Bounty

Respite Care

Respite care is any sort of help and support that enables a person to take a break from the responsibility of caring for somebody else.

Caring for someone can be a full-time job and, like any job, you sometimes need to take a break.

You may feel guilty or apprehensive about taking a break from the person you are looking after. However, it is important to remember that if you go too long without taking a proper break, you may become ill, anxious or depressed. This can make life more difficult for you and the person you are caring for.

Types of respite care

There are a number of different types of respite care, which are described below.

• Residential respite care is where the person being cared for goes away to live and be looked after by someone else for a while. 
• Emergency respite care is where care is provided when someone is cannot fulfil their caring responsibilities due to unforeseen circumstances, such as illness. 
• Domiciliary care is where support is provided in the home to help out with some of the carer’s responsibilities for a few hours. 
• Day centre care is where the person being cared for spends time at a centre to allow the carer to have a few spare hours of their own.

See Care options for more detailed information and advice about the different types of respite care that are available.

What is a carer?

When local authorities and other government organisations talk about carers they do not mean someone who is paid to provide care as part of a contract of employment, such as a care worker or care staff.

Carers are usually people who look after a relative or a friend who needs support because of:

• their age
• a physical disability
• a learning disability
• a health condition
• a mental health condition
• an addiction, such as drugs or alcohol 

For example, a carer could be a parent with a child who needs additional help due to a long-term health condition.

Any person of any age can become a carer.

Young carers

A young carer is a child or a young adult who is under 18 years old. A young carer carries out tasks and has high levels of responsibilities for another person. This level of responsibility would usually be taken by an adult.

Assessment and help

Assessment of needs

To see whether you qualify for help with caring, you must contact your local authority and ask them to carry out an assessment of the person you care for and an assessment of yourself.

The social worker who carries out the assessment will consider the health and social care needs of the person that you are looking after, as well as the community care services that are needed to meet those needs.

After the assessment, the social worker will use the information they have gained to determine what help and services you are eligible for. This will be put into a care plan and sent to you and the person you look after.

The Carers Equal Opportunity Act (2004)

Under the Carers Equal Opportunity Act (2004) the local authority also has a legal responsibility to consider:

• whether you wish to work or take part in training
• your own health and wellbeing
• your right to have a reasonable amount of leisure time to yourself

Young carers (those under 18 years old) are also entitled to an assessment under the Children Act (1989). The assessment takes things like education, development and leisure time into consideration when assessing the needs of a young carer.  

See Carers Direct - assessments for more information.

Financial assessment

Local authorities can charge for care services. Most services have a minimum charge (or no charge at all) and a maximum charge. The amount that is charged for care services will be subject to a means tested financial assessment.

The person receiving the care service will be asked to complete a financial assessment form, which takes into account any income and assets they have. Social services must make sure that:

• they charge a ‘reasonable’ amount for services
• no one is denied a service because they are unable to pay
• an individual’s extra costs for a disability or ill health are considered

It is important to complete the financial assessment form when applying for care services. If it is not completed, you will be charged the maximum amount. But note that this may still be less than if you were to pay for private care services.

Financial help

Vouchers

Some local authorities provide vouchers that can be exchanged for services, such as those offered by care agencies or residential homes. The vouchers are issued to carers by local authorities after they have been assessed under the Carers Recognition Act 1995.

The vouchers are designed to let carers take a break from caring by giving the person they care for care support while their carer has time off. The vouchers can be used to pay for a number of different services provided by approved care organisations. These services include:

• residential care
• domiciliary care
• nursing care
• any other approved carer break service that meets local authority requirements

The voucher scheme gives the carer and the person being cared for more choice about when and where they receive support from various different services.

The scheme is currently only used by some local authorities, although the number of authorities using the scheme is increasing. Check with your local social services to find out whether your local authority uses the voucher scheme.

Direct payment

Alternatively, your local authority can make a direct payment to you or the person you are caring for. This can be spent on care services from an appropriate individual or agency.

The direct payments are designed to allow you to organise the support that you need in a more flexible and personalised way.
 
Direct payments can be made to:

• older people who have been assessed and need community care services
• disabled people who are 16 years old or over, including those with short-term and long-term needs
• carers who can use the money to buy services that support them in their caring role
• families with disabled children for children's services, such as education, health, and early years and social care services
• disabled parents for children's services

A person must have enough mental capacity to manage the direct payment. However, they can be helped in managing the payment on a day-to-day basis.

The local authority has a legal responsibility to provide a direct payment when the above criteria are met. The person receiving the payment also has a responsibility to ensure that the money is spent appropriately.

A carer can use a direct payment in a number of different ways. Some examples include paying for:

• taxi fares
• training courses
• counselling
• driving lessons
• help with housework or gardening
• leisure classes
• gym membership
• computers
• mobile phones

Your local council social services department will explain what the money can and cannot be spent on. You will need to discuss with the council how you intend to use your direct payments to arrange services.

If you prefer to receive local council services to meet some of your needs, the council may agree to offer you a combination of direct payments and services.

As direct payments are designed to help people live independent lives, they cannot be spent on permanent residential care. However, you may be able to use the payments to pay for occasional short periods in residential accommodation if your local council agrees that it is in the best interest of the carer and the person they care for.

Most councils will not allow a direct payment to be used as a wage to pay:

• a spouse (husband or wife)
• a civil partner
• a partner with whom you live as a couple
• a close relative who you live with or the spouse or partner of that relative

Exceptions to this will only be made under certain circumstances. The local authority makes the decision whether to grant a direct payment or not.

Be aware that if you are paying someone to do care work on your behalf, you may have certain legal responsibilities as their employer. Responsibilities include:

• paying at least the minimum wage
• providing an itemised pay slip
• drawing up a written contract of employment terms

You can get help with this from social services or carers' organisations, such as Carers UK.
 
See Carers Direct - practical support for more information about direct payments. 

Care options

Arranging care at home

Arranging for someone to come into your house is a good way of giving yourself a break from your caring duties and responsibilities. You can also make flexible arrangements regarding how much or how little home care you need.

Some advice about finding home care is listed below.

• personal recommendations – a fellow carer, your GP or a relevant charity or support group may be able to recommend someone suitable
• local advertising – this can allow the person you are caring for to meet potential applicants
• home care agencies – these can provide qualified carers, but they can be more expensive than other options

When arranging home care, you may want to consider the following points:

• Interview every applicant in person and check any references.
• Ask applicants if they have training and experience in meeting the needs of the person being cared for.
• Check with your insurance company that you are covered for someone else working in your home, to ensure against accident or theft.
• Check the applicant's employment status – if they are not self-employed, as an employer you will have some responsibilities (see Care assessment and assistance). If they are a non-EU citizen you will have to check that they have a valid employment visa that entitles them to work in the UK.
• Draw up a clear job description outlining exactly what tasks and responsibilities you expect the applicant to carry out. 
• Make sure that there is a clear agreement about payment and fees, and put this in writing.

After you have found a suitable home carer, you may want to draw up a list of instructions for them. For example, you may want to include:

• information about the person that you are caring for – for example, their likes and dislikes, any dietary requirements, their daily routine or any cultural or religious beliefs that need to be respected 
• instructions about the running of the house – for example, how household appliances (such as the washing machine and cooker) work
• important contact details – for example, those of your GP and of any social worker who may be involved in providing care and support

Day care centres

Many local communities have day care centres, or community centres, which have the facilities and staff to care for your relative or friend for a few hours.

Day care centres also offer a chance for the person being cared for to meet and talk to other people, as well as enabling them to take part in new activities.

Your local authority can advise you about the facilities available in your area.

Residential and nursing care

There may be some circumstances when you need to take a complete break from your caring responsibilities, or you have to leave your home for a short period of time. In such cases, you may want to consider arranging short-term care at a residential or nursing home.

Staff at a residential care home can provide help and support with tasks such as dressing, washing, eating and going to the toilet, but they are not usually trained to provide nursing care.

If the person you are caring for has complex or demanding health needs, a nursing home may be a better option than a residential home. As a result of the extra responsibilities, nursing homes usually charge higher fees. Places at nursing homes can be limited, so book well in advance where possible.

See Carers Direct - practical support for more information about care homes for different groups of people.

Short breaks and holidays

A number of charities and voluntary organisations provide specialist holidays for people with disabilities and their carers.

Charities, such as Vitalise provide short breaks and other services for people with a disability and their carers.

The Princess Royal Trust for Carer's provides information and advice about taking a holiday with someone who has a disability. The website also has links to charities and organisations that offer holidays, plus useful information relating to travelling with people who have specific health conditions.

See Carers Direct - time off for more information about the different types of breaks and holidays that are available.

Emergency care

It is recommended that you draw up a contingency plan in the event that an emergency prevents you from looking after the person you are caring for.

For example, possible emergencies could include:

• transport problems, such as a missed train or broken-down car
• accident or illness
• a sudden death in the family
• an urgent medical appointment that you need to attend

Your contingency plan should include the details of those who are willing to help, what they should do and how they can be contacted. Your local authority can give you advice about drawing up a plan for emergency care. It can also inform you on what their provision for emergency respite care is.

You may also want to consider joining a warden scheme where, in the event of an emergency, the person you are caring for can contact a warden by telephone or by using a panic alarm.

See Carers Direct - emergencies for more information and advice about planning for emergencies.