Who will actually provide a Domiciliary Care service in Bath & North East Somerset?
If you are eligible for a service provided through Social Services, you may receive a service from one of a number of different providers. The Council commissions services from independent and privately owned agencies.
People eligible under Social Services criteria can sometimes have a Direct Payment in order to employ someone of their own choice to provide a service. Your social worker can tell you more about Direct payments.
If someone is not financially eligible for a service from Social Services but cannot deal with purchasing a service on their own behalf, and has no one to do this for them, Social Services will sometimes set up and manage the service on their behalf. In this case the client will still pay the full cost.
Standards and Regulation
Domiciliary Care is what is known as a Registered Service. This means anyone who has a business providing a service of personal care to people in their own homes must be registered with an independent government agency called the Care Quality Commission and must conform to certain legal standards, including criminal records bureau checks for staff. The Care Quality Commission carries out regular inspections of agencies and inspection reports are available to the public.
Independent agencies who are commissioned to provide a service to clients of Social Services must also sign a contract with the Council which stipulates high standards of service.
For those who are not financially eligible for a service through Social Services, the Council can provide a list of local Domiciliary Care agencies on request. For further information see the end of this leaflet.
Cost
Self Funding clients can expect to pay between £10 and £17 per hour, with higher rates sometimes applying at weekends, nights and bank holidays.
People receiving a service via Social Services may be exempt if they are receiving certain benefits, or pay a sliding scale of charges depending on a financial assessment.
What can a Domiciliary Care Worker do?
Typically, a domiciliary care worker will carry out personal care tasks which a caring relative might perform, such as help with washing, bathing, showering, dressing, shaving, oral hygiene, emptying a catheter bag and dealing with incontinence pads, emptying commodes, applying skin cream, and prompting with medication. They will not carry out tasks which require qualified nurse training such as giving injections or dressing wounds. Some tasks which are ‘borderline’ nursing tasks such as changing ileostomy bags may be carried out only after training or guidance from a District Nurse or other qualified person. This will need to be considered when setting up the service.
Domestic tasks might include shopping, cleaning, vacuuming, collecting prescriptions, ensuring disposal of out of date food in the fridge, making up beds, machine laundry, heating ready meals, washing up etc.
Please note that clients receiving a Social Services funded service will only receive help to meet critical and substantial needs. This may not cover some things which you may think are essential to keep up your personal standards.
The social worker who carries out your assessment will be able to discuss with you what can be provided in more detail.
Self funding clients who have a private contract with an agency may be able to purchase help with a wider range of tasks.
All providers have a responsibility for the health and safety of their staff - for example staff will not lift heavy weights which may cause them injury. Providers will normally carry out a risk assessment in the client’s home before agreeing to start providing a service.
Will they know about me and my needs?
Where a service is arranged we will carry out an assessment of needs and write a care plan which will detail the services to be provided. You will be fully involved and consulted at all stages, and will receive a written copy of your assessment and care plan, as will the provider.
If there is particular information about you which you do not wish to be shared with a provider, you can discuss this with your social worker. We can only share information about you with your consent, but we have a duty to protect the health and safety of members of staff. In the very small number of cases where we consider that there is a risk to staff from the household, we will record this on your case file and must inform our providers. You will be informed if this is the case and have an opportunity to comment.
All providers are under a duty to keep information about you confidential.
If you are arranging a service privately, the manager of the service should carry out their own interview with you and gather information from other people who know you such as your doctor or district nurse, to ensure that you receive appropriate care.
This information should be passed to staff actually providing your care.
Complaints
For people receiving a Social Services arranged service:
You should contact the provider direct and discuss it with a manager in the first instance.
If you are unable to resolve the problem with the provider, you should contact your social worker if you have one. Most people will not have a permanently allocated social services worker, in which case you can ring the Council on 01225 396000 and ask for Community and Health Access Team Duty Team.
For people with a privately arranged service who pay for their own care:
All agencies should have a complaints procedure. Normally you should contact the manager of the agency and most complaints can be resolved in this way. Complaints can also be addressed to the Care Quality Commission.