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Community care

When we refer to the local authority social services department, this term includes the Social Work Department in Scotland and the Health and Social Services Trust in Northern Ireland.

What are community care services

Community care is a complex area. If you're having problems getting community care services, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email, click on nearest CAB.

Community care services are care services that are arranged or provided by the local authority social services department, mainly to adults who have care needs. Community care services include a place in a care home or services to help you carry on living in your home and keep as much independence as possible.

You may need community care services because of your age or because you are disabled or physically or mentally ill.

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What services may be available

There is a wide range of community care services that you may be entitled to. The following list gives only the main examples:

  • a place in a care home
  • home care services
  • home helps
  • adaptations to the home
  • meals
  • recreational and occupational activities.

Care homes

If you need long-term care, and you can’t manage in your own home anymore, one option may be moving into a care home.

All care homes can provide personal care if you need it. This could include help with washing, dressing or going to the toilet. Some care homes can also provide nursing care.

The rules about how charges are made for care homes are different to the rules about charging for other community care services.

For more information about care homes, including how charges are made, see Care homes.

Home care services

Home care services generally mean help with personal tasks, for example, bathing and washing, getting up and going to bed, shopping and managing finances. Providing home care involves someone coming to your home at agreed times. This could be two or three times a day or even 24-hour care where necessary.

Home helps

Home helps can provide assistance with general domestic tasks including cleaning and cooking and may be particularly important in maintaining hygiene in the home.

Adaptations to the home

Adaptations to the home could be major or minor and can be particularly important in allowing you to remain at home. Major adaptations could include, for example, the installation of a stair lift or downstairs lavatory or the lowering of work tops in the kitchen. Minor adaptations would include, for example, hand rails in the bathroom.

Meals

The provision of meals as a community care service could mean a daily delivery of a meal or, in some areas, the delivery of a weekly or monthly supply of frozen food. It could also mean providing meals at a day centre or lunch club.

Recreational and occupational activities

The local authority social services department can provide a range of recreational, occupational, educational and cultural activities, for example, at a day centre. These activities could include lectures, games, outings, and help with living skills and budgeting. The local authority social services department may also provide transport to enable you to make use of the facilities.

The local authority social services department may also be able to provide radio, televisions or visiting library services.

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How to get a community care service

Unless you urgently need services, you will have to have your needs assessed by the local authority social services department before they will provide services for you. This is called a community care assessment. The local authority social services department must carry out an assessment for anyone who appears to need a community care service because they are, for example, elderly, disabled or suffering from a physical or mental illness.

If you think that you need community care services, you should contact your local authority social services department and ask for an assessment. A carer, friend or relative can also ask for an assessment on your behalf.

It may be that, after you've contacted the local authority social services department, there are problems with an assessment. If so, you may need to contact a specialist adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail, click on nearest CAB.

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How an assessment is carried out

An assessment is carried out by someone from or acting on behalf of the local authority social services department. More than one person could be involved in carrying out the assessment, including a social worker, a physiotherapist and an occupational therapist. The assessment procedure may involve filling in a form but this will vary from area to area.

The assessment should take into account:

  • your wishes as the person being assessed
  • whether you have any particular physical difficulties, for example, problems with walking or climbing stairs
  • whether you have any particular health or housing needs
  • what sources of help you have access to, such as carers, family or nearby friends, and their willingness to continue providing care
  • what needs these people who provide care may have.

What happens after an assessment

Once an assessment has been carried out, the local authority social services department has to decide whether you are entitled to services to meet your needs. This is based on your level of need, not on how much money you have. Entitlement to services is a complicated area.

If your local authority social services department says that you aren't entitled to community care services, you should get advice, for example, from a Citizens Advice Bureau. To search for details of your nearest CAB, including those who can give advice by e-mail, click on nearest CAB.

If the local authority social services department is going to provide services, the services must be set out in a care plan. You should be given the care plan in writing if you request it. The care plan will set out:

  • the services which are to be provided, by who, when and what will be achieved by providing them
  • a contact point to deal with problems about services
  • information on how to ask for a review of the services being provided if your circumstances change.

Assessment for a carer

A carer is someone like a relative or friend who takes responsibility for looking after a disabled, ill or elderly person and who does not provide the care as part of a job or as a volunteer with a voluntary organisation. Some carers provide care for a few hours a week, others for 24 hours a day, every day. A carer does not have to be living with the person being cared for.

You are entitled to ask for your needs as a carer to be assessed when an assessment is being carried out for the person you care for. You can ask to be assessed even if the person you care for is entitled to an assessment but does not want one. Some carers of disabled children can also have an assessment. In Scotland, local authority social services departments must consider the views of both the carer and the person cared for when they carry out any assessment.

You can find information about assessments for carers on the Carers Trust website at www.carers.org/carers-assessment.

In England and Wales, local authority social services departments can provide services directly to carers and offer you direct payments for your own needs. However, the results of the carer’s assessment must be taken into account when they decide what community care services the person being cared for will receive.

If, after contacting the local social services department, you have problems with an assessment, it may be necessary to contact a specialist adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those who can give advice by e-mail, click on nearest CAB.

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Paying for community care services

The rules about which community care services must be paid for, and how much can be charged, are complicated. If you want information on this, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those who can give advice by e-mail, click on nearest CAB.

The local authority social services department can charge for providing some community care services. Some local authorities only charge for some services, for example, meals on wheels or home helps, while others charge for all the services they are allowed to charge for.

The information below does not cover charges for care homes.

For more information about how charges are made for care homes, see Care homes.

If you’re a carer in England and Wales and you get services for your needs, you can be charged for those services.

If you live in Scotland, are aged 65 or over, and get personal care or personal support care at home, you should get this free. If the local authority refuses to provide a service for free, you can challenge the decision. You could then make a complaint to the Scottish Public Services Ombudsman.

A local authority social services department must make information about charges generally available. If you are having your community care needs assessed by the local authority social services department (and in England and Wales, if you are having your needs as a carer assessed), you must also be given full information on charges for any services provided.

Some local authority social services departments make a flat rate charge for a service, for example, meals on wheels. Others may want to know how much income and savings you have and then charge according to a sliding scale.

In England and Wales, local authority social services departments must follow the following Government guidance when they assess how much you can pay for services:

  • they must not charge you if you get Income Support, income-based Jobseeker's Allowance or Pension Credit (guarantee credit only) and your overall income is less than a certain amount
  • they should not take your or your partner's earnings into account
  • they should only take your savings and capital into account if they are above a set limit. Your home isn’t taken into account when they assess your capital
  • in England only, if they take into account any disability-related benefits you get, for example, Attendance Allowance or Personal Independence Payment, they must also assess and allow for any extra expenses you have as a result of your disability, for example, extra heating or laundry costs
  • in Wales, allowances must be made for any disability-related expenses you may have
  • they should offer you advice on social security benefits
  • in Wales, there is a maximum charge of £50 a week (£55 from 7 April 2014). However, this will not apply to some services for which a flat-rate charge is made.

In Scotland, local authority social services departments should follow the guidance about charges produced by the Convention of Scottish Local Authorities (COSLA). This guidance can be found on their website at www.cosla.gov.uk.

If you have been asked to pay for services and you think the charges are unreasonable or you can't afford to pay them, you can ask for the charges to be reviewed.

If you want to challenge charges, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those who can give advice by e-mail, click on nearest CAB.

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Direct payments

Direct payments are payments of money a local authority social services department makes to people to arrange their own community care services, instead of the local authority arranging the services.

If you're entitled to get community care services, your local authority social services department must give you the option of getting direct payments, as long as you are able to manage a direct payment.

In Scotland, the local authority must also offer you other options for choosing and arranging the support that will best meet your needs. This is called self-directed support. The other options are:

  • you tell the local authority what support you would like and they arrange it and hold and manage the budget
  • you ask the local authority to choose and arrange the support that it thinks is right for you
  • you choose a mix of the other options.

The Scottish Government has produced a user’s guide to self-directed support that provides more information about the four options as well as links to organisations that can provide further help. It is available at: http://guidance.selfdirectedsupportscotland.org.uk/index.html. You can also get more information about self-directed support from the Self-Directed Support in Scotland website at: www.selfdirectedsupportscotland.org.uk.

The amount of direct payments you get should cover the cost of buying services to meet your needs. This includes any extra costs you have to pay in order to get the service. For example, if you employ your own carer, you will have to pay recruitment costs, holiday and sick pay and insurance.

In the same way that you may have to pay for services arranged by the local authority social services department, you may have to make a contribution towards the cost of services you are buying with direct payments. The local authority social services department will work this out in the same way it works out how much you have to pay towards services it arranges itself (see heading Paying for community care services). They will either deduct your contribution before paying you the direct payment or pay the direct payment in full and you will have to pay your contribution back.

If you're offered a direct payment, you do not have to accept it if you would rather have services arranged by the local authority social services department.

If you do get direct payments, you will have to arrange your own services. Local support organisations may be able to help you with these arrangements.

Disability Rights UK holds a list of these organisations. You can contact them at www.disabilityrightsuk.org.

You can get more information about direct payments in England on the NHS choices website at www.nhs.uk.

For more about direct payments in Wales, see Direct payments – what are they.

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Inspections of care services

In England, the Care Quality Commission inspects care homes and home care services. It does unannounced inspections on a regular basis.

In Wales, the Care and Social Services Inspectorate Wales inspects care homes and home care services regularly.

In Scotland all care homes and agencies providing support services in someone's home can be inspected once in every 12 month period by the Care Inspectorate. The inspection will be unannounced.

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Complaints

If you are not satisfied with the standard of community care services offered by your local authority, you may be able to make a complaint. You can get in touch with them to find out about their complaints procedure.

For more information about how to make a complaint in England, see NHS and local authority social services complaints. In Scotland the complaints procedure for community care services is explained on the Care Inspectorate website at www.scswis.com. In Northern Ireland, see HSC complaints in Northern Ireland.

In Wales, you can find information about how to complain about a local authority service, on the Welsh Government website at: new.wales.gov.uk.

In England, you may have a complaint about a social care provider, such as a care home or home care agency, for care you have arranged or paid for yourself without the help of the local authority. You should first complain to the provider. If you can't resolve your complaint this way, you can ask the Local Government Ombudsman to investigate.

In Scotland if you have a complaint about a social care provider you can use their complaints procedure first then complain to the Care Inspectorate, or you can complain directly to the Care Inspectorate. All care providers have to be registered with the Care Inspectorate. You can get information about how to complain on the website at www.scswis.com.

For more information about how the Local Government Ombudsman deals with complaints about adult social care, go to the website at www.lgo.org.uk/adult-social-care.

In Wales, if you have a complaint about a social care provider, such as a care home or home care agency for care you have arranged or paid for yourself, you should first complain to the provider. If you can't resolve your complaint this way, you can ask the Care and Social Services Inspectorate Wales (CSSIW) to investigate.

For more information, go to the CSSIW website at: wales.gov.uk.

You can find a guide about what you can expect from home care services and how to complain about a service on the Equality and Human Rights Commission's website at www.humanrightsinhealthcare.nhs.uk.

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Other help

If you need community care services because you are disabled, make sure that you are also claiming all the benefits you are entitled to. There may be other support available, for example, travel concessions.

In England, if you are a carer, the NHS has a helpline for carers called Carers Direct which gives information and advice about community care services, benefits and other matters.

The helpline number is: 0808 802 0202 and you can go to their website at: www.nhs.uk/carersdirect.

In Scotland, Care Information Scotland provides a telephone and website service which gives information about community care services for older people in Scotland and their carers and families. It also produces a useful leaflet called Finding the Care That is Right for You and this can be found on its website. The helpline number is: 08456 001 001. The website address is: www.careinfoscotland.co.uk.

For more information about benefits, see Benefits for people who are sick and disabled.

For more information about travel concessions, see Transport options for disabled people.

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