Bexley

Health & Social CareSignposting Directory

Issue 1

Your local spotlighton Health & SocialCare covers servicesin Bexley

ContentsContentS

Disclaimer

This Directory has been compiled to signpost primary health and social care providers throughout Bexley.

Whilst we have taken every care in compiling this publication, the publishers and promoters cannot accept responsibilityfor any inaccuracies.

All listings are supplied via the Care Quality Commission (CQC) and NHS Choices. Neither Healthwatch Bexley norHealthCare Publications can be held responsible for any errors or omissions.

All signposting services are up to date as of December 2014.A note on advertising: We offer businesses the chance to reach potential customers via this publication. It is our intention to clearly indicate that anadvertisement is being displayed and no endorsement or approval by the promoters of any product, service or supplier should be implied.

Healthwatch Bexley 1 – 2Nhs - Know your Rights! 3 – 4Advocacy for All 5Mental Health & Emotional Wellbeing 6Healthy Living 7The Heart of the Matter 8Free NHS Health Check 9 – 10Don’t just go to A & E... 11 – 12Patient Choice of GP Practices 13GP’s & GP Surgeries 14Pharmacies 15 – 16Dentists, Opticians & Hearing Centres 17 – 18Social Care & Independent Living 19 – 22Understanding the Care Act 23 – 24Personal Health Budgets 25Are you a Carer? 26Telecare & Telehealth 27 – 28Care in your own Home 29 - 30Choosing between Residential, Nursing & Independent Living 31 – 32Residential Care Costs 33 Residential & Nursing Care 34Expressing Complaints & Concerns 35 - 36

Another quality publication by Healthcare PublicationsIf you require extra copies of this directory or are interested in advertising in future editions

please email Healthcare Publications on admin@healthcarepublications.org or visit: www.hcpublications.org

1Bexley

HeALtHWAtCH BeXLeY

Healthwatch Bexley representseveryone in our community; adults,young people and children alike. Inorder to help shape YoUR servicesfor the future, Healthwatch Bexleywants to hear from you on the localhealth and social care services youreceive.If you want to share your experience – good andbad – then get in touch.

Healthwatch Bexley works with local people andagencies to challenge service providers and driveimprovements on behalf of patients and the public.Championing diversity, Healthwatch Bexley isrooted in communities and responsive to theirneeds.

Healthwatch Bexley is:

• A consumer watchdog concerned with the performance of health and social care providers

• A consumer champion, promoting the needs, priorities and experiences of patients to commissioners and other agencies

Information and adviceIt can be difficult to know where to turn whenyou need help from health or social careservices. We can tell you:

• What services are available?• How you can get the help you need.• What your rights and options are.

The powers that Healthwatch Bexley has:

• Healthwatch Bexley has a seat on the Bexley Health and Wellbeing Board. This body oversees health and social care in Bexley, and can influence how services are designed and delivered

• Healthwatch Bexley has the right to go into health and social care premises to collect the views of patients and residents who are using the services

• We pass information, issues and concerns to the organisations which regulate health and social care and escalate recommendations to Healthwatch England and the Care Quality Commission (CQC)

Healthwatch BexleyMilton House240a Broadway

Bexleyheath, Kent DA6 8ASTel: 0208 304 9344

Email us:info@healthwatchbexley.co.uk

Visit our website:www.healthwatchbexley.co.uk

Twitter: @HWBexleyFacebook: Healthwatch Bexley

Healthwatch isindependent andtransparent - withthe authority todemand action

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HeALtHWAtCH BeXLeY

Healthwatch Enter & View TeamIf you care about services and the way they aredelivered, you may wish to be trained as an Enter& View representative to visit hospital wards,Nursing or Residential Homes, GP’s, Dentists,Opticians or Pharmacies. Training is thorough andsupportive and the reports written as a result ofyour findings make recommendations whichsupport the improvement of the service.Contact usfor further details.

Please tell us:

• Are you happy with the health and/or social careyou are receiving?

• Do you have a relative or a friend living in a carehome? Are they / you happy with the care they receive?

• Can you get an appointment with your GP/Dentist when you need to?

• Have you had a stay in or visit to hospital recently? What was your experience like?

• Do you or a relative suffer from a long term illness; are you/they happy with the help and support you/they receive?

• Do you know what services are available and how to choose the right one, when you need it?

• If you could fix one thing in health and social care what would it be?

Get InvolvedThere are many ways you can get involved withHealthwatch Bexley.

Sign up to our quarterly Newsletter to find outwhat is going on at Healthwatch Bexley and thework we have been doing to improve services inBexley.

Share your stories with us, so we can build up apicture of the services that are doing well, andthose that could be improved.

Contact us:There are lots of ways you can get in touch withHealthwatch Bexley.

Write to us at:

Healthwatch BexleyMilton House, 240a BroadwayBexleyheath, Kent DA6 8AS

Tel: 0208 304 9344Email us: info@healthwatchbexley.co.ukVisit our website: www.healthwatchbexley.co.ukTwitter: @HWBexleyFacebook: Healthwatch Bexley

What you’re saying quality public

helping A&E ease support doctorsfriendly waiting health long-term

improvements good happy patient

We want to hear about the treatment and care you

have received.Whether you’ve had a positive experience

or there is room for improvement, have your say on the Healthwatch

Bexley website today. You can even leave feedback anonymously.

www.healthwatchbexley.co.uk

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nHS - KnoW YoUR RIgHtS!

You have the right to expect your NHS to assessthe health requirements of your community and to commission and put in place the services tomeet those needs as considered necessary, and inthe case of public health services commissioned bylocal authorities, to take steps to improve thehealth of the local community.

You have the right, in certain circumstances, to goto other European Economic Area countries orSwitzerland for treatment which would beavailable to you through your NHS commissioner.

You have the right not to be unlawfullydiscriminated against in the provision of NHSservices including on grounds of gender, race,disability, age, sexual orientation, religion, belief,gender reassignment, pregnancy and maternity ormarital or civil partnership status.

You have the right to access certain servicescommissioned by NHS bodies within maximumwaiting times, or for the NHS to take allreasonable steps to offer you a range of suitablealternative providers if this is not possible.

You have the right to be treated with aprofessional standard of care, by appropriatelyqualified and experienced staff, in a properlyapproved or registered organisation that meetsrequired levels of safety and quality.

You have the right to expect NHS bodies tomonitor, and make efforts to improve continuously,the quality of healthcare they commission orprovide. This includes improvements to the safety,effectiveness and experience of services.

You have the right to be treated with dignity andrespect, in accordance with your human rights.

You have the right to have any complaint youmake about NHS services acknowledged withinthree working days and to have it properlyinvestigated.

You have the right to discuss the manner in whichthe complaint is to be handled, and to know theperiod within which the investigation is likely to becompleted and the response sent.

You have the right to accept or refuse treatmentthat is offered to you, and not to be given anyphysical examination or treatment unless you havegiven valid consent. If you do not have thecapacity to do so, consent must be obtained from aperson legally able to act on your behalf, or thetreatment must be in your best interests.

Everyone has the right to information andeducation about how to take care of themselvesand what they are entitled to within the healthand social care system.

Healthwatch Bexley helps individuals tounderstand, and use information to promote andmaintain good health and make the best use oflocal services and care support.

We can:• Explain your rights and what standards to expectfrom services

• Signpost you to access services and find your way through care ‘pathways’ – find the right service for you

• Put you in touch with Support Groups, Voluntary and Community Organisations

• We can register your concerns and provide information on making complaints

• Pass on your reports of excellent services and care

• If you need advocacy we can refer you to the Advocacy for All

You have the right to receive NHS services free ofcharge, apart from certain limited exceptionssanctioned by Parliament.

You have the right to access NHS services. You willnot be refused access on unreasonable grounds.

tell us yourexperiences

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You have the right to be given information aboutthe test and treatment options available to you,what they involve and their risks and benefits. You have the right of access to your own healthrecords and to have any factual inaccuraciescorrected.

You have the right to privacy and confidentialityand to expect the NHS to keep your confidentialinformation safe and secure.

You have the right to be informed about how yourinformation is used.

You have the right to request that yourconfidential information is not used beyond yourown care and treatment and to have yourobjections considered, and where your wishescannot be followed, to be told the reasonsincluding the legal basis.

You have the right to choose your GP practice,and to be accepted by that practice unless thereare reasonable grounds to refuse, in which caseyou will be informed of those reasons.

You have the right to express a preference forusing a particular doctor within your GP practice,and for the practice to try to comply.

You have the right to make choices about theservices commissioned by NHS bodies and toinformation to support these choices.

You have the right to be involved in discussionsand decisions about your health and care, includingyour end of life care, and to be given informationto enable you to do this. Where appropriate thisright includes your family and carers.

You have the right to be kept informed of progressand to know the outcome of any investigation into your complaint, including an explanation of theconclusions and confirmation that any actionneeded in consequence of the complaint has beentaken or is proposed to be taken.

You have the right to take your complaint to theindependent Parliamentary and Health Service Ombudsman or Local Government Ombudsman, ifyou are not satisfied with the way your complainthas been dealt with by the NHS.

You have the right to make a claim for judicialreview if you think you have been directly affectedby an unlawful act or decision of an NHS body orlocal authority.

You have the right to compensation where youhave been harmed by negligent treatment.

You have the right to choose the organisation thatprovides your NHS care.

With all the changes to health and care servicesit’s not always clear where you should go to reportan urgent issue, to make a complaint, or forfurther information.

Healthwatch Bexley can help you find the rightservices to suit your needs through our Information& Signposting Service.

We cannot give you advice or make specificrecommendations but we can help you make aninformed decision in finding the right health andsocial care service whether it is provided by theNHS, the Council, a voluntary or communityorganisation.

Contact Us:Office telephone:0208 304 9344

Write to us at: Milton House240a BroadwayBexleyheath, Kent DA6 8AS

Email us at: info@healthwatchbexley.co.uk

Visit our website: www.healthwatchbexley.co.uk

nHS - KnoW YoUR RIgHtS!

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ADVoCACY foR ALL

Bexley – Advocacy for NHS complaints Advocacy for All provide free independent supportto Bexley residents who want to complain aboutNHS services including hospitals and/or NHS staff,doctors’ surgeries, pharmacies opticians, dentistsand the ambulance service.

We provide information to help clients decide ifthey want to proceed with a complaint and discusswhat other options they might have.

We give people the opportunity to speakconfidentially to someone who is independent ofthe NHS. If they decide to make a complaint wehelp them through the process. This can includehelping them to write letters, attending meetingsand talking over what to do at each stage.

We can support clients with the local complaintsprocedures through to complaining to the HealthService Ombudsman. We do not give legal ormedical advice but we can signpost people to findadvice if appropriate.

For more information contact:

Bigger Voices . . .Better Lives!

Bexley

Geraldine CahillNHS ComplaintsCommunications Officer

Russell PrestwichNHS Complaints Co-ordinator

Unit 1, 241 Main Road, Sidcup, DA14 6QSTel: 0208 269 8692

Email: bexleynhscomplaints@advocacyforall.org.uk

www.advocacyforall.org.uk

As the service is only for Bexley residents, we aimto reach a wide cross section of the borough’sresidents including those who find it most difficultto get their voices heard. Our main aim is toensure complaints are used positively to improveNHS services for the whole community.

We hope that you will use our service or pass ourdetails to others.

Please contact us if you would like to talk throughany NHS concern you have or if you want to knowmore about the service we provide.

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MentAL HeALtH & eMotIonAL WeLLBeIng

Mental health factsAt least one in four people experience adiagnosable mental health problem in any oneyear, and one in six experiences this at any onetime.

• More than half of those with a common mental health problem have both depression and anxiety

• There are approximately 570,000 people with dementia in England, a figure that could double in the next 30 years

• Nearly 850,000 children and young people aged five to sixteen years have a mental health problem – about 10% of the population. Fewer than one in ten accesses treatment

Common mental health problems such as anxiety,depression, panic disorders, phobias and obsessivecompulsive disorder can cause great emotionaldistress, and can affect how you cope with day-to-day life and your ability to work. Less commonconditions, such as psychosis, can make youexperience changes in thinking and perceptionsevere enough to significantly alter yourexperience of reality. These conditions includeschizophrenia and affective psychosis, such asbipolar disorder, and can have the same lifelongimpact as any long-term physical condition.

Many issues can be managed without the help of aGP by using the variety of sources of help nowavailable, whether it’s through books, localorganisations such as Mind in Bexley or online.Mental illness is treatable and, with appropriatesupport and treatment, people do recover. Manymove on with their lives and are able to care fortheir family, contribute to the local community,and get back into employment or training.

How your GP can helpYou should make an appointment to see your GP ifyou’ve been feeling depressed for a few weeks oryour anxiety is having an impact on your daily life,such as stopping you from going to work orshopping. Mind in Bexley deliver NICErecommended psychological interventions foranxiety and depression.

• Your GP or healthcare professional can refer

• Individuals can also self-refer into the service

There are also community based recovery, peersupport and employment services in Bexley whichwork with people who have mental health issuesThe service is a partnership between Mind inBexley, Oxleas Foundation Trust and Reinstate.Further information is available from the Mind inBexley website www.mindinbexley.org.uk

Mental health, emotional wellbeingand resilience is all about how wecope with what life throws at us. Itconcerns the way we feel aboutourselves, conduct relationships,handle stress or deal with loss.good mental health and resilienceare fundamental to good physicalhealth, relationships, educationand work, as well as being key toachieving our potential.

020 8303 8932

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HeALtHY LIVIng

The choices we make about how we livecan have a significant effect on ourhealth. Eating a healthy diet, doingregular exercise, not smoking and notdrinking too much alcohol can help youstay well and enjoy a long life. Keeping fit and healthy can be a challenge if youare living with a long-term condition, but it willmake a big difference to your wellbeing. If you’vebeen thinking about making changes to yourlifestyle, such as stopping smoking, losing weight,eating healthily, drinking a little less alcohol, ordoing more exercise, there’s plenty of help andsupport available.

Talking to your GP and other healthcare workers,including pharmacists, is the first step. They’llhelp you look at your lifestyle and suggest changesthat are suitable for your condition and anytreatment you’re having. Your health or careworker can also let you know about local servicesthat can help you.

For example, if you want to start exercising butyou're unsure how to, your GP can put you on theExercise on Referral scheme. These schemes arerun with local gyms and fitness centres and caninclude swimming. Ask at your GP practice formore information.

Your GP can also help you if you want to stopsmoking, for instance by enrolling you in a clinicwhere you’ll get support from other people whoare also trying to stop. Nicotine replacementtherapy and other stop smoking treatmentsprovided by your GP can also help you resistcravings and boost your chances of quittingsuccessfully.

You're never too young or too old to switch to ahealthier lifestyle. Children who learn healthyhabits at a young age will benefit from themthroughout their life. And giving up bad habits canimprove your health at any age.

Stop Smoking for goodGiving up smoking is probably the best thing youcan do to improve your health. Research showsthat smoking is responsible for almost one in fiveof all deaths in the UK. This means that smokingcauses an estimated 110,000 deaths a year.

Smokers are almost twice as likely to have a heartattack as people who have never smoked. Smokingalso increases your risk of developing many cancersand lung disease.

Rethink your drinkingDrinking too much alcohol could increase your riskof getting 14 major diseases, including mouth andthroat cancers, liver cirrhosis, strokes and mentalhealth problems.

Alcohol is believed to be responsible for as many as22,000 premature deaths in England and Walesevery year. But it’s not just binge drinkers who areat risk: regularly drinking more than the recommendedlimit can cause significant health problems.

Get active, feel fitter, live longerWhatever your age, there's strong scientificevidence that being physically active can help youlead a healthier and even happier life.

Adults should do at least 150 minutes (2 hours and30 minutes) of moderate-intensity aerobic activityeach week. Young people (5-18) should do 60minutes every day.

If you do this, it can reduce your risk of heartdisease and stroke by up to 50% and lower your riskof early death by up to 30%.

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tHe HeARt of tHe MAtteR

Cardiovascular Disease (CVD) describesdisorders that can affect the heart andthe body’s system of blood vessels(vascular). Cardiovascular problemsresult in chronic conditions that developor persist over a long period of time. Itcan also result in heart attacks andstrokes when a vessel supplying blood tothe heart or brain becomes blocked.CVD (including stroke) is the second largest causeof death and premature death after cancer. It isestimated that Cardiovascular Disease (CVD)affects more than 20,000 people in Bexley.

Fortunately the vast majority of CVD ispreventable. Much of the risk can be reduced bymaking lifestyle changes. These include stoppingsmoking, increasing physical activity, improvingdiet and nutrition, and reducing high levels ofalcohol consumption.

Residents aged 40-74 without pre-existing heart orvascular disease conditions such as heart disease,Type 2 diabetes, hypertension or stroke areentitled to a free NHS Health Check once everyfive years.

The NHS Health Check will give you a CVD riskscore and link you into programmes that supporthealthy lifestyles such as weight managementprogrammes, stop smoking services and healthtrainers, where appropriate.

Find out more about Public Health services and the support available in Bexley at: www.bexley.gov.uk/health

"gP practices in Bexleyprovide nHS Health Checks,

if you are called for yournHS Health Check, please

contact your surgery tomake an appointment"

How does smoking damage your heart?Smoking is estimated to cause nearly 10% ofcardiovascular disease, which includes coronaryheart disease and stroke. Smoking is the leadingcause of CVD after high blood pressure.

• Smoking damages the lining of your arteries, leading to a build-up of fatty material (atheroma) which narrows the artery. This can cause angina, a heart attack or a stroke.

• The carbon monoxide produced by tobacco smoke reduces the amount of oxygen in your blood. This means your heart has to pump harderto supply the body with the oxygen it needs. This puts a strain on the heart and reduces oxygen in the blood supply by up to 15%.

• The nicotine in cigarettes stimulates your body to produce adrenaline, which makes your heart beat faster and raises your blood pressure, making your heart work harder.

• Your blood is more likely to clot, which increasesyour risk of having a heart attack or a stroke. Bexley has an award winning local Stop Smoking Service just waiting to help you give up! GP practices in Bexley and a number of Pharmacies offer the service as well as specialists from the core team.

Call the Public Health Team Stop Smoking Servicenow on: 0800 783 2514or visit: smokefreebexley.co.uk for further details

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fRee nHS HeALtH CHeCK

Everyone is at risk of developing heartdisease, stroke, diabetes, kidney disease,and some forms of dementia. The goodnews is that these conditions can oftenbe prevented – even if you have a historyof them in your family. Have your freeNHS Health Check and you will be betterprepared for the future and be able totake steps to maintain or improveyour health.Why do I need an NHS Health Check?We know that your risk of developing heartdisease, stroke, type 2 diabetes, kidney disease,and dementia increases with age. There are alsocertain things that will put you at even greaterrisk.

These are:

• Being overweight

• Being physically inactive

• Not eating healthily

• Smoking

• Drinking too much alcohol

• High blood pressure

• High cholesterol

Both men and women can develop theseconditions, and having one could increase your risk of developing another in the future.

• In the brain a blocked artery or a bleed can cause a stroke

• In the heart a blocked artery can cause a heart attack or angina

• The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heartattack

• Being overweight and physically inactive can lead to type 2 diabetes

• If unrecognised or unmanaged, type 2 diabetes could increase your risk of further healthproblems, including heart disease, kidney disease and stroke

Who is it for?

The NHS Health Check scheme isavailable across Bexley.If a person is aged between 40 and 74 and hasn’talready been diagnosed with heart disease,diabetes, kidney disease, or had a stroke, theymay be invited by their GP for the NHS HealthCheck by letter, text or they may be offered theNHS Health Check when they are at their GP foranother reason.

Helping you prevent heart disease, stroke,diabetes, kidney disease and dementia

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fRee nHS HeALtH CHeCK

Even if you’re feeling well, it’s worthhaving your NHS Health Check now.We can then work with you to lower yourchances of developing these healthproblems in the future.

What happens at the check?This check is to assess your risk of developing heartdisease, type 2 diabetes, kidney disease,and stroke.

• The check will take about 20-30 minutes

• You’ll be asked some simple questions. For example, about your family history and choices which may put your health at risk

• We’ll record your height, weight, age, sex and ethnicity

• We’ll take your blood pressure

• We’ll do a simple blood test to check your cholesterol level

What happens after the check?We will discuss how you can reduce your risk andstay healthy.

• You’ll be taken through your results and told what they mean. Some people may be asked to return at a later date for their results

• You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle

• Some people with raised blood pressure will have their kidneys checked through a blood test

• Some people may need to have another blood test to check for type 2 diabetes. Your healthprofessional will be able to tell you more

• Treatment or medication may be prescribed to help you maintain your health

Questions you may have

Why do I need this check? I feel fine!The NHS Health Check helps to identify potentialrisks early. By having this check and followingthe advice of your health professional, youimprove your chances of living a healthier life.

But don’t these conditions run in the family?If you have a history of heart disease, stroke, type2 diabetes, or kidney disease in your familythen you may be more at risk. Taking action nowcan help you to prevent the onset of theseconditions.

I know what I’m doing wrong. How can the doctor help me?If you would like help, we will work with you tofind ways to eat healthily, reach your healthyweight, be more active, cut down your drinking, orstop smoking.

If I am assessed as being at ‘low risk’,does this mean I won’t develop theseconditions?It is impossible to say that someone will or won’tgo on to develop one of these conditions.But takingaction now can help you lower your potential risk.

Will everyone have this check?This check is part of a national scheme to helpprevent the onset of these health problems.Everyone between the ages of 40 and 74 who hasnot been diagnosed with the conditions mentionedwill be invited for a check once every fiveyears. If you are outside the age range andconcerned about your health, you should contactyour GP.

Helping you prevent heart disease, stroke,diabetes, kidney disease and dementia

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Don’t JUSt go to A & e...

What to do or where to go when you and yourfamily become unexpectedly injured or unwell

Depending on the severity of your illness or injury,there are a number of places you and your familycan go to access treatment or health advice. Thisguide will help you to receive treatment fast,leaving emergency services to those who needthem most. A copy of the leaflet Don't just go toA&E can be downloaded from the NHS Bexleywebsite at www.bexleyccg.nhs.uk.

Self Care A range of common illnesses and injuries can betreated at home, simply by combining a well-stocked medicine cabinet and ensuring you getplenty of rest. Make sure that your medicinecabinet is well stocked with:

• Paracetamol • A thermometer • Antihistamines • Aspirin • Rehydration mixture • Plasters • Indigestion remedies • Anti-diarrhoea medicine

Pharmacy Your pharmacist is a healthcare professional whocan provide advice and treatment for commonconditions such as diarrhoea, sore throats, painfulcoughs, upset stomach and skin conditions.Pharmacists also dispense prescriptions.

If you need advice on how you can treat yourself orhave a question about your medication, visit yourlocal pharmacist.

Free emergency contraception is also availablefrom some local pharmacies in Bexley. For details of pharmacies open in Bexley and otherlocal boroughs during Christmas and the New Yearbank holidays in 2014/2015 see the downloadsection in the left hand menu.

GP practice If you have a medical problem that is not life-threatening – for example back ache, ear pain andhigh temperature – visit your family doctor.

Your GP provides a range of services byappointment and will be able to assess yourimmediate needs as well as refer you into aspecialist service, such as outpatients, ifnecessary. They also know your medical history soare best placed to manage your care.

NHS 111If your GP practice is closed, call the NHS 111service by dialling 111.NHS 111 may:• Give medical advice over the phone, for example, you may be asked to go to a 24-hour chemist, or advised to wait until your doctor's surgery is open in the morning• Direct you to an out-of-hours doctor's service. Depending on your condition, the doctor will either visit you at home, or ask you to attend the urgent care centre at Queen Mary's Hospital, where a doctor will be expecting you.• Ask you to attend the urgent care centre at Queen Mary's Hospital, where a team of healthcare professionals will be able to treat you• Direct you to an accident and emergency department – but this will only happen if your illness or injury is life-threatening or very serious

Urgent Care Centres (UCCs) If you have a minor injury or medical problem thatis urgent but not life threatening, visit the UCC atQueen Mary's Hospital, Sidcup or the UCC at ErithHospital. The types of illnesses and injuries bothUCCs can treat includes, but is not limited to:• Broken bones, sprains and strains• Minor head injuries • Burns and scalds• Bites and stings • Minor chest, neck and backinjuries or pain • Foreign objects in wounds orother parts of the body • Infections includingwounds • Minor eye injuries

If you have a minor injury or medical problem thatis urgent but not life threatening – a broken bone,sprain, burn, infection or minor eye injury, visitthe UCC at:Queen Mary's Hospital, Sidcup (24 hours a day, 7 days a week), or the UCC at Erith Hospital (8am to 10pm, seven days a week).

Accident and emergency departments Accident and Emergency (A&E) departments shouldonly be used in a critical or life-threateningsituation. A&E departments provide immediateemergency care for people with very serious orlife-threatening illness. For emergency healthcarehelp, dial 999 or go immediately to your nearestA&E department.• Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH• Darent Valley Hospital, Darenth Wood Road, Dartford, Kent DA2 8DA• Princess Royal University Hospital, Farnborough Common, Kent BR6 8ND

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13

PAtIent CHoICe of gP PRACtICeS

During 2012 and 2013, the Departmentof Health ran a pilot scheme to explorehow patient choice of GP practice couldbe expanded. The Patient Choice Schemepilot was available in different parts ofEngland and offered patients new ways of accessing GP services outside their GPpractice's boundary area.As a result of this scheme, and following changesto GP contracts, all GP practices in England willbe free to register new patients who live outsidetheir practice boundary area from January 2015.

This means that you are able to join practices inmore convenient locations, such as a practice nearyour work.

The idea is to provide you with greater choice andto improve the quality of GP services over time, asGPs providing a good service are naturally morepopular.

These new arrangements are voluntary for GPpractices. If the practice has no capacity at thetime or feels it is not clinically appropriate orpractical for you to be registered so far away fromhome then they can still refuse registration. Thepractice should explain their reason to you indetail.

What to consider when registering with a GP practice further awayYou may wish to join a GP near work or remainregistered with your old GP following a move. Thenew arrangements make this possible; however,there are a few things to consider.

Because of the greater distance to your home, theGP you register with is under no obligation to offeryou a home visit. If you are not well enough to goto the practice yourself then other arrangementswill have to be made. NHS England (the bodyresponsible for buying GP services) has to ensurethat you are able to access a service either nearyour home or at home. When you register with apractice away from home you will be giveninformation about what you should do in thosecircumstances.

What to expect from your GPGPs look after the health of people in their localcommunity and deal with a whole range of healthproblems. They also provide health education,offer advice on smoking and diet, run clinics, givevaccinations and carry out simple surgicaloperations.

GPs usually work in practices as part of a team,which includes nurses, healthcare assistants,practice managers, receptionists and other staff.Practices also work closely with other healthcareprofessionals, such as health visitors, midwives,and social services. You would normally see GPs orother healthcare professionals at their premises(surgery). Some operate from more than onebuilding. If your GP cannot deal with a problemthen you’ll usually be referred to a hospital fortests, treatment, or to see a consultant withspecialist knowledge. GP practices should makeinformation about their services easily available to their patients. Most practices have a practiceleaflet available, otherwise please ask your GP orsurgery for one.

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gP’S & gP SURgeRIeS

Surgery Address Area Postcode Telephone

Data correct with NHS Choices - December 2014

Getting a GP appointment If you want to see a doctor, you'll usually need to make an appointment. MostGP surgeries operate independently and have their own booking routines. Your surgery should be able tooffer you an appointment to see a GP or other healthcare professional quickly if necessary. However, if itis more convenient, you should also be able to book appointments in advance. Familiarise yourself withyour GP surgery’s appointment system, and try to plan in advance if you can. For routine appointmentsyou may be able to book online, so check on the practice website or with the receptionist.

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PHARMACIeS

Around 70% of pharmacists work in thecommunity in premises on local highstreets all over the country. Communitypharmacists prepare and dispenseprescription and non-prescriptionmedicines. They are also able to give youadvice about how to use your medicinesand highlight any possible side effects.They offer advice on common problems such ascoughs, colds, aches and pains, as well as healthyeating and stopping smoking. They can also helpyou decide whether you need to see a doctor.

This means that your pharmacist may ask you arange of questions before handing over anymedicines, especially if you ask for medicinesthat do not require a prescription.

Questions your pharmacistmay ask include:• Have you taken the medicine before?• Who is the medicine for?• What are the symptoms?• How long have you had these symptoms?• What action has already been taken?• Are you taking any other medication for this or any other reasons?

Talk to your PharmacistYou can talk to your pharmacist in confidence,even about the most personal symptoms, and youdon't need to make an appointment. It is possibleto walk into any community pharmacy and ask tospeak with the pharmacist. They may be able tospend some time with you or offer you anappointment for a consultation. All the discussionswith your pharmacist can take place in person orby phone.

Around 85% of pharmacies now have a privateconsultation area where patients can discuss issueswith pharmacy staff without being overheard byother members of the public.

Make sure you have repeat prescriptionsIf you or someone you care for requires medicinesregularly, make sure you order and collect repeatprescriptions in good time to ensure you or yourfamily have enough medicine to last i.e.weekends, Bank holidays and breaks away.

Many of the calls to out of hours health servicesare for emergency repeat prescriptions whenpeople have run out of their medication - asituation that could be avoided with someforethought and planning. By thinking ahead foryour regular medication you are helping our busyout of hour’s doctors and nurses.

For opening times and NHSSERVICES available from yourPharmacy Please scan the QR codewith your smartphone or visitwww.nhs.uk

What if I have a complaint or concernabout my Pharmacy or Pharmacist?Any complaint to go through the NHS complaintsprocedure needs to be made either to the practicedirectly or to NHS England. Any other concernsabout a pharmacist 'fitness to work' should bemade via General Pharmaceutical Council.

You can contact the General PharmaceuticalCouncil, either by emailconcerns@pharmacyregulation.org

or by post:Raising a concernGeneral Pharmaceutical Council129 Lambeth Road, London SE1 7BJTel: 020 3365 3603

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PHARMACIeS

Pharmacy / Chemist Address Area Postcode Telephone

Data correct with NHS Choices - December 2014

17

DentIStS, oPtICIAnS & HeARIng CentReS

Dentist Address Area Postcode Telephone

Optician Address Area Postcode Telephone

Hearing Centre Address Area Postcode Telephone

Data correct with NHS Choices - December 2014

18

NHS DENTAL CHARGESBand 1 course of treatment

£18.50 This covers an examination, diagnosis

(eg X-rays), advice on how to prevent futureproblems, a scale and polish if needed, andapplication of fluoride varnish or fissure

sealant. If you require urgent care, even ifyour urgent treatment needs more than oneappointment to complete, you will only need

to pay one Band 1 charge.

Band 2 course of treatment£50.50

This covers everything listed in Band 1above, plus any further treatment such asfillings, root canal work or if your dentist

needs to take out one or more of your teeth.

Band 3 course of treatment£219.00

This covers everything listed in Bands 1 and 2above, plus crowns, dentures and bridges.

NHS DENTISTRYKNOW YOUR RIGHTS

You're entitled to have all clinically necessarytreatment on the NHS. This means that the NHSwill provide any treatment that you need tokeep your mouth, teeth and gums healthy

and free of pain.

If your dentist says you need a particular type oftreatment, you should not be asked to pay for itprivately. Your dentist is not allowed to refuse

you any treatment available on the NHS but thenoffer the same treatment privately. Also,

any treatment provided on the NHS has to be of the same high quality as treatments

provided privately.

Depending on what you need to have done, youshould only ever be asked to pay one charge foreach complete course of treatment, even if youneed to visit your dentist more than once tofinish it. You will not be charged for individual

items within the course of treatment.

Regular eye tests are important because youreyes don't usually hurt when something iswrong. A sight test is a vital health check foryour eyes that can pick up early signs ofeye|conditions before you're aware of anysymptoms – many of which can be treated iffound early enough.

What your eye test will showA sight test will show if you need to get glassesfor the first time or change your current glasses.

A sight test will also include a generalhealth check that can pick up earlysigns of eye disease before you’reaware of any symptoms. Some healthconditions can affect the eyes such as:Diabetes, Macular Degeneration or Glaucoma

Your Sight TestIt’s recommended that adults have their eyestested every two years, unless their ophthalmicpractitioner advises them to have a sight testmore often than that.Your employer may payfor this test for you so ask for advice on this,and if you are over 60 your test is free ofcharge.

19

SoCIAL CARe & InDePenDent LIVIng

How do I get Social care?If you have decided that you need social caresupport, you may want to think about the type ofsupport you require, be it homecare workers,equipment or respite breaks.

Your first step should be to ask your local authoritysocial services department for an assessment ofyou needs.

Local authorities have a duty to assess anyone whoappears to need the community care services theyoffer.

Your local authority should:

• assess your needs and give you advice, whatever your financial circumstances• tell you about local services and who to contact locally for advice• be able to provide information about services and support options available to you in your area• give you relevant information if you are an unpaid/family carer

The assessment by the local authority is importantbecause it helps them work out what yourdifficulties are and what services will help youmost. Each local authority has its own way ofworking out who is eligible for social care supportand what services it can offer.

If your local authority thinks you are eligible forsocial care support, you have a specific level ofneed and meet financial rules, you should beinvolved in the decision-making process thatfollows. If appropriate, the next step will be forsocial services or an independent adviser to workwith you to create a care plan.

Often only minor assistance is needed – such asmeals on wheels and help with washing ordressing. Yet these services could make a bigdifference to your life.

If you feel that your needs have changed overtime, you will have to be re-assessed. Contact thesocial care team at your local authority to discussit with them.

Your rights and entitlementsIn most cases, you shouldn’t have to actively exertyour rights in regards to the care that you receive.However, if you feel you are being unjustly treatedin breach of your rights, you may want to takeaction. You can do this by telling someone youtrust, seeking help from Healthwatch Bexley orcontacting the local authority team in charge of‘safeguarding’.

Under UK law, you should be looked after andtreated fairly and with dignity whenever you aregiven social care services. This applies toeveryone, regardless of where they are given careand who does the caring. Other laws may alsoprotect you from discrimination because of whoyou are, including some protection for carersunder the rules designed to protect disabledpeople. For example, if you are an older person,this should not stop you from having treatmentsimilar to that which a younger person would be given.

Family SupportFamilies with disabled children may be eligible forFamily Support to help you look after your child.This can include day care for children under five,help with parenting such as parenting classes,courses or family support workers, practical homehelp, and access to a Children’s Centre. Some ofthese services are available to all families.

20

21

SoCIAL CARe & InDePenDent LIVIng

What social care support can I get?Many people’s first impression or thoughts of socialcare might be a residential care home. In fact,there’s a wide variety of social care servicesavailable and most who need social care supportwill be able to have care provided in their home.The kind of social care support that you can getdepends largely on your needs. This means thetype of condition you have, or the severity of yourdisability. For example, if you have a neurologicalproblem that causes you to have trouble walkingyou may simply require some equipment to helpyou remain mobile and independent. However, ifyou have a significant neurological problem thatseriously affects your mental capacity or ability tomove and look after yourself, you are likely toneed a much wider range of social care services.Itis worth taking time to think about your specificneeds and what you think you might need to helpyou achieve the best quality of life you can.

Care and support services might typically include:• equipment• help in your home or in a care home• community support and activities• day centres• home adaptations• residential care• financial support• information and advisory services, and advocacy• support for carers• other support for care

EquipmentGetting the right equipment can revolutionise yourlife. The ability for you to remain independentsometimes hinges on small factors and tools, suchas a jar gripper (to help you remove lids) or waysto raise your seat (so that you can get up moreeasily), which can make all the difference.However, equipment can also help with weightierissues, for example, hoists to help people withmobility problems get on and off chairs or toilets,or in and out of the bath or bed. The equipmentyou may be able to access could includemonitoring devices that check whether you haveleft the house if you have a condition, such asdementia, that causes confusion and wandering.

Help in your home or in a care homeYou may want to have someone who can come toyour home and give you the support you need tolive your life. This can include help with tasks suchas getting dressed, help with using the toilet,washing, preparing and eating food, cleaning andlaundry, getting out and about, and taking part inleisure and social activities.

Healthwatch Bexley or your local authority will beable to provide you with information and advice onwhat services are available in your local area.

Community support and activitiesSome social care services can be provided to helpyou continue to play an active role in yourcommunity and to get out and about and do thethings you want to do. For example, you may wantto work or to partake in religious or cultural eventssuch as a festival or a sports match. Social careservices may be able to support you in a widerange of ways to enable you to continue to dothese things, for example a community transportservice.

Day centresVisiting a day centre can be a good alternative tomoving into a care home. Day centres provide anopportunity to socialise and do activities thatmight not be available at home and may providerespite for family carers.

Adaptations to your homeA common way that social care can support ill ordisabled people to live independently at home issimple adaptations to the home. If you havedifficulty living at home because of your condition,it is often a better option to improve your homethan to move somewhere new.For example,depending on your condition, you might be able toget lowered kitchen surfaces and storage, widerdoorways to accommodate wheelchairs or walkingframes, or improved flooring to prevent trips andfalls.

SoCIAL CARe & InDePenDent LIVIng

Residential careIf living at home is no longer a realistic or practicaloption, you may want to consider residential care.There are many different types of ‘residentialcare’ – it may mean a permanent move into a carehome for older people, or it could be a stay in ahome for younger adults with disabilities, or ahome for children. Residential care may beprivately owned, or run by a charity or the localauthority.

The main types of residential care are:• residential care homes• residential care homes with nursing care• extra care and sheltered housing• supported living• retirement villages

Deciding on a long-term stay in residential care is avery significant decision financially, practically andemotionally. You will need to think about your ownpreferences and decide what services will meetyour needs now, as well as being flexible enough totake account of your future care needs. It is notalways an easy decision. Independent advice canbe important in helping you make the rightdecision, taking into account all the important factors.Your local authority will be able to give you detailsof information services they commission locally.

Support for carersYou’re a carer if you’re looking after a person whois disabled, has a long-term health condition or iselderly and frail. Carers can get help with theircaring role, and by enabling the person they carefor to get the support they need, they can maketheir own life easier. For example, it’s importantthat carers have time for themselves, and one ofthe best ways to arrange breaks from caring is toensure that you have had a carer’s assessment.This will help identify how substantial anddemanding your caring is and how much supportyou are likely to need. If you are looking after achild with a learning disability or similar, youshould also consider the support that your childwill need with their education. Again, talk to yourlocal authority to discuss the types of support youmight be able to get.

Who to contact for an assessmentfor Social CareThe London Borough of Bexley provides a range ofsocial care services to support vulnerable childrenand adults across the borough. We are here tooffer you practical information and advice whichwill help you to continue to live independently athome. This may include, for example, help withmobility and confidence after an accident, illness,injury or deterioration in a condition.

Contact Care CentralContact CentreCivic Offices 2 Watling Street Bexleyheath DA6 7ATTel: 020 8303 7777Email: screeners@bexley.gov.uk

Out-of-hours social service supportBexley operates an out-of-hours emergency serviceevenings and weekends to ensure help is alwaysavailable.

Monday to Thursday 6pm to 8am, and from 6pmFriday through to Monday 8am.

To access the service simply telephone:020 8303 7777

Children and family care servicesAll families with children below the age of 18 wholive in the Bexley borough can receive advice andinformation from the Children and Familiesservice.

Tel: 020 8303 7777 Email: childrenssocialcare.admin@bexley.gov.uk

Disabled children's serviceThe disabled children's service is a specialist teamresponsible for the assessment of disabled childrenup to the age of 18 and the provision ofinformation, and the packages of support to meettheir assessed needs.

Disabled Children's ServiceCivic Offices 2 Watling Street Bexleyheath DA6 7ATTel: 020 3045 3600 Email: disabledchildrenserviceunit@bexley.gov.uk

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23

UnDeRStAnDIng tHe CARe ACt

What is the Care Act? The number of people in England who have healthproblems requiring both health and social care isincreasing. For example, in the next 20 years, thepercentage of people over 85 will double. Thismeans there are likely to be more people with‘complex health needs’ - more than one healthproblem - who require a combination of health and social care services.

The Care Act is a new law about care and supportfor adults in England that will come into force inApril 2015, making one new law saying whatpeople can expect and what local authorities willhave to do.

Care and support is something that nearlyeveryone in this country will experience at somepoint in their lives; even if you don’t need careyourself, you will probably know a family memberor friend who does, or you may already care forsomeone. Until now it’s been almost impossible forpeople who need care, carers, and even those whomanage the care system, to understand how theprevious law affecting them worked. The Care Acthas created a single, modern law that makes itclear what kind of care people should expect.

To help make things clearer the government haveintroduced a minimum eligibility threshold acrossthe country - a set of rules that makes it clearwhen local authorities will have to provide supportto people. Until now, local authorities have beenable to decide this threshold themselves, meaningdecisions varied from place to place.

Most local authorities have had a one size fits allapproach to care. The focus has been on whatdisabilities someone has, or what services the local authority can provide, rather than on theindividuals needs. So for the first time the systemwill be built around each person -what they need,how they can best be cared for, and what theywant.

For the first time, the Act provides people with alegal entitlement to a personal budget, which is an important part of their care and support plan.The personal budget must be included in everyplan, unless the person is only receivingintermediate care or reablement support to meettheir identified needs.

The main themes of the Care Act arearound promoting:• Wellbeing: giving people greater choice and control to be independent and providing advice and support.

• Carers entitlements and rights: carers will be entitled to their own assessments to see if they are eligible for support.

• A lifetime cap on care costs: there will be a limit to the amount you will have to pay for care in your lifetime (this will not come into force until April 2016). The lifetime cap on care costs will be £72,000 for people aged 65+. Local authorities must also help people to benefit from independent financial advice, so that they can get support to plan and prepare for the future costs of care.

• Advocacy: the local authority must find you an independent advocate who will help you and represent your best interests to get the right services if you are unable to do so.

• Keeping adults safe: This is the first time there as been a law telling local authorities what to do to help keep adults safe from abuse or neglect.

24

UnDeRStAnDIng tHe CARe ACt

How does the care act benefit carers?Currently, carers don’t have a legal right to receivesupport, although local authorities can providesupport at their discretion. This means that accessto assessment and the range of support on offercan vary considerably.

The Care Act gives local authorities a responsibilityto assess a carer’s needs for support, where thecarer appears to have such needs. This replacesthe existing law, which says that the carer must beproviding “a substantial amount of care on aregular basis” to qualify for an assessment. Thiswill mean more carers are able to have anassessment. The local authority will assess whetherthe carer has needs and what those needs may be.This assessment will consider the impact of caringon the carer. It will also consider the things that acarer wants to achieve in their own day-to-daylife. It must also consider other important issues,such as whether the carer is able or willing tocarry on caring, whether they work or want towork, and whether they want to study or do moresocially. If both the carer and the person they carefor agree, a combined assessment of both theirneeds can be undertaken.

Adults caring for disabled childrenAn adult caring for a disabled child can get supportthrough children’s services. This is usually the bestway to meet their needs, so they are not coveredby this Act.

However, there is provision in the Act for an adultcarer of a disabled child to ask for an assessmentof their caring needs before the child reaches 18.When a local authority carries out such anassessment, it has the power to provide support tothe carer, even though they are caring for a child,rather than an adult. This would, for example,enable a local authority to provide support that isavailable through an adult carers’ centre.

The Care Act and young carersThe Care Act does not deal with the assessment ofpeople under the age of 18 who care for others.However, young carers can be supported under thelaw relating to children. The Children and FamiliesAct gives young carers (and parent carers) similarrights to assessment as other carers have under theCare Act.

To view The Children and Families Act in furtherdetail please visit:www.legislation.gov.uk/ukpga/2014/6/contents/enacted

The RulesWell-being: Local Authorities must have services tomeet different people’s needs. They must alwaysthink about your wellbeing.

Information and advice: Local authorities willneed to provide comprehensive information andadvice about care and support services in theirlocal area. This will help people to understand howcare and support services work locally, the careand funding options available, and how people canaccess care and support services.

The Act clearly sets out what local authoritiesmust provide information on:

• what types of care and support are available – e.g. specialised dementia care, befriending services, reablement, personal assistance, residential care etc…

• the range of care and support services available to local people, i.e. what local providers offer certain types of services

• what process local people need to use to get care and support that is available

• where local people can find independent financial advice about care and support and helpthem to access it

• how people can raise concerns about the safety or wellbeing of someone who has care and support needs

Prevention: Local authorities must provide orarrange services that help prevent peopledeveloping needs for care and support or delaypeople deteriorating such that they would needongoing care and support.

Person-centred care and support: Person-centredcare is when people understand what is importantto you and give you the right care and support todo the things you want. The Local Authority mustinvolve you in writing and checking your plan.

Work and having a job: Local Authorities mustnow think about education, training and workwhen they look at the care and support you need.

To view The Care Act in further detail please visit: www.gov.uk/government/publications/care-act-2014-part-1-factsheets

25

PeRSonAL HeALtH BUDgetS

Can I have a personal health budget aswell as a personal budget for social careand support?Yes. If you already have a personal budget for careand support from social services and your NHSteam agrees, you can also have a personal healthbudget and ask for both to be combined.

Do I have to have a personal healthbudget?No. If having a personal health budget does notwork for you, your local NHS will provide the careyou need as it has always done.

What is the difference between apersonal health budget, a personalbudget, an individual budget and a direct payment?A personal health budget is for your NHShealthcare and support needs.

A personal budget is for your social care andsupport needs.

An individual budget includes your social care andsupport needs plus other funding, such asindependent living.

A direct payment is one way of managing thesebudgets, where you get the cash to buy the agreedcare and support you need.

Key Points• Personal health budgets should help people get a better service from the NHS. They should not make things worse.

• You do not have to have a personal health budget if you do not want one.

• You should have as much control over decisions as you want.

• NHS and social care organisations should work in partnership with you and with each other.

• If you are not able to have a personal health budget, you can still speak to your NHS team about how your needs can be met in another way that is more personal to you.

Personal Health BudgetsPersonal health budgets are being introduced bythe NHS to help people manage their care in a waythat suits them.

They have been piloted in a number of placesacross England and, from April 2014, anyonereceiving NHS continuing healthcare will have aright to ask for a personal health budget.

What is a Personal Health Budget?A personal health budget is an amount of money tosupport your identified health and wellbeingneeds, planned and agreed between you and yourlocal NHS team. The aim is to give people withlong-term conditions and disabilities greater choiceand control over the healthcare and support theyreceive. Personal health budgets work in a similarway to the personal budgets that many people arealready using to manage and pay for their socialcare. Together with your NHS team (such as a GP)you will develop a care plan. The plan sets outyour personal health and wellbeing needs, thehealth outcomes you want to achieve, the amountof money in the budget and how you are going tospend it.

You can use a personal health budget to pay for awide range of items and services, includingtherapies, personal care and equipment. This willallow you more choice and control over the healthservices and care you receive.

You don’t have to change any healthcare orsupport that is working well for you just becauseyou get a personal health budget, but if somethingisn’t working, you can change it.

Who can have a Personal Health Budget?The first group to be able to ask for a personalhealth budget, from April 2014, are people gettingNHS continuing healthcare, which is NHS-fundedlong-term health and personal care providedoutside hospital. Local NHS organisations can offerpersonal health budgets to other people if theythink an individual will benefit. It is theGovernment’s long-term aim to introduce a right toa personal health budget for people who wouldbenefit from it.

26

ARe YoU A CAReR?

A carer is anybody who looks after a familymember, partner or friend who needs help becauseof their illness, frailty or disability. Many carersdon't see themselves as carers and it takes carersan average of two years to acknowledge their roleas a carer. It can be difficult for carers to see theircaring role as separate from the relationship theyhave with the person they care for, whether theyare a parent, son, daughter, sibling or friend. Theysimply may think of themselves as a friend orfamily of the person they care for. It is because ofthis that they often don’t realise there is helpavailable to them as well. Such as how they canget assessments, direct payments, home care,housing adaptations or funding for short breaks andrespite.

Some carers can suffer from poor health becauseof the demands of their caring role. For example,back pain can result from lifting or moving theperson being cared for. It may also be difficult tomaintain a healthy diet and exercise routine whilecaring.

Without the right support, being a carer can be anextremely stressful role.

• Ask for help: We all need help from time to time and carers are no exception. Help is out there, you only need to ask!

• Know your rights: It sounds simple, but knowingwhat you’re entitled to and what support is available can help a great deal.

• Tell your GP: Your GP practice can record that you are a carer to ensure you get your annual flu vaccination and additional support as a carer.

• Get an assessment: This can sound a little daunting at first, but ensuring that you and the person you care for get a assessment of your needs through the Local Authority can give you access to a whole host of additional practical help and support.

• Be a little selfish! We all need time to ourselves, but it’s particularly important for carers. This could be as simple as setting some me time aside for a relaxing bath or a night out.

Carers Direct helplineCall the Carers Direct helplineon 0300 123 1053 if you need

help with your caring role and want to talk tosomeone about what options are available to you.

If you are busy at certain times of day, you cansend us a message to ask us to call you back forfree at a time that is convenient to you. Thehelpline is open from 9am to 8pm Monday toFriday, and from 11am to 4pm, at weekends. Thehelpline is closed on bank holidays. Calls are freefrom landlines and mobiles within the UK.

InformationThe helpline advisers can give you information tohelp you make decisions about your personalsupport needs and the needs of the person you'relooking after.

This information includes assessments, benefits,direct payments, individual budgets, time off andmaintaining, leaving or going back to work oreducation.

The helpline staff will tell you how to complain ifanything goes wrong with any of the services youuse or put you in touch with your local authority orNHS services.

Local and specialist helpOur helpline advisers can put you in touch withspecialist national or local sources of help,including social care, healthcare and self-helpnetworks and resources.

The Carers Direct helpline doesn't provide personalfinancial, medical or legal advice and doesn'tprovide casework, advocacy, representation,counselling or emotional support. But our adviserscan help you get in touch with people who doprovide these services.

27

teLeCARe & teLeHeALtH

Telecare is a service that enables people,especially older and more vulnerableindividuals, to live independently in theirown home. 90% of people say that that istheir wish and telecare allows it tohappen. Equally it gives peace of mind tofamily, friends and carers, knowing thatwhen they are unable to watch over theirloved ones, telecare will.Telecare is as much about the philosophy of dignityand independence as it is about technology andservices. The service package, and choice oftechnology, is provided to support the individual intheir home and is tailored to meet their needs. Itcan be as simple as the basic social alarm service,able to respond 24/7 in a given situation, it caninclude sensors and triggers such as motion or falldetectors and fire and gas alarms, that trigger awarning to a response centre staffed 24 hours aday, 365 days a year. It can also include locationdevices that can be used to enable an individual tohave security outside of their home.

As well as responding to an immediate need,telecare can work in a preventative mode, withservices programmed to monitor an individual'shealth or well-being. Often known as lifestylemonitoring, this can provide early warning ofdeterioration, prompting a response from family or professionals.

Telehealth equipment is used to monitor yourhealth in your own home. It can be equipment tomeasure your blood pressure, blood glucose levelsor your weight. This can reduce the number ofvisits you make to your GP and unplanned visits tothe hospital. You’re taught how to do the tests onyourself and the measurements are automaticallytransmitted to your doctor or nurse, who can thensee the information without you having to leavehome. They can let you know if they have anyconcerns.

Telecare and telehealth can be used on their ownor in combination in order to best meet the needsof the individual and get the best fit with localservices, including those provided by family andfriends. The services need to balance technologywith other forms of care and support and bereviewed in the same way as all other packages ofhealth and social care.

For more information about telehealth andtelecare services, visit www.telecare.org.uk orspeak to your GP, social worker or local authority

Telecare & Telehealth can be of benefit to:• Older, frail or disabled people or those

temporarily unwell after perhaps an operation

• People who have been discharged from hospital and need to be able to get help at home if needed

• Vulnerable people of any age living alone

• Reassurance to partners, family and carers of people with dementia, medical conditions or disabilities be that physical, mental or sensory

To benefit from the service all you need is a phoneline and modern electric plug socket. This range oftechnology offers extra independence and peace ofmind. Pictured overleaf are some of our mostpopular devices, however, many more areavailable.

28

teLeCARe & teLeHeALtH

Falls DetectorWill sense if you fall andautomatically alert us. Wewill get help to you quickly.

These can be carried withyou around the home and inyour garden (within 50metres). In an emergencysimply press the alarmbutton and a message issent directly to the LifelineControl Centre.

Flood DetectorWill alert you and us when abath or sink is overflowing.

Smoke DetectorWill alert you and us ifsmoke or fire is detected inyour home. Your house issafe even when you are notin it.

Exit AlertWill detect and alert us if adoor is opened, and canhelp should a person be atrisk of wandering.

Bed SensorWill alert you and us if aperson does not return totheir bed. This couldindicate a fall has occurred.

Telecare Panic ButtonThis system offers reassurance to anyone athome alone. The pendantis linked into an on sitetelecare alarm unit. If youare concerned about anysituation, you simply needto press the button. Ifsupport is requiredoperators will raise an alarmshould the incident becritical.

Examples of Telecare Equipment:

29

CARe In YoUR oWn HoMe

Home care isn’t for everyone but frequent visitsfrom carers and a few home modifications canhelp you retain your home comforts andindependence.

Receiving care in your home is an increasinglycommon alternative to staying in hospital ormoving into a care home.

Depending on your needs, you can receive helpand support that allows you to stay in your ownhome as long as possible. Not only do you avoidany upheaval and stay in familiar surroundings, it can also be a more economical alternative toresidential care.

What home care services are available?• Regular visits from home care workers to help with daily tasks and personal care

• Meals delivered to your home• Equipment and home modifications to help with mobility and accessibility, such as getting in andout of the bath, and getting up and down stairs

• Personal fall and panic alarms that are monitored around the clock

• Support for health needs, such as incontinence• Day care and transport to take you there• Gardening and handyman services

Direct Payments

If you are assessed as needing community careservices and qualify for social services fundingthey must offer you direct payments as an option.

If someone isn't able to manage their own directpayments, it's possible for another person tomanage the direct payments on their behalf.

Direct payments are part of a move towards‘personalised’ social care so that people havemore choice and control over the support theyget, letting you choose and buy the services youneed yourself, rather than having it arranged foryou by social services.

It's important to know that if you receive a directpayment to pay a care worker or personalassistant, you become an employer and have legalresponsibilities.

Direct Payments can be made to:• Disabled people aged 16 or over (with short or long-term needs)

• Disabled parents for children’s services• Carers aged 16 or over (including people with parental responsibility for a disabled child)

• Elderly people who need community care services

Choosing Direct Payments

The choice of direct payments is voluntary. If youdecide to have direct payments, you can changeyour mind about this at any time. If you no longerwant direct payments, contact your local socialservices and ask them to arrange services instead.

It's possible to try direct payments by asking socialservices for a direct payment for some of yoursupport while you continue to get your othersupport directly from social services.

Direct payments can only be spent on things thatwill meet the assessed needs of the person gettingthem. If you spend a direct payment on somethingthat doesn't meet your needs, social services canrecover the money from you.

Everyone who gets support from social servicesshould have their needs reassessed at least once a year.

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Care Provider Address Area Postcode Telephone

CARe In YoUR oWn HoMe

Data correct with CQC - December 2014

31

CHooSIng BetWeen ReSIDentIAL,

There are many types of residential care homesavailable. These include permanent care homes forolder people, homes for younger adults withdisabilities and homes for children. They may beprivately owned or run by the voluntary sector orlocal authorities. You may want to consider indetail the many options for residential care beforeyou make a decision.

Older peopleCare homes for older people may provide personalcare or nursing care. A care home which isregistered to provide personal care will offersupport, ensuring that basic personal needs, suchas meals, bathing, going to the toilet andmedication, are taken care of. In some homesmore able residents have greater independenceand take care of many of their own needs.Someresidents may need medical care and some carehomes are registered to provide this. These areoften referred to as nursing homes. Some homesspecialise in certain types of disability, forexample, dementia.

Adults aged 18-65There are also residential care homes that providecare and support for younger adults with, forexample, severe physical disabilities, learningdisabilities, acquired brain injury, progressiveneurological conditions or mental health problems.Care can be provided for adults with more thanone condition and some homes have expertise inproviding care for adults with alcohol or drugdependency.

These homes offer permanent residence or providecare for a temporary period until the adult is able to live independently or move to a different typeof accommodation.

Choosing between residential care andindependent livingSocial services normally encourage younger adultswho they assess for support to be as independentas their circumstances allow. The care plan foradults with disabilities will consider whatindependent tasks they can carry out and how theycan be helped to achieve more. Even if adults havevery severe disabilities their needs are reviewedfrom time to time to check whether residentialcare or a very high level of support is stillappropriate.Supported living may be an option foryounger adults. This allows people to liveindependently in the community but with basicsupport. The support offered includes help withsetting up a home and managing finances, andassistance with cleaning and shopping.

For older people there are various alternatives toresidential care. These include sheltered housingand extra care housing schemes, which offerindependence with an increased level of care and support.

For many people there is also the choice of livingindependently at home with community caresupport.

Choice of accommodationThe law says that where the local authority isfunding accommodation it must allow the personentering residential care to choose which carehome they would prefer. Social services must firstagree that the home is suitable for the person’sneeds and that it would not cost more than theywould normally pay for a home that would meetthose needs. If the person chooses to go into amore expensive home, a relative or friend may be able to ‘top up’ the difference in cost.

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nURSIng & InDePenDent LIVIng

Choosing a care homeCare homes may be arranged through the localauthority but many people will want to arrangethem independently. It is a good idea to visitseveral homes before making a choice. Make sure you spend enough time in each home to get a good idea of what it is like.

Respite and short term staysResidential care home stays don't necessarily haveto be permanent. Temporary stays can be arrangedfor respite care (in which you take a break fromcaring for somebody else), or as a trial periodbefore a permanent stay.

Temporary stays can give you flexibility whencovering unexpected events, such as:

• Palliative care (which manages or reduces pain) after a hospital stay or illness

• Support for newly disabled people and their carers• Enabling someone to continue living independently if they live alone and suddenly require care

• Giving someone a chance to try potential future homes

What your choices areA list of all nursing and residential care homeswithin your locality can be found on the followingpages. Every care home in England must beregistered with the national regulatory body Care Quality Commission (CQC).

They inspect each care home on a regular basisand write an inspection report for you to read. It isadvisable to read this report before making a finaldecision.

To check up-to-date information onthe Nursing and Residential carehomes within your locality visitwww.cqc.org.uk or scan the QR CODE WITH YOUR SMARTPHONE

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www.ageuk.org.uk

www.carersuk.org

www.findmegoodcare.co.uk

www.moneyadviceservice.org.uk

www.societyoflaterlifeadvisers.co.uk

ReSIDentIAL CARe CoStS

In some cases the residential care needed by theperson you're looking after may be paid for by theNHS under the NHS continuing care scheme. Thecare may also be provided free of charge becauseit is 'intermediate care'. It may be free because theperson you're looking after has previously been amental health inpatient. If this is the case, theservices are funded under the Mental Health Act.

Residential care is also free if the local authoritycould charge but decides not to do so. This canoccur if the stay in residential care is onlytemporary (normally less than eight weeks), or ifthe residential care is for a child. If none of theabove applies, the person you're looking after willbe given a financial assessment. This is also knownas a means-tested assessment. They will berequired to give information about their incomeand capital. There are rules that determine howincome and capital are treated. Some types,including benefits, can be disregarded. Thefinancial assessment will work out how much theperson you're looking after will be expected tocontribute towards the cost of their care home fees.

Owning PropertyThere are rules that explain how the property ofthe person you're looking after will be taken intoaccount In some cases it can be disregarded, this isthe case if a partner is still living in the property.

The capital limit for residential care is £23,250.Local authorities will investigate if they believethat the person you're looking after hasdeliberately reduced their capital to avoid payingcare home fees. There is a scheme called thedeferred payment scheme which allows someonewho goes into care to keep their property and stillget help from the local authority with paying carehome fees. The local authority recovers the feesfrom the proceeds when the property is sold. Thisscheme can also be used if there is a delay inselling a property.

Self-fundersAfter the means-tested assessment, the personyou're looking after may receive a decision thatthey will have to pay their own care home fees.People paying their own fees are referred to asself-funders. Self-funders will still receive adviceabout the arrangements for residential care. Oncea self-funder's capital reaches £23,250 the localauthority is responsible for helping out with thecare home fees. This will require another assessment.

Get personal advice on care fundingThe cost of care and support is likely to be a long-term commitment and may be substantial,particularly if you opt for residential care. If you ora member of the family need to pay for care in acare home, it’s important to seek advice tailoredto your individual needs.

The cost of your care will vary depending on itstype, intensity, specialisation, location andduration. For example, a place in a residentialcare home will cost hundreds of pounds a week.Decisions that have such financial implicationsshould be made with advice and only afterconsidering the costs of alternatives.

For example, the cost of a care home needs to beweighed against the cost of care and support thatmay help you remain in your existingaccommodation.

The costs of long-term care can be significant andhow you may wish to arrange to pay for it is a bigfinancial decision for most people. Cost can varyacross the country and different care homes willcharge different amounts based on the level ofcare needs, the quality of the accommodation, orthe area of England it is in.

Few of us will have the income or ready access tothe cash to pay for their ongoing care needs. Oftenpeople find that they need to sell or remortgagetheir home to pay for care or enter into an equityrelease scheme. Before taking such significantfinancial steps it is advisable to get properindependent financial advice. For advice on self-funding care, visit the Money Advice Service or theSociety of Later Life Advisers. You may also havepreviously arranged an investment or insuranceplan to fund your care. Again, it is worth takingindependent advice on these potentially significantfinancial arrangements.

Find out more about paying for care on thewebsites of:

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ReSIDentIAL & nURSIng CARe

Residential Homes Address Area Postcode Telephone

Nursing Homes Address Area Postcode Telephone

Data correct with NHS Choices - December 2014

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eXPReSSIng CoMPLAIntS & ConCeRnS

Although most people have no problems whenusing Health & Social care services, sometimesthings can go wrong. This information explainswhat to do if you, or a member of your family,want to complain about the care that you havereceived.

How to complainWho you contact to complain will depend on:

• Whether you are complaining about health care or social care, and

• Whether the care is paid for by public funds or you have paid for it yourself.

It is usually a good idea to keep a record ofwhat you said and who you said it to if thecomplaint is made verbally. Healthwatch Bexleywill be able to tell you if you can get free help,advice and support in making your complaint.

NHS Advocacy Service Advocacy For All provides advocacy for NHScomplaints for people living in Bexley.

We support people to make a complaint aboutservices commissioned or provided by the NHS.

Please call: 020 8269 8692 or email:Bexleynhscomplaints@advocacyforall.org.uk

Advocacy for All241 Main Road, Sidcup, Kent DA14 6QSwww.advocacyforall.org.uk

How to make a complaint about health careIf you are unhappy with the care you havereceived from the NHS, you have the right to make a complaint.

Ask to see a copy of the complaints procedurefor the NHS service you are unhappy about. Thiswill tell you who to contact, how they willhandle your complaint and how they will learnfrom your complaint. Where possible, youshould contact the NHS service (hospital, GPpractice, dentist etc.) directly. You can do thisin person, by telephone, email or letter. Thiswill give the NHS service a chance to sort outany problem you might have and put things rightfor you.

Complaints about primary care services(including GP, dental, pharmacy and optical)may be referred directly to the service provideror to NHS England on: 0300 311 2233 or email: england.contactus@nhs.net

Complaints about hospital, mental health orcommunity trust services may be referreddirectly to the service provider; for Bexleypatients the most common providers, with theircontacts are:

• Queen Elizabeth Hospital: pals.qeht@nhs.netor 020 8836 4592

• Queen Mary’s Hospital: qmh-pals@oxleas.nhs.uk or 020 8308 5449

• Princess Royal University Hospital:kch-tr.patientcomplaints@nhs.net or 020 3299 3209

• Darent Valley Hospital: complaints@dvh.nhs.uk or 01322 428735

• Oxleas NHS Foundation Trust for mental health and community services:complaints@oxleas.nhs.uk or 01322 625013

Complaints can also be made to NHS BexleyCCG, as the commissioner of the service, via theCCG patient experience team at:contactus@nhs.net or on free phone: 0800 328 9712www.bexleyccg.nhs.uk

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eXPReSSIng CoMPLAIntS & ConCeRnS

If you are not content with the reply you getIf you are not happy with the final reply fromthe care service or Bexley Council, you have theright to ask the Local Government Ombudsmanto investigate your complaint.

This right applies whether you pay for youprivately fund your own care or the LocalAuthority funds it.

You can contact the Local GovernmentOmbudsman on 0300 061 0614, Local Government Ombudsman, PO Box 4771, Coventry CV4 0EHwww.lgo.org.uk

How to make a complaint about Social care If you are unhappy with the care you havereceived from a care home, nursing home,home-care agency or other social care service,you have the right to make a complaint. If theservice is provided in a social care setting but isfunded by the NHS, e.g. dental services, youwill need to follow the NHS complaints process,‘How to complain about health care’ on theopposite page. Ask to see a copy of thecomplaints procedure for the care service youare unhappy about. This will tell you who tocontact, how they will handle your complaintand how they will learn from your complaint.Where possible, you should contact the careservice directly (care or nursing home, etc.).You can do this in person, by telephone, emailor letter. This will give the care service thechance to sort out any problem you may haveand put things right for you.

If you are not able to do this, or if you feelworried about contacting the service directly,you can contact:

London Borough of BexleyCivic Offices, 2 Watling Street, Bexleyheath Kent DA6 7ATEmail: customer.services@bexley.gov.ukCustomer Contact Centre on: 020 8303 7777The Bexley Complaints Procedure can be foundat: www.bexley.gov.uk/feedback

For further help and advice on raising a concern or making a complaint relating

to Health or Social Care contact:

Healthwatch BexleyMilton House240a BroadwayBexleyheath, Kent DA6 8AS

Tel: 0208 304 9344

Email us:info@healthwatchbexley.co.uk

Visit our website:www.healthwatchbexley.co.uk

Twitter: @HWBexley

Facebook: Healthwatch Bexley

If you are not content with the replyyou getIf you are not content with the outcome of yourcomplaint or how it was dealt with, you havethe right to ask the Health Service Ombudsmanto investigate your complaint. This is a free,independent service that will usually onlyinvestigate a complaint after the NHS have hada chance to try to deal with your complaint, ifthey decide the NHS have got things wrong, theycan make recommendations to put things right.

The Parliamentary and Health ServiceOmbudsman, Millbank Tower, Millbank,London SW1P 4QPTel: 0345 015 4033 Email: phso.enquiries@ombudsman.org.ukwww.ombudsman.org.ukText phone: 0300 061 4298 if you are deaf orhave problems using a standard telephonerequest a call by texting ‘call back’ with yourname and mobile number to 07624 813 005.