A guide to care and independent living PeterboroughOPTIONS

Summer 2018

CONTRIBUTORS:

Age UK Cambridgeshire & Peterborough

Alzheimer’s Society

North West Anglia NHS FT

NHS Choices

Rutland County Council

Leaving hospitalWhat’s next?

Healthcare servicesChoosing the right one

NHScontinuing healthcareWho’s eligible?

SOCIAL CARE

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Find out more about our home care and live in care and the difference it can make to your life.

Email the Bluebird Care team peterborough@bluebirdcare.co.uk

or call us on 01780 480881 or 01733 459907

bluebirdcare.co.uk/peterborough-rutland

My life My home My care, just the way I like itHome care & live in care from Bluebird Care

Supporting people throughoutPeterborough, Oundle, Stamford & Rutland

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This guide is intended to help you, your carer and your relatives understand how your local health services can help you after discharge from hospital. Also information to help you to live independently or access support and care services in your area.

Welcome and introduction

ContentsThe right place for your care ............................................................................................. 4-5Help and advice while in hospital ........................................................................................ 5Leaving hospital ................................................................................................................. 5-6Your experience as our patient at Peterborough City Hospital and Stamford Hospital .. 7Intermediate care .................................................................................................................. 7Hospital at home service ....................................................................................................... 8Community Matron service .................................................................................................. 8District nursing ...................................................................................................................... 8Reablement ........................................................................................................................... 8Keeping healthy ............................................................................................................... 9-10 When you need urgent help .............................................................................................. 11Mental health and wellbeing ............................................................................................. 12Self-refer to Psychological Wellbeing service .................................................................... 12

NHS continuing healthcare ............................................................................................ 16-18Personalised care ............................................................................................................ 18-19What is NHS-funded nursing care? .................................................................................... 20Paying for your own care and support ......................................................................... 21-22Care and support: what's available ............................................................................... 23-24Driving and using public transport ............................................................................... 24-25

If you need medical help fast, but it is not life threatening – call 111 ............................ 13

Age UK Cambridgeshire & Peterborough Services ...................................................... 30-31

Alzheimer's Society – Unite against dementia in Peterborough ................................ 28-29

The Care Quality Commission Social Care Top Tips ........................................................... 15

Healthy and Independent in Rutland ................................................................................ 14

NHS hospitals and services in Peterborough ..................................................................... 32Useful contacts .................................................................................................................... 33

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O C T A G O NDESIGN & MARKETING LTD

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The right place for your care

An acute hospital Trust is a hospital that provides consultant-led health services within the National Health Service. Acute care is for patients who require emergency, medical or surgical services within a hospital environment. North West Anglia NHS Foundation Trust provides care for patients who require this level of care.

Hospitals are the right place to be when you are in need of specific medical or surgical treatment. However, when your treatment has been completed, it is important that your stay is not delayed for the following reasons:

Staying in hospital increases the risk of infection, muscle wasting and loss of independence.

Some people find it harder to return home the longer they stay in hospital due to loss of confidence and worry about being able to manage.

Beds are needed for people who are very unwell, and who may be waiting in the Emergency Department for a bed to become available.

People awaiting surgery, both urgent and non-urgent, may have their operations cancelled if a bed is unavailable.

It is good practice to start planning for your discharge as soon as you come into hospital or even before you arrive. This means that we can begin to:

Assess what your needs are likely to be when you are ready to leave.

Involve relevant staff who can help in meeting those needs (e.g. social worker, occupational therapist, physiotherapist, district nurse)

Talk to your family regarding any needs you may have after discharge.

Make arrangements for equipment or services which need to be in place when you are medically

ready to leave.

Make sure that your carer is given any information, help or advice that is needed to aid your recovery.

All staff will work with you, and your carer or relatives, as a team, in order to discuss your

discharge with you.

We need to discuss any concerns you have at the earliest opportunity, e.g.

your safety at home, managing your personal care or domestic arrangements, your ability to move around and any equipment you may need.

You will be given a Predicted Date for Discharge based on when it is expected that your treatment will be completed. It is important that everyone involved is aware of this date so that we can all work towards

it, and so that the necessary arrangements can be made.

These may include:Transport home. Patients will

be expected to arrange their own transport when leaving hospital.

See page 7 for more information. You will need:

Suitable clothing and footwear if you are not already using them in hospital.

Access to a key to your property.

Adequate basic food stocks.

Adequate heating in your home.

Adequate support for your carer or family members.

Your current medication will be returned to you and any additional medication will be ordered from the Hospital Pharmacy and

This hospital, in partnership with other hospitals in the region, and your local authorities, recognise and support each patient to receive the right treatment, at the right place and by the right professional.

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delivered to you before you leave the hospital. You will also have a discharge letter to take with you.

If you have any questions or concerns about your medication please ask to speak to your pharmacist or a member of the nursing team. Relatives or carers coming to collect you can meet you on the ward or Discharge Lounge, or a nurse can escort you to the main reception area.

Finally, we understand that any hospital stay can be stressful and we need to support you and your relatives/carer during your time here.

For most patients, being discharged from hospital to their home is straightforward. Some may need information and advice, or may need the support of social care from the local council. Some people have ongoing health, care and support needs which require a more detailed assessment. Staff from health and social care will work together to plan and deliver services to support people after discharge. Sometimes it is necessary to move to an interim destination whilst awaiting a care package or care home of choice. It is not possible to stay in hospital until such arrangements are in place. The hospital discharge team will arrange your interim destination for you.

This guide explains some of these processes and explains the role of the hospital and social care team in the hospital discharge process, as well as the help and support available to you following your discharge.

If you or your family have any questions, worries, or you do not understand what is happening at any stage during your hospital stay, please speak to your nurse, doctor or ward manager. They will be happy to discuss any aspects of your care to ensure that you are fully prepared to be discharged.

After discharge, if you have any concerns about your condition please contact your GP surgery.

If you have any concerns about your medication, you can speak to your local pharmacist in the first instance.

Help and advice while in hospital

We aim to tell you a predicted discharge date and time within 24 hours of your admission to help you and your carers make arrangements to ensure the services you need are available. The date will be reviewed with you by the consultant on their ward round.

Leaving hospital

Sometimes discharge dates need to change and when this happens we will give you as much notice as possible. If this happens, please share this information with your relatives and/or carers.

Where will I be discharged to?You will normally be discharged to your home address. However it may be necessary to transfer you to another facility to continue your care once you no longer need to stay in hospital. This place of care could be anywhere in your local authority area. This may be a temporary move whilst awaiting a different service or care home.

We recognise that some people might lose confidence and become more dependent whilst in hospital, but we will work with you to maintain your independence. If additional support is needed after your hospital care, we may ask for your care to be transferred to a community setting.

The doctors, nurses and therapists involved in your care will discuss the following with you: Are you able to return to your own home? Do you need a short period of rehabilitation/

intermediate care? Do you need nursing or social care support at home?

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Do you need to move into a care home rather than return home?

We will liaise with social care and community health team to confirm these details with you.

How you can help with your discharge from hospitalYou have the most important part to play, and you can help us in several ways. We ask that you: Think carefully about going home again and tell

the ward staff without delay if you think there may be problems.

Talk to your family or friends if you think you might need some support at home.

�Ask for a Social Worker to see you if you think you may need more support when you leave hospital with everyday tasks such as preparing food and shopping.

Ensure that you have day clothes, shoes and a coat ready so that you can leave hospital fully dressed and comfortable.

Arrange with family/friends or a carer to collect you from hospital at the agreed time. If you do not have anyone who can collect you and you are fit and able, the ward can arrange a taxi for you – please let staff know if that is the case. More information on transport is on the right.

In order to ensure that you are receiving the right care at the right time during your stay, we would recommend that you ask staff responsible for your care 'what needs to happen for me to go home' and 'when can I go home'.

What happens on the day of my discharge?Leaving the ward: Unless otherwise informed, we will aim to discharge you by 10am. We will ensure that you are ready so that your bed can be prepared for a new patient. We will liaise with you and your relatives/carers about your discharge time.

Getting your medicines: Prescribed medication will be obtained for you to take home, if required. You may hear the ward nurses or doctors refer to these as ‘TTOs’. This stands for 'Tablets to Take Out'.

Any remaining medicines that you brought in to hospital with you will be returned to you (unless they are no longer needed and will be destroyed with your permission).

A registered nurse will explain any new medication to you, identify any possible side effects and discuss with you how to obtain further supplies. Written information on potential side effects is also contained within each tablet packet.

Your discharge letter: A discharge letter explaining your care and treatment and a list of your medications will be given to you and a copy sent to your GP electronically, or by post. We may lend you hospital equipment for short-term use at home. Please return it to the hospital as soon as possible when you no longer need it so that we can use it for other patients.

If you need a follow-up appointment we will make this before you leave, or, if appropriate, we will write to you. If an appointment has not arrived within three weeks, please contact the outpatient appointments call centre on 01733 673555.

Transport: Wheelchairs are available for use within the hospital and can be collected from the reception area in the atrium by the front entrance.

We ask that you make your own arrangements for transport home. We can arrange taxis with a reputable firm if necessary, but you will need to pay for this, so please ensure you have enough money to pay the driver directly.

Hospital transport is only provided if you meet specific clinical criteria which will be assessed by staff. Where

transport is provided, please be aware that relatives and carers are not normally able

to travel with you as this incurs an extra charge to the hospital.

Information about Non-Emergency Patient Transport Services, including the eligibility criteria, can be found on Cambridgeshire and Peterborough Clinical Commissioning Group’s website at http://www.cambridgeshireandpeterboroughccg.nhs.uk/your-health-and-services/other-local-services/non-emergency-patient-transport/

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Tell us about your experience in our hospital. Your feedback is very important to us. You can tell us what you think in various ways:

Complete the patient feedback card that will be given to you on the ward. What you tell us about your hospital stay will be used to improve the experience our patients receive in the future. We would really appreciate you taking the time to fill out the ‘I Want Great Care’ questionnaire and handing it back to a member of ward staff before you go home.

Alternatively, you can provide online feedback via the I Want Great Care website. (www.iwantgreatcare.org)

If you have a concern or complaint that has not been addressed by the ward team, or if you want to pass

on praise or good comments about your treatment, please contact our Patient Advice and Liaison Service (PALS). The PALS team is located at the desk at the bottom of the lifts in the main atrium at Peterborough City Hospital. They can be contacted by telephone on 01733 673405 (between 8.30am and 4.30pm, Monday to Friday) or via email: nwangliaft.pals@nhs.net. Alternatively, you can write to them at: PALS, Department 003, Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough, PE3 9GZ.

Your experience as our patient at Peterborough City Hospital and Stamford Hospital

If you are well enough to leave hospital, but need extra support before you can return home or once you are home, the Intermediate Care Team at Cambridgeshire and Peterborough NHS Foundation Trust can help. This is available to residents living in Cambridgeshire.

The Intermediate Care Service is for anyone over the age of 18 who is registered with a GP in the Peterborough area.

Care can be provided in your own home or in one of the Intermediate Care Units, based at the City Care Centre, Thorpe Road, Peterborough, North Cambs Hospital, Wisbech or Princess of Wales Hospital, Ely.

Intermediate Care is short-term support which aims to enable you to reach your maximum level of independence, through assessment and rehabilitation. The team is made up of nurses, physiotherapists, occupational therapists, GPs, therapy support workers and health care assistants.

The Intermediate Care Unit (City Care Centre) is a modern, purpose-built 34 bed unit equipped with a wide range of facilities, including a gym, and a roof garden.

The unit is made up of single rooms, each with a shower and toilet. All meals are provided, with a large menu to choose from each day. You will be encouraged to wear day clothes. There is also access to a small shop and cafeteria for yourself and visitors.

Once admitted to the service you will be encouraged to develop goals and work with the team to achieve them. The team will be responsible for discussing how you will manage at the end of your stay and making any onward referrals, for example to social care for a longer term care package. Your care will be delivered at any of the available units depending on bed availability and may not be nearest to where you live.

Intermediate care

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The Hospital at Home service, aims to help people who live in Cambridgeshire leave hospital early and prevent further hospital admissions.

Patients receive the service if they require rehabilitation, if they have become unwell or if they are reaching the end of their life and require support to remain at home at this time.

The service is delivered by a team of specially trained healthcare assistants who help to deliver care plans formulated by GPs, district nurses,

physiotherapists and occupational therapists.

The healthcare assistants can perform tasks such as washing, dressing and help with meals and toileting, but the Hospital at Home staff can also support physiotherapy and occupational therapy programmes.

The Hospital and Home service is provided by Cambridgeshire and Peterborough NHS Foundation Trust, but is supported by the charitable efforts of the Hospital at Home Friends Group.

Hospital at home service

If you have a number of long term conditions, such as diabetes, arthritis or heart disease, which put you at risk of needing further hospital care, you may be referred to the Community Matron Service operated by Cambridgeshire and Peterborough NHS Foundation Trust.

Community Matrons work with you to help co-ordinate your care with everyone involved and help you to manage

your health. The matron can make a full assessment of your needs, help to co-ordinate the services you will receive and can work with your doctors to give you help and advice on how to manage your conditions.

Your matron will develop a care plan, with your input, which will outline your needs, the services you require, the goals you are working towards and what to do if your conditions get worse.

Community Matron service

ReablementReablement is short-term support designed to help people over the age of 18 increase their independence at home which they may have lost as a consequence of poor health, disability, an accident or a stay in hospital.

This can include help with personal care, preparing meals and improving mobility.

An Occupational Therapist may visit soon after reablement starts to discuss how best he/she can support you. Together, you will agree goals to work towards with your support workers. At first, you may need a number of visits per day, but as you progress this may reduce. Your progress will be reviewed regularly.

A reablement programme is a short-term service that can last anywhere from 6 hours to 6 weeks, depending upon your need.

For further information, email: adultsocialcare@peterborough.gcsx.gov.uk or call 01733 747474.

District nursingDistrict nurses assess, plan and provide nursing clinical care in a patient’s own home if you are housebound. If, on discharge from hospital, you still require nursing care, for example for treatment following an operation, you may receive care from a district nurse.

Taking care of yourselfThere are some simple steps you can take to look after yourself at home. This could range from managing a long-term condition, taking medication when needed or managing a cold to eating well and being active.

There are lots of minor conditions you can treat at home using just your medicine cupboard and plenty of rest. These include coughs, colds, headaches, sore throat, minor cuts and grazes, bumps and bruises, indigestion and mild diarrhoea.

It’s a good idea to have a medicine cabinet where you can keep some basic medication. In doing so it might save you going out if you’re not feeling well, or if the weather is bad. The following medicines might be useful:

painkillers

anti-diarrhoeal tablets/oral rehydration salts

plasters and bandages

bite and sting relief spray or cream

antiseptic cream

indigestion treatment

a thermometer

cough medicine

antihistamine medicine

suncream

Always follow the directions on medicine packets and information leaflets, never exceed the stated dose and make sure the medicine is not out of date.

Your local pharmacySome of the things your pharmacy can help with includes aches, pains, stopping smoking, medicines advice, hay fever, coughs, colds, diarrhoea, allergies, skin conditions and flu jabs.

You can talk to your pharmacist in confidence and you don’t need to make an appointment. It is possible to walk into any community pharmacy and ask to speak with the pharmacist.

They may be able to spend some time with you or offer you an appointment for a consultation. All the discussions with your pharmacist can take place in person or by phone.

Most pharmacies have a private consultation area where patients can discuss issues with pharmacy staff without

being overheard by other members of the public.

Your local GPGPs, or General Practitioners, deal with a whole range of health problems. They also offer advice and run clinics, give vaccinations and some carry out simple surgical operations.

You would normally see a GP or other healthcare professionals at their surgery.

If you have an illness or injury that won’t go away make an appointment with your GP or telephone for advice. They provide a range of services by appointment and, when absolutely essential, can make home visits.

Some things GPs can help with are flu jabs, persistent ear pain, persistent back ache, persistent vomiting or diarrhoea, allergic reactions, long-term conditions, counselling and emotional problems.

Preventing fallsThere are several measures you can take to help prevent a fall.

Simple, everyday measures around the home include:

mopping up spills to avoid wet floors

getting help lifting or moving items that are heavy or difficult to lift

removing clutter, trailing wires and frayed carpet

using non-slip mats and rugs

using high-wattage light bulbs in lamps and torches so that you can see clearly

organising your home so that climbing, stretching and bending are kept to a minimum and to avoid bumping into things

getting help to do things that you are unable to do safely on your own

not walking on slippery floors in socks or tights

not wearing loose-fitting, trailing clothes that might trip you up

wearing well-fitting shoes that are in good condition and support the ankle

taking care of your feet by trimming toenails regularly, using moisturiser and seeing a GP or chiropodist about any foot problems

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Keeping healthy

What should you do if you have a fall?If you have a fall, it is important to keep calm. If you are not hurt and you feel strong enough to get up, get up slowly. Roll onto your hands and knees and look for a stable piece of furniture, such as a chair or bed. Hold on to the furniture with both hands to support yourself and when you feel ready, slowly get up.

Sit down and rest for a while. If you are hurt or unable to get up, try to get someone’s attention by calling out for help, banging on the wall or floor or using your aid call button (if you have one). If possible, crawl to a telephone and dial 999 for an ambulance.

Try to reach something warm to put over you, particularly your legs and feet, such as a blanket or a dressing gown. Stay as comfortable as possible and try to change your position at least once every half an hour or so.

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Travel carefully in icy weatherIcy pavements and roads can be very slippery. Take extra care if you go out and wear boots or shoes with good grip on the soles. Put grit or cat litter on your paths and driveway to lessen the risk of slipping. You should wait until the roads have been gritted if you’re travelling by car. Bear in mind that black ice on pavements or roads might not be clearly visible, and that compacted snow may turn to ice and become slippery.

Out of hours GP serviceSometimes you might need to see a GP urgently in the evenings or at weekends. If your usual GP practice is closed then it’s still possible to see a GP or get advice from the GP over the phone.

To contact an out of hours GP, just call 111 and you will be connected to the NHS 111 service, which can help you access the out of hours services across Cambridgeshire and Peterborough.

NHS 111 is the phone number to call when you need medical help or advice urgently, but it’s not a life-threatening situation.

Calling 111 will connect you to a team of fully trained call advisers, who are supported by experienced nurses and paramedics. They will ask you questions to assess the symptoms, and give you healthcare advice or direct you to the most appropriate and available local service. You should use 111 if:

it’s not a 999 emergency

you think you need to go to A&E or another NHS urgent care service but you’re not sure

you don’t think you can wait for an appointment with your GP

you don’t know who to call for medical help

When an ambulance is required, they will dispatch one immediately – just as if you had originally dialled 999.

Minor Injury UnitsIf your injury or illness is not serious, you can get help from your local Minor Injury Unit rather than going to an A&E department.

These offer convenient access to treatment for a range of minor illnesses and injuries.

Conditions that can be treated at the Minor Injury Units include wounds, bites, minor burns and scalds, eye problems, earache, and minor head injuries (with no loss of consciousness).

Peterborough Minor Illness and Injury UnitAlso provides X-rays, wound stitching and applications of casts City Care Centre, Thorpe Road, Peterborough PE3 6DB. Tel: 01733 293 800. Opening hours: Monday-Sunday, 8am-8pm.

Stamford Hospital Minor Injuries UnitRyhall Road, Stamford, Lincolnshire, PE9 1UA. Tel: 01733 678000 Opening hours: Monday-Friday, 9am-5pm.

North Cambridgeshire Hospital Minor Injuries UnitThe Park, Wisbech, PE13 3AB. Tel: 01945 488 068. Opening hours: Monday-Friday, 8.30am-6pm; Closed Saturday, Sunday and Bank Holidays. MIU X-ray: Monday-Friday, 9am to 4.45pm.

Doddington Community Hospital Minor Injuries UnitBenwick Road, Doddington, PE15 0UG. Tel: 01354 644 243. Opening hours: Monday-Friday, 8.30am-6pm; Saturday, Sunday and Bank Holidays, 9am-5pm; Closed Christmas Day and New Year’s Day. MIU X-ray: Monday-Friday, 9am-5.45pm, Saturday 1pm-5pm and Sunday 1pm - 4.45pm.

Emergency department (A&E) or calling 999You should only go to the Emergency Department or call 999 when it’s a critical or life-threatening emergency. Dialling 999 and stating that it’s an emergency situation will result in an ambulance being sent out to you.

Emergency situations include: stroke, overdose, choking, blacking out, open wound with blood loss, loss of consciousness, acute confused state, fits, severe allergic reactions, breathing difficulties and persistent, severe chest pain. If you think you or someone else is having a heart attack then dial 999 straight away.

When you need urgent help

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Depression: If you are depressed it is likely that you will have a loss of interest or pleasure in normally enjoyable activities. Symptoms include:

too much or too little sleep

changes in appetite and weight

feeling irritable or anxious

loss of energy

feeling sad, guilty or hopeless

Anxiety: Anxiety creates an unpleasant feeling that is typically described as uneasiness, fear, or worry. You may also get tiredness, headaches and sweating.

Lifestyle changes are simple but an effective way to treat depression or anxiety. Sometimes they might be all you need. Even if you need other treatment as well, lifestyle changes go a long way toward helping lift depression. Lifestyle changes include:

Exercise - It stimulates the body to produce hormones that prevent depression. Taking exercise can increase self-confidence and, if you join an exercise class, it can also improve your social life.

Diet - Eating a well-balanced diet and reducing the amount of sugar and caffeine in your diet can help.

Alcohol - Alcohol does not help with depression and can make it worse. People suffering from depression should stop drinking alcohol.

Sleep - It is very important to make sure that you are getting the amount of sleep you need because poor sleep has a strong effect on mood. Make sure you are relaxed before you go to bed, have a warm, milky drink and make sure that your bedroom is not too cold or too hot.

Social support - Keeping in regular contact with friends and family can help or consider joining a class or group. If you are able, volunteering is a wonderful way to help others while also helping yourself.

Mental health and wellbeingDepression and anxiety can affect anyone. People with depression frequently also suffer from anxiety.

Cambridgeshire and Peterborough Foundation Trust provides a Psychological

Wellbeing service that people can self-refer to.

This service is set up to help those aged 17 and over who are suffering from mild to moderate depression and anxiety disorders including generalised anxiety, social anxiety, post traumatic stress, health anxiety, panic, phobia or obsessive compulsive disorder.

Appointments are offered throughout the day, from Monday to Friday.

Call 0300 300 0055. Lines are open from 9am to 5pm, Monday to Friday, excluding Bank Holidays.

Self-refer to Psychological Wellbeing service

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13Content supplied by:

Rutland Health and Adult Social Care services are working closer to ensure that Rutland residents enjoy the best health and wellbeing throughout their life. The aim is to be able to access the right support and information to help reduce, prevent or delay the need for care.

Help to return homeAll Rutland residents admitted to hospital will be offered support to return home. The Rutland Integrated Hospital Team will contact you in hospital to understand your needs. Alternatively, you can contact the Team by calling 01572 722 577. The Team will help look at practical aspects with you including your safety at home, your ability to move around and how you will manage your personal care and domestic arrangements. Our aim is to get you back into your usual routines as soon as possible.

If you cannot return directly home, for example because you are not mobile, you may continue your recovery in a community hospital or care home bed in or near Rutland. You might also be offered a short period of physical therapy to give you the skills and confidence to thrive at home. ‘Rehabilitation’ is exercise rebuilding your strength and movement, while ‘reablement’ helps you to learn new ways to accomplish daily tasks that have become more challenging. The professionals working with you will explain what to expect from your personalised therapy programme and will agree the aims with you.

Other services• If you would like a broader chat about support to

help you to manage at home longer term, you can contact Rutland’s Adult Social Care team who may signpost, offer advice or recommend a social care

assessment. To contact them call 01572 758341, or email adultduty@rutland.gov.uk.

• It could be that a few carefully chosen additions or changes around your home are all that is needed to help you to continue living there comfortably and independently. If so, you can request a free ‘Housing MOT’ from Spire Homes to look at falls prevention, fire safety, energy efficiency and maintenance (Tel: 01933 410084, Email: spirehomes.careandrepair@longhurst-group.org.uk).

• Rutland residents who are living with dementia or caring for someone with this condition can also contact the Council’s new Admiral Nurse service for support and advice (Tel: 01572 758341, or email adultduty@rutland.gov.uk).

• You can also contact the Rutland Community Wellbeing Service who will be able to help you to find solutions that work for you, if for example you are living with a limiting health condition, facing financial issues, or even just want to find ways to get out and about more. Contact them on 01572 725 805 or email info@rutlandrap.org.uk

• You can also find a wide range of support services, activities, events, groups and organisations on the Rutland Information Service (RIS) website: ris.rutland.gov.uk.

Healthy and Independent in Rutland

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Social care Top tips

1The Care Quality Commission (CQC) registers all care homes and home care agencies. You can find out which ones support specific groups of people, such as people with a learning disability or those living with dementia.

2CQC’s Chief Inspector for Adult Social Care, Andrea Sutcliffe always uses ‘The Mum Test’: is a care home safe, caring, effective, responsive to people’s needs and well-led? In other words, is it good enough for my Mum (or anyone else I love and care for)?

5A care home will be a home for you or your loved one. Residents should be treated as individuals with their likes and dislikes taken into account. Think about whether a home is close enough to family, friends, and community facilities.

Look for care homes and home care agencies where the staff involve people who use services and their families and carers, and treat individuals with compassion, kindness, dignity and respect.

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Whether you are being cared for in your own home or in a residential setting, the staff looking after you need to be skilled, kind and supportive. They should also be capable and confident in dealing with your particular needs. You should always feel that their support is helping you to live the life you want to.

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Look at how well-led and managed a home is. What does it have in place to ensure that it delivers high quality care? Does it promote meaningful activity and connect the home with the community?

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If you or a loved one needs help with day-to-day care, you can contact your local council’s social services department. They will ‘make an assessment of your needs’ and depending on circumstances, may be able to help you access financial help. For more advice visit Age UK’s website www.ageuk.org.uk /home-and-care.

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If you would like to organise your care yourself, you can find a care worker or personal assistant through an agency. Your local social services department should be able to provide details of approved agencies.

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CQC’s ratings will identify services as:Outstanding

Good ●Requires improvement ●

Inadequate ●This will help you make informed choices around your care. There’s also useful advice on the Social Care Institute for Excellence’s Find me good care website www.scie.org.uk/findmegoodcare/

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Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police.You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.

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The Care Quality Commission has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does the Care Quality Commission endorse any of the products or services.

The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care.We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one.You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia.We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided.You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care. You can also call us to share an experience of care on 03000 61 61 61.Here are some tips to help you choose your care.

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NHS continuing healthcareSome people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.

Where can NHS continuing healthcare be provided?NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your home or in a registered care home.

Am I eligible for NHS continuing healthcare?NHS continuing healthcare is for adults. Children and young people may receive a “continuing care package” if they have needs arising from disability, accident or illness that can’t be met by existing universal or specialist services alone.

To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a “multidisciplinary team”). The team will look at all your care needs and relate them to: what help you need how complex your needs are how intense or severe your needs can be how unpredictable they are, including any risks to your

health if the right care isn’t provided at the right time

Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change.

You should be fully involved in the assessment process and kept informed, and have your views about your needs and support taken into account. Carers and family members should also be consulted where appropriate.

A decision about eligibility should usually be made within 28 days of it being decided that the person needs a full assessment for NHS continuing healthcare.

If you aren’t eligible for NHS continuing healthcare, you can be referred to your local authority who can discuss with you whether you may be eligible for support from them. If you still have some health needs then the NHS may pay for part of the package of support. This is sometimes known as a “joint package” of care.

NHS continuing healthcare assessmentsClinical commissioning groups, known as CCGs (the NHS organisations that commission local health services), must assess you for NHS continuing healthcare if it seems that you may need it.

For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment. However, if you need care urgently – for example, if you’re terminally ill – your assessment may be fast-tracked.

Initial assessment for NHS continuing healthcareThe initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed, and be asked for your consent.

Depending on the outcome of the checklist, you’ll either be told that you don’t meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility.

Being referred for a full assessment doesn’t necessarily mean you’ll be eligible for NHS continuing healthcare. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment.

The professional(s) completing the checklist should record

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in writing the reasons for their decision, and sign and date it. You should be given a copy of the completed checklist. You can download a blank copy of the NHS continuing healthcare checklist from GOV.UK.

Full assessment for NHS continuing healthcareFull assessments for NHS continuing healthcare are undertaken by a “multidisciplinary team” made up of a minimum of two health or care professionals who are already involved in your care. You should be informed who is co-ordinating the NHS continuing healthcare assessment.

The team’s assessment will consider your needs under the following headings: behaviour cognition (understanding) communication psychological/emotional needs mobility nutrition (food and drink) continence skin (including wounds and ulcers) breathing symptom control through drug therapies and medication altered states of consciousness other significant needs

These needs are given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.

If you have at least one priority need, or severe needs in at least two areas, you should be eligible for NHS continuing healthcare. You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.

In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS continuing healthcare should be provided.

The assessment should take into account your views and the views of any carers you have. You should be given a copy of the decision documents, along with clear reasons

for the decision.

You can download a blank copy of the NHS continuing healthcare decision support tool.

Fast-track assessment for NHS continuing healthcare

If your health is deteriorating quickly and you’re nearing the end of your life, you should be considered for the NHS continuing healthcare fast track pathway, so that an appropriate care and support package can be put in

place as soon as possible – usually within 48 hours.

An organisation called Beacon gives free independent advice on NHS continuing healthcare. Visit the Beacon website or call the free helpline on 0345 548 0300.

Care and support planningIf you’re eligible for NHS continuing healthcare, the next stage is to arrange a care and support package that meets your assessed needs.

Depending on your situation, different options could be suitable, including support in your own home and the option of a personal health budget. If it’s agreed that a care home is the best option for you, there could be more than one local care home that’s suitable.

Your CCG should work collaboratively with you and consider your views when agreeing your care and support package and the setting where it will be provided. However, they can also take other factors into account, such as the cost and value for money of different options.

NHS continuing healthcare reviewsIf you’re eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within three months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs. If your needs have changed, the review will also consider whether you’re still eligible for NHS continuing healthcare.

Refunds for delays in NHS continuing healthcare fundingCCGs will normally make a decision about eligibility for NHS continuing healthcare within 28 days of getting a completed checklist or request for a full assessment, unless there are circumstances beyond its control.

If the CCG decides you’re eligible, but takes longer than 28 days to decide this and the delay is unjustifiable, they should refund any care costs from the 29th day until the date of their decision.

If your CCG decided that you weren’t eligible for NHS continuing healthcare, but then revised this decision after a dispute, it should refund your care costs for the period between their original decision and their revised decision.

If you’re not eligible for NHS continuing healthcareIf you’re not eligible for NHS continuing healthcare, but you’re assessed as requiring nursing care in a care home (in other words, a care home that’s registered to provide nursing care) you’ll be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the cost of your registered nursing care. NHS-funded nursing care is available irrespective of who is funding the rest of the care home fees. >>

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Read more information from NHS England about NHS continuing healthcare.

Frequently asked questions about NHS continuing healthcareI have a local authority support package that works well. I’m now eligible for NHS continuing healthcare – will my support package change?If you’re concerned about changes to your care package because of a move to NHS continuing healthcare, your CCG should talk to you about ways that it can give you as much choice and control as possible. This could include the use of a personal health budget, with one option being a “direct payment for healthcare”.

Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority?An assessment for NHS continuing healthcare can’t be carried out without your consent, so it’s possible to refuse. However, if you refuse, although you’ll still be entitled to an assessment by the local authority there’s no guarantee that you’ll be provided with services. There’s a legal limit on the type of services that a local authority can provide.

If you refuse to be assessed for NHS continuing healthcare, the CCG should explore your reasons for refusing, and try to address your concerns. If someone lacks the mental capacity to consent to or refuse an assessment, the principles of the Mental Capacity Act will apply and in most circumstances an assessment will be provided in the person’s best interest.

My relative is in a care home and has become eligible for NHS continuing healthcare. The CCG says the fees charged by this care home are more than they would usually pay, and has proposed a move to a different care home. I think a move will have a negative effect on my relative. What can we do?If there’s evidence that a move is likely to have a detrimental effect on your relative’s health or wellbeing, discuss this with the CCG. It will take your concerns into account when considering the most appropriate arrangements.

If the CCG decides to arrange an alternative placement, they should provide a reasonable choice of homes.

Is it possible to pay top-up fees for NHS continuing healthcare?No, it isn’t possible to top up NHS continuing healthcare packages, like you can with local authority care packages.

The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you get from the NHS. These private services should be provided by different staff and preferably in a different setting.

You’ll be given a personal budget, and can choose to receive it as a direct payment.

Personal budgetsA personal budget is the amount of money the local authority allocates for your care, based on its assessment of your needs.

You can be put in charge of this budget either by telling the local authority how you would like it spent, or by the council giving you the money so you can directly pay for your own care (a direct payment).

It can also be given to a separate organisation (such as a user-controlled trust) that will spend the money on your care as you see fit, if you prefer. These are known as Individual Service Funds.

You can choose a combination of the above (for example, a direct payment with some council-arranged care and support), often called a mixed package.

Find out how personal budgets work.

Direct paymentsDirect payments give you the most control over your care.

If you’re unhappy with the services you’re getting, you can decide to change who gives you the care services without having to go through the local authority.

But you have to be able to account for how you spend the budget. And you have responsibilities as an employer if you hire a personal assistant with your direct payment.

The Money Advice Service has a guide to using direct payments.

The pros and cons of personalised carePersonalised care means you have to spend some time and effort thinking about your care and support needs and the outcomes you want.

There may be extra responsibilities. For example, if you decide to request a direct payment to cover the cost of homecare, you could use the payment to hire an individual, giving you the responsibilities of an employer.

Alternatively, you could hire care workers through an agency. This removes the legal obligations of being an employer, but may cost more and may remove some of the benefits of having the same person provide your care.

Personalised care

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If your local authority agrees to pay for some or all of your home care needs, it must offer you choice and control over how your needs are met. This is known as personalised care.

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Personalised care

Read more about how to choose care services.

How does personalised care work?You and your social worker or care manager need to work together to create a care plan. This plan details your care and support needs, and can be used to work out the value of your personal budget.

Your care plan should include:

what’s important to you, including your interests, lifestyle, personal tastes and the people in your life

your hopes for the future, such as whether you’d like to study or take on more hobbies outside the home

what limitations you currently have and how you want to change

what you want to achieve by managing your own support

Make sure you include information about how you’ll manage your money and what you’ll spend the money on (including personal assistants, transport, housing adaptations, therapists and respite services).

Clarify how you’ll receive your money. If you choose to receive your personal budget as a direct payment, the local authority may pay the money straight into a bank account that you control (you must set up a new bank account to do this) or they may give you a pre-paid card.

Alternatively, you may prefer your personal budget to be managed by the local authority or by someone else, such as:

a friend or family member (the local authority must agree to this)

a broker, independent social worker or an advocate

your care manager or social worker

Discuss these options with your social worker or carer to work out which option is best for you.

If someone else will be looking after your money, you may need to create a decision-making agreement. This should state how they’ll look after your money and what decisions they can and can’t make on your behalf.

The local authority may want to check what you do with your money to make sure you’re spending your budget appropriately, and your care and support needs are being met.

You may need to keep receipts (especially for large purchases) so you can show them you have spent your money responsibly.

If you choose a direct payment, the council will give you a direct payment agreement that sets out the terms and conditions.

If you’re struggling to manage your money, the local authority can advise you on how to make your money work best for you.

Check your care plan is workingMeet with your local authority at least once a year to discuss whether your care plan is working.

This is an opportunity to discuss whether your needs are being met in the best way, and it’s also your chance to talk about changes you want to make for the future.

You don’t have to wait for a review meeting to change the way you spend your budget. You can change things as you go along.

If you want to make a big change, consult your care manager or social worker, who may arrange a review.

You can ask for a review meeting about your care plan at any time. To prepare for a review, provide any receipts you have kept since you were awarded a personal budget.

If someone is managing your funds for you, get them to join the review meeting.

Disagreements about care plans and personal budgetsIf you have been told that you’re not eligible for services or you don’t agree with the amount allocated to you in your personal budget, you can ask for a reassessment.

Speak to your social worker or care manager about being reassessed, or phone your local authority social services department and request a complaints form.

If your local authority agrees to pay for some or all of your home care needs, it must offer you choice and control over how your needs are met. This is known as personalised care.

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What is the rate of payment for NHS-funded nursing care?NHS-funded nursing care is paid at the same rate across England. In April 2017, the rate was set at £155.05 a week (standard rate).

Before October 1 2007, there were three different levels or bands of payment for NHS-funded nursing care – low, medium and high.

If you moved into a care home before October 1 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date.

If you moved into a care home before October 1 2007, and you were on the high band, NHS-funded nursing care is paid at a higher rate. In April 2017, the higher rate was set at £213.32 a week. You’re entitled to continue on this rate unless:

you no longer have nursing needs

you no longer live in a care home that provides nursing

your nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £155.05 a week, or

you become entitled to NHS continuing healthcare instead.

What is NHS-funded nursing care?

Who is eligible for NHS-funded nursing care?You may be eligible for NHS-funded nursing care if:

you are not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse

you live in a care home registered to provide nursing care

How will my needs be assessed?You should be assessed for NHS continuing healthcare before a decision is made about whether you are eligible for NHS-funded nursing care.

Most people don’t need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven’t already had one, your clinical commissioning group (CCG) can arrange an assessment for you.

Outcome of the assessmentIf you’re eligible for NHS-funded nursing care, the NHS will arrange and fund nursing care provided by registered nurses employed by the care home. Services provided by a registered nurse can include planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care.

If you’re not eligible for NHS-funded nursing care and you don’t agree with the decision about your eligibility, you can ask your CCG to review the decision.

Deferred payment agreementsA deferred payment agreement is an arrangement with your local council that enables you to use the value of your home to help pay care home costs. If you are eligible, the council will make payments to the care home on your behalf as an ongoing loan, on which interest will be charged, using your home as security. You can delay repaying the council until you choose to sell your home.

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NHS-funded nursing care is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this registered nursing care.

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Many people who use care and support services will pay for all of the costs. This is known as being a “self-funder”.The cost of your care will vary depending on its type, intensity, specialisation, location and duration. For example, a place in a residential care home will cost hundreds of pounds a week.

To make decisions that have such major financial implications, you may want to seek independent financial advice and it’s always worth researching the costs of alternatives first. For example, if you are considering a care home place, the cost should be weighed against the cost of care and support that may help you remain in your current home, such as homecare.

How much will care cost?If you are thinking about your future care needs or are facing immediate decisions about care options, it can be helpful to get an idea how much care can cost.

Inevitably, the price you would pay will depend on your particular circumstances and needs. The costs also vary depending on where you live. Unfortunately, care homes and homecare agencies tend not to provide this information publicly but you may find it helpful to search for and contact care services in your area to get some idea of likely costs.

The ‘cap on care costs’Currently, it is not easy to plan for your future care needs, as it’s hard to estimate how long you will need care for and how your circumstances may change. From April 2020, a “cap” on the costs of meeting your eligible care needs (but not accommodation associated with care or nursing costs) is being introduced. The cap means that, once reached, the local authority will take over paying the cost of their eligible care needs.

The cap will not cover your daily living costs. These costs include expenses such as rent, food and utilities and the costs you would face even if you did not have care needs. It is important to note that daily living costs will be a nationally set figure. This figure will be a “notional” amount rather than the actual costs. This is designed to support consistency and enable people to plan.

To benefit from the cap once it comes in, you will need to contact your local authority to see if your needs are eligible. If you are seen to have eligible care needs, the local authority will open a “care account” for you. This account records your progress (the amount of costs you have incurred) towards the cap.

The cap does not begin until April 2020 and any costs incurred before this will not count towards the cap.

The BBC’s care calculator can estimate how much you may have to pay for care services depending on where you live in England, once the new rules are in place. This will give you an idea of how the cap will work for you, but actual costs will vary to reflect your individual circumstances and needs and how they change over time.

For more information on how paying for care is changing from 2020, read about the changes in the Care Act.

Ask for help from your local authorityIt’s worth checking whether you’re eligible for means-tested support from your local authority or other financial support – for example, through a care needs assessment and a financial assessment.

Few of us will have the income or ready access to the cash to pay for our ongoing care needs, and you may need to look at selling or remortgaging any property you may own. The new Care Act means more people may be able to benefit from “deferred payments”.

Deferred payments can help people avoid being forced to sell their home in a crisis in order to pay for their care by having the council temporarily cover the cost – usually until you sell your property.

Following the Care Act, every local authority in England has to make deferred payment agreements available.

As an alternative, you may be able to enter an “equity release scheme” with a financial organisation. Equity release can pay for the fees from the value of property you own. However, you should consider which of these options best meets your needs, and what the overall costs to you will be.

Before taking such significant financial steps as equity release, you might want to get independent financial advice. You can find information on equity release for care at home from Which? Elderly Care or the Money Advice Service’s equity release information.

If you’re planning ahead, you may consider arranging an investment or insurance plan to fund your care. Again, it may be worth taking independent advice on financial arrangements before making major changes. Because of the new rules, there are likely to be more financial products emerging that are designed to help

Paying for your own care and support

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people pay for care.

You may also want to explore whether the NHS would meet some or all of your care and support costs, or you may have entitlement to benefits that may help you meet costs. Read about other ways of funding care.

Advice on paying for careEven if your local authority is not able to help fund your care, it will be able to make an assessment of your care and support needs. From this, the local authority can provide you with access to a range of information and advice available locally.

You can also get independent advice from:

The Money Advice Service website: offers information on paying for care or the option to speak to an online adviser. You can call the Money Advice Service on 0300 500 5000.

The Society of Later Life Advisers: the society can also help you find advice on how to make financial plans for care in your old age.

Find Me Good Care: a website of the Social Care Institute for Excellence. It has advice on all aspects of planning and funding social care.

Age UK: has great advice for older people and those planning for their later years.

Carers UK: an excellent resource of advice for carers who need to help someone else.

Which? Elderly Care has a guide to financing care.

Deferred payments if you are unable to pay for care servicesCare home fees are a big financial commitment, and the decision to go into a care home is often made at a moment of crisis or urgency, such as when being discharged from hospital. This can make finding the money to pay for fees (usually several hundred pounds a week) challenging for people funding their own care.

In particular, if you own property outright but have little in the way of savings, you may be expected to fund your own care but have little immediately available money to pay for it. Some people going to stay in a care home for a long time find that they have no option but to sell their property to pay the care home fees.

Your council may be able to help you if you are at risk of having to sell your home. Where there is a delay in selling the property, or you don’t want to sell the property immediately, you may be eligible to have your care fee payment “deferred”. This is where the local authority helps you to pay your care fees temporarily, and you repay the costs to the local authority at a later date.

If the local authority agrees to the deferred payment and pays the care home fees, it will take payment from the money raised once the property is sold.This can be:

during your lifetime if you choose to sell your home

once you die, the local authority can be repaid from your estate

All councils must offer people the chance to defer payment if they meet a set of eligibility criteria.

A deferred payment scheme is only available if you don’t have enough income to cover your care home fees, and you have less in savings than £23,250. In these circumstances, the savings don’t include the value of your property, but does include money in bank accounts.

The local authority will put a “legal charge” (similar to a mortgage) on the property and will then pay the remaining care fees in full. You will then be assessed to see whether they are able to pay a weekly charge to the authority. Your ability to pay is based on your income less a set “disposable income allowance” (currently £144 per week).

Before considering deferred payments, you should look into whether the property will or won’t be counted in how your capital is calculated. For instance, it may be disregarded because your partner still lives there, and if it is a deferred payment agreement wouldn’t be necessary.

It’s wise to get independent financial advice before agreeing to a deferred payment, and it’s worth bearing in mind that choosing deferred payments can impact on some welfare benefits.

Protection for self-fundersWhile you may have the savings in place to afford care services, if you lack the capacity to make the arrangements, the local authority can step in to help.

The local authority can also help people who lack capacity by negotiating fees with a care provider and paying them directly. The local authority will need to be reimbursed.

Anyone entering into a contract for care services should be given adequate information about the fees. Care providers should supply:

information about the fees charged for various services provided

arrangements for paying the fees

the fees charged for any additional services

If your capital falls below the set levels for local authority funding (currently £23,250), you will be eligible for reassessment for help with funding your care.

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Home care costs around £18 an hour. Depending on your circumstances, this may be funded by your local council or you may have to pay yourself.

Types of care and supportCare and support comes in many forms and there are many names used to describe it, including home help, care attendants, and “carers” (not to be confused with unpaid family or friends who care for you).

Care and support can suit you if you need: personal care, such as washing or dressing housekeeping or domestic work, such as vacuuming help with cooking or preparing meals nursing and healthcare companionship

Care and support can be very flexible. The same person or agency may be able to provide some or all of these options for the duration of your care: long-term 24-hour care short breaks for an unpaid family carer emergency care day care sessions ranging from 15-minute visits to 24-hour

assistance and everything in between

If you already know what you want, you can search NHS Choices directories for: local care and support services and agencies a list of national care and support organisations supported living services – these are services that

can help you stay safe and well in your home on a long-term basis, including financial help, help with medicines, advocacy, social support and practical support

a place to live with a family who will care for you – this is known as shared lives services or adult placement services

Funding home careIf you believe you might benefit from some help at home, the first thing to do is to contact your local authority’s social services department to ask for a care needs assessment.

If you’re eligible for care and support services funded by your local council, your local council may provide or

arrange the help themselves.

Alternatively, you can arrange your own care, funded by the council, through direct payments or a personal budget.

If you choose direct payments or a personal budget, or you aren’t eligible for council funding and want to get care privately, you can arrange it in several different ways: using a care and support agency hiring a personal assistant getting care and support from a charity, such as Age UK

Independent care and support agenciesIf you use an independent care and support agency, you or the person looking after you has to find the care agency and pay them.

The agency will provide a service through a trained team of care workers, which means you may not always have the same person visiting your home, although the agency will do its best to take your choices into account.

Care and support providers are regulated by the Care Quality Commission (CQC). They must meet the CQC’s national minimum standards and regulations in areas such as training and record keeping.

The CQC has the power to inspect agencies and enforce standards. Care and support agencies must vet care and support workers before engaging them by taking up references and carrying out Disclosure and Barring Service (DBS) checks on potential employees.

Care and support agencies can also: take over the burden of being an employer –

for example, payroll, training, disciplinary issues and insurance

train their care and support workers through national qualifications and service-specific training

replace workers when they’re ill, on holiday or resign put things right when they go wrong

An agency will want to see you and the person looking after you so they can assess your needs.

This also means you can make a joint decision about the right type of care and support.

Find out more from the UK Homecare Association.

Care and support: what’s availableIf you need help around the home, a good option is to have a care worker come into your home to help you.

How much does a care and support agency cost?Using a care and support agency can be expensive. The agency will charge a fee on top of the payment made to the care worker to cover their running costs and profits.

You normally have to make a regular payment to the agency, which includes both the worker’s earnings and the agency’s fee.

Questions to ask when using a care and support agencyBefore deciding to go ahead with an agency, you should ask questions about the fee and what it covers.

These include: Does the agency check references? What training and supervision do they provide? What’s their complaints policy? Who’s responsible for insurance? Is there any out-of-hours or emergency contact

if needed? Will they be able to provide staff if your own care

worker is ill or away? If an agency is contracted to provide care every day, it must do that.

Hiring a personal assistantInstead of using an agency, you can hire a personal assistant to act as a care and support worker for you.

Personal assistants can offer you all that you’ll get from an agency worker, but you’ll also get continuity, familiarity and an ongoing relationship with an assistant.

But if you employ a personal assistant, you have the legal responsibility of an employer. This includes arranging cover for their illness and holidays.

Which? Elderly Care has advice on employing private individuals.

Get more information on becoming an employer.

Care and support from charitiesCharities such as Age UK and Carers Trust can provide home help.

Carers Trust also supports carers by giving them a break from their caring responsibilities through care and support services.

Marie Curie Nurses can provide practical and emotional support for people near the end of their lives in their own homes.

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You can get help: using public transport getting discounts on public transport from the NHS with travel costs finding community transport schemes

If you have mobility problems and you need a car to get around, you may be able to get help with costs through: discounted or free road tax a Blue Badge parking permit help with the cost of buying or hiring a vehicle through

the Motability scheme

Using public transport with a disabilityAll public transport vehicles have to be “accessible” so disabled passengers can use them. Public transport also has to accept guide dogs or assistance dogs.

But if you’re using public transport, it’s worth contacting the transport operator before you travel to make sure they’re able to offer the assistance you require.

Buses and trains usually have priority seating for older people and people with disabilities. They also usually have space and wide doors for wheelchairs. Some buses, trains and trams are fitted with automatic ramps.

The London Underground is being upgraded to improve step-free access.

Staff at Underground stations are also trained to help people move around the underground system – for example, by helping you avoid escalators and calling ahead to arrange for assistance at your destination.

Discounts on public transport for older people and disabled peopleOlder people and people with disabilities can travel free on local buses anywhere in England between 9.30am and 11pm Monday to Friday, and at any time during the weekend and on bank holidays.

Some authorities offer free travel for longer, and some allow a companion to travel with the pass holder for free.

You may have to apply through your local authority, but in most areas you can apply online for an older person’s bus pass or for a disabled person’s bus pass.Content supplied by:

Although mobility problems make it harder to get around, transport has been getting more accessible for disabled and elderly people over the years.

Driving and using public transport

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Although mobility problems make it harder to get around, transport has been getting more accessible for disabled and elderly people over the years.

Driving and using public transport

If you often travel by train, it’s probably worth getting a Disabled Railcard Card. This gives you a third off the price of rail tickets. Check the criteria to see if you’re eligible.

Children aged 5 to 16 with disabilities are eligible for a Disabled Person’s Railcard. This lets an adult to travel with them for a third of the cost of an adult fare, while the child pays the normal child fare.

Taxi and private hire companies can provide wheelchair-accessible vehicles if you ask for one when you book a vehicle.

Some councils also give free taxi vouchers to people who find it difficult to use public transport because they’re frail or disabled.

NHS help with travel and transport costsIf you pay to travel to a hospital or other NHS premises for NHS-funded treatment or diagnostic tests, you may be able to claim a refund of reasonable travel costs.

Find out more about the Healthcare Travel Costs Scheme and who’s eligible.

Community transport schemesThese schemes provide transport to and from hospitals, doctors’ and dentists’ surgeries, and opticians and chiropodists.

Many areas offer a free “Dial-a-Ride” service, offering door-to-door transport for people unable to use normal buses.

Some schemes require you to register and may charge a fee. Carers may be able to travel with you for an additional charge.

Check with your local council whether your area has a community transport scheme.

The British Red Cross runs a similar transport service in some areas. Contact your local Red Cross branch for information.

Cars and parkingRoad tax reductions

If you’re disabled or have a serious long-term condition, you might be eligible for a reduction in your road tax, or even be exempt from it altogether.

Find out more on GOV.UK about vehicle tax exemption and

vehicle tax reduction.

Blue Badge disabled parking scheme

If you have severe mobility problems that make using public transport difficult, you may be able to get a Blue Badge parking permit for your car.

This lets you park closer to places you wish to visit, such as in marked disabled parking bays.

You may also be able to: park for free within certain time limits in some places park on single and double yellow lines stay longer in on-street time-limited parking bays

Blue Badge schemes are run by councils. Most councils will let you apply for a Blue Badge online.

Central London is exempt from the national Blue Badge regulations and the central London boroughs of Kensington and Chelsea, Camden, Westminster and City of London don’t fully operate the Blue Badge scheme.

But if you’re exempt from road tax or have a Blue Badge permit, you may be able to get an exemption from paying the central London congestion charge.

Motability schemeThe Motability scheme allows some disabled people receiving a mobility allowance to get a car, powered wheelchair or scooter.

The scheme uses some or all of your mobility benefit payments to cover the cost of contract hire or hire purchase of an appropriate vehicle.

You can also pay an extra amount of money if you want a more expensive vehicle.

Find out more about how the scheme works and who can join.

NHS Choices have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does NHS Choices endorse any of the products or

services. All information and figures correct at the time of going to print.

Editorial content for pages 13 and 16-25 supplied by:

26

O C T A G O NDESIGN & MARKETING LTDD

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01302 714528

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Peterborough and all surrounding areas 01733 286305Stamford, Bourne and all surrounding areas 01780 429086

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28

Unite against dementia in PeterboroughAlzheimer’s Society in Peterborough wants everyone affected by dementia to know that whoever you are, whatever you are going through, you can turn to Alzheimer’s Society for support, help and advice.There are more than 1,900 people living with the condition in the city, yet too many are facing dementia alone without adequate support.

That’s why staff at the Dementia Resource Centre in Peterborough are sharing the number of ways people can access local support networks and speak to professionals. If you need:

Someone to talk toYou can phone at any time during the opening hours – 9am to 5pm, Monday to Friday – to talk in confidence with a member of staff from the Dementia Support Service.

Alternatively come and attend one of the drop-in peer support groups at the Dementia Resource Centre:

■ Every Tuesday, 10.30am to 12 noon, for carers

■ Every Wednesday, 11am to 12.30pm, for people with dementia.

Staff are available to listen when you just feel the need to talk, or to offer information and guidance on specific issues.

Dementia Advisers and Dementia Support Workers Dementia Advisers offer information about all aspects of living with dementia and supports people to access services.

Dementia Support Workers give personalised information and support to people with dementia and their carers to help better understand the condition, cope with day-to-day challenges and prepare for the future. Home visits can be arranged through here if needed.

The Carer Information and Support Programme (CrISP) The Carer Information Support Programme is a series of workshops available in Peterborough for carers and family members of people with dementia. This

programme aims to offer structured information to inform and support the caring role. Carers do not necessarily have to live with the person with dementia.

Activity Groups There are various opportunities available to give people affected by dementia the chance to take part in structured activities. These give people the availability to meet others in an informal relaxed setting. You can call the Dementia Resource Centre to find out what activities are available and would best suit you.

Become a Dementia Friend Alzheimer’s Society’s Dementia Friends Programme is a national initiative to improve people’s understanding of dementia.

During a Dementia Friend Information Session you will learn a little bit more about what it is like to live with dementia and then turn that understanding into action.

To find your nearest Dementia Friend Information Session, visit www.dementiafriends.org.uk.

Get involved in Cupcake Day – Thursday 14 June Alzheimer’s Society’s Cupcake Day is back and whether you’re a baking novice or a seasoned pro, unite against dementia with family, friends and colleagues by baking or buying cupcakes to raise vital funds.Whether you choose to celebrate on 14 June or mark the occasion another time in the month, there are no excuses not to get involved. Unite against dementia by signing up for Cupcake Day, visit www.cupcakeday.org.uk

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Taking on dementia together

Get in touchIf you are affected by dementia and would like information and support visit us:

The Dementia Resource Centre, 441 Lincoln Road, Millfield, Peterborough PE1 2PE

Call or email: Phone: 01733 893853 Email: peterborough@alzheimers.org.uk

Open 9am – 5pm, Monday to Friday

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Age UK Cambridgeshire and Peterborough is your local independent charity working with and for older people across Cambridgeshire and Peterborough. Our objectives are to help older people to maintain their independence, health and well being by providing services that meet individual needs.

We recognise that you want a choice in how you are supported, to continue to remain independent in your own home. The following services are designed to offer you support and help keep your independence.

Information & AdviceThis is a free and confidential service.We provide rights based information, which can be used with confidence to make informed decisions and choices, on a range of issues including: income and benefits, housing, health and social care. We have a range of FREE fact sheets and guides.

Social ConnectionsWe aim to reduce social isolation by bringing people together, providing opportunities to meet people and develop friendships.Day Club based at Steve Woolley Court:An opportunity to meet friends and participate in various activities.Friendship Clubs:Across the city and its borders there are 12 Friendship Clubs that meet regularly for companionship and an opportunity to socialise. These clubs organise outings, quizzes and guest speakers, many of the clubs offer a freshly cooked two course lunch and meet on a weekly basis.Sharing Time:We visit older people in their own homes for company and conversation sharing time with each other to help prevent feelings of loneliness.

Sunday Lunch Club:Our club meets alternate Sundays at Mellows Close in Peterborough for a home cooked two course Sunday Lunch, activities and social contact.

Volunteering:We have a whole range of volunteering opportunities, to include sharing time volunteers, fundraising and administration - please get in touch to find out more.

Practical ServicesOur services offer a range of support so that you can be happier in your own home, stay safe and remain independent. Our services include: Home Help/Support:Help with household tasks such as cleaning, laundry, shopping, meal preparation etc.

Gardening:We can support you with one off or regular gardening jobs to help keep your garden neat and tidy.Home Checks:Working alongside Adult Social Care Occupational Health teams we can assess your home for aids and adaptions to enable you to keep safe in your own home.

Community Support at Home:Daily contact (Mon-Fri) providing support to live in your own home, e.g. help with shopping, making appointments.

N.B. Charges are made for some services.

Age UK Cambridgeshire & Peterborough Services

To find out more about any of our services – call us on: 0300 666 9860

E: infoandadvice@ageukcap.org.uk or visit: www.ageukcap.org.uk

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Insurance, Products and ServicesMost of us want to remain independent and to keep doing things in life we love most. Age UK Enterprises offers a wide range of products and services designed for the over 50s.Home Insurance – Cover for Buildings, Contents or both is available with no hidden admin fees and the choice to pay by monthly instalments at no extra cost (0% APR Representative)Car Insurance – Cover with no upper age limit and the choice to pay by monthly instalments at no extra cost (0% APR Representative)Motor Breakdown – Cover wherever you are in the UK including Roadside, Recovery and Home Services^.Travel Insurance – Choice of Single Trip or Annual Multi-trip cover with no upper age limit and cover for existing medical conditions wherever possible*.Funeral Plan – Your family will be spared the worry of having to make all the arrangements, and the financial strain of paying for them will be eased. Acceptance is guaranteed if you are over 50 and there are easy payment options.Personal Alarms – If you want to remain independent and have peace of mind, Personal Alarms could be the service for you. Professional and friendly help in an emergency,

any time of the day and night. No obligation home demonstration available upon request or order online and connect the unit yourself with Easy-Connect.Wills and Legal Services – In association with leading law firm Irwin Mitchell, we offer a range of legal services providing advice in relation to Wills, family and relationships, personal injury, buying or selling a home and rights at work.Age UK Home, Car and Travel Insurance are administered by Ageas Retail Limited.Age UK Motor Breakdown is provided by Intana Assistance.Age UK Funeral Plans are provided by Dignity. Brought to you by Age UK Enterprises Limited.Age UK Personal Alarms are provided by PPP Taking Care Limited and brought to you by Age UK Trading CIC..^ Only available in Mainland Great Britain.* Subject to medical screening and acceptance by the underwriters.Age UK Cambridgeshire and Peterborough is an appointed representative of Age UK Enterprises Ltd which is authorised and regulated by the Financial Conduct Authority for insurance mediation and introducing potential annuity customers. ACOEE2777V1JUL17

To find out about insurance, products and services – Call us on 01733 307124(Direct dial to Age UK Enterprises Insurance, Products and Services only)

Love later life

NHS hospitals and services in Peterborough

The locations on the map indicate where services operate out of.

WHITTLESEY

MARKET DEEPINGSTAMFORD

Orthopaedics & Spine Specialist Hospital 1 Stirling Way, Peterborough,

Cambridgeshire, PE3 8YA

01733 333156

Fitzwilliam Hospital Milton Way, Bretton,

Peterborough,

Cambridgeshire, PE3 9AQ

01733 261717

Dementia Resource Centre (entrance on York Road), 441 London Road, Millfield, Peterborough PE1 2PE 01733 893853

The Lindens, 86 Lincoln Road, Peterborough, PE1 2SN 0300 666 9860

CROWLAND

PETERBOROUGH

Peterborough City Hospital Edith Cavell Campus, Bretton Gate,

Peterborough, PE3 9GZ

01733 678000

Stamford & Rutland Hospital Ryhall Road, Stamford, Lincs PE9 1UA

01780 764151

Rutland Integrated Hospital Team – supports the discharge of Rutland patients, including those hospitalised in the area. They can be contacted on: 01572 722 577 (see p14).

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Healthwatch Rutland, Land’s End Way, Oakham, Rutland, LE15 6RB Telephone: 01572 720381 Email: info@healthwatchrutland.co.uk

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Action on Elder Abuse 080 880 88141 We work to protect, and prevent the abuse of, vulnerable older adults. Action on Elder Abuse, PO Box 60001, Streatham SW16 9BY I www.elderabuse.org.uk I enquiries@elderabuse.org.uk

Admiral Nurses 0800 888 6678 Admiral Nurses provide the specialist dementia support that families need. When things get challenging or difficult, our nurses work alongside the entire family, giving them one-to-one support, expert guidance and practical solutions. I www.dementiauk.org I direct@dementiauk.org

Age UK Cambridgeshire & Peterborough 0300 666 9860 Providing practical services and support to make later life better. The Lindens, 86 Lincoln Road, Peterborough PE1 2SN I www.ageukcap.org.uk I infoandadvice@ageukcap.org.uk

Alzheimer's Society 01733 893 853 The UK's leading support and research charity for people with dementia, their families and carers. I www.alzheimers.org.uk I peterborough@alzheimers.org.uk

CareAware 0161 707 1107 A one stop shop for free advice on care fee funding for older people. I www.careaware.co.uk I enquiries@careaware.co.uk

Care Quality Commission (CQC) 03000 616161 National Correspondence, Citygate, Gallowgate, Newcastle upon Tyne NE1 4PA I www.cqc.org.uk I enquiries@cqc.org.uk

Carers Trust Peterborough 01733 645234 Comprehensive support services for unpaid family carers of all ages in Peterborough. 60 St Mark’s Street, Peterborough PE1 2TU I www.carerstrustpeterborough.org I carers@carerstrustpeterborough.org

Carers UK 0808 808 7777 Prevents carers from becoming emotionally drained, and from forgetting to take care of themselves. 20 Great Dover Street, London SE1 4LX I General enquiries: 0207 378 4999 I Advice line: 0808 808 7777 I www.carersuk.org I info@carersuk.org

Cruse Bereavement Care 0808 808 1677 Cruse Bereavement Care is here to support you after the death of someone close. I www.cruse.org.uk I helpline@cruse.org.uk

DIAL (Disability Information Advice Line) 01733 265 551 DIAL Peterborough provide information and advice to disabled people, their family and professionals on all aspects of living with a disability. DIAL Peterborough, Cresset Centre, Peterborough PE3 8DX

Disability Benefits Helpline – 0845 712 3456 for Disability Living Allowance and Attendance Allowance I Textphone: 0845 722 4433 I www.direct.gov.uk/en/Dl1/Directories DG_10011169

Elderly Accommodation Counsel 0800 377 7070 Elderly Accommodation Counsel (EAC) is a national charity that aims to help older people make informed choices about meeting their housing and care needs. I www.eac.org.uk I info@firststopadvice.org.uk

Healthwatch Peterborough 03451 202064 The new independent consumer champion created to gather and represent the views of the public at both national and local level. I www.healthwatchpeterborough.co.uk

Healthwatch Rutland 01572 720381 I www.healthwatchrutland.co.uk I info@healthwatchrutland.co.uk

Integrated Care Council 01379 678243 The Integrated Care Council (ICC) is a body that brings together British health and social care, public and independent sector organisations that commission or directly provide support for people living at home. I www.integratedcarecouncil.co.uk

Mind (National Association for Mental Health) 0300 123 3393 The leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. I www.mind.org.uk I contact@mind.org.uk

National Osteoporosis Society 0845 450 0230 Advice, information and support group for people with osteoporosis. I www.nos.org.uk

National Rheumatoid Arthritis Society (NRAS) 0800 298 7650 Provide information, support and advice for people living with Rheumatoid Arthritis. I www.nras.org.uk I enquiries@nras.org.uk

NHS 111 111

Peterborough Citizens Advice Bureau 0844 855 2122 16-17 St Mark's Street, Peterborough, PE1 2TU I www.peterboroughcab.org.uk

Parkinson's Disease Society 0800 800 0303 I www.parkinsons.org.uk

Royal Voluntary Service 0845 608 0122 A volunteer organisation that enriches the lives of older people and their families across Britain. We support older people by giving time and practical help to help them get the best from life. Royal Voluntary Service, Cardiff Gate, Beck Court, Cardiff Gate Business Park, Cardiff CF23 8RP I www.royalvoluntaryservice.org.uk

Rutland Community Wellbeing Service 01572 725805 Healthy lifestyles, emotional and financial wellbeing. I info@rutlandrap.org.uk

Rutland County Council – General enquiries 01572 722577 I www.rutland.gov.uk I enquiries@rutland.gov.uk

Rutland Housing MOT 01933 410084 I spirehomes.careandrepair@longhurst-group.org.uk

Rutland Information Service Online directory of organisations, activities and services in Rutland covering things to do, health and wellbeing, care options and staying independent. I http://ris.rutland.gov.uk

Stroke Association 0845 3033 100 Advice and information for stroke patients and their families. I www.stroke.org.uk

The Department of Work and Pensions I www.dwp.gov.ukThe Pension Service 0845 606 0265 I www.dwp.gov.uk/about-dwp/customerdelivery/the-pension-service

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Every possible care has been taken to ensure that the information given in this publication is correct at the time of going to print. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. Octagon Design & Marketing Ltd has not vetted the advertisers in

this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Octagon Design & Marketing Ltd endorse any of the products or services. No

reproduction by any method whatsoever of any part of this publication is permitted without prior written consent of the copyright owners.

Octagon Design & Marketing Ltd. ©2018. Hawks Nest Cottage, Great North Road, Bawtry, Doncaster, South Yorkshire, DN10 6AB. Telephone: 01302 714528

Options Peterborough is published by Octagon Design and Marketing Ltd with editorial contributions from North West Anglia NHS Foundation Trust, the CQC, Age UK, the Alzheimer’s Society, NHS choices and Rutland County Council. The

editorial contributors have not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor do the editorial

contributors endorse any of the products or services.

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INDEPENDENT CARE ADVICEWe will all need to think about care options and how we can

fund them at some point in our lives. The Care Advice Centre offers independent, no jargon, advice on care and funding issues. It is vital that the most cost effective methods of funding care fees

are considered. Such planning will give peace of mind that the available capital will last as long as possible.

ATTENDANCE ALLOWANCEYou may be able to claim Attendance Allowance if you have care

needs. You don’t actually have to receive help from a carer because Attendance Allowance is based on the help you need, not the help

you actually get. Attendance Allowance is not means-tested.

NHS CONTINUING HEALTHCARE FUNDINGYou may be able to claim NHS continuing healthcare funding if

you have a complex, progressive health care need. This is funding from the NHS. If you are found eligible, it can pay all of your care fees, whether you are at home or in a care home. NHS continuing

healthcare is not means-tested.

Please contact us on 07766 490473Email: info@care-advice-centre.co.uk www.care-advice-centre.co.uk

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To visit please contact the Home Manager/Proprietor Mrs T H Watts on 01733 252980 m: 07801 273804 e: gardenlodge37a@aol.com

37a Lincoln Road, Glinton, Peterborough PE6 7JS

Garden Lodge registered for 9 residents onlyYour local residential and dementia care home in Glinton, Peterborough.

Garden Lodge is a very small single storey care home with an uplifting garden, a peaceful and loving family environment. Garden Lodge is a family run home.

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