Reablement: the free six weeks

All four are short term, and all four are aimed at getting somebody back to managing rather than at looking after them for the long run. The NHS describes intermediate care as short-term care that helps you recover and regain independence, usually for a maximum of six weeks depending on your needs, your circumstances and the progress you make towards your goals.

The free six weeks in regulation 4 applies where a council provides the support under section 2 of the Care Act 2014. Some services are run by councils, some by NHS community teams and some jointly, and local names vary a great deal. If you are given a name you have not heard, ask which of the four it is, who provides it and how long it is meant to run. Hospital discharge explained sets out how that decision is made on the ward, and the hospital discharge and post-operative care pillar covers the weeks either side.

A reablement worker will stand next to your relative while they butter their own toast, and will not butter it for them. From the doorway that can look like somebody being left to struggle, and it is deliberate: a task comes back only if the person does it. NICE asks for goals to be agreed with your relative, documented and given to them, so the plan should be written down.

Nights are the gap that catches people out after an operation, because pain relief runs out at three in the morning and an unfamiliar route to the bathroom in the half dark is where a fall happens. Short-term night care after a hospital discharge explains what sleeping and waking nights involve, and reducing the risk of falls at home is worth reading before the first night rather than after it.

Reablement sits alongside anything clinical rather than replacing it, and district nursing and wound care stay free for as long as the clinical need lasts. Post-operative rehabilitation and convalescent care covers a longer recovery at home, and hourly care after a hospital stay sets a short package of paid visits next to reablement.

1. 1

   Ask on the ward, before the discharge date

   While they are still in

   Ask the discharge team whether intermediate care or reablement has been referred for, and which service it is. Asking before a date is set is easier than unpicking a plan afterwards.
2. 2

   Ring adult social services if nobody has referred

   The same week

   Your relative does not have to have been in hospital. The NHS says to speak to a GP surgery or the local council about intermediate care after a fall or an illness at home.
3. 3

   Describe the change, not the worry

   On the call

   Say what your relative could do a month ago and cannot do now: the stairs, getting out of the bath, cooking a meal. A specific change is what an assessor works from.
4. 4

   Get the dates and the numbers in writing

   Before the first visit

   The date and time of the first visit, how many visits a day, the name of the service, and a number that answers at the weekend. A short email is enough.

The end date is the part worth planning around. The NICE guideline on intermediate care including reablement says people should be told at the outset that it is a short-term service and what is likely to happen afterwards, so it is reasonable to ask for that in week one rather than week five. The statutory guidance under the Care Act says councils should consider carrying on free beyond six weeks where there are clear preventative benefits to the person, so a service close to finishing the job can be asked to continue. If the last visit comes and nothing has been arranged to follow it, that is the week a family finds itself doing everything. Funding care after a hospital stay sets out the help available first.

The two assessments are the hinge. Ask for both while the free weeks are still running, because a date in week seven is no use to anyone. If your relative's savings are below £23,250, local authority funding for care at home explains how the means test works. If their needs are mainly health needs, NHS Continuing Healthcare explained sets out the test that decides it.

Where a family is paying for the visits that carry on, you can search for carers near your relative's home and compare their rates, reviews and availability in the last fortnight of reablement rather than the week after it stops. Carers on PrimeCarers charge £18 to £25 an hour with our fee included, typically about £20, against £28 to £35 through an agency. Our pricing explains how the carer's rate and our fee work.

PrimeCarers introduces carers and families to each other and does not provide or manage care, so the visits, the hours and the rate are agreed between your relative and the carer. Every carer on PrimeCarers has had an identity check, a right to work check and an enhanced DBS check on the Update Service, and has been interviewed online before their profile appears. Their insurance covers them while they work, which is separate from those checks. References sit on a carer's profile, and skills and training are worth asking about.

Raise all of this before the discharge rather than after it, because a plan that has not happened yet is easier to change than one to unpick. What to do when the person you care for is leaving hospital sets out the Patient Advice and Liaison Service route and the complaints process, and what is a carer's assessment explains what asking for one involves.