Community care and aftercare

Answers some of the common questions about community care and aftercare and explains the options available.

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What is 'community care'?

The phrase 'community care' is used to describe the various services available to help people manage their physical and mental health problems in the community e.g. nursing or social work support, home help, day centres, counselling, supported accommodation.

Community care is usually arranged by social services departments or Community Mental Health Teams (CMHTs). The system for delivering community care services to most adults is called 'care planning'.

What is the Care Programme Approach (CPA)?

The Care Programme Approach is a process of care planning used if you have significant mental health needs. It involves mental health professionals assessing your needs and drawing up a care plan, which should be reviewed regularly.

A care coordinator should be appointed to you to ensure that the services in your care plan are put in place and that they continue to meet your needs. The care coordinator will usually be a mental health professional who works in a CMHT.

How do I get assessed for community care services?

Under the NHS and Community Care Act 1990, any person who appears to need community care services – including anyone with known mental or physical health problems – has the right to have their needs assessed by their local authority.

The first step is a community care assessment, which is usually arranged by the local authority's social services department.

  • The assessment should take place within a reasonable time of social services finding out that you may need community care services.
  • You do not have to make a formal application for an assessment.
  • If social services know that you may need services, they should offer to assess you without you having to ask – they have a legal duty.
  • If your GP or CMHT believe that your mental health needs are not serious enough to require the Care Programme Approach, you may still have a right to an assessment of your community care needs under the NHS and Community Care Act 1990.

If you are having problems getting an assessment, you should get legal advice. A mental health advocate may be able to help you with this. See Advocacy for more information.

Care assessment for carers (on request)

Under the Carers and Disabled Children Act 2000, someone who is 16 or older and spends a lot of time caring for you can also ask to be assessed to see if they need any help, e.g. home help support or occasional holidays from caring.

Your carer's right to an assessment does not necessarily mean that they will get the services they are asking for; this will depend on what the professionals see as their 'needs'. For more about this, they can contact Carers UK.

Who is involved in planning my care?

  • If you live in the community, your care plan is usually drawn up by your care coordinator or your social worker with help from other professionals who will be involved in your care plan.
  • If you are in hospital when your care plan is drawn up, your responsible clinician and other hospital staff should be involved.

The professionals should talk to you before they decide what support you should get and you should tell them what you think you will need. If a friend or relative helps or supports you, they should be involved in these discussions if you want them to be.

Which local authority will assess me and which will provide services?

  • The local authority in the area where you live has the duty to assess your community care needs (but it is possible to ask another local authority for an assessment e.g. if you are away from home). It is up to the local authority where you live to provide services.
  • If you are in hospital when the professionals decide that you should be assessed for community care, the local authority where you were living before you were admitted to hospital is generally responsible for providing services. This is so even if you have given up your home since your hospital admission.
  • If you are in the community but have no settled home, it is the authority where you are at the time that will be responsible for providing services.

Can they take away my community care services?

Community care services can be stopped or reduced if you no longer need them; however, your needs must be assessed again before this can happen. If you think you still need the same services or same level of services, you should seek legal advice.

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