Social care and support
This information applies to Scotland only
What are social care services
There are lots of services which offer help and support to improve your quality of life and allow you to continue to live in your own home. For example, if you are elderly or disabled, have a long-term health condition or are unwell. However, it can sometimes be confusing to try to work out what help is available and who offers what services.
There are various agencies involved in providing help and support in your community including your local authority social care or social work department, as well as NHS Scotland, for example your GP. The term 'social care' is used to describe care services in your community provided by your local authority. It can also be called community care.
Everyone’s needs are unique. No two people will require exactly the same amount, or type, of support. If you're having problems getting services or getting the support that is right for you, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email - where to get advice.
Services you could get
You may be entitled to:
- care and support in your home
- support after leaving hospital
- equipment and adaptations for your home
- day care and support
- help and support provided by the NHS
- a place in a care home.
This list is not exhaustive. In order to ensure that you get the support that is right for you, local authorities have a legal duty to involve you in decisions about your support.
Care and support in your home
Depending on your needs, this can include help with:
- going to the toilet
- getting in and out of bed
- taking medication
- meals - making them or having them delivered to you
Sometimes you may be able to get help with general domestic tasks including cleaning, cooking and shopping.
If you need care or support services at home the person providing your care will come to your home at agreed times, for example a social care worker or support worker. Depending on your needs, this could be two or three times a day or even 24-hour care if necessary.
Support after leaving hospital
If you have recently been in hospital you may need more intensive care and support, at home, on a short-term basis. If possible, any services that you may require should be organised before going home from hospital. However, if you find that you are not managing at home and need additional support you can contact your local authority. There is information on discharge from hospital on Care Information Scotland’s website at:
Care Information Scotland
Helpline: 0800 011 3200 (local rate) (every day 8.00am - 10.00pm)
Depending on your needs you may be able to get equipment that will make day-to-day living easier for you. For example, a raised toilet seat or a long shoe horn. You may also be able to get your home adapted for your needs. Adaptations can help you to be as independent as possible in your own home. They can range from small adjustments, such as hand rails in your shower, to larger adaptations such as the installation of a stair lift or downstairs toilet. There is some information on the Scottish Government website at www.gov.scot.
Day care and support
Your local authority may provide a range of recreational, occupational, educational and cultural activities, for example, at a day centre or lunch club. These activities could include social activities, such as games or outings, as well as help with everyday living skills, such as budgeting. You may be able to get transport from your local authority to enable you to make use of these facilities.
Help and support provided by the NHS
Your GP’s surgery has nurses who can arrange and offer help for you. This team will vary but can include a practice nurse, district nurse and health care assistant.
You can usually make an appointment with the practice nurse yourself, but you will need to ask your GP to refer you for district nursing services. Some other services may be run from a local community hospital, if there is one in your area.
If you are assessed as having very high level, or complex, care needs, you may be entitled to NHS continuing healthcare. This is both arranged and fully funded by the NHS. See When the NHS can pay for ongoing care.
If you need long-term care, and you can’t manage in your own home anymore, one option may be moving into a care home. All care homes can provide personal care if you need it. This could include help with washing, dressing or going to the toilet. Some care homes can also provide nursing care.
Some care homes also offer respite care or short-term care, for example, after a stay in hospital.
The rules about how charges are made for care homes are different to the rules about charging for other social care services. For more information about care homes, including how charges are made, see Care homes.
How to get social care services
Unless you urgently need services, for example, if you have just left hospital, you will have to have your needs assessed before your local authority will provide social care services for you. This is called a community care assessment.
If you think that you need help and support in order to continue to live at home then you should contact your local authority social care department and ask for an assessment. A carer, friend or relative can also ask for an assessment on your behalf and a carer can ask for an assessment of their own needs. The local authority has a duty to make sure the carer knows about their right to be assessed. Your local authority must carry out an assessment for anyone who appears to need a social care service, for example if you are elderly, disabled or have a long-term health condition.
If there are problems with an assessment after you've contacted your local authority social care department, you can contact a specialist adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email - where to get advice.
How an assessment is carried out
An assessment is carried out by someone from or acting on behalf of the local authority. A social worker, occupational therapist or community care assistant usually arranges to meet with you, often in your own home. You, and your carers, may want to think about what your needs are before this assessment takes place.
The assessment procedure may involve filling in a form but this will vary from area to area. The assessment should take into account:
- your wishes as the person being assessed
- whether you have any particular physical difficulties, for example, problems with walking or climbing stairs
- whether you have any particular health or housing needs
- what sources of help you have access to, such as carers, family or nearby friends, and their willingness to continue providing care.
Support for carers
A carer is someone such as a relative or friend who takes responsibility for looking after you and who does not provide the care as part of a job or as a volunteer with a voluntary organisation. Some carers provide care for a few hours a week, others for 24 hours a day, every day. A carer does not have to be living with you.
You can ask for support for yourself even if the person you care for is entitled to an assessment but does not want one. If you are an adult, you should ask for an Adult Carer Support Plan. If you are a child or a young adult, you should ask for a Young Carers Statement. Carers of disabled children can also ask for an Adult Carer Support Plan or Young Carers Statement.
There is more information about support for carers on our page Carers: help and support.
You can ask for a reassessment of your needs at any time if you feel the services you are getting no longer meet your needs. You should be aware that the local authority may decide to increase, change or reduce the services it provides depending on the reassessment.
If you are provided with supported accommodation under a private residential tenancy, for example, you may be assessed as no longer having this need and could lose your home as a result. In this case you may need to think carefully about whether a reassessment is required and get advice from your local Citizens Advice Bureau before asking for one - where to get advice.
The local authority may also start a reassessment if it plans to stop, change or reduce the services it provides.
If you want to challenge a reassessment decision, you can get help from your local Citizens Advice Bureau. They will also provide specialist housing advice if you are in danger of losing your supported acccommodation.
Paying for community care services
The rules about which community care services must be paid for, and how much can be charged, are complicated. If you want information on this, it may help you to consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email - where to get advice.
The information below does not cover charges for care homes. For more information about how charges are made for care homes, see Care homes.
Your local authority social care department can charge for providing some community care services.
Some local authorities only charge for some services, for example, a meal delivery service. Other local authorities may charge for all the services they are allowed to charge for.
Free personal or nursing care
If you are aged 65 or over, and get personal care or nursing care at home, you should get this free. There is information on what type of help comes under these rules on the Care Information Scotland website at:
Care Information Scotland
Helpline: 0800 011 3200 (local rate) (every day 8.00am - 10.00pm)
Challenge a refusal of free provision of a service
If your local authority social care department refuses to provide a service for free, you can challenge the decision. If you are not happy with the outcome, you could then make a complaint to the Scottish Public Services Ombudsman - see Complaints.
Check available information that must be provided
Your local authority social care department must make information about charges generally available. If you are having your community care needs assessed by your local authority social care department you must also be given full information on charges for any services provided.
Flat rate fee or sliding scale
Some local authority social care departments make a flat rate charge for a service, for example, a meal delivery service. Others may want to know how much income and savings you have and then charge according to a sliding scale.
Your local authority social services departments should follow the guidance about charging for non-residential care services produced by the Convention of Scottish Local Authorities, COSLA. You can ask your local authority or COSLA for a copy of this guidance. The COSLA website is www.cosla.gov.uk.
Ask for a review of charges
If you have been asked to pay for services and you think the charges are unreasonable or you can't afford to pay them, you can ask for the charges to be reviewed. If you want to challenge charges, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email - where to get advice.
Self-directed support aims to give you choice and control over your care. You can decide how much ongoing control and responsibility you want over your own care arrangements. Some people will choose to have lots of control over their care and some will leave most of the decisions and work to their local authority. Other people may do a bit of both. If you decide that you want to pay for the care yourself, you will get a direct payment from the local authority. There are four options for self-directed support.
You take a direct payment
Your local authority decides how much money can be spent on your support and this is paid directly to you. You and your family or carer then arrange your own care and support. See Direct payments.
You decide and your local authority arranges support
Your local authority decides how much money can be spent on your support. You chose a care organisation to provide your support and your local authority arranges it for you.
After discussion with you, your local authority both decides and arranges support
Your local authority decides how much money can be spent on your support. You ask your local authority to arrange the support that they think is right for you.
You use a mixture of ways to arrange your care and support
This option lets you decide on some aspects of your support and leave other decisions to your local authority.
If you decide that you want to pay for the care yourself, you will get a direct payment from the local authority. The amount of direct payment you get should cover the cost of buying services to meet your needs. This includes any extra costs you have to pay in order to get the service. For example, if you employ your own carer, you will have to pay costs such as recruitment costs, holiday and sick pay and insurance.
In the same way that you may have to pay for services arranged by your local authority social care department, you may have to make a contribution towards the cost of services you are buying with direct payments. Your local authority will work this out in the same way it works out how much you have to pay towards services it arranges itself - see Paying for community care services. The local authority will either deduct your contribution before paying you the direct payment or pay the direct payment in full and you will have to pay your contribution back.
If you are offered a direct payment, you do not have to accept it if you would rather have services arranged by the local authority social services department.
If you do get direct payments, you will have to arrange your own services. Local support organisations may be able to help you with these arrangements.
Help with self-directed support
You can get more information about self-directed support from the Self-Directed Support in Scotland website at www.selfdirectedsupportscotland.org.uk. It has a postcode search feature to help find services and organisations that can provide further help in you local area.
You can also get information and advice about self-directed support from the charity MECOPP. Their 3 R's project is available throughout Scotland to anyone who needs help with issues around self-directed support. MECOPP can provide telephone advice and information, as well as casework to help deal with more complicated issues.
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Inspections of care services
All care providers have to be registered with the Care Inspectorate. All care homes and agencies providing support services in your home can be inspected once in every 12 month period by the Care Inspectorate. The inspection may be unannounced. There is more information on the Care Inspectorate's website at www.careinspectorate.com.
If you are not satisfied with the standard of social work or social care services offered by your local authority or other care provider, you can make a complaint. You can get in touch with them to find out about their complaints procedure.
If you need community care services because you are disabled, make sure that you are also claiming all the benefits you are entitled to. There may be other support available, for example, travel concessions.
ALISS (A Local Information System for Scotland)
ALISS (A Local Information System for Scotland) is an online source of health and wellbeing resources in Scotland. It can help you to find community support. You can find this website at www.aliss.org.