Care After Hospital: Your Rights

Before you go home, the hospital should check whether you will be safe and whether you need help with washing, dressing, meals, medication, walking, or using the toilet. This is called a discharge assessment or a transfer of care assessment. It is not the same as a full council social care assessment, but it should trigger one if ongoing care looks likely.^{[1]NHS[2]NICE NG27}

Under the Discharge to Assess approach used in many areas, you can be discharged home with a short package of support so that your longer-term needs can be assessed in your own environment. This is often called a "home first" or "discharge to assess" pathway. You should not be kept in hospital simply because the council has not finished its paperwork.^{[3]GOV.UK discharge guidance}

If you are going to need ongoing care, the hospital should arrange for the council or a NHS team to visit you before you leave. Ask: "Who will be assessing my needs?", "When will they visit?", and"What help will be in place on the day I get home?"^{[14]Age UK}

If you think you need help at home, you have a legal right to ask your local council for a needs assessment. This is free, and the council must do it even if you are not sure you will qualify. You can ask yourself, or a family member, doctor, nurse, or hospital discharge team can ask for you.^{[4]Care Act 2014[11]Citizens Advice}

A social worker or occupational therapist will usually visit you at home. They will ask about your daily life, what you can do safely, what you struggle with, and what help you already have. They must consider:

• Your health and any disabilities.
• Your home and whether it is safe or suitable.
• Your family and carer situation.
• Your wellbeing, including mental health, dignity, and social connections.
• Whether you want to stay independent, work, or study.

After the assessment, the council decides whether you have eligible needs under the Care Act. If you do, they must write a care and support plan that says what help you will get and how it will be arranged. They must also tell you about your choices.^{[4]GOV.UK Care Act}

If the council agrees you have eligible needs, the care and support plan may include things like:

• A home care worker to help with getting washed, dressed, or using the toilet.
• Meals delivered to your home (meals on wheels).
• Equipment such as grab rails, raised toilet seats, shower seats, or a commode.
• Aids and minor adaptations costing £1,000 or less — often free through the council.
• Bigger adaptations like stairlifts or wet rooms — sometimes funded through a Disabled Facilities Grant.
• Day centres or activities to keep you connected and active.
• Short-term reablement — free, intensive support to help you regain independence after a setback.
• A place in a care home or respite care if that is the only way to meet your needs. Read our guide to choosing a care home and costs.
• Help getting to hospital or follow-up appointments — see Ambulances and Medical Transport for NHS patient transport, community transport and travel-cost help.

The council should focus on what you want to achieve — not just what you cannot do. This is called a person-centred plan.^{[4]Care Act 2014}

If a family member or friend is looking after you, they are legally entitled to their own carer's assessment. This is separate from your needs assessment and looks at whether the carer is able and willing to continue, what support they need, and whether their own health or wellbeing is at risk.^{[5]NHS carers' assessment[6]Carers UK}

A carer's assessment can lead to:

• Respite care so the carer can have a break.
• Help with transport, taxi vouchers, or driving costs.
• Training, equipment, or a sitting service.
• Information about local carers' groups and benefits.
• A direct payment for the carer to buy support that helps them keep caring.

Carers do not have to pay for their own assessment. If they are caring for more than 35 hours a week and you get certain benefits, they may also be able to claim Carer's Allowance.^{[15]Carers UK}

Social care is not always free. Unlike NHS care, most council-arranged social care is means-tested. After the needs assessment, the council must do a separate financial assessment to work out what you can afford to contribute.^{[7]Age UK}

The council looks at your income and savings. In England, if you have savings or assets above£23,250, you will usually pay the full cost of your care. If your savings are between£14,250 and £23,250, you pay a reduced amount. Below £14,250, you pay only from your income, and you must be left with a minimum income guarantee. These thresholds are different in Scotland, Wales and Northern Ireland.^{[7]Age UK}

Your main home is not counted as savings while you or your partner still live there. It can be counted in some care home situations, but there are rules to protect couples and dependants.

You cannot be charged for:

• The needs assessment itself.
• The carer's assessment.
• Most NHS care, including NHS Continuing Healthcare if you qualify.
• Short-term reablement in many areas.
• Aids and minor adaptations under £1,000 in many council schemes.

If your main need is a health need rather than a social care need, the NHS may pay for all your care — at home or in a care home. This is called NHS Continuing Healthcare (CHC) and it is not means-tested. Your savings and income do not matter.^{[8]GOV.UK CHC}

A checklist and a full assessment (the Decision Support Tool) are used to decide whether you qualify. People with complex, intense or unpredictable health needs are most likely to qualify — for example, someone with severe mobility problems needing frequent repositioning, or someone with advanced dementia needing constant supervision.^{[8]GOV.UK CHC}

If you are in a care home and need nursing care but do not qualify for full CHC, you may get a set weekly payment called NHS-funded nursing care to cover the nursing part of your fees.^[9]NHS

If the council decides you need care, you do not have to accept exactly what they offer. You can ask for adirect payment instead. This is money paid to you (or someone you trust) so you can buy your own care, employ a personal assistant, or pay for services that suit you better.^{[10]GOV.UK direct payments}

A direct payment must be enough to meet your eligible needs. It should be clear what it can be spent on, and you may need to keep receipts or records. You can also have a personal budget managed by the council but with more say over how it is spent.^{[10]GOV.UK direct payments}

If you are not confident managing money or paperwork, you can ask a trusted relative, friend, or an organisation to help. Some councils provide a managed account or a brokerage service.

You have the right to be involved in decisions about your care. If you find it hard to speak up because of illness, disability, or distress, you can ask for an independent advocate to help you understand your options and make your views heard. The Care Act says councils must provide advocacy for people who would struggle to be involved without it.^{[17]VoiceAbility}

If you are unhappy with a decision, you can complain. The usual steps are:

1. Talk to the council or hospital first. Ask for a written explanation of the decision.
2. Use the formal complaints procedure. The council must respond within a set time.
3. Contact the Local Government and Social Care Ombudsman if you are still unhappy after the council's final response. This is free and independent.^[12]LGO
4. Contact the Care Quality Commission (CQC) if the issue is about a poor care provider.^[13]CQC

You can also challenge a care needs assessment or a financial assessment if you think it is wrong. Ask for it to be reviewed, or get help from Citizens Advice or a local disability rights group.^{[11]Citizens Advice[16]Disability Rights UK}

• "Has my discharge team asked the council to assess my needs?"
• "When will the council do my needs assessment?"
• "Can I have a carer's assessment for my family member?"
• "Will I have to pay, and can I see the financial assessment in writing?"
• "Do I qualify for NHS Continuing Healthcare?"
• "Can I have a direct payment instead of council-arranged services?"
• "What help is available from today, and what is being arranged for later?"
• "Who do I phone if the care does not arrive or is not good enough?"

• NHS 111 · urgent health advice, 24/7
• Social Services · find your local council via gov.uk/find-local-council
• Age UK Advice Line · 0800 678 1602 · free, 8am–7pm, 365 days a year · ageuk.org.uk^{[14]Age UK}
• Carers UK Helpline · 0808 808 7777 (Mon–Fri 9am–6pm) · carersuk.org^{[15]Carers UK}
• Citizens Advice · free advice on benefits, debt, housing and care · citizensadvice.org.uk^{[11]Citizens Advice}
• Disability Rights UK · rights and benefits information · disabilityrightsuk.org^{[16]Disability Rights UK}
• VoiceAbility · independent advocacy · voiceability.org.uk^{[17]VoiceAbility}
• Local Government and Social Care Ombudsman · 0300 061 0614 · free complaints service · lgo.org.uk^[12]LGO