Never before has independent care advice been more important, for both privately funded individuals and those dependent on the Local Authority for the funding of their care.

Exceptional demands are being made on our NHS and Adult Social Care Teams who, as always, are on the frontline when it comes to supporting older people and their families, often at a time of crisis. As an NHS trained nurse with many years hospital based experience, I applaud them unreservedly.

Inevitably it has become necessary for essential changes to be made to how services are delivered by both sectors and I give a brief summary of my understanding of these, together with their likely impact on older people and their families, below:

Adult Social Care

The Coronavirus Act 2020 became law last week and all main stream duties of Local Authorities as set out in the Care Act 2014 have been downgraded to powers, with the exception of ; where meeting needs is necessary to avoid a breach of the Human Rights Act.

This means that:

Many individuals may struggle to access care needs assessments and carer’s assessments, eligibility decisions and reviews for the foreseeable future leaving large numbers with unassessed and therefore unmet needs.

Family, other advocates and care providers may not necessarily be involved in new assessments.

There will be no requirement for Local Authorities to provide a written report following a care needs or carer’s assessment so accountability will be removed.

The principles of person centred care may be lost.

Temporary eligibility criteria for services may be set in such a way that makes them incredibly difficult to meet resulting in a huge level of unmet need amongst older people.

Unpaid carers will feel even more pressured to provide more support than they already are, alongside concerns about breaching guidance on social distancing and self-isolation.

Financial assessment, a pre-condition to a charge being agreed or paid may be delayed until after the crisis is over, though I should add that this will not in itself be an obstacle to services being provided.

The postponement of financial assessments whilst services continue to be delivered means that individuals may be put in a position where they have to accept a service that they will later be charged for without knowing what that charge will be, causing some individuals to decline services altogether.

This may cause conflict for the representatives of individuals who lack mental capacity, in particular concerned sons and daughters who are themselves under huge financial strain due to the crisis.

Hospital Discharges

Patients are understandably being discharged from much needed hospital beds earlier than ever, using the “discharge to assess” protocol.

Guidance to NHS staff states that patients must leave their acute hospital bed within an hour of the decision to discharge and the discharge lounge within two hours. It is the intention that “a leading healthcare professional” will visit patients who return to their own homes, on the same day as their discharge from hospital to arrange on going support services.

This means that :

A huge strain is being placed on local care agencies and community health staff

Pre-existing problems with the availability of care staff and the distribution of equipment to maintain independent and safety at home will be exacerbated.

There will be a rise in anxiety amongst older people and their families about accessing essential services.

Patients in need of residential care are likely to be denied choice in the rush to arrange “placement” at the earliest opportunity.

NHS Continuing Healthcare Assessments

CHC assessments, with the exception of Fast Track applications, are not currently being conducted until after the Covid 19 crisis, though 3 and 12 month reviews of funding already in place, and which can result in funds being withdrawn, may continue in some instances.

Requests to appeal a previous decision can be made but will not be acted on until after the crisis.

This means that:

There is going to be a massive backlog of NHS CHC Checklist and Decision Support Tool Assessments.

Where 3 and 12 month reviews of existing CHC arrangements are conducted, these are likely to take place without the option of genuine representation and may result in funding being withdrawn unfairly.

How Claire Edwards Eldercare Consultant can help

Continued provision of consultations and assessments by Telephone, Facetime, Skype or Zoom, so that independent, accurate and personalised advice and support can be given.

Liaison with Hospital, Adult Social Care Staff and Care Providers as required to support families and carers whilst suitable care arrangements are put in place.

Use of my expertise, knowledge and time to research and report on the most suitable care providers of home care and residential care to support informed choice and decision making.

Support understanding all aspects of care fees funding, for now and at the end of this crisis, for both clients dependent on Local Authority and those who are able to fund their own care, including assistance making successful applications for statutory funding where appropriate and accessing regulated financial advice where this is required.

Provision of emotional support to older people and their families through what has become a frightening time for so many.

Signposting to ancillary services and relevant helplines.

Essentially

Older people continue to live with multiple health conditions that impact on their quality of life, with or without coronavirus.

All the difficulties within our healthcare systems remain but with the added pressures of this far reaching infection.

Older people are more vulnerable than ever ( of both social isolation and the potentially serious consequence of infection ), huge demands are being made on our NHS staff and there is an inevitable knock on effect on Adult Social Care Services in the community.

Families need help navigating the new guidance set down by the Government, finding the right care solutions and accessing all available funding.

Care homes and care agencies continue to accept new clients and care still needs to be paid for.

If you are supporting an older person professionally or personally, this is the time to take individually tailored and flexibly delivered independent care advice.

Keep safe.

Claire