Take court action for damages.

In most cases you should seek further advice and guidance before deciding how to proceed. You can call THT Direct or talk to an Online Adviser if you need help with this.



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The Information Standard: Certified member

This article was last reviewed on 19/9/2014 by C. Berry

Date due for the next review: 30/9/2017

Content Author: G. Arrindell

Current Owner: D. Anyanwu

More information:

Citizen's Advice, Advisernet - Community Care