What to do while you wait for care to start

Before you ring, write down what has changed and when, what medication your relative takes, and what happens tonight if nobody comes. A nurse or a social worker will ask for all of it, and having it written down means you are not reconstructing it while you are tired.

This page is about the gap before care starts. If care has fallen through altogether, emergency care at home covers arranging somebody for tomorrow, with separate guides for an agency that has cancelled, for a discharge tomorrow with no care in place, and for cover when the family carer is in hospital.

1. 1

   Ring NHS 111 or the GP surgery

   Free

   Say what has changed, say that you are trying to keep your relative out of hospital, and ask to be referred to the urgent community response team. Providers are asked to take referrals from the person and their carer too, so ask whether your local team does.
2. 2

   Describe the problem in the terms they use

   Two minutes

   NHS England sets out the needs every team covers as a minimum: a fall with no apparent serious injury, a sudden loss of strength or mobility, frailty that has tipped over after a minor illness, new or worsening confusion, a blocked or painful catheter, urgent help with diabetes, urgent equipment to make somebody safe, palliative symptom control, and an unpaid carer who can no longer manage.
3. 3

   They come to the house

   Within two hours

   The team is a mix of nurses, paramedics, occupational therapists, physiotherapists and therapy assistants. They can assess and treat there and then, review or prescribe medication, and leave equipment behind.
4. 4

   Ask what happens next before they leave

   Same visit

   Ask for a referral into reablement, a falls service or adult social care. A referral written by a clinician who has just seen your relative carries detail a phone call from you cannot. Write down the service and when it should be in touch.

NHS England publishes the full guidance as urgent community response services. If the fall has already happened, the first 72 hours at home after a fall covers what to watch for, and how to deal with falls covers helping somebody who has gone down.

The six free weeks are set out in regulation 4 of the Care and Support (Preventing Needs for Care and Support) Regulations 2014, and the NHS describes the service in its guide to care to support recovery after a hospital stay, a fall or an illness. It also says these services are not yet available everywhere, so ask what your council runs.

Six weeks goes quickly, and what follows needs arranging before it arrives. Reablement: the free six weeks, what it covers and why it ends goes through the handover, and hospital discharge explained covers how it fits into a discharge to assess. If you want the council to fund what comes next, ask for the assessment now rather than in week five.

Section 19(3) of the Care Act 2014 allows a local authority to meet an adult's needs for care and support which appear to it to be urgent, whether or not the adult lives in its area, without having yet carried out a needs assessment or a financial assessment. That is the sentence to quote if you are told nothing can happen until your relative has been assessed. It permits urgent action rather than requiring it, so it is not a guarantee, but it answers the reply that the assessment has to come first. You can ask for the assessment through gov.uk's needs assessment page.

Outside office hours the call goes to the emergency duty team, the out of hours social work service covering evenings, nights, weekends and bank holidays. It exists for situations where an adult is at risk and a decision cannot wait until the next working day, so say why tonight is different. The number is on your council's website under adult social care or out of hours, and gov.uk will find your council from a postcode.

If nobody rings back, or you are refused and the reason does not stand up, the route is the council's own complaints procedure first and the Local Government and Social Care Ombudsman after that, so start the written trail early. Age UK gives free advice to older people and their families.

If the nights frighten you most, short-term night care after a hospital stay covers what a carer does overnight. If a discharge is coming and none of this is in place, what to arrange before discharge day is the fuller list.

PrimeCarers is an introductory service rather than an agency, so the arrangement is between you and the carer. You search for carers near you and compare their rates by postcode, read their profiles and reviews, and agree the visits directly with whoever you choose. Carers are self-employed and set their own rates. Before a carer appears on the site their identity and right to work are checked, an enhanced DBS certificate on the Update Service is checked, and they have had an online interview with us. Qualifications, training and references are not something we verify: references sit on a carer's profile, and skills and training are worth asking about yourself. Carers are insured while they work.

Two parts of the contract matter when you book to cover a gap. Hourly visits end on 48 hours' notice agreed between you and the carer, so a week booked while you wait can be stopped once reablement or a council package begins. A visit you cancel is payable in full, unless the reason is unplanned hospitalisation, illness, or another reason the carer agrees to, which is worth knowing when a discharge date is likely to move. PrimeCarers charges nothing itself when you cancel and does not set those terms; they sit between you and the carer. Bank holiday visits are charged at one and a half times the carer's normal rate and Christmas Day at twice, and travel time is chargeable only where it has been agreed in advance in writing. Cancelled and late visits covers all of that, and hourly cost of care at home sets private and agency rates side by side.