This webpage offers practical tips and information to help you if you need to make changes to your home, or find alternative accommodation after a stroke.
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On our moving to a care home after stroke page we have put together some information and advice that we hope will help you understand your options and choose the care home that suits your needs.
On this page
Your accommodation needs after a stroke
If you have a disability after a stroke, you might need to make some changes in your home to help you live independently. If your needs cannot be met at home, then you will be supported to find a new home which could include options such as sheltered housing or a nursing home.
Assessment of your needs
After a stroke, your care and accommodation needs should be assessed.
In England and Wales you should have a care and support needs assessment from the local authority. If you are likely to need changes to your home or new accommodation, you will also have a home needs assessment.
In Scotland this is called an 'assessment of your care needs'.
In Northern Ireland, the local Health and Social Care Trust carries out the review of your social care needs.
If you stayed in hospital after your stroke, this assessment should be arranged as part of the hospital discharge process. The support you need should be included in a written care plan, which you are entitled to a copy of. If an assessment wasn't carried out, or if you develop new support needs some time after a stroke, you are entitled to have your needs reassessed.
Care and support plan
An assessment looks at your support and care needs, and sets out what help you might benefit from. This is drawn up in a care plan. This plan can include services to help you at home such as equipment, or carers to help with washing or dressing. It can also include information and support for you and your carer. The assessment may make a recommendation about your accommodation.
The social services department of your local authority is responsible for the care and support needs assessment, but they sometimes ask other organisations to carry out the work. Different professionals may be involved in making an assessment, including a social worker and an occupational therapist.
Your assessment may take place at home or in hospital. If you are in hospital for some time after your stroke, social services should carry out your assessment before you are discharged. The assessment will usually look at your physical, psychological, social and cultural needs.
Each local authority has its own assessment process, and you can ask to see a copy. This covers eligibility, the application process, waiting times, decisions, the services they can provide and complaints. It may include a means test, to look at your savings and income to work out whether you will have to contribute to paying for your care.
Following the assessment, you, social services and health professionals, and your family will decide if you need any community care services. If necessary, the health and social care professionals team will put together a package of support for you. You should be fully involved in decision making. If you find it difficult to understand your care or express your opinions, an advocate can be appointed to represent you in discussions. For more information about advocates see the 'Who decides where I live' section below.
If you find it difficult to look after yourself and your needs cannot fully be met at home, other options will be explored with you, which may include supported living or a care home. There are eligibility criteria for all levels of support offered by your local authority. There are fewer criteria around your choices if you are self-funding your care or change of accommodation. The social worker or your occupational therapist will be able to guide you through the options appropriate to you.
NHS continuing healthcare
People with very serious health needs may qualify for NHS continuing healthcare. This is a package of ongoing care and support arranged and paid for by the NHS in England, Wales and Northern Ireland. It can be provided in your own home or in a care home. The NHS pays for your care home fees as well as any medical care. In Scotland, the Hospital based complex clinical care scheme provides care for people in a suitable setting outside hospital.
To find out if you are eligible, you go through an assessment process. The assessment involves an initial set of checks against a list of eligibility criteria, completed by a health or social care professional. Afterwards, you may be referred for a full assessment. This will involve several different professionals and looks in more detail at all your different care needs such as cognition, continence, mobility and nutrition. For information and advice about the continuing healthcare process visit beaconchc.co.uk.
Help in your own home
A care and support plan might suggest equipment or alterations that could help you in the home. This could include grab rails or raised toilet seats. If you need equipment, or minor adaptations to your home such as buying and installing a grab rail, you should get this free of charge through your council, up to the value of £1000. A council can make a charge for minor adaptations costing more than £1000.
If you need a larger alteration to your home, such as widening doors or installing a stair lift, the Disabled Facilities Grant is available through local authorities in England, Wales and Northern Ireland. This is means tested, so you could be asked to pay for some of the work. In Scotland, you can apply to the local authority's Scheme of Assistance for help with repairing and adapting housing if you have a disability. It can only be arranged after you return from hospital, so some people might need to have a temporary arrangement at home. This could be a bed, armchair, commode and hoist in one room.
If your care plan suggests you have a carer in your own home, the means assessment decides how much funding you receive and how much you will pay yourself. If you are eligible for homecare services, this may be provided by the council. You may be able to arrange it yourself, with funding from direct payments or a personal budget. Home help and care is available from private providers and charities.
If you need mobility equipment like wheelchairs or walking frames, you might be able to get it on loan from the NHS for a short while. There is more information about equipment to help you live independently on our equipment for independent living and mobility webpage.
Moving to a care home
People move into a care home for different reasons. Someone might not be able to look after themselves safely, or might not be able to manage on their own overnight, or cope between visits from a carer.
A care home provides support from staff 24 hours a day. The home will provide you with care and services, a room (sometimes with en-suite facilities), communal areas and meals. Residents will usually also be offered social activities. Homes are owned and run by local authorities, voluntary organisations or private companies. Your choice of care home will depend on the amount of care you need. If you need to live in a care home, a financial assessment is carried out to see how much you should contribute to the cost.
Supporting a loved one
Moving home can be a huge emotional upheaval. The change may be distressing for both you and your loved ones. It can be hard for someone to leave their home, particularly if they have lived there for a long time.
On the positive side, the move will enable them to get more help and support and a good care home will help new residents settle in. Providing ongoing support to your loved one, both practically and emotionally, will also help.
Other things you can do include:
- Gaining information about the home so you are fully informed.
- Thinking about any fears your loved one has and what might help reduce these.
- Helping them find ways to keep in touch with family and friends.
- Encouraging them to talk to other residents about the experience and join in with social activities.
- Finding out who to go to for extra support.
- Allowing time to adjust to the changes.