You may be dealing with a medical emergency, thinking about more care at home, or searching for elderly care home options nearby. This introduction explains how the elderly care system works so you can better navigate around it.
Navigating the elderly care system
Elderly care services are available from a number of sources – click on the links below to skip to further information on each:
- GP surgeries
- Local authority
- NHS/community care hubs
- Private providers
- Charities and other organisations
The source and level of individual care may come down to funding and availability locally, but this introduction will point you in the direction of where to start.
The GP surgery – the first place to start
Many services should be/might be available through the GP including home visits by a District Nurse or a member of the community care team; you should also be able to access referrals to memory, falls and continence clinics, as well as physios and occupational therapists.
Social prescribing is becoming more widely available from the GP surgery. As it might suggest, this is more about the well-being of someone and enabling them to access more general health options – yoga, pilates etc and social activities – courses, classes, get- togethers.
You may well need permission from your parents to discuss their medical records/needs with their GP. You can search by postcode in the directory of all GP surgeries .
Local authority adult social care department
As important as the GP surgery. The adult social care department of the local authority is the provider and facilitator for a range of elderly care options and support services.
To be able to access much of the support available for elderly parents or relatives they will need to undertake a care needs and financial assessment (what it’s actually called may change locally).
The assessment will provide different providers/options for the types of care proposed, and crucially, will determine whether or not the local authority pays for any, some or all of the care.
Care and financial assessments
We’ve written a complete guide to care assessments to provide detailed guidance on getting an assessment, including what it entails, how to prepare for it and what to expect.
As a result of an assessment the local authority will decide what type of care your parents need. It could be help with washing and dressing, help with shopping or cooking, home modifications or more intensive care.
The financial element of the assessment will determine what level of financial support the local authority will provide. In general in England and Wales, if your parents have assets (excluding the value of the home) of more than £23,500 the local authority will not fund any care or support that is means tested.
Not all care and support services are means tested. And not all care is funded by the local authority. The NHS provides free care outside hospital in some cases through NHS Continuing Care and NHS Nursing Care. Both need to also be applied for.
The state funds some care through specific benefits such as Attendance Allowance, Disability Living Allowance and the replacement benefit called Personal Independent Payments. Click on these links to find out more.
- NHS Continuing Care
- NHS Nursing Care
- Attendance Allowance
- Disability living allowance/Personal Independent Payments
Even if you feel sure that your parents will be paying for their own care, it is a good idea to have an assessment because some of it isn’t means tested.
Assessments need to be arranged. This may be initiated by the GP or community care team; if you want to organise one yourself this can be done either online via the local authority website, or by telephone.
Unfortunately in many locations there is a waiting list of upto 3 months for an assessment. It can be arranged privately.
Local community NHS care hubs
With any luck you may find locally that the NHS and local authority are working together through community care hubs or similar named operations.
While the struggle to sort out health and social care continues there is no standard set up for joined up care and support in the UK. So you may stumble across words like locality, hub or community which may be the co-ordinated efforts at a local level. Or you may not. Everywhere operates slightly differently and changes often, so the best place to start is the GP.
Mum went downhill really fast at home. Emma, The Community nurse, co-ordinated all her additional help including commodes, a riser chair and other home modifications; visits by the GP, social services and other community services. When she decided that Mum was no longer safe at home, she found a bed for her in the nearby hospital late on a friday afternoon. Throughout she was always so kind and reassuring to Dad.
If your parents need more help at home and the local authority is not funding it, there are plenty of private providers offering a range of services. 2 options are domiciliary care (daily visits), and live-in care (round-the-clock homecare). This can help with getting out of bed, getting dressed and washed, going to bed; help with cooking and shopping, as well as more specialist help including Dementia support.
Of course, word of mouth and personal recommendations are very useful. All care providers are regulated by the Care Quality Commission and they also provide a directory by postcode of services.
We strongly suggest that you review any potential care agency on the CQC website. Read more in our guide on choosing more care at home.
The CQC also regulate Care Homes, both nursing homes (which provide nursing care on the premises), or residential homes which may not have nursing care on site. You can read more more in our guide to choosing a care home.
We also hear from many Age Space users that they find extra help locally – cleaners, gardeners and neighbours who are amazing and happy to go that extra mile. And, there is very often the extraordinary kindness of strangers.
Charities and other organisations
Thousands of voluntary organisations and charities work in the elderly care sector, from local church lunch clubs to large national charities, driving services to home adaptation providers. It can be very confusing as to who provides what, but here are a few charities to start you off.
You can also access our dedicated Age Space local hubs, which have directories of of resources available locally.
- Admiral Nurses
- Alzheimer’s Society
Age Space Top Tips
- Many local authorities provide an online directory of local services
- National charities also provide a postcode search service
- Micro local services can often be found in parish magazines or on noticeboards in GP surgeries.