Scotland - the services and process explained

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Scotland - the services and process explained

In Scotland, 32 councils are in charge of local government. The Social Care Department of each council provides care services for the elderly.  If care is required, the council or, in some parts of Scotland, the local NHS can decide if the criteria for financial assistance have been met. The council will consider the following factors:

  • needs, as well as any existing support.
  • requirements that can be met by community care services.
  • who will be responsible for paying for the services, and how much will they cost.

Community care services include:

  • support for personal care needs
  • monitoring devices
  • daycare
  • lunch clubs
  • support over-night
  • respite care, which includes staying in a care home for a short period
  • equipment to help with everyday tasks and increase safety, like handrails
  • meal delivery
  • transport services

How does the council decide who qualifies for support?

Each council has its own set of eligibility criteria. If community care services seem to be required, a free Care Needs Assessment should be conducted.

The assessment looks at whether independence and wellbeing would be at a high, moderate, low, or critical risk if care services were not provided.

Due to budget limitations, services are often only given to people who are classified as having critical or substantial needs. But councils should always consider the need for support if it could prevent problems from developing in the future.

The Care Needs Assessment

To obtain an assessment, contact the adult social services department. If there has been an accident that has resulted in hospitalisation, the assessment may be arranged by a hospital social worker before discharge, or the GP may make a referral.

The assessment is normally done at home (although it can also be done online or over the phone). A friend or family member should be present to take notes.

Questions will be asked regarding what tasks can be completed independently, where challenges exist, and what would like to be accomplished.  As an example:

  • dressing and undressing
  • getting up and going to bed
  • eating and drinking
  • washing and bathing
  • moving around the home
  • managing medications
  • housework and shopping
  • social and cultural activities

Questions will be asked about any support that is already in place. It’s important to say if this help is not going to continue in the long term.

After the assessment, a care plan (or support plan) will be provided, which will give details of the help that can be provided.

The care plan should include information about:

  • the services, who will arrange them, and how much they will cost.
  • the needs and any risks that might be faced.
  • why the services are being provided and how they will help
  • what will happen if there is an emergency?
  • any support that is already there
  • the date the care plan will be reviewed.

The plan could include, for example, help with personal care, equipment or adaptations for the home, and services to help anyone who is providing unpaid care. A package that includes social care, nursing care, health services, and housing services could be proposed.

If the council decides that help is required, support services should be put in place without unreasonable delay. If you feel the wait has been unreasonable, you can make a complaint using the social work department's complaints procedure.

If you have trouble finding the information needed to start the process, watch our guide

Find the council website here→

Who pays?

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Personal care and nursing care provided at home by the local council is free for people over 65 who have been assessed as needing it. This entitlement is regardless of income, capital assets, marital or civil partnership status. Free personal care includes:

  • services to support personal hygiene e.g. help with bathing, shaving, mouth, teeth and nail care
  • personal assistance e.g. help with dressing, to get in and out of bed and use of a hoist if necessary
  • help to manage continence e.g. toileting, catheter or stoma care, bed changing and laundry
  • food and diet including help with eating and the preparation of meals (but not the cost of supplying food)
  • dealing with the problems of poor mobility and enabling outdoor activities
  • counselling and support e.g. safety devices and psychological support
  • simple treatments e.g. help with medication, application of creams and drops.

Once assessed as needing support, a choice of four options will be offered:

Option 1: Receive a budget and choose and manage care services yourself. This is called a Direct Payment.

Option 2: You choose the care provider and the council arranges and manages the service.

Option 3: The council chooses the care provider and arranges and manages the service.

Option 4: A mixture of the above.

A private contribution towards the costs of any help that is classified as ‘non-personal care’ such as day care, domestic help, lunch clubs, meals on wheels, community alarms or help to shop may still be required.

Each council has discretion about which ‘non personal care’ services it will charge for, and what the charge is. Fees vary for similar services in different parts of Scotland. A means test will be applied. A copy of the charging policy should be available on the council website.

If nursing care is needed at home, this will be arranged and provided for free by NHS Scotland. Ask the GP to start the application process.

What contribution is made to care home fees?

If the assessment by the council reveals that care is best provided in a care home, the council will find one and use a means test to determine how much of the costs you have to pay for. As long as an assessment takes place and it concludes that personal and nursing care support is required, the council will give a flat rate payment for the personal and nursing care portion of the care home's charges, which will be paid directly to the home. Accommodation costs, any difference in higher personal or nursing care fees, and other disbursements must be paid privately.

The current personal and nursing care payment rates are:

£248.70 per week for personal care.

£111.90 per week for nursing care.

If a means test finds that capital is between £21,500 and £35,000, the council will pay more.

If the capital is less than £21,500, the criteria for being "fully funded" is met. Being fully funded entitles you to the following maximum payments:

up to £948.59 a week for nursing care.

up to £825.94 a week for residential care.

These are the maximum amounts of financing available, but they do not guarantee that you will receive them. How much money you get will depend on what kind of care you need and how much different care homes charge.

You can choose your own care home, but if the council is paying and the home costs more than the approved budget, the difference (known as the top-up fee) must be paid privately.

Even if the qualifying conditions for council funding are not met, requesting a care needs assessment from the council is still a good idea because:

You will be advised on what type of care home would be suitable.

You will have begun the application process for financial assistance (just in case the eligibility conditions are met in the future).

You will be able to receive personal and nursing care payments.

Finding services in Scotland

Search by county for home care→

Search by county for a care or nursing home→

Checking services  - The Care Inspectorate

The Care Inspectorate is the independent regulator of health and adult social care in Scotland which monitors and evaluates registered care services. All care services in Scotland must be registered.

Evaluation of services is based on 5 key questions:

  • How well supported is the users wellbeing?
  • How good is the leadership?    
  • How good are the staff?      
  • How good is the care setting?          
  • How well is care and support planned?

A six-point scoring scale is used to describe the quality:

6 = Excellent, outstanding or sector leading

5 = Very good, the service has some major strengths

4 = Good, the service has important strengths, with some areas for improvement

3 = Adequate, strengths just outweigh weaknesses

2 = Weak, priority action is required

1 = Unsatisfactory, urgent remedial action is needed

To check the details of registered home care agencies or care homes in the area of your choice (and read their inspection results), use the search function on the Care Inspectorate website.