Care is needed this week
Something has changed and the arrangement that was working has stopped working. You have days, not months. This page is the order we would work in, the calls we would make first, and the things not to sign while you are under pressure.
Before anything else
If someone is at immediate risk of serious harm, ring 999. If you are worried that an adult is being abused or neglected, contact the adult safeguarding team at their local council. Neither of those is what this page is for, and neither can wait for a plan.
If the person is medically unwell but not in danger, ring 111 or the GP before you ring anyone about care. A great many “urgent care” situations turn out to be an untreated infection, a medication problem or unmanaged pain, and they resolve with treatment rather than a care package.
If nobody is unwell and nobody is in danger, and the problem is simply that the person cannot manage and the family cannot cover it, then the rest of this page applies.
- There has been a fall with a head injury, or they cannot get up
- They are confused in a way that is new and sudden
- They have not eaten or had fluids for a day or more
- They are being hurt, frightened, or having money taken
- They are alone and unable to summon help
- You are frightened of what will happen tonight
What to do, in sequence
Each step takes a phone call. Do them in this order — the later ones get easier once the earlier ones are done.
Ring adult social care and use the word urgent
Every council has an adult social care duty line. Say that an adult has care and support needs, that they are urgent, and that you cannot meet them safely. Under section 19(3) of the Care Act the council can put care in place before any assessment has been completed. Ask for a reference number.
Ask for a needs assessment at the same time
The urgent response and the assessment are different things. Ask for both. The assessment is a duty and it does not depend on the person’s savings — do not let anyone tell you otherwise.
Ask for a carer’s assessment for yourself
If you are the one holding this together, you have your own right to an assessment. It is almost never offered and it is often the thing that unlocks practical help.
Work out what the actual gap is
Not “they need care” but: which specific tasks, at which times of day, are not happening. Mornings? Medication? Night-time safety? Meals? The answer changes what you should be arranging and what it costs.
Cover this week, not the next ten years
A short private package, a respite bed, family rota, or a mix. Buy time. The decisions that matter — where they live, who pays — should not be made this week if they can possibly be made in three weeks.
What can realistically be in place within days
Emergency council response
Where needs appear urgent, the council can arrange care before the assessment is finished. Speed varies enormously by area, which is why you ring first and arrange privately in parallel.
A short private home-care package
Agencies can often start within 48 hours for visits, though early-morning and evening slots are the hardest to fill. Ask about a two-week arrangement, not a rolling contract.
A respite or short-stay bed
A fortnight in a care home on a short-stay basis is far easier to arrange — and far easier to undo — than a permanent placement. Ask homes directly about short stays.
Live-in care
Slower to start, usually a week or more, but it can hold a household together when visits cannot. It is a genuine alternative to a care home and is often not mentioned to families.
Equipment and adaptations
A key safe, a raised toilet seat, a perching stool, a falls alarm. Small, fast and often free or cheap through the council, and they sometimes remove the need for a visit altogether.
Family and community cover
A rota that gets you to the following Monday is a legitimate plan. So is a neighbour with a key. Write down who is doing what, because you will not remember by Thursday.
What not to agree to while you are under pressure
The most expensive decisions in care are made in weeks like this one. Not because anyone behaves badly, but because a family under pressure will sign whatever gets someone safe tonight.
Two things are worth holding on to. First, only the money belonging to the person receiving care is assessed — not yours, not their spouse’s. Second, agreeing to self-fund a permanent placement before anyone has screened for NHS Continuing Healthcare is the single most costly mistake we see, and it is very hard to unpick afterwards.
None of that means refuse help. It means take the help, and keep the permanent decisions open.
- Ask, in writing, for a Continuing Healthcare Checklist
- Check whether the arrangement is genuinely permanent or a short stay
- Sign as attorney or deputy, never in your own name, or you may be liable
- Ask what the notice period is and what is payable on ending it
- Ask what is included and what is charged as an extra
- Ask whether a top-up is being requested, and why
Questions when care is needed quickly
Can the council really arrange care this quickly?
It can. Section 19(3) of the Care Act 2014 lets a local authority meet needs that appear to it to be urgent without having yet carried out a needs assessment, an eligibility determination or a financial assessment. It is a power rather than a duty, so it helps to be explicit: ask the adult social care duty team for an urgent response, and use the word urgent.
Will we have to pay for emergency care?
Possibly, and possibly not. Care arranged urgently can be provided before any financial assessment has happened. A charge may follow later, and it will be based on the person’s own capital and income, not yours. That is a reason to accept help now and sort the money out afterwards, not the other way round.
Should we just book a care agency privately to get through the week?
Sometimes that is the right call, and it is often the fastest. Two cautions: ask the council for an urgent assessment in the same breath, because private arrangements do not stop you being assessed; and do not sign anything long-term while you are exhausted. A short private arrangement is very different from a permanent placement contract.
What if the person refuses help?
An adult with capacity can refuse care, however unwise it looks. What you can do is make the refusal an informed one, reduce the risk around it, and ask for a capacity assessment if you genuinely think the decision is not being made with an understanding of the consequences. If there is a serious and immediate risk of harm, safeguarding is the right route.
Is respite an option this week?
Often yes. A short-stay or respite bed in a care home can buy a fortnight of breathing space, and it is a much lower-stakes decision than a permanent move. Ask specifically about short stays — homes do not always volunteer them.
We are about to run out of options. What do we say?
Say the words: “I am telling you that this adult has care and support needs, that those needs are urgent, and that I am not able to meet them safely. I am asking you to exercise your power under section 19(3) of the Care Act to meet urgent needs, and I am requesting a needs assessment.” Then ask for the name of the person you spoke to and a reference number, in writing.
Take it further
Being discharged from hospital
What a safe discharge looks like and what to do when it is not one.
Care needs assessment
What the council must do, and how to ask for it properly.
Should the NHS be paying?
If the need is primarily a health need, the NHS pays for all of it.
Home care, live-in or a care home?
How the three options actually compare once you look at cost and need.
You don’t need to know which service you need.
Just tell us what’s happening.
No pressure. No care-provider commissions. Just a conversation about what may help.Independent · no commission from any care provider · fees published
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