Long-term care
July 2006
Older people often require a combination of support from medical, nursing, social care, community health, welfare rights and housing services in order to meet their long-term care needs. Changes implemented as a result of the NHS Plan, July 2000, should ensure that primary care trusts work more closely with local authorities to meet the health and social care needs of patients.[see reference 1] The Department of Health white paper Our health, our care, our say (2006) specifically outlines the ambition to improve the management of long-term conditions.
The system of long-term care throughout the UK is complex. Whilst some services are provided by the NHS, others are provided through local authorities and some people opt for private care. Some care is free but other types are means-tested and there are further anomalies between countries within the UK. For example, in Scotland personal care is free whereas in England personal care is not.[see reference 2]
Long-term care could include care provided in a residential home; by carers either unpaid, ie relatives or paid carers such as home helps; meals on wheels and laundry services. Carers provide a significant amount of long-term care to older people. Carers themselves are a diverse group which include children and young people, parents, middle-aged people and even older people caring for their partners. Without carers many more people would be reliant on statutory services. It is important to recognise that carers themselves have needs and require support in order to fulfil their role.
The following legislation gives rights to carers in terms of assessing needs, providing information, support groups and services:
The Carers (Recognition and Services) Act 1995
NHS Act 1977
Disabled Persons (Services Consultation and Representation) Act 1986
Carers and Disabled Children’s Act 2000 [see reference 3]
Community Care and Health (Scotland) Act 2002
Carers (Equal Opportunities) Act 2004
Work and Families Act 2006
Many people will spend their later years in residential care homes, recently renamed ‘care homes’. Care homes will provide different levels of care. For example, some will provide personal care alone, whereas others provide personal and nursing care. From April 2002 all care homes are required to be registered and regulated by the local care standards authority.
The regulating authorities in the UK are as follows:
England – the Commission for Social Care Inspection
Scotland – the Scottish Commission for the Regulation of Care.
Wales – Care Standards Inspectorate for Wales
Northern Ireland - Regulation and Quality Improvement Authority [see reference 4]
The financial arrangements for paying to live in a care home can be confusing. Both Help the Aged and Age Concern produce detailed factsheets which clarify this situation.[see reference 5]
References:
[1] Department of Health (2001) Shifting the balance of power within the NHS: Securing delivery. London: Department of Health.
[2] Scottish Executive Health Department
[3] BMA Committee on Community Care (2003) Working with carers: Guidelines for good practice. London: BMA.
[4] Help the Aged (2006) Care homes. London: Help the Aged.
[5] Help the Aged (2006) Paying for your care home. London: Help the Aged.
Age Concern (2006) Local authority charging procedures for care homes. London: Age Concern.
Further information:
- Age Concern
- Commission for Social Care Inspection
- Carers UK
- Help the Aged
- Older People’s Advocacy Alliance UK