How Does the Private Elderly Care System Work? 

Professionals working in elderly health and social care system can sometimes presume that people accessing their services understand this system too. This can be frustrating for many families when they need healthcare or help at home. They often don’t know who to contact, what they might be entitled to, or how much social care might cost.

This guide explains the elderly care system in the UK and how we work together to provide services to people needing health or social care support.

Health and Social Care is a term that relates to the services that are available from all health and social care providers in the UK. It refers to the whole of the healthcare provision infrastructure including the public sector and private care agencies or care homes.

Health and Social Care Definitions

Healthcare is defined as the treatment or prevention of disease by trained or licensed professionals.

Social care is defined as practical support with activities such as personal care, dressing, meal preparation, or medication.

In-home carers can offer social care but also help with certain healthcare tasks such as applying dressings, peg feeding, oxygen monitoring, etc. Carers receive specific training for these tasks, often by a health professional in the community.

The health and social care system includes the National Health Service, Adult Social Care, Private Home Care Services and Third Sector Partners such as AGE UK.

National Health Service

This includes all hospitals, GP practices, nurses, podiatrists, occupational therapists, ambulance services etc. Hospitals may also have ‘response services’ made up of healthcare assistants who can provide short-term care visits when a patient first returns home from hospital.

When patients are medically ‘fit for discharge’ but require either in-home care services or a care home place, then hospitals refer patients to Adult Social Care. District Nurses work in partnership with these providers advising them on specific treatments or healthcare regimes that need to be put in place. They may also refer their patients to home care providers if they identify health or care needs.

Adult Social Care

Adult social care work in partnership with the NHS. When a patient requires care either at home or in a care home then a social worker will undertake an assessment. This could happen in hospital or at home. The social worker will assess how much care is required and should provide advice about charities and private services available to you. They should tell you what activities are available in your area that would benefit your health & wellbeing.

They can organise a means test to see how much you may have to contribute towards any care. You may also be entitled to reablement care if you have just been discharged from hospital. Reablement care is free and can be provided by either the council’s own care service, private care services, or NHS reablement services depending on where you live.

If you need to pay for your care without a contribution from Adult Social Care then the social worker will recommend a private in-home care provider. If Adult Social Care is paying for some or part of your care, then they will organise for a private care company or care home to provide the care. Adult social care will then pay the provider directly however you can still choose your own private care agency.

Once care has been organised then Adult Social Care will still be responsible for your overall care whether you are paying for care or not. They will review your care needs at least annually along with the care provider and suggest any adaptations or changes like access to Occupational Therapists or other health services. If you need your care reviewed sooner, then you should contact your care provider to discuss any changes you want to make. Your care provider will then liaise with Adult Social Care if required, for instance if extra care is needed.

Private Home Care Services

Care providers include services that provide care to people in their own homes, nursing homes or care homes. These providers work in partnership with the NHS and adult social care. In England, Wales, and Northern Ireland they must be registered with the Care Quality Commission, a government body that monitors and inspects all health and social care establishments. In Scotland care providers must be registered with Care Inspectorate. Many care providers have contracts with local councils and must meet certain standards to become a ‘Preferred Provider’. Their main purpose is to provide support with hygiene, washing, dressing, medication, domestic help and some healthcare tasks. Providers will organise specific healthcare training to meet different individual requirements.

Third Sector Partners

Partners include charities or third-sector organisations who support older and disabled people in the community. They include organisations such as Age UK, Meals on Wheels, Day Care Services, Lunch Clubs, Carer Support Services, Alzheimer’s Society, etc. These partners complement the services provided by larger organisations such as the NHS and Adult Social Care. They can advise on care costs, services, and activities that are available to you locally. Some have their own in-home services including dementia support visits.

Next Steps

Find out more care costs and what you might be entitled to. You can compare local care providers at the Care Quality Commission. Join Care Begins at Home for more expert advice and support for people caring for a loved one.