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  • Abuse

    Harm that is caused by anyone who has power over another person, which may include family members, friends, unpaid carers and health or social care workers. It can take various forms, including physical harm or neglect, and verbal, emotional or sexual abuse. Adults at risk can also be the victim of financial abuse from people they trust. Abuse may be carried out by individuals or by the organisation that employs them.

    See also:

  • Accelerated access collaborative

    A group of health professionals who work with NHS England to speed up new treatments becoming available to patients on the NHS. They identify specific health conditions and types of treatment as priorities, and make sure that these treatments are developed and agreed for use as quickly as possible. 

  • Accelerated access pathway

    A fast-track route for new medicines and treatments to reach patients on the NHS. Medicines with the greatest potential to be effective could be available on the NHS up to four years earlier than under the usual process.

  • Access

    The opportunity to use, get or benefit from something. If you have a disability, you may need changes to be made to enable you to have full access to everything in your community, including services, facilities and information.

    See also:

  • Access to Work

    A scheme run by the Government that provides practical advice and financial support to help you work if you have a disability. It can pay for things like someone to help you communicate at a job interview, special equipment to help you do the job, or additional travel costs if you are unable to use public transport. How much you receive depends on your circumstances. You can find details of your local access to work centre at:

  • Accountability

    When a person or organisation is responsible for ensuring that things happen, and is expected to explain what happened and why.

  • Acquired impairment

    A disability that you are not born with but is caused, or develops during your life, by an injury or illness. 

  • Activated patient

    Someone who has a good understanding of their health condition and the treatment they are receiving, and is able to communicate confidently with the professionals who are caring for them. They do not just receive care but are actively involved in looking after their own health.

  • Active listening

    A way of listening that enables you to be fully heard, especially if you have dementia or difficulties with communication. Someone who is actively listening to you will be making eye contact, not interrupting, giving you their full attention, not doing other things, and checking with you that they understand what you are saying.

  • Active participation

    When you are included in decisions about your care and support, and have a say in how you live your life and how you want to spend your time.When you are included in decisions about your care and support, and have a say in how you live your life and how you want to spend your time.

  • Active support

    Support for people with a learning disability that enables them to take part in all types of activities of daily life, not just 'therapy'. It focuses on activities that are appropriate for the person's age and is based on what they can and want to do.

  • Activities of daily living

    Things you do every day to look after yourself, such as eating, washing, dressing and using the toilet. An assessment of your needs will look at how well you can manage your activities of daily living, and what help and support you need.

    See also:

  • Acute care

    Health care that you receive in hospital following an injury, operation or illness. It is different to any care you may receive for an ongoing health condition from your GP, community nurse or other professionals in the community where you live.

  • Adequate security

    If you are considering a ‘deferred payment’ agreement with your local council to fund your own care, the council will need to make sure that you can afford to repay them when the time comes – this is called making sure there is ‘adequate security’ for the agreement. This security may be the value of your house, or a valuable possession (for example, a piece of art or jewellery), or someone who can guarantee that payment will be made. Councils must publish a policy saying what types of security they will accept.

    See also:

  • ADHD

    A condition where an individual finds it hard to concentrate, may be over-active and can struggle to manage their behaviour. It is not the same as a learning disability. The condition can be managed with good support and sometimes medication. 

    See also:

  • Adult at risk

    An adult who is in need of extra support because of their age, disability, or physical or mental ill-health, and who may be unable to protect themselves from harm, neglect or exploitation.

    See also:

  • Adult placement scheme

    When an adult with a disability or mental health problem lives in an ordinary home with an individual or family who provides them with a place to live and support. It is like a fostering arrangement for adults: adult placement carers must be checked and approved, and the arrangement is monitored by the local council. People may be placed in someone's home for a short break or on a permanent basis.

    See also:

  • Adult social care

    Care and support for adults who need extra help to manage their lives and be independent - including older people, people with a disability or long-term illness, people with mental health problems, and carers. Adult social care includes assessment of your needs, provision of services or allocation of funds to enable you to purchase your own care and support. It includes residential care, home care, personal assistants, day services, the provision of aids and adaptations and personal budgets.

  • Adult Social Care Outcomes Framework (ASCOF)

    A tool that the Department of Health in England uses to measure how well your local care and support services are doing in helping local people achieve the outcomes that matter most to them. It should help councils improve the services they offer.

  • Advance care planning

    Thinking ahead about your wishes and preferences for your future treatment and care, and making sure that other people know what you want. It is an opportunity to think about what is important to you, and to let other people know about things you would – or would not – like to happen as you approach the end of your life. 

    See also:

  • Advance decision

    A decision you make about what medical treatment you would or would not want in the future, if you were unable to make decisions because of illness or because you lacked capacity to consent. Unlike an advance statement, it is legally binding in England and Wales. If you are thinking about making an advance decision, you should talk about this with your family and your GP.

    See also:

  • Advance statement

    A written document that lets people know what your wishes, feelings and preferences are about your future care and support, in case you become unable to tell them. (It may also be included in your support plan.) It can cover any aspect of your care, such as where you want to live and how you like to do things. You can write it yourself, with support from your family, friends, doctor and anyone else you wish. It isn't a legal document, but it may help you get the care and support you want. It is different to an 'advance decision' about medical treatment, which is a decision you can make now about whether you want a particular type of treatment in the future.

    See also:

  • Adverse drug reaction

    Unexpected harm caused to you by taking a particular medicine, either from a single dose or from ongoing use.


  • Adverse event

    When something happens that isn’t planned and causes harm, or puts people or organisations at risk of harm.

  • Advocacy

    Help to enable you to get the care and support you need that is independent of your local council. An advocate can help you express your needs and wishes, and weigh up and take decisions about the options available to you. They can help you find services, make sure correct procedures are followed and challenge decisions made by councils or other organisations.

    The advocate is there to represent your interests, which they can do by supporting you to speak, or by speaking on your behalf. They do not speak for the council or any other organisation. If you wish to speak up for yourself to make your needs and wishes heard, this is known as self-advocacy.

  • Affective disorders

    A type of mental illness that affects a person's mood or feelings. The main examples are depression, bipolar disorder or anxiety, which may be mild or severe.

  • After-care

    Support that is provided in your home, or in the community you live in, after you leave hospital. The term is used in relation to mental health to refer to specific support you may receive, free of charge, from a community psychiatric nurse, counselling, therapy, or support with employment, accommodation, family relationships, finances and other things.

  • Age discrimination

    If you are treated differently because of your age, and not offered the same opportunities as other people.

    See also:

  • Agency

    An independent organisation that provides care and support services, such as care in your own home. It is not part of your local council. The council may arrange for care and support to be provided for you by a local agency, or you can arrange this yourself.

  • Aids and adaptations

    Help to make things easier for you around the home. If you are struggling or disabled, you may need special equipment to enable you to live more comfortably and independently. You may also need changes to your home to make it easier and safer to get around. Aids and adaptations include things like grab rails, ramps, walk-in showers and stair-lifts.

  • Alert

    When a concern is raised that a vulnerable adult may be a victim of abuse or neglect. This concern may be caused by what someone has said, or what has been seen. Anyone can raise an alert, and to do so you should contact the adults’ services department of the local council. If you believe a crime has been committed, you should talk to the police about it.

  • Alliance contracting

    When there is a single agreement (a contract) between a commissioner and a group of organisations who provide different services. The organisations work together, rather than competing with each other, and aim for the same outcomes.

  • Allied health professionals

    People who provide different types of health care who are not doctors, nurses or pharmacists. The description includes a wide range of roles, including physiotherapists, occupational therapists, dietitians, podiatrists and others.

  • Allocated case

    When responsibility for assessing your care and support needs is given to a named worker, who will continue to work with you until you no longer need their help.

  • Ambulatory care

    Health care such as tests or treatment that you receive in hospital as an outpatient, without having to stay in overnight.

  • Any Qualified Provider (AQP)

    A scheme in some areas where you may be able to choose who provides a health service you need, and the NHS will pay for it. You make your choice from a list of organisations, including charities and private organisations, that the NHS has decided provide a good quality service. Different types of services are included – for example, hearing tests or pain management services. It is up to the NHS in your area whether they offer this.

  • Appearance of needs

    When it appears that you may need some care or support, the law (Care Act 2014) says that you are entitled to have an assessment. No-one should decide whether you need care and support before an assessment has taken place, and if you appear to need help, then you should have your needs assessed.

    See also:

  • Appointee service

    A service that your council may offer to manage your money for you, if you are unable to do this yourself and have no family or friends who can help you. The council can receive benefit payments on your behalf, and arrange the payment of your living costs. You may have to pay the council a fee to provide this service.

  • Appreciative inquiry

    A way of finding out what works well in a particular setting, and using this information to improve the service people are offered. It is about building on what is working, rather than focusing on problems.

  • Appropriate adult

    Someone over the age of 18 who stays with you if you have a mental health problem or disability, or are perceived as 'vulnerable', and are held by the police for any reason. This person, who should not work for the police, is there to support you and help you understand what is happening.

  • Approved mental health professional

    A professional with specialist training who can be called on to arrange for a person to have their mental health assessed, to decide whether they should be admitted to hospital for their own safety or the safety of others. The approved professional's main job may be social worker, occupational therapist, community mental health nurse or psychologist.

  • Arms length body

    An organisation that is not part of the Government but carries out a task that the Government has given it. It is funded by the Government, and may be a large or small organisation.

  • Assertive outreach team (AOT)

    A specialist service that may be offered in the place where you live if you have severe mental health needs that affect your ability to manage your daily life. The team is made up of highly experienced staff, who can help you cope with all aspects of daily living, such as shopping, cooking, cleaning, taking medicine, finding education or employment, or finding somewhere to live. You are likely to be referred to an AOT by your community mental health team rather than your GP.

  • Assessment

    The process of working out what your needs are. A community care assessment looks at how you are managing everyday activities such as looking after yourself, household tasks and getting out and about. You are entitled to an assessment if you have social care needs, and your views are central to this process.

  • Assessment and treatment unit

    An inpatient unit that someone with a learning disability or mental health problem may go into for a short period, while their needs are assessed and plans are made to meet these needs. It should not become a person's permanent home. There are various reasons why a person may go into an assessment and treatment unit, including their existing placement coming to an end or their behaviour becoming a challenge for the people who care for them. The unit may be run by the NHS or by the independent sector.

  • Asset-based approach

    A way of helping people by looking at what they have, rather than what they lack. This approach helps people make use of their existing skills, knowledge and relationships. It is also called a 'strengths-based approach', and can be used as a way of improving local areas, by promoting what is good about an area rather than focusing on problems. See also co-production.

  • Asset-based community development

    Making use of what a community already has (such as existing organisations and resources), and using these things to make the area better for the people who live there. The aim is to look at what communities have, rather than what they lack. It has been described as ‘using what’s strong to deal with what’s wrong’.

  • Asset-mapping

    Working with individuals and communities to look at the positive things that people and communities have, and at what they are able to do rather than what they lack. These positive things - assets - include people's knowledge and skills, local community organisations and the connections that exist between people.

  • Assets

    Things you have that may be valuable in money terms (such as a house), or useful in other ways (such as particular skills, knowledge or relationships).

  • Assisted discharge

    Help that you may be offered if you are well enough to go home from hospital but if you don’t have much support at home – for example, if you live on your own. This service may be provided by a home care service or by volunteers, who can help you get home from hospital and get settled in your home, preparing food and doing any necessary shopping for you.

  • Assisted living

    Housing for older or disabled people, usually privately owned, where you have your own apartment within a larger development, and support (such as help with meals or laundry) is provided to meet your own particular needs.

  • Assisted living technology (ALT)

    Products that are designed to help you live independently in your own home.

    See also:

  • Assistive and adaptive technology

    Devices or equipment to help you do things if you have a disability. The term often refers to systems that help people communicate if they have problems with speaking.

  • Assistive technology

    Equipment that helps you carry out daily activities and manage more easily and safely in your own home. Examples include electronic medicine dispensers, memory prompts, 'big button' telephones or remote controls, and pendant alarms for wearing around your neck or wrist. It also includes equipment that can detect potential hazards in your home, such as a fire or flood, or that can alert a carer or the emergency services in the event of a fall or seizure.

  • Asymptomatic

    When you don’t show any signs of being ill, even though you may be infected with a disease such as coronavirus. The US Centers for Disease Control and Prevention estimates that as many as 25 per cent of people infected with coronavirus may not show symptoms.

    See also:

  • Audit

    A check to make sure that care is being provided in the way that it should be. An audit lets the care provider and people who use the service know what is being done well and where there could be improvements.

  • Authorised person

    Someone who can request direct payments from a local council on behalf of a person who does not have capacity to do this themselves. This person must act in your best interests and be able to manage your direct payments for you.

  • Autism spectrum disorder

    A condition that someone is born with that affects their ability to communicate and interact with the world around them. It is also called autism, and covers a wide range of symptoms. It affects people in different ways, and some individuals need much more help and support than others.

  • Autism strategy

    A national plan covering all of England that explains what the Government is doing to make sure that adults with autism get the help they need with things such as living independently and finding employment. The autism strategy tells local councils and health services what they should do to help support autistic adults. Many councils have their own autism strategy setting out what they will do to improve the lives of autistic adults in their area.

  • Autonomy

    Having control and choice over your life and the freedom to decide what happens to you. Even when you need a lot of care and support, you should still be able to make your own choices and should be treated with dignity.


  • Avoidable admission

    If you have an unplanned hospital stay that could have been prevented with care given in your community or at home. 


  • Background support

    On-call or emergency support that is available on site in extra-care or supported housing, in case it is needed by residents. It is separate to the personal care you may receive in these places that is for your specific needs. The cost of providing background support may be added as an additional charge to your extra-care or supported housing, if you pay for this.

  • Barred list

    An official list of people who are unsuitable to work or volunteer with children or with adults who may be at risk of harm or abuse, because of their past record. If you employ someone regularly to provide personal care, you should expect them to have completed a Disclosure and Barring Service (DBS) check, which will show whether they are on the barred list or not.

    See also:

  • Beacon service

    A service that highlights how something can be done differently and better, and shares what it has learned with other organisations.

  • Behaviour disorders

    When someone's behaviour is persistently different to what is usually accepted, and causes difficulties for the individual and the people around them. Symptoms may include disruptive, antisocial or aggressive behaviour, poor relationships, and problems with concentrating and paying attention. 

  • Behaviour support plan

    A written document to help support a child or adult with a disability who behaves in a way that other people find difficult. It should go everywhere with them. The plan should explain how to help the person communicate, and how to help them get what they need. It should also describe the kind of situations the person finds difficult and explain what can be done to make things easier for them. 

  • Behavioural intervention

    A type of therapy that aims to help a person understand and change their behaviour, if it is causing problems for them.

  • Benchmark

    A way of comparing the same type of service in different places. The level of quality that every service should provide is set as a ‘benchmark’, and each service is measured against it and compared. ‘Benchmarking’ in this way should help services to work out how they can do things better and where they are doing well.

  • Best interests

    Other people should act in your 'best interests' if you are unable to make a particular decision for yourself (for example, about your health or your finances). The law does not define what 'best interests' might be, but gives a list of things that the people around you must consider when they are deciding what is best for you. These include your wishes, feelings and beliefs, the views of your close family and friends on what you would want, and all your personal circumstances.

  • Best interests assessor

    An independent person who looks at whether someone who lacks capacity and is in hospital or a care home is there for the right reasons, and whether it is in their best interests to stay there.
  • Best practice

    A way of doing something that has been shown to be the most effective way of doing it.

  • Better Care Exchange

    An online community – like a social network – for everyone who is involved in bringing health and social care services together in a local area. It is an opportunity to share queries, concerns and information about the Better Care Fund. 

    See also:

  • Better Care Fund

    Money that has been given by the Government to local areas to make the NHS and local councils in England work together better. The aim is to improve your experience by moving care out of hospital and into your home and sharing information so that everyone involved in your care understands what your needs are.

  • Block contract

    An agreement between a commissioner (such as a council) and an organisation to provide a service to a number of people, for a fixed amount of time, for a fixed sum of money. The number of people who receive the service may not be fixed, and the exact type of care and support they receive may not be specified. This type of contract is not tailored to people's individual needs.

  • Block purchase

    When an organisation such as your local council pays a provider for a service for a group of people with a particular need. Because block purchases guarantee an amount of work for a provider, services usually cost the council less. However, individual people who use these services may not have much choice about who provides their care or what they receive. 

  • Broker (also known as a Care Navigator)

    Someone whose job it is to provide you with advice and information about what services are available in your area, so that you can choose to purchase the care and support that best meets your needs. They can also help you think about different ways that you can get support, for example by making arrangements with friends and family. A broker can help you think about what you need, find services and work out the cost. Brokerage can be provided by local councils, voluntary organisations or private companies.


  • Caldicott guardian

    A senior person in an NHS organisation or local council who is responsible for making sure that your personal health and care information is kept confidential, and is not shared with anyone who does not need to see it.

    The law says that all NHS organisations and councils that provide social care services must have a Caldicott guardian. The name comes from the person who chaired a government review of confidential information in the 1990s, Dame Fiona Caldicott. 

    See also:

  • Capabilities

    What you are able to do, what your strengths are, and what you might be able to do if you had support or assistance.

  • Capacity

    The ability to make your own choices and decisions. In order to do this, you need to be able to understand and remember information, and communicate clearly - whether verbally or non-verbally - what you have decided. A person may lack capacity because of a mental health problem, dementia or learning disability.

  • Capacity to consent

    'Consent' is when you give your permission to someone to do something to you or for you. 'Capacity' is your ability to understand what you are being asked to decide, to make a decision and to communicate that decision to people around you. Mental capacity can vary over time. If you have capacity to consent, then you understand what you are being asked to agree to, and you are able to let people know whether you agree. See also informed consent.

  • Capital limits

    If the value of your capital - any savings you have, as well as assets such as a house you own - is below a certain level (currently £14,250 in England in 2022/23) you will not have to use any of your capital to contribute to the cost of your care. What you contribute will be assessed based on your income. If your capital is between £14,250 and £23,250 you will have to contribute something towards your care, based on a calculation that you have £1 per week extra in your income for every £250 in capital between these limits. If your capital is worth more than £23,250, you will be expected to use this to pay the full cost of your care. This will all be looked at and calculated during a financial assessment.  

  • Care Act 2014

    A law passed in England in 2014 that sets out what care and support you are entitled to and what local councils have to do. According to the law, councils have to consider your wellbeing, assess your needs and help you get independent financial advice on paying for care and support.

  • Care Act easements

    Temporary changes to the Care Act 2014 during the coronavirus outbreak to help councils cope. If a council cannot meet everyone’s needs, it can give priority to people with the most urgent care and support needs. This would affect assessments, care plans and reviews. Councils should only do this if it is essential in their area, and they still have a duty to uphold people’s human rights. The Government has published an ‘ethical framework’ for councils to help them plan their response to coronavirus in their local area.

  • Care consortium

    A group of individuals or organisations that work in partnership to meet a specific need – such as providing care services in a particular area – with each organisation providing the thing they specialise in.

  • Care funding calculator

    A method that some councils use to work out how much a person's care and support will cost, based on how much assistance you need with daily living. You will be asked about everything that you might need help and support with, and the calculator then works out the cost of providing that help and support. This helps councils agree a price with care providers.

  • Care home

    A home that you live in with other people, with staff providing care and support. The home provides you with your own room, meals and personal care. Some care homes – but not all – also employ registered nurses to provide nursing care. Care homes may be privately owned or may be run by a charity or a local council.  They are regularly inspected by the Care Quality Commission.

  • Care market

    The full range of care and support services that are available in a particular area. This may be the local area covered by a single council, or it may be the whole country.
  • Care navigator (also known as a Broker)

    Someone whose job it is to provide you with advice and information about what services are available in your area, so that you can choose to purchase the care and support that best meets your needs. They can also help you think about different ways that you can get support, for example by making arrangements with friends and family. A broker can help you think about what you need, find services and work out the cost. Brokerage can be provided by local councils, voluntary organisations or private companies.

    See also:

  • Care needs portrayal

    A document that is used to record and describe your care needs, if you are being assessed to see whether you are entitled to NHS continuing health care. 

  • Care package

    The range of services offered to you as an individual by your council, following an assessment of your needs. It may include day services, aids and adaptations for your home and personal care.

  • Care pathway

    A plan for the care of someone who has a particular health condition and will move between services. It sets out in a single document what is expected to happen when, and who is responsible. It is based on evidence about what works best to treat and manage your particular condition.

  • Care plan

    A written plan after you have had an assessment, setting out what your care and support needs are, how they will be met (including what you or anyone who cares for you will do) and what services you will receive. You should have the opportunity to be fully involved in the plan and to say what your own priorities are. If you are in a care home or attend a day service, the plan for your daily care may also be called a care plan.

    See also:

  • Care Programme Approach (CPA)

    An approach to care planning for people with serious mental health problems. It helps mental health services to assess your needs and work out how best to support you. You will have regular contact with a care coordinator, who may be a social worker, community psychiatric nurse or occupational therapist. The coordinator will work with you to write a 'care plan', based on your individual needs and circumstances.

  • Care Quality Commission (CQC)

    An organisation set up by the Government to make sure that all hospitals, care homes, dentists, GPs and home care agencies in England provide care that is safe, caring, effective, responsive and well-led. If you are unhappy with the care or support you receive, you can contact CQC to let them know. Although CQC cannot investigate complaints about an individual person's treatment or care, it inspects services and will use any information it receives from you to help it decide what to look at during an inspection.

  • Care records

    Information about you that is collected and kept by organisations that assess your needs and provide care and support services. Your records include basic personal details such as your name, address, date of birth, close relatives and carers, as well as information about your health and ability to carry out activities of daily living, and what has been agreed about your care and support. Your care records must be kept safely, and you should be asked if you are happy for them to be shared with people who are involved in your care. You have the right to see your own records and should receive a copy of all assessments and care plans.

  • Care worker

    A person who is paid to support someone who is ill, struggling or disabled and could not manage without this help.

  • Care, education and treatment review (CETR)

    A meeting about a child or young person who has a learning disability and/or autism and who is in a mental health hospital or learning disability hospital, or is at risk of being admitted to one of these hospitals. The aim of the meeting is to make a plan to prevent the young person going into hospital, or to plan their move out of hospital if they are already there. It should include all the health, social care and education professionals involved in the young person’s care.

  • Carer

    A person who provides unpaid support to a partner, family member, friend or neighbour who is ill, struggling or disabled and could not manage without this help. This is distinct from a care worker, who is paid to support people.

  • Carer's Allowance

    A weekly payment from the Government if you provide support to a partner, family member, friend or neighbour, who could not manage without your help. You don't have to be related to the person or live with them to be able to claim Carer's Allowance. Whether you can claim it depends on how many hours a week you provide care for, what benefits the person you care for receives, and how much you earn (but not how much money you have in savings).

    See also:

  • Carer's assessment

    If you are an unpaid carer for a family member or friend, you have the right to discuss with your local council what your own needs are, separate to the needs of the person you care for. You can discuss anything that you think would help you with your own health or with managing other aspects of your life. The council uses this information to decide what help it can offer you.



    See also:

  • Caring activism

    When a group of people in a local area join together to support a person or group of people who need help or support.

  • Case conference

    A meeting that is usually held when you are believed to be at risk of harm or abuse. The purpose is to discuss your situation and decide on a course of action to keep you safe. It will be attended by people who know you, such as your GP, community nurse or social worker. You (or your representative) should also be invited to the meeting.

  • Case finding

    The process of finding individuals who may need a particular type of support or treatment. It is often used as a way of helping people stay out of hospital. An example may be identifying people who have lung disease and encouraging them to have a flu vaccination, or identifying people living in care homes who have dementia.

  • Case management

    A way of bringing together services to meet all your different needs if you have an ongoing health condition, and helping you stay independent. If you choose this option, a single, named case manager (sometimes known as a 'key worker') will take the lead in coordinating all the care and support provided by different agencies, offer person-centred care and enable you to remain in your own home and out of hospital as much as possible.

  • Centre for Independent Living (CIL)

    A local organisation run by people with disabilities, that supports disabled people in their area to make choices about how and where they live their lives, with the assistance and support they need to live as independently as possible.

    See also:

  • Challenging behaviour

    Behaviour that may cause harm to the person or to those around them, and may make it difficult for them to go out and about. It may include aggression, self-injury or disruptive or destructive behaviour. It is often caused by a person's difficulty in communicating what they need - perhaps because of a learning disability, autism, dementia or a mental health problem. People whose behaviour is a threat to their own wellbeing or to others need the right support. They may be referred by their GP to a specialist behavioural team. The specialist team will work on understanding the causes of the behaviour and finding solutions. This is sometimes known as positive behaviour support.

  • Champion

    Someone who is given the task of supporting and speaking up for a particular thing, such as dignity in care, or for a specific group of people, such as children or older people. A champion may be a care professional or may be a person who uses care services.

  • Change management

    The process of preparing an organisation to make big changes to the way it works.

  • Changing places toilet

    A fully accessible public toilet for people with disabilities who are unable to use the toilet independently and need extra equipment and space. It is different to a standard disabled toilet, as it includes an adult-sized changing bench and a hoist, as well as enough space in the changing area for the disabled person and up to two carers. A map of where to find a changing places toilet can be found at


    See also:

  • Chargeable services

    Services that your local council may expect you to pay towards, such as day care or home care. The law says that the amount the council charges must be reasonable, and councils have to follow guidance from the Government, to make sure that you are not charged more than you can afford to pay. There are some services that the council is not allowed to charge you for, and these are called non-chargeable services.

  • Checklist screening

    A way of deciding if you might be entitled to receive NHS continuing health care. The checklist consists of a list of statements, and a nurse or social worker will decide which of these statements best describes your needs. Once the checklist has been completed, your local clinical commissioning group will decide whether to carry out a full assessment of your needs.

  • Child & Adolescent Mental Health Services (CAMHS)

    Specialist services provided by the NHS for children and young people up to the age of 18 who are having emotional or behavioural problems. A young person may be referred to their local CAMHS for depression, eating difficulties, anxiety, sleeping problems, violent and angry behaviour, and other things. They can be referred by a GP or other health professional, or by school staff or a social worker.

  • Child's needs assessment

    An assessment that the council should carry out before a young person turns 18, if it is likely that they will need care and support from adult community care services. You can ask for this even if a child has not previously been receiving any services. The assessment should include a predicted personal budget, so that young people and their families can plan for the future.

  • Choice of accommodation

    If you live in a care home and your fees are paid by your local council, you have the right to say where you would like to live. This can include a care home outside your local area, if that is what you want. The council should try to arrange for you to have a place in the home you prefer, as long as it meets your needs, does not cost more than the council would usually expect to pay, and the home has a space for you. If your choice of home costs more than the council expects to pay, you can still have a place there if you or someone else (such as a member of your family) is willing to pay the difference in cost. 

    See also:

  • Chronic condition

    A persistent or long-lasting illness or health condition that you live with, that cannot be cured but can usually be managed with medicines, treatments, care and support.

  • Circle of support

    Sometimes also called a 'circle of friends', this is a group of people who act as a community around a person who needs help and support. The person themselves remains in control. The group may include the person's family, friends and other supportive people from the community they live in. They are not paid, and their role is to help the person do the things they want to do and plan for new events in their life.

  • Citizen advocate

    A volunteer from your local community who can work with you if you are isolated and need some help with making your needs and wishes known and with taking up opportunities. The advocate can help you get what you are entitled to, find out what your options are, make choices and take part in activities. You can find out if citizen advocates are available in your area through local charities or support groups.

    See also:

  • Citizens Advice (also known as CAB)

    A charity that offers free, independent, confidential advice - in your local area, online or over the phone - for a range of problems. Advisers can help with things like money, benefits, housing or employment problems, and can help you find legal advice, if necessary.

  • Client contribution

    The amount you may need to pay towards the cost of the social care services you receive. Whether you need to pay, and the amount you need to pay, depends on your local council's charging policy, although residential care charges are set nationally. Councils receive guidance from the Government on how much they can charge.

    See also:

  • Client group

    A group of people with social care needs who fit within a broad single category. Client groups include older people, people with physical disability, people with learning disability, people with mental health problems, and so on.
  • Clinical audit

    A way of finding out if the health care provided by a particular organisation is good enough, and what needs to be done better. It involves looking at how things should be done, comparing what is actually being done by an organisation, making changes where necessary, and then looking again to check for improvements. 

  • Clinical Commissioning Group (CCG)

    A group of GP practices in a particular area that work together to plan and design health services in that area. Each CCG is given a budget from NHS England to spend on a wide range of services that include hospital care, rehabilitation and community-based. Your local CCG should work with the council and local community groups to ensure that the needs of local people are being met.

  • Clinical effectiveness

    Using knowledge from research about what works best in health care to get the best results for people.

    See also:

  • Clinical governance

    A way for health care organisations to continuously improve the quality and safety of care they provide, and to explain how they are doing this.

    See also:

  • Clinical impact

    The effect of a particular type of treatment on individual people who receive it, and on groups of people with a particular condition.

  • Clinical negligence

    When a doctor or other health professional causes you harm because of something they did, or something they should have done, and this harm would not have otherwise occurred. Examples include failing to diagnose a condition, making a mistake during treatment, giving the wrong drug, not warning you about the risks of treatment, or not getting your agreement to treatment.

  • Clinical outcomes

    Specific changes in your health or quality of life, as a result of the medical treatment or care you receive.

  • Clinical trial

    A scientific study that looks at a specific type of treatment to work out whether it is safe, whether it works and whether it is better than other treatments.

  • Close care scheme

    A housing development for older people next to a care home that will provide you with personal care if you need it. This type of scheme may be a good choice for a couple who have different care needs, or a person with a worsening health condition.

  • Co-commissioning

    Joint working between commissioning authorities, such as NHS England and local groups of GPs, to make sure that particular health services are available.

  • Co-design

    When you are involved in designing and planning services, based on your experiences and ideas. You may be invited to work with professionals to design how a new service could work, or to share your experiences in order to help a service improve.

    See also:

  • Co-funding

    When you and your council both contribute to the cost of the care and support you receive. This may cover things like home care, day services or assistive technology.

  • Cognitive behavioural therapy

    A type of therapy that can help you manage your problems by changing the way you think and act. It is often used to treat anxiety and depression and can help you think about how your thoughts, beliefs and attitudes may be affecting your feelings and behaviour. You may see a therapist face-to-face or take a therapy course online.

    See also:

  • Cognitive impairment

    A problem with your brain that may make it difficult for you to remember things, solve problems, learn new things or make decisions. It may be mild or severe, and may be something you are born with or caused by an illness or injury.

  • Collaborative commissioning

    When several organisations, such as local councils and health organisations, work together to plan specific care services and share funding.

  • Co-location

    When services are based in the same place or cover the same geographical area. People may not be part of the same team, but being co-located can help with collaboration and encourage them to share information and provide a better service.

  • Commissioner

    A person or organisation that plans the services that are needed by the people who live in the area the organisation covers, and ensures that services are available. Sometimes the commissioner will pay for services, but not always. Your local council is the commissioner for adult social care. NHS care is commissioned separately by local clinical commissioning groups. In many areas health and social care commissioners' work together to make sure that the right services are in place for the local population.

  • Commissioning

    The process of planning services for a group of people who live in a particular area. It does not always mean paying for services, but making sure that the services people need are available in that area.

  • Commissioning authority

    An organisation, such as a local council or NHS clinical commissioning group (CCG), that plans the services that are needed by the people who live in a particular area.
  • Commissioning for Quality & Innovation (CQUIN)

    A national plan to encourage health organisations to provide better care for people by holding back part of their budget unless they can show that care is improving for people and outcomes are better.

    See also:

  • Commissioning standards

    What good commissioning - planning of services - should look like, in order to improve the care and support that people receive. The standards have been created to help everyone who is involved in commissioning understand what excellent services look like, so that they can put the right care and support in place. They cover things like focusing on outcomes for people, ensuring equality, and using evidence about what works best.

    See also:

  • Communicable disease

    A disease that is passed from one person to another through people being near each other.

  • Communication passport

    A tool for passing on essential information about someone with communication difficulties, to help people who work with them understand who they are, what they need and how they communicate. The person's own views are recorded and information is presented in a way that is very clear and easy to read. It is a particularly important tool when people move to a new environment or when new staff or volunteers become involved with their care and support.

  • Communication support plan

    A document that explains how an individual person with a learning disability communicates, what support they need, and how the person providing support should communicate with them.

  • Community alarm

    A service to help keep you safe in your home by connecting you with a call centre if you need help. An alarm is installed in your home via your telephone line, and you will be given a button to press if you need assistance. The button may be on a pendant that you can wear, so it is always on you. Call centre staff are on duty 24 hours a day and can call a member of your family or the emergency services. The service is likely to be organised by your local council, and you may have to pay towards it.

  • Community anchor

    A well-established organisation within a local community that supports the neighbourhood and helps other community organisations to develop and provide services that the whole community needs. It may be a community housing association, for example, or another type of non-profit organisation.

  • Community capacity

    What people in local communities are able to do to help and support each other. It involves making use of resources that already exist - such as neighbourhood groups and befriending schemes - and developing new ones. It helps people find ways of meeting their own needs, and the needs of others, in the place where they live.

  • Community care services

    Social care services that can help you live a full, independent life and to remain in your own home for as long as possible.
  • Community circle

    A way for a person’s family and friends to come together to support them. Members of the ‘circle’ meet with the person to talk about what help is needed and make an action plan. There may be an independent person at the meeting to guide the conversation and help make the plan.

    See also:

  • Community connectors

    Individuals who can help you find out what is available to support you in your local area and how to get involved in social activities. They may be employed by your council to help connect you with local services, facilities and activities. 

  • Community equipment service

    A service in your area that supplies equipment to you, on loan, to enable you to live safely in your own home and remain independent. The type of equipment offered includes walking aids, bathing aids, special beds and other things that may be useful to you after a hospital stay, or to enable you to remain at home rather than going into a care home. A health professional such as a nurse or therapist will carry out an assessment of what you need. The service is likely to be a partnership arrangement between your council and local NHS organisations.

  • Community health services

    Health services that are provided outside hospitals, such as district nursing.
  • Community interest company

    A type of business that helps people or communities and uses the money it makes to do more for the community it supports, rather than giving profits to private shareholders. Many social enterprises are registered as community interest companies, which are different to charities because they remain a private company.

    See also:

  • Community intervention team

    A team of different professionals from health and social care, including nurses, therapists, social workers and others, who support you in your own home for short periods. A community intervention service may be offered after you have been in hospital, or to help you avoid needing to go into hospital.

  • Community learning disability team (CLDT)

    A team made up of a number of different professionals, including therapists, nurses, psychologists and others. This team provides health advice and support to adults with a learning disability, their families and others who are involved in their care and support. Local teams support people with learning disabilities to live full and healthy lives within their communities.

  • Community Mental Health Team (CMHT)

    A team of professionals who can support you in your own home, rather than in hospital, if you have a complex or serious mental health problem. The team may include psychiatrists, psychologists, nurses, social workers and occupational therapists. Their role is to organise and coordinate your treatment and care.

  • Community navigator service

    A service that helps people who are older or disabled find their way around local health and social care services, so that they can find the support they need. This service may be provided via your GP surgery, or by a local charity.

  • Community psychiatric nurse

    Also known as a 'community mental health nurse', this is a specialist nurse who works in the community rather than in hospital with people who have mental health problems. They are a key part of your local community mental health team and can offer you help and support in managing your condition.

  • Community spread

    When a disease such as coronavirus spreads within a community, including to people who have had no contact they know of with someone who is infected, and who have not travelled to an area where the disease is widespread.

  • Community wellbeing

    An approach that looks at the health and wellbeing of the whole community, focusing on a wide range of things that can affect how people feel. This approach recognises that being well is about more than just not being ill: social and emotional factors are important too.

    See also:

  • Co-morbidity

    When you are living with more than one health condition at the same time.

  • Complex discharge

    When you come out of hospital still needing care and support once you are at home. This care and support should be planned by a team of staff at the hospital where you are treated, and you should receive a copy of your care plan. This should say what your needs are, what treatment and support you will get, who is responsible for providing this, when and it will be provided, and who to contact if there is an emergency. It is unlike minimal discharge, where ongoing care and support are not needed.

  • Complex needs

    You may have complex needs if you require a high level of support with many aspects of your daily life and rely on a range of health and social care services. This may be because of illness, disability or loss of sight or hearing - or a combination of these. Complex needs may be present from birth, or may develop following illness or injury or as people get older.

  • Compliance

    When a person or organisation does what is required of them. This may be an organisation such as a care provider sticking to the law about what they should do and how they should do it. It may also be an individual doing something like taking their medicine regularly.

  • Compulsory admission

    When you can be made to go into hospital, according to the law, for your own safety or the safety of others. This follows an assessment of your mental health. It is also known as ‘being sectioned’ or ‘sectioning’.  (This refers to sections 2 and 3 of the Mental Health Act.)

  • Confidentiality

    Keeping information about someone safe and private, and not sharing it without the person's knowledge and agreement. Any information you provide about yourself should be protected carefully, and should only be shared with people or organisations who genuinely need to know it. Your personal details should not be discussed without your agreement.

  • Congenital disorder

    A condition that a person is born with rather than something they develop during their life.

  • Consent

    When you give your permission to someone to do something to you or for you.

  • Consultation

    An invitation to express your views and opinions about a particular service or proposed change, before any final decisions are taken. Your local council, NHS and organisations that provide services may consult you before making a change that will affect you. You may be able to give your views in writing or in discussion at a meeting.

  • Contact tracing

    The process of working out who has had contact with someone who is infected with a disease such as coronavirus. This means that everyone who has been in contact with an infected person can be tested for the virus and can be told to isolate themselves.

  • Contagious

    When a disease such as coronavirus can be passed on by direct or indirect contact between people.

  • Continuing health care

    Ongoing care outside hospital for someone who is ill or disabled, arranged and funded by the NHS. This type of care can be provided anywhere, and can include the full cost of a place in a nursing home. It is provided when your need for day to day support is mostly due to your need for health care, rather than social care. The Government has issued guidance to the NHS on how people should be assessed for continuing health care, and who is entitled to receive it.

  • Continuity of care

    There are two meanings to the phrase 'continuity of care': seeing the same doctor or other care professional every time you have an appointment, or having your care well coordinated by a number of different professionals who communicate well with each other and with you. It is particularly important if you have a long-term condition or complex needs.

    See also:

  • Conversation record

    The notes from a discussion you may have with a care professional about the help and support you need to live your life the way you want. This conversation is different to a formal assessment of your needs and what you might be entitled to, and focuses on your own thoughts about what you are able to do and what help you need. A conversation record is also a way of noting the views of a child or young person and their parents/carers as part of the education, health and care assessment process.

  • Coordinated care

    A way of joining up all the care and support offered to someone with complex needs by getting people and processes to work together. It means considering what you need as a whole person, not just treating each type of symptoms separately.

  • Co-production

    When you as an individual are involved as an equal partner in designing the support and services you receive. Co-production recognises that people who use social care services (and their families) have knowledge and experience that can be used to help make services better, not only for themselves but for other people who need social care.

    See also:

  • Coronavirus

    An umbrella term to describe a family of viruses that cause disease in animals. Some of these viruses, including Covid-19, the new one that is affecting people worldwide, have made the jump to humans. Most are not serious. The virus appears in the shape of a crown under a microscope, which is how it gets its name.

    Download the Covid 19 explainer 

  • Coronavirus Act 2020

    An emergency law passed by Parliament in March 2020 that gives the Government new powers to deal with the coronavirus outbreak. Areas covered by the new law include social care, the NHS, schools, police, local councils, courts and funerals. The Act is in place for two years.

    See also:

  • Corporate parent

    An organisation such as a council that is responsible for children who have been taken into care. The council takes on the responsibility of a child’s parent, and is expected to do many of the things a good parent would, such as providing a stable place to live, ensuring a child has a good education and helping them prepare for adult life.

  • Cost-effectiveness

    A comparison of how much something costs in relation to how much benefit you get from it. Looking at cost-effectiveness can help you decide what to spend money on. Councils and other organisations do the same thing.

    See also:

  • Counsellor

    Someone who is trained to listen and help you think through particular problems or issues and how you feel about them.

  • Court of Protection

    An English court that makes decisions about the property, finances, health and welfare of people who lack mental capacity to make decisions for themselves. The court can appoint a 'deputy' to make ongoing decisions on behalf of someone who lacks capacity. It is also able to grant power of attorney.

  • Covert spread

    When a disease such as coronavirus is spread by people who may be infected but show no signs and feel well.

  • Covid 19

    The formal name given to the current outbreak of coronavirus. It is an infectious illness that may be mild or severe that is caused by a coronavirus. It usually causes a fever, cough and shortness of breath, and may progress to pneumonia and respiratory failure. The word comes from coronavirus plus disease, and the 19 refers to 2019, the year the disease was first identified in China.

    Download the Covid 19 explainer

  • Crisis care planning

    A plan for where and how you can get support in a crisis, if you have mental health problems. A mental health crisis is when you no longer feel able to cope or be in control of your situation. The aim of the plan is to keep you safe, help you recover from the crisis, and avoid having to stay in hospital.

  • Crisis intervention

    A way of helping people cope at a time of crisis when they are overwhelmed, and enabling them to remain in their home. It is used with people who have mental health problems, and with families who are facing challenges.

  • Cross-border placement

    When your local council finds a place for you in a care home in another council area. This may be because you have requested it, in order to be nearer your family or friends, or because there is no suitable place available in a care home in your home area. You should be involved in any decision to move to a new area, and it cannot happen without your agreement. If you move, your council should let the other council know that you are there, and they should agree which council is responsible for your care.


  • Daily living costs

    An amount you have to pay to cover things like rent, food and bills if you live in a care home.

  • Day services

    Opportunities to do things during the day, while living in your own home. These may include social activities, education, or the opportunity to learn new skills. What your local council offers will vary, depending on what you need and what is available in your area. You may have to pay something towards the cost.

  • Debt recovery

    The law allows councils to claim back money from you for care and support you have received, if you have had a financial assessment and can afford to contribute and have not paid. If you live in a care home or extra-care housing, your council should offer you a deferred payment arrangement before starting debt recovery. Debt recovery should be a last resort, and councils should always consider people’s individual circumstances.

  • Decommissioning

    Removing or replacing a service. In the case of a local service that provides care or support, the council as commissioner may stop using it or paying for it. This may mean the service will close.

  • Deferred payments

    If you need residential care, the council will assess what you need and whether you can afford to pay for a care home. You may only be able to pay care home fees if you sell your house. If this is the case, the council may help pay the fees while you wait for your house to be sold. You would still have to pay as much as you can during this time, based on your income or available capital. Once the house is sold, you would then have to repay the council. In certain circumstances councils will have to offer this scheme to people. Broadly this is when someone has limited savings other than the value of their property.

  • Deficit model

    A traditional approach to assessing your needs that looks primarily at what you are unable to do and what your weaknesses are. It should no longer be used, as it is the opposite of an asset-based approach and the reverse of personalisation, where you have control over your life.

    See also:

  • Degenerative condition

    An illness that gets worse over time.

  • Delayed discharge

    When you are well enough to leave hospital after an illness or accident, but you have to stay there while the care you need in your own home or in another place is arranged.

  • Delayed transfer of care (DTOC)

    Similar to delayed discharge. When you are ready to move from hospital to another type of care, but the care you need is not available, meaning that you spend longer in hospital than medically necessary.

    See also:

  • Dementia advisor

    Someone who knows a lot about dementia and supports you if you, or someone you are close to, has been diagnosed with dementia. The advisor will listen to your questions and concerns, and offer signposting to services that might help you.

  • Dementia-friendly community

    A city, town or village where people are aware of dementia and understand it, and people with dementia are respected, supported and included in their community. It is led by local people, who work to remove the barriers that stop people with dementia taking part in community life. The Alzheimer’s Society has a recognition scheme for dementia-friendly communities.

  • Deprivation of assets

    When you deliberately reduce the amount of savings or property you have, in order to qualify for help from your council with paying for care costs or for various benefits. Your council may judge that you have deliberately reduced your assets if it believes that you knew you would probably need care and support.

  • Deprivation of Liberty Safeguards

    Legal protection for people in hospitals or care homes who are unable to make decisions about their own care and support, property or finances. People with mental health conditions, including dementia, may not be allowed to make decisions for themselves, if this is deemed to be in their best interests. The safeguards exist to make sure that people do not lose the right to make their own decisions for the wrong reasons.

  • Deputy [in the legal context of making decisions]

    Someone appointed by the Court of Protection to make decisions on your behalf if you lack capacity to make those decisisons yourself and have not already given someone power of attorney. A deputy can be appointed to make decisions about your property and financial affairs, or about your health and welfare, or both. Deputies may be famly members or friends, or they may be a professional person such as a solicitor. 

  • Developmental disability

    A type of disability that affects the development of a person's brain, causing them difficulties throughout their life with things like speaking, moving, learning and living independently.

  • Diagnostic overshadowing

    When you have a particular health condition or disability and professionals use this as an explanation for all health problems or symptoms you have. It often affects people with an existing learning disability or mental health condition, and can mean that illnesses are missed or not treated properly.

  • Diagnostic pathway

    The tests and assessments that are carried out by health professionals to help them decide if you have a specific condition or illness.

  • Diagnostic tool

    A test to help a health professional identify a condition or disease. It may be a medical test, or may be a set of questions about what you are experiencing.

  • Dignity

    Being worthy of respect as a human being and being treated as if you matter. You should be treated with dignity by everyone involved in your care and support. If dignity is not part of the care and support you receive, you may feel uncomfortable, embarrassed and unable to make decisions for yourself. Dignity applies equally to everyone, regardless of whether they have capacity.

  • Dignity in Care

    A national campaign to put dignity and respect at the centre of care services in the UK.

  • Direct enhanced service (DES)

    An additional service provided by your GP, beyond what they would normally provide, to meet a particular need – such as working out which of their patients may be at risk of an unplanned hospital stay, and finding ways to avoid this happening. GP practices are paid extra for these services, and can choose whether to provide them.

  • Direct payments

    Money that is paid to you (or someone acting on your behalf) on a regular basis by your local council so you can arrange your own support, instead of receiving social care services arranged by the council. Direct payments are available to people who have been assessed as being eligible for council-funded social care. They are not yet available for residential care. This is one type of personal budget.

    See also:

  • Disability-related expenses (DRE)

    Money that you have to spend on things because of your disability, that you would not have to spend otherwise. This may be for things like extra laundry, high heating bills or special clothes. The law says that your council should look at these expenses when it does a financial assessment, to work out how much you can reasonably afford to pay for chargeable services.

  • Disabled Facilities Grant (DFG)

    A grant you might be able to get from your local council in order to make changes to your home because you have a disability. Changes include things like widening doors, adding ramps or installing a downstairs bathroom. If the person with a disability is an adult, your household income and savings will be looked at, and you may need to pay towards the cost of the work. If the person is under 18, the family can get a grant without the parents' income being taken into account. If you want to apply for a DFG, you should contact your local council. This applies to England, Wales and Northern Ireland, but not Scotland.

  • Discharge planning

    If you go into hospital, this is the process of planning when you will leave, where you will go, what you are likely to need once you are out of hospital, and how your needs will be met. You should expect discharge planning to begin as soon as you go into hospital. You should also expect to be part of these discussions and to know what is happening.

  • Discharge summary

    A report or letter that is sent to your GP when you have stayed in hospital, so that your GP knows what has happened and what you need. You should also be given a copy. The report should explain why you were in hospital, what treatment you received, the results of any tests that were done, what changes may have been made to your medicines, and any follow-up care that is needed.

    See also:

  • Discharge to assess (D2A)

    If you are ready to leave hospital but still need some care and support, you may be able to go home with care provided in your home for a short period while discussions take place about the care and support you may need in the longer term. This means you can continue your recovery at home, rather than having to stay in hospital while your future support is worked out. It also means that your needs can be assessed in your own home, where you may be able to do things for yourself differently than in hospital.

  • Disclosure & Barring Service (DBS)

    A government organisation that checks people's criminal records, in order to prevent unsuitable people from working with children or adults who may be at risk of harm or abuse.

    See also:

  • Discretion

    When there is no fixed rule about what should be done in a particular situation, and a person or organisation making a decision has freedom to use their own judgement. For example, your local council has discretion over whether to charge for some services.


  • Discretionary services

    Services that your council may offer that it doesn't have to provide by law. These are also known as 'non-statutory services'. (Services that the law says councils have to provide are called 'statutory services'.) Examples of discretionary services include leisure centres, libraries and lunch clubs.

  • Discrimination

    Treating a person, or a group of people, differently to other people because of their sex, age, race or other things. It usually means treating the person unfairly and not offering them the same opportunities as other people.

  • Disengagement

    When someone avoids contact with care services, either intentionally or unintentionally, and misses appointments and other things that may have been planned.

  • Disposable income allowance

    The amount of your income that you can keep each week, if you have a deferred payment agreement with your local council. In this situation, the council pays for your care, while you keep your house, with the plan that you will pay the council back eventually when the house is sold. In the meantime, you must use most of your income from your pension or benefits to contribute to the cost of your care, but you can keep a certain amount (currently £144 per week) to pay for the costs of looking after the house you own.

    See also:

  • Disproportionate

    When something is too large or too small in relation to something else. Councils may describe the cost of providing a particular service as ‘disproportionate’ in relation to the overall amount of money that is available.

  • Diversity

    Recognising and respecting people's differences in race, gender, sexual orientation, age, physical abilities, religious beliefs, and other things. Valuing and including people from different backgrounds, and helping everyone contribute to the community.

  • Domains

    Specific areas where you may need particular help, such as moving around, eating or breathing. If you have a continuing health care assessment, these are the areas that are looked at and measured. ‘Domains’ can also refer to particular areas of care that are looked at by the Care Quality Commission.

  • Dual diagnosis

    A combination of severe illness and problematic drug or alcohol use. These two things are closely linked for many people. People with a dual diagnosis often have serious physical, social and psychological problems.

  • Duties

    In relation to a public organisation such as your local council, duties are things that the law tells the organisation it must do. (Services that the council has a duty to arrange or provider are known as 'mandatory' services.) With regard to care and support, your council has a duty to assess your needs, arrange care and support if you are entitled to it, and provide you with information about what care and support is available.

  • Duty of candour

    When something goes wrong with the health or social care that is provided to you, the organisation that provides the care has a legal duty to be open with you, to explain what has happened and to apologise to you.


  • Early discharge planning

    Making sure people do not stay in hospital any longer than they need to by beginning to plan what will happen when they leave hospital as soon as they go in, or even before. Hospitals and community services should work together, and should tell you within your first two days in hospital, if possible, when you are likely to go home.

  • Early intervention

    Action that is taken at an early stage to prevent problems worsening at a later stage. It may apply to children and young people, or to help that is offered to older people or people with disabilities to enable them to stay well and remain independent. See also preventive services.

  • Education, Health & Care (EHC) plan

    A legal document for a child or young person up to the age of 25 if they have a disability or special educational needs (SEN). It describes the child or young person's particular educational, health and social needs, and sets out the support and extra help they should have to meet those needs, and how this will support them to achieve what they want in their life. EHC plans replaced SEN statements on 1 September 2014. Children who currently have a SEN statement are being gradually transferred to a EHC plan. EHC plans are developed by the child or young person's local council, which is responsible for carrying out an education, health and care needs assessment and deciding whether a EHC plan is needed.

  • Eligibility

    When your needs fit the criteria that allow you to receive a service.

  • Eligible care and support needs

    The needs you have for care and support that your council is required by law to meet. Under the Care Act 2014, councils no longer decide for themselves what type of needs they will meet, and now have to follow the new national minimum eligibility threshold. You are likely to have 'eligible needs' if you need a lot of help to do things like washing yourself, getting dressed, getting in and out of bed, and keeping your home safe.

  • Enablement

    A way of helping you to become more independent by gaining the ability to move around and do everyday tasks for yourself. You may be offered an enablement service if you have lost some daily living skills because of poor health, disability or a hospital stay. It usually lasts for around six weeks, takes place in your own home, and you won't have to pay.

  • Enforceability

    When something such as a rule or a law can be made to happen the way that it says it will, because there is something in place to check and insist on it.

  • Enforcement action

    Action that can be taken to make sure that organisations such as care providers do what the law says they should. A regulator such as the Care Quality Commission can issue warnings to services that are not up to standard, make them pay a fine, or ultimately close them down if they do not improve.

  • Enhancing health in care homes

    A way of providing better care to people who live in care homes, to help reduce unnecessary trips to hospital and help people leave hospital sooner. It means GPs, community nurses, care homes and local councils all working more closely together in a coordinated way.

  • Entitlement

    Having a right to do or receive something.

  • Epidemic

    A number of outbreaks of a disease in a number of different areas at the same time.

    See also:

  • Episode of care

    The time you spend receiving one particular type of care for a specific condition. For example, a stay in a respite unit or in hospital as an inpatient may count as a single episode of care

  • Equality impact assessment

    A process of considering the effect a new policy or project will have on all groups of people, and making sure that no-one is left out or worse off. The aim is to see whether changes to the way things are done will have a good or bad result for people from particular groups, such as disabled people, older people and people from ethnic minority groups.

  • Equity release

    A financial plan offered by private lenders if you own your own home. It allows you to release some money from the value of your home to pay for care and support, or for other things. This is then paid back to the lender after your death or when you move permanently into a care home. You should always get independent expert advice before taking out a plan like this.

  • Ethical framework for adult social care

    Guidance for councils on how they should plan their response to coronavirus in their local area for people who need social care and support.

  • Evaluation

    A judgement about how well something works or how well it does what it is supposed to do, based on a set of clear statements about what it should be like.

  • Evidence-based practice

    When doctors or other care professionals use the best available evidence about what works most effectively, including evidence from people who have lived with a particular health condition, when deciding what treatment, care or support to offer you as an individual.

  • Exchange model

    A form of assessment that is based on a two-way discussion of what your needs are and how they could be met. This approach recognises you as an expert in your own needs, and expects you will work in partnership with a social worker who can help you find solutions.

    See also:

  • Expert Patients Programme (EPP)

    A programme of weekly classes to help you manage your own health and live as well as possible with a long-term condition. EPP courses take place across the country and cover all types of health conditions. More information is available from the organisation Self Management UK.

  • Extra-care housing

    Similar to sheltered housing, but with additional care and support available for people with illnesses or disabilities who wish to have a home of their own. Extra-care housing may be an option if living alone at home is difficult, but you do not wish to opt for residential care. It allows you to have your own home, either rented or bought, with personal care and domestic help readily available.

    See also:


  • Fairer charging

    Guidance to councils from the Government on how much they should charge you for things like home care and day services (but not a care home). You should not be charged more than is 'reasonable' for you to pay, or more than it costs to provide the service.

  • Family group conference

    When family members are invited to get together to make a plan to support and protect a child or adult who is at risk of abuse or neglect. Families can choose whether or not they wish to take part in this process, and are helped by an independent person. The aim is to make it possible for families to problem-solve, and to avoid blaming anyone.

    See also:

  • Family model

    Supporting an individual, such as a parent who has a mental health problem, by considering not just that person’s needs, but the needs of their family as a whole.

  • Fast-track pathway

    If a person is near the end of their life or their condition is getting worse quickly, they can receive a faster than usual assessment for continuing health care. This can help NHS funding for their care to be put in place as quickly as possible, usually within 48 hours.

  • Fettering of discretion

    When an individual or organisation that is allowed to use their judgement to make a decision – because there is no fixed rule about what they should do – expresses an opinion on one side or the other before the decision is made. There cannot be a blanket rule about something that applies to everyone. If someone has ‘fettered their discretion’, they have decided the outcome before considering all the facts of the case.

  • Financial assessment

    A discussion that your council may have with you to work out how much you can afford to pay towards the care and support you need. It involves looking at your income, savings and individual circumstances. This will take place after an assessment of your care and support needs.

  • First contact

    The first time you get in touch with the care system through your local council and begin the process of assessment.

  • Five Year Forward View (5YFV)

    A five-year plan for the future of the NHS that was published in 2014. It sets out how the NHS needs to do things differently to improve people’s health and manage within the funds that are available. The aim is to find new ways of providing care and make better use of money.

  • Flattening the curve

    A way of slowing the rate at which people become infected with coronavirus, to avoid everyone becoming ill at the same time and to allow the health service to cope. It does not necessarily mean reducing the number of cases of the disease overall, and may mean that the outbreak lasts longer.

  • Fluctuating needs

    Care and support needs that change over time, or that vary from day to day. The Care Act 2014 says that councils should ask, as part of your assessment, how your needs vary, and should look at you over a long enough period of time to get a complete picture of your needs. If you have fluctuating needs, your care plan or support plan should say what you want to happen if you have a sudden change or an emergency.

  • Forensic services

    Services for people with a mental disorder who may be a risk to others, or who have been involved in the criminal justice system. Services may be provided in a secure hospital or in the community.

  • Formal patient

    Someone who is held in a mental health ward in hospital and is not allowed to leave - by law - for their own safety or the safety of others. This is sometimes described as being 'sectioned'.

    See also:

  • Frailty

    A condition that may develop as you get older and your body becomes less able to recover from illness or injury. It makes you more likely to become ill and to spend time in hospital. It is not an illness in itself, and is not the same as physical disability, although disability and frailty may overlap with each other.

  • Functional ability

    What you are able to do for yourself, and how well you are able to manage everyday tasks such as dressing yourself, preparing food and looking after your home. Your ability to do these things, and also to work, might change as a result of illness or disability. Professionals have various ways of measuring your functional ability and working out how much help and support you need.

  • Functional assessment

    When a care professional looks at what you are able to do for yourself, and how well you are able to manage everyday tasks such as dressing yourself, preparing food and looking after your home. They will look at how your ability to do these things might have changed as a result of illness or disability.

  • Furlough

    A temporary absence from work, when workers keep their job but are not working while the coronavirus outbreak continues.

    It is intended to be a temporary arrangement and workers will return to their jobs, but there is no guarantee that employers will keep everyone on when furlough ends.


  • Gap analysis

    The process of looking at what exists and what is needed. This can apply to looking at what services are needed for people in a particular area, comparing it with what already exists, and seeing where the gaps are. This enables commissioners to plan for the future.

  • Gateway worker

    A mental health worker such as a nurse, social worker, occupational therapist or psychologist, who can help you with problems such as mild depression, anxiety or stress. Gateway workers work closely with GPs and can give you information and advice about support services in your area that may be helpful for you. You may see a gateway worker at your GP surgery or in your own home.


  • Hand-off

    The process of handing over information and responsibility for a person’s care from one health or care professional to another.


  • Handyperson service

    A local service that offers help with small, practical jobs in your home, to make your life easier and your home safer. It includes jobs like putting up curtain rails, replacing light bulbs or fitting smoke alarms. It is not an emergency service. It may be run by the council, a charity or a private company, and you are likely to have to pay something towards it.

  • Health Action Plan

    A personal plan for young people and adults with a learning disability about how to stay healthy and what help and support they may need to look after their health.

  • Health and Wellbeing Board

    Every council area in England has a Health and Wellbeing Board to bring together local GPs, councillors and managers from the NHS and the council. Their job is to plan how to improve people's health and make health and social care services better in their area. Members of the public have the chance to be involved in the work of their local Health and Wellbeing Board through your local Healthwatch.

  • Health inequalities

    Differences in how healthy different groups of people are, and how easily they are able to get the health care they need. These differences may be affected by things like poverty, housing and education.

  • Healthwatch England

    A national organisation that represents people who use health and care services in England. It is independent, and exists to gather and represent the views of the public, but does not have the power to change how things are done. It reports problems and concerns to the Care Quality Commission, which has the power to make changes. There is a local Healthwatch in every council area.

  • Herd immunity

    When the majority of people in a population are protected against a disease, either because they have already had it or because they have been vaccinated against it.

  • High impact change model

    A way of helping people get home from hospital sooner by getting health and care organisations to look at how well they work in a local area, and how they could make changes.

  • Holistic care

    Care and support that treats you as a whole person and considers all your needs at the same time - physical, psychological, social and spiritual.

  • Home care

    Care provided in your own home by paid care workers to help you with your daily life. It is also known as domiciliary care. Home care workers are usually employed by an independent agency, and the service may be arranged by your local council or by you (or someone acting on your behalf).

  • Home First

    A service offered in some areas when you are well enough to leave hospital, but still need some support. The planning for your future support takes place in your own home rather than in hospital: an assessment of your needs is carried out in your own home on the same day as you leave hospital. This service may also be used to help you avoid going into hospital, by providing the care and support you need at home.


  • Homeshare

    An arrangement where someone who needs some help to live independently in their own home (the householder) is matched with someone who needs a place to live in return for the help they can provide (the homesharer). Homesharers help around the house and provide company, but do not provide personal care. There are homeshare organisations in a number of areas to match up householders and homesharers.

  • Horizon scanning

    A way that organisations plan for the future by looking ahead at how an area might change, what people's needs are likely to be, and which services are likely to be available and which will need to be developed.

  • Hospital at home

    Health treatment that you get in your own home that you would otherwise receive in hospital. It is usually provided by experienced nurses, for a limited period, and can help you avoid going into hospital or allow you to come home from hospital sooner.

    See also:

  • Hospital passport

    A way of helping someone with communication difficulties or learning disabilities communicate what they need when they are in hospital. It is a document that provides information for hospital staff about the person, including their likes and dislikes, interests, and other things. Many hospitals have their own version for you to fill in if you have a hospital stay coming up.

  • Household model of care

    A way of organising a care home so that it feels more like a private home than an institution, with small groups of residents living together in separate sections of the home. The aim is that residents should feel like they are living in a homely environment.

    See also:


  • 'I' statements

    What good care and support looks like from your perspective, with your feelings, beliefs and experiences expressed as a statement that begins with the word 'I'. For example: 'I am in control of planning my care and support.'

    See also:

  • Immediate needs annuity

    A way of paying for the long-term care you need in your own home or in a care home. You make an upfront lump sum payment to an insurance company, and then you get a regular income, which is guaranteed for your lifetime to pay your care costs. You will need a medical assessment to confirm that you need care. There are many companies selling annuities, and independent information on the different options can be found at .

  • Impairment

    A physical or mental problem, caused by an injury, illness or condition you were born with.

  • Implied consent

    When you are not specifically asked if you agree to something being done to you, but you behave as if you understand and agree. For example, putting your arm out when a nurse or doctor comes to take a blood sample suggests 'implied consent' on your part. Implied consent also applies if you are unconscious in an emergency. Medical staff may assume that you would agree to treatment if it is necessary to save your life.

  • Improving Access to Psychological Therapies (IAPT)

    A programme to help people with mental health problems such as depression or anxiety get a limited number of sessions of ‘talking therapies’ through the NHS. You can refer yourself to this programme online, or a professional can refer you.

  • Inappropriate care

    Care that is not best for you and does not meet your particular needs, that is not in a place where you need or choose to be.

  • Inclusion

    Meeting the needs of everyone in a community by taking action to create an environment where everyone feels comfortable, respected and able to achieve their potential. It means treating people as equals and removing barriers that may stop them participating in an event or activity.

  • Incubation period

    The time before a person shows signs that they are ill, after being infected with a disease.

  • Independent living

    The right to choose the way you live your life. It does not necessarily mean living by yourself or doing everything for yourself. It means the right to receive the assistance and support you need so you can participate in your community and live the life you want.

  • Independent Mental Capacity Advocate (IMCA)

    An independent person who is knowledgeable about the Mental Capacity Act and people's rights. An IMCA represents someone who does not have capacity to consent to specific decisions, such as whether they should move to a new home or agree to medical treatment. The law says that people over the age of 16 have the right to receive support from an IMCA, if they lack capacity and have no-one else to support or represent them.

  • Independent Mental Health Advocacy (IMHA)

    A service that should be offered to you if you are being treated in hospital or somewhere else under the Mental Health Act. Independent Mental Health Advocates are there to help you understand your legal rights, and to help make your views heard. This is not the same as Independent Mental Capacity Advocacy (IMCA), which is for people who are unable to make certain decisions and have no one to support or represent them. But there may be times when someone needs both an IMHA and an IMCA.

  • Independent review panel

    A panel that you can appeal to if you have been told that the NHS will not fund your continuing health care, and you think the wrong decision has been made. If your local clinical commissioning group decides you are not eligible for continuing health care, you can request a review by the independent review panel. The panel is made up of people from outside your immediate area who have not looked at your case before and can investigate why the decision was made and whether it is right or wrong.

  • Independent sector

    Organisations that are independent of the NHS, councils and other publicly-run bodies. Independent sector organisations may be voluntary and non-profit-making, or they may be private organisations that exist to make a profit. The majority of care and support services are provided by the independent sector (even if they are funded by your local council). Some health services are also provided by the independent sector, with NHS funding, so that they are free for you when you use them.

  • Independent supporter

    A trained person who provides advice and support, independent of the local council, to parents whose child is being assessed for an Education, Health and Care plan. Independent supporters often work for a charity. They can explain the process, help you to work out how the Local Offer can help, and ensure you have all the information you need.

  • Independent User Trust (IUT) See also Personal budget

    If you have a personal budget and do not want to manage the money yourself, you can set up a trust to receive the money for you and use it to pay for the care and support you choose. An independent user trust is run by independent individuals acting as trustees, who should be people who know you and know what is important to you.

  • Indicative personal budget

    An approximate guide to how much money you may receive in your personal budget to help meet your care and support needs. It is estimated by the council using the Resource Allocation System, following their assessment of your needs and your finances. It is not an exact figure: the final amount is agreed later, based on the actual cost of the support you need, as set out in your support plan.

  • Individual Service Fund (ISF)

    If you want to use your personal budget from the council to pay for support (such as home care) from a particular provider, the money can be held by that provider in an Individual Service Fund. You remain in control of what the money is spent on, but you don't have the responsibility of managing the budget yourself.

  • Informal patient

    Someone who is in a mental health ward in hospital who is there by choice and can leave if they wish. This is different to a formal patient, who does not have the freedom to leave.

    See also:

  • Information transfer

    The process of transferring information about your care so that everyone understands what your needs are. This may be between professionals such as doctors and social workers, between settings such as a hospital and care home as you move from one to the other, or between shifts of staff in a hospital or care home.

  • Informed consent

    When you have received the right information to enable you to decide whether to allow someone to do something to you or for you. You should only give consent if you understand what you are being asked to agree to, what the benefits and risks might be, and what the alternatives are if you do not agree. See also capacity to consent.
  • Innovation

    Doing something in a new way, with the aim of doing it better.

  • Institutional abuse

    Harm that is caused to people by poor care or support provided by an organisation, caused not just by the actions of individuals but by the way the organisation works (such as their routines or structures). It can happen in care homes, hospitals, schools and other places.

    See also:

  • Institutional discrimination

    When people are treated differently because of things like their age, race or disability, because of the way an organisation works rather than because of the way that individual people behave, and when an organisation’s routines and procedures become more important than individual people’s needs.

    See also:

  • Integrated Care

    Joined up, coordinated health and social care that is planned and organised around the needs and preferences of the individual, their carer and family. This may also involve integration with other services for example housing.
  • Integrated care logic model

    A description of what it looks like in an area when health and social care work together for people. The model explains what needs to happen, what the outcomes will be for people, and what the wider benefits are.

    See also:

  • Integrated care provider

    An organisation that brings together different health and care services in a single system in a specific local area.

  • Integrated care system

    An organisation that brings together different health and care services – such as a hospital, a clinical commissioning group, a council, an ambulance service, local GPs, local mental health services and other things in a specific local area. The aim is to work together to make better use of public money and provide better care for people who live in the area.

    Formerly known as 'accountable care organisations'.

  • Integrated personal budget

    A single personal budget that covers the health and social care services you may need. It is being introduced gradually, and is currently only available in some areas. Also known as a 'joint personal budget', it means you have a single care plan, control of the money needed to fund your care and support, and can make decisions about how this money is spent to best meet your needs.

  • Integrated Personal Commissioning

    A programme that is available in some areas that combines health and social care funding for you as an individual, if you have complex needs. It allows you to decide and plan for yourself how the money should be spent to meet your needs, keep you well and avoid a crisis.

    See also:

  • Inter-agency

    Where more than one organisation is working together on something.

  • Interim provision

    Care arrangements that are made while you are waiting for a permanent arrangement to be put in place.

  • Intermediate care

    A wide range of services aimed at keeping you at home rather than in hospital, or helping you to come home early from hospital after illness or injury. It is normally made up of a specific programme of care for a fixed period of time, usually up to six weeks, and is free of charge. 

    See also:

  • Intervention

    Action of some kind where someone gets involved to improve a situation or prevent it getting worse.


  • Joint assessment

    There are two possible meanings to the term 'joint assessment': having the needs of the person who cares for you assessed at the same time as your own needs, or having an assessment carried out by more than one type of care professional at the same time.

    See also:

  • Joint commissioning

    When two or more organisations in a local area - usually the NHS and local council - work together to plan services to meet the needs of people who live in the area. Together the commissioners plan what kind of services should be available, who should provide them and how they should be paid for.

    See also:

  • Joint package of care

    A range of personalised services provided to you by both the NHS and your local council, following an assessment of your needs. You may be given a joint package if you have health needs as well as social care needs, but not if your main need is for health care. If your main need is for health care, this is known as a ‘primary health need’ and you may be entitled to ‘continuing health care’.

  • Joint strategic needs assessment

    The process of identifying the future health, care and wellbeing needs of the population in a particular area, and planning services to help meet those needs. This process is led by your council, working with the NHS and private and voluntary organisations in your area.

    See also:

  • Judicial review

    A type of court case in which a judge looks at whether a decision made by a public body such as a local council has been made in the right way, and whether they had the right to make it. It does not rule on whether the right decision has been made, but whether the right process has been followed. You can talk to a solicitor about applying for judicial review if you believe that an organisation has not followed the law in making a decision about something that affects you.



  • Key lines of enquiry (KLOE)

    This is a term used by the Care Quality Commission to describe the questions it asks when it inspects care homes and other services, to decide how good these services are: Are they safe? Are they effective? Are they caring? Do they meet people’s needs? Are they well run?

  • Key worker

    A person who acts as a single point of contact for you, helps coordinate your care and can give you information and advice.

    See also:

  • Kinship care

    When family or friends care for a child on a full-time basis if their parents are unable to do so. This may be for a short period or permanently.


  • Lead professional

    A central person involved in providing and coordinating your care, and a single point of contact for you.

    See also:

  • Learning difficulty

    A term that refers to the difficulty someone may have with learning and processing new information, such as difficulties with reading, spelling or maths. It is different to a learning disability because the person's underlying intelligence is not affected. The two terms are sometimes used interchangeably, but the distinction between them lies in whether a person's intelligence is impaired. 

  • Learning Disabilities Mortality Review Programme (LeDeR)

    A national research programme looking at why people with learning disabilities often die at a younger age than other people. LeDeR reports to NHS England on the main causes of these deaths and on how they could be prevented.

  • Learning disability

    A term that is used to describe a brain impairment that may make it difficult for someone to communicate, to understand new or complex information, or to learn new skills. The person may need help to manage everyday tasks or live independently. Learning disability starts in childhood and has a lasting effect on a person's development. It can affect people mildly or severely.

  • Least restrictive option

    When this term is used in relation to the Mental Capacity Act, it means that if you are making decisions on behalf of someone who does not have capacity to make decisions for themselves, you should make sure that you don’t restrict their rights or freedoms any more than necessary.

  • Legal mortgage charge

    If you have a deferred payment agreement and the council is paying your care home fees until your home is sold, the ‘legal mortgage charge’ is the amount that must be repaid to the council when the sale takes place.

    See also:

  • Liability

    When someone is legally responsible for something and can be forced to take responsibility.

  • Light touch assessment

    If you need care and support that the council charges for, you may not need the usual detailed financial assessment of your income, savings and assets if you can provide evidence that you can afford to pay for the care and support you need. You can request this type of light touch assessment if you wish. 


  • Lived experience

    The knowledge and understanding you gain when you have lived through something or experienced it for yourself.

  • Local area coordination

    An approach that is being used by some councils to help people live better, less isolated lives in their home area. Local area coordinators help people make the most of what is available locally, and make sure that communities are supportive and welcoming to older people and people with disabilities, mental health problems or other needs.

  • Local offer

    This relates to services for children and young people up to the age of 25 who have special educational needs or a disability. All councils are required to publish a local offer that sets out in a single place what services are available in their area, so that parents and carers can see what exists and how to access it.

  • Localism

    When power to make decisions, and to spend money, is transferred from central government to local organisations such as councils. The aim is to make decisions close to the people who will be affected by them, and to ask for people’s views.

  • Locality commissioning

    When a group of organisations in a local area come together to combine their funds and create a single process to plan and pay for the services that are needed in that area.

    See also:

  • Lockdown

    When people are told by the Government not to leave their homes without an essential reason. Essential reasons include buying food or picking up medicine, seeing a doctor, taking brief exercise once a day close to home, or helping someone who is vulnerable. This may be enforced by the police or armed forces.

  • Long-term condition

    An illness or health condition that you live with, that cannot be cured but can usually be managed with medicines or other treatments. Examples include asthma, diabetes, arthritis, epilepsy and other things.

  • Looked-after child

    A child who is in the care of the local council rather than their parents, either because the child is at risk of harm or because the parents are struggling and have asked the council to be involved. Looked-after children may live away from their parents or family in foster care or in a children’s home, or they may remain in their own home supervised by a social worker. The council takes on the responsibilities of a parent.


  • Mainstream services

    Services that are open to everyone. These are the opposite of specialist services, which are designed for people with specific needs. They include education, employment, housing and health services.

  • Maladministration

    When the actions of a public body such as a local council cause injustice. You can ask the Ombudsman to investigate if you believe that an organisation has failed in this way. There is no exact legal definition of ‘maladministration’, but examples include an organisation failing to act in the way it should, giving out misleading information, or not doing what it said it would.

    See also:

  • Managed budget

    When your council allocates an amount of money to you as a personal budget, you can take this either as cash through a direct payment or as a managed budget (also known as a virtual budget). If you take it as a managed budget, the council manages the money for you to arrange the services you choose, and you aren't responsible for paying directly for the services you receive.

  • Manual handling

    When you move or lift someone or something that is heavy and may cause you physical strain. You may need training in the best techniques for moving or lifting someone you are caring for. Your council may provide you with equipment to help make lifting someone easier.

  • Mapping

    Part of the process of planning services in a particular area and looking at what already exists, what is needed, and where.

    See also:

  • Market facilitation

    The process by which councils make sure that there is a variety of care and support services in their area to meet all the different needs of everyone who lives in the area. Councils need to have a good understanding of what people need, where the service providers are, and where the gaps are.

  • Market management

    When a commissioner such as a council controls which care and support services are available in their area, through the choices they make about who they place contracts with.

  • Market oversight

    The job of overseeing the finances of certain adult social care providers in a particular area that are considered to be hard to replace if they stopped existing. This is to help protect people who use care services, and help councils make sure that care continues to be available to people who need it. This role is carried out by the Care Quality Commission.

  • Market position statement (MPS)

    A description of what care and support services are available in a particular area, what services will be needed in the future, and what the commissioner will do to make sure that the services people need are available (regardless of who funds them). Every council has to produce a MPS, which should contain detailed information on what is needed in the area and what the council's plans are.

  • Market shaping

    The way in which a council looks at what people's care and support needs are in the local area, considers what care and support services are available in that area, and works out where the gaps are and how they can be filled. The aim is to make sure that people can find care and support that meets their needs, and that a variety of options are available to suit people's individual circumstances and preferences.

  • Meaningful engagement

    Where you have the right, opportunity and support to express your own views to professionals, say what you need and make your own decisions.

  • Means-tested contribution

    If the council assesses your needs and finds you are entitled to care and support, it will then carry out a financial assessment. This is to work out how much you can afford to pay for the services you receive. The amount you pay is your means-tested contribution, based on how much money you have.

  • Mechanical restraint

    Using some kind of equipment to prevent a person moving their body freely, in order to prevent their actions hurting themselves or someone else.

  • Mediation

    A way of solving disputes or disagreements without going to court. It involves meeting with the person you have a disagreement with, alongside a mediator who is a trained, independent person. The aim is to find something you can agree on. Mediation can take place between family members, or between an individual or family and a care professional.

  • Medical device

    An object - not a drug - that is used to diagnose, prevent or treat illness or look after your health. There are many kinds of medical device, from the simple to the highly complex. A thermometer, an implant, an artificial limb and a wheelchair are all examples of medical devices.

  • Mental Capacity Act

    A law that is designed to protect people who are unable to make decisions about their own care and support, property or finances, because of a mental health condition, learning disability, brain injury or illness. 'Mental capacity' is the ability to make decisions for yourself. The law says that people may lose the right to make decisions if this is in their best interests. Deprivation of Liberty Safeguards are included in the law, to make sure that people are treated fairly.

  • Mental health problems

    Problems with the way you think, feel and react, which affect your ability to  cope with life, make choices and relate to other people. There are many different types of mental health problems, including depression, anxiety, eating problems, and other things. These may be treated in a variety of different ways, and may last a long or short time.

  • Micro-commissioner

    An individual who commissions their own care and support through personalisation and direct payments or a personal budget.

  • Minimal discharge

    If you come out of hospital and go home to the place where you normally live without needing ongoing care and support. It is not like complex discharge, where care continues to be needed.

  • Minimum income guarantee

    A way of keeping some of your income when you have to pay for all or some of the care you receive in your own home. When the council carries out a financial assessment, it must make sure that your care costs do not cause your income to fall below a certain level. There is a different arrangement if you live in a care home, where you will have a personal expenses allowance.

  • Mixed budget

    If you want to arrange and manage some of your personal budget yourself, and want the council to arrange the rest, you may have the option of a mixed budget.

  • Model of care

    A way of providing care based on a set of beliefs and principles about what is right and works best. There are various different ways of providing care, and each organisation will decide which model to use.

  • Monitor

    An organisation set up by the Government to make sure that NHS foundation trusts in England (NHS bodies that have been given greater independence) are run well. It sets the prices that hospitals are allowed to charge commissioners and works closely with the Care Quality Commission. It does not have the power to investigate complaints about an individual person's treatment or care.
  • Monitoring officer

    A senior person at a local council who is responsible for making sure that everything the council does, or proposes to do, is legal. The law says that every council must have a monitoring officer. If you think that something your council is doing is against the law, you can contact the monitoring officer. Your council’s legal department will be able to tell you who this person is and how to contact them.

  • Morbidity

    A state of poor health, due to a specific illness. 'Co-morbidity' refers to several different types of illness that you may have at once.

    See also:

  • Mortality rate

    The number of people who have died of a disease in relation to the number of people who get the disease, and in relation to the population as a whole.

  • Multi-agency discharge event (MADE)

    An event that lasts for one or more days, when a team of senior professionals from a hospital, community services and the local council look at how people who are staying in hospital can be supported to go home. They visit people on hospital wards, with a particular focus on individuals who have been in hospital for a week or more. They look at what support people need at home, and aim to solve problems and reduce delays.

  • Multi-agency discharge team

    A local team working across the NHS, local councils and community organisations to improving planning for when people leave hospital, to make sure they get the care and support they need in the community.

  • Multi-agency risk assessment conference (MARAC)

    A regular meeting in your local area where information is shared between different organisations (such as the council, police, health services and others) about individuals who are at high risk of domestic violence or abuse. The organisations at the meeting discuss how to help people who are at risk of harm, and create an action plan to make them safer. 

    See also:

  • Multi-agency safeguarding hub (MASH)

    A single point of contact in a local area where concerns can be raised about the safety of adults and children who may be at risk. It is a way of making people safer by sharing information in a single place and responding quickly when someone is at risk of harm. 

    See also:

  • Multi-agency working

    When different organisations work together to provide a range of support for people who have a wide range of needs. 

  • Multidisciplinary team

    A team of different professionals (such as doctors, nurses, therapists, psychologists, social workers, and others) working together to provide care and support that meets your needs. The team brings together many different types of knowledge, skills and expertise, and should look at you as a whole person.

  • Multimorbidity

    Not an illness in itself, but where you have two or more long-term conditions at the same time that may require ongoing care. The way it affects your health will depend on the exact conditions you have.

  • Mutuality

    People working together to achieve something that they both, or all, want to achieve. Everyone has something they are responsible for doing, and something they can expect to receive.


  • Named social worker

    A single social worker who is allocated to you as a point of contact.

  • National Institute for Health and Care Excellence (NICE)

    An organisation that provides advice and guidance to improve health and social care services in England and Wales. It looks at all the evidence on what works and what doesn't and how much it costs, and advises on what treatment and care should be offered to people. It doesn't have the power to insist that its guidance is followed in local areas.

  • National minimum eligibility threshold

    The level at which your needs reach the point that your council, by law, has to meet them. From April 2015, every council in England will have to offer care and support services to adults who have a lot of care needs. This replaces the previous situation, where each council made its own decision about what level of need it would meet.

  • National Patient Safety Agency (NPSA)

    An organisation that is part of the NHS, that exists to improve safety in the NHS, reduce risks to patients and make sure that any harmful events are reported.

  • Natural support

    Support that may already be there for you, provided informally by your family or friends. It exists 'naturally' and in the relationships you have, and does not have to be formally planned or commissioned.

  • Near miss

    Something that is not supposed to happen and is prevented before harm is caused.

  • Nearest relative

    A term that is used in the Mental Health Act 1983 to refer to a single member of your family who is given certain rights and responsibilities if you are kept in hospital (also known as being ‘sectioned’). It is not the same as ‘next of kin’ and may not necessarily be the person you have given power of attorney to (if this is relevant to you). The law decides who your nearest relative is, and although you cannot choose who this is, it can sometimes be changed.

  • Necessary care

    Care and support provided by an unpaid carer - a family member or friend - to help the person being cared for to do things that they are unable to do for themselves. If you are a carer and provide necessary care to someone, your council should consider paying for you to have some support. You may wish to request a carer's assessment.

    See also:

  • Needs and safety assessment (NSA)

    Information that is gathered about your needs and any risks you may face, to produce an individual care plan.

  • Needs assessment

    The process of considering whether you need help or support because of your age, disability or illness. Anyone who appears to have a need for care or support - regardless of how severe those needs are or how much money they have - is entitled to a needs assessment, which can be arranged by contacting the adult social services department at your local council and requesting it.

    See also:

  • Needs-led provision

    When care and support services are adapted to your particular needs, rather than your needs having to fit into the services that already exist. This approach can apply to health and care services and to education.

  • Neglect

    When you are mistreated by not being given the care and support you need, if you are unable to care for yourself. It may include not being given enough food, or the right kind of food, being left without help to wash or change your clothes, or not being helped to see a doctor when you need to.

    See also:

  • Neurodiversity

    Variations between individual people in the way their brains and minds work. The neurodiversity movement campaigns for acceptance and equal rights for people with conditions such as autism and ADHD.

  • Neurotypical

    A word to describe someone who has a brain that functions in a typical way and who does not have an autistic spectrum disorder or a developmental disability.

  • Never event

    Something that would cause harm to people that should never happen and can be prevented.

  • Next of kin

    Your closest relative by marriage or blood. The person who is your next of kin does not have any automatic legal rights to make decisions for you. Next of kin is not the same as power of attorney. If you want to give someone the power to make decisions on your behalf and manage your financial affairs, you need to give them ‘power of attorney’.

    See also:

  • NHS England

    The organisation that decides what the most important health issues in England are and how NHS money should be spent. It is given money by the Department of Health and shares this out to local areas and clinical commissioning groups

  • NHS Improvement

    A national organisation that is responsible for working with local health organisations to help them improve the work they do and provide better, safer care to people.

  • NHS Local Area Teams

    Teams in each council area that are responsible for buying services for local people from GPs, dentists and pharmacists.

    See also:

  • NHS Long-term Plan

    A detailed 10-year plan for the future of the NHS from 2019 to 2029,setting out what the main priorities are and how the budget will be spent. The aim is to improve the quality of care people receive. Priorities include improving care for children and young people, cancer, heart disease and mental health.

  • NHS Mandate

    A document published every year that says what the main priorities are for NHS organisations in England and what it needs to achieve. It also says how much money is available to the NHS to spend.

  • NHS nursing care contribution

    If you are in a care home and need nursing care, this may be funded by the NHS. It is paid regardless of whether you are paying for your own care or whether your local council is paying for your care. It is different from continuing health care funding, and may be paid if you don't need full continuing health care but still need some nursing care. It is paid directly to the care home by the NHS. If you are paying your own care home fees, the amount that the NHS pays for your nursing care should be deducted from your bill. You should be assessed for NHS continuing health care before a decision is made about whether you are eligible for NHS-funded nursing care, and you won't need to make a seperate claim.

  • NICE guidelines

    Recommendations on health and care produced by an organisation called NICE, based on the best evidence about what works and what is best value for money. The guidelines set out the care and services that are suitable for most people with a specific condition or type of need. They are put together by professional experts and people who use health and care services and are based on evidence from research. They apply to England only.

  • Nominated individual

    A person who leads a care service (such as a care home or home care agency) and makes sure that the service is safe and good enough quality. The nominated individual is the service's main point of contact with the Care Quality Commission. (The term 'nominated person' means something different, and is defined separately.)

  • Nominated person

    If you receive direct payments from the council to arrange your own care and support, you can choose someone you trust to receive these payments on your behalf. This person is called your 'nominated person' and is different to a 'suitable person', who receives direct payments on behalf of someone who does not have mental capacity to make decisions for themselves.

  • Non-chargeable services

    Care and support services you receive in your home or in your community that the local council does not charge you for. The law prevents councils from charging for certain things, including assessments and advice about services. On other things (including day care, home care, domestic help and equipment and adaptations), each council makes its own decisions about which services it will charge for and how much the charge will be.

  • Notifiable disease

    A disease that has to be reported by law to government authorities, because it is potentially dangerous to wider human health. Covid-19 is a notifiable disease.

  • Notifiable incident

    Any unexpected event that causes any sort of harm to a person while they are receiving treatment or care. If this happens, the law says that care providers have to tell the person (or someone acting on their behalf) what has happened, apologise for it, explain what the effects might be, and offer to help fix the situation. 

  • Notional budget

    A type of personal health budget. It is the amount of money that is set aside for your care and support. You do not receive this money but decide how you want it to be spent to meet your needs. Care is then arranged for you, based on the amount of money that is available and the decisions you make about how to spend it.

  • Novel coronavirus

    The newest type of coronavirus that is currently affecting many people around the world.

    See also:


  • Occupational therapist

    A professional with specialist training in working with people with different types of disability or mental health needs. An OT can help you learn new skills or regain lost skills, and can arrange for aids and adaptations you need in your home. Occupational therapists are employed both by the NHS and by local councils.
  • Older people

    Older people are the largest group of people who use adult social care services. Some councils define people over the age of 50 as 'older', but social care services for older people are usually for people over the age of 65 - unless you have particular needs that make you eligible before this age.

  • Ombudsman

    Someone appointed by the Government or Parliament to investigate your complaints about an organisation or service. In England, if you have made a complaint about the NHS that you think has not been fully dealt with or you are unhappy with the response, you can ask the Parliamentary and Health Service Ombudsman to look at your complaint. If you have made a complaint to a council, you can contact the Local Government Ombudsman if you haven't had a response within a reasonable time or if you are unhappy with the result.

  • Ordinary residence

    The place where you live, or main home, which determines which council will assess your needs and potentially fund any care and support you need. If you have more than one home, councils follow guidance from the Government to help them decide which one is your main home, and which council should fund your care.

  • Out of area placement

    If you need residential care and your council is arranging this, you may be offered a place outside your home area. This may be because there is nowhere suitable for you to move into in your home area, or because you want to move to a different area. Your home council remains responsible for checking that the care you are receiving is right for you and continues to meet your needs.

  • Outbreak

    A sudden rise in the number of cases of a particular disease in a particular area or among a particular group of people.

    See also:

  • Outcomes

    In social care, an 'outcome' refers to an aim or objective you would like to achieve or need to happen - for example, continuing to live in your own home, or being able to go out and about. You should be able to say which outcomes are the most important to you, and receive support to achieve them.

    See also:

  • Outcomes framework

    A way of measuring how good services are at delivering results for people, and comparing results in different areas.

    See also:

  • Outputs

    The things that an individual or organisation produces as a result of the work they do. Outputs are not the same as outcomes, which refer to the things you hope to achieve. For example, the output of a care agency is the number of hours they spend providing you with a care service. The outcome for you is that you remain in your own home.

    See also:

  • Outreach

    Support that you may be offered in your home or community, to help you with a particular condition or course of treatment or to help you take part in activities outside your home.

  • Overview and Scrutiny

    The part of your local council that looks at decisions - including decisions affecting people with care and support needs - made by the council's elected decision-makers. In many councils, the main decisions are made by councillors in the Cabinet. The Overview and Scrutiny Committee, which is made up of councillors who are not in the Cabinet, reviews these decisions, asks questions, investigates issues affecting the local area, and makes recommendations. If you are unhappy about your council's policy on some aspect of the care and support you need, you could contact your local councillor or the chair of your local Overview and Scrutiny Committee.


  • Palliative care

    Care that you receive if you have an advanced, progressive illness for which there is no cure. The aim is to manage pain and other symptoms and to help you have best quality of life you can. It may be provided in your home or in a hospital or hospice.

  • Pandemic

    Numerous outbreaks of a particular disease all over the world at the same time. It relates to the way a disease spreads, not the severity of the disease itself. The World Health Organisation decides when a series of epidemics are widespread enough to be called to be a pandemic.

    See also:

  • Panel

    A group of people with different backgrounds and areas of expertise who jointly make decisions - or agree decisions made by others - about services and funding.

  • Parent Carer Forum

    A group of parents and carers of disabled children who work with councils, schools and health and care providers in a local area to help parents have a say and make sure services meet the needs of children and their families. There is a Parent Carer Forum in most local council areas in England.
  • Participation

    Taking part in decisions about things that affect you and other people. This may be about your own day-to-day life, such as what to eat or how to spend your time, or about how a service or organisation is run. It is more than consultation: you should not just be asked your view, but should be able to have an influence over the final decision.

  • Pathway

    When the way that a particular illness or condition should be managed is set out in writing, including the process of care and what is expected to happen. This should be based on best practice.

    The term also describes other processes by health professionals, such as the process of obtaining equipment or supplies for a person who needs these things.

  • Patient activation

    Where people take action to develop their knowledge, skill and confidence in managing their own health condition. Research shows that 'activated' patients are likely to have better health, spend less time in hospital and take part in more activities than people who have not learned as much about how to manage their health needs.

  • Patient Advocacy & Liaison Service (PALS)

    A service within every NHS Trust that can provide information or advice on any aspect of your health care that you are concerned about. It can help you resolve problems, understand your options or make a complaint.

  • Patient safety incident

    Something that is not supposed to happen that caused, or could have caused, harm to someone receiving health care. These incidents should be reported, to prevent them happening again.

    See also:

  • Peer challenge

    Where a council invites senior people from other councils to look at the work the council is doing - for example in adult social care - and how it could improve. It is not an inspection, but a discussion about what could be done differently and better, using other people's experiences.

  • Peer support

    The practical and emotional help and support that people who have personal experience of a particular health condition or disability can give each other, based on their shared experience. People support each other as equals, one-to-one or in groups, either face-to-face, online or on the telephone.

  • People who use services

    Anyone who uses care services, whether you are in your own home, in residential care or in hospital. The NHS is likely to describe you as a 'patient', while the council and other care providers may also describe you as a 'client' or 'service user'. You may also be described as a 'cared-for person', in relation to your carer.

    See also:

  • Performance indicators

    Ways of checking that an organisation is doing what it is supposed to be doing, by measuring progress towards particular goals. An example of a performance indicator might be how long people have to wait after requesting an assessment.

  • Performance rating

    A judgement about how good a particular service or organisation is, or how well it does something, to help you compare services and make a choice. It is usually given as a single description such as ‘outstanding’ or ‘inadequate’, or sometimes a number of stars. Organisations that provide care have to display the performance rating they are given by the Care Quality Commission so that people can see it.

  • Personal assistant

    Someone you choose and employ to provide the support you need, in the way that suits you best. This may include cooking, cleaning, help with personal care such as washing and dressing, and other things such as getting out and about in your community. Your personal assistant can be paid through direct payments or a personal health budget.

  • Personal budget

    Money that is allocated to you by your local council to pay for care or support to meet your assessed needs. The money comes solely from adult social care. You can take your personal budget as a direct payment, or choose to leave the council to arrange services (sometimes known as a managed budget) - or a combination of the two.

    An alternative is an individual service fund, which is a personal budget that a care provider manages on your behalf. A personal health budget may also be available: it is a plan for your health care that you develop and control, knowing how much NHS money is available.

  • Personal care

    Help with personal matters such as eating, drinking, washing, going to the toilet, getting up, getting dressed, going to bed, taking medicines and other things.

  • Personal expenses allowance

    The amount of money you are allowed to keep for your own personal needs if you move into a care home and paying for care takes up all of your income or savings. The allowance is currently £24.40 per week (in January 2015).

  • Personal health budget

    An amount of money to pay for your specific health needs, given to you - or managed for you - by the NHS. It is based on your own individual care plan, which sets out your health goals and how your budget will help you reach them. You can spend it on things like therapies, personal care and equipment. You cannot use it to pay for emergency care or care you usually get from a family doctor. Using a personal health budget is a choice: you do not have to have one unless you want to. See also personal budget.

  • Personal Health Budget peer network

    A group of people in a particular area who use a personal health budget and are interested in connecting with other users and in working with professionals to help personal health budgets develop further in their area. There is also a national personal health budget peer network, through which users can contribute their views and experiences.

  • Personal Independence Payment (PIP)

    A regular benefit payment to help you with some of the extra costs caused by long-term illness or disability if you are over 16 and under 65. (PIP has replaced Disability Living Allowance, or DLA, for adults, although children under the age of 16 still receive DLA.) How much you get depends on how your condition affects you and how much help you need, not on the condition itself. You will be assessed on how well you can manage your activities of daily living and on how easily you can get around. It is dependent solely on your needs, not on your income or savings, and can be paid whether or not you are in work and alongside other benefits.

  • Personal protective equipment (PPE)

    Equipment that protects you against risks to your health or safety at work. Care workers and health care staff such as nurses and doctors rely on things like facemasks, gloves and aprons to protect their own health while they are treating people with coronavirus, and to avoid spreading infection between people.

  • Personalisation

    A way of thinking about care and support services that puts you at the centre of the process of working out what your needs are, choosing what support you need and having control over your life. It is about you as an individual, not about groups of people whose needs are assumed to be similar, or about the needs of organisations.
  • Personalised medicine

    Treatment that is designed for you as an individual, based on your own gentic make-up and how your body is likely to respond, rather than the same treatment given to everyone with the same illness or condition. 

  • Person-centred care

    An approach that puts the person receiving care and support at the centre of the way care is planned and delivered. It is based around you and your own needs, preferences and priorities. It treats you as an equal partner, and puts into practice the principle of 'no decision about me without me'.

  • Person-held record (PHR)

    When you hold your own notes and records about your health or social care, and bring this with you to appointments. 

  • Physical intervention

    Taking some kind of action in response to a person who behaves in a way that is challenging to others, to prevent or restrict their movement. This may include physically holding them, using some kind of equipment to restrain them, or putting them in a separate room or space by themselves. It should  only be done for a limited amount of time, which should be stated in the person’s support plan.

  • Place-based commissioning

    When organisations work together to plan, develop and pay for services to meet the needs of people in a single local area. The aim is to improve the health and wellbeing of the population of a particular area, and to focus on this rather than on the organisations that provide services.

    See also:

  • Placement

    A place that is arranged for you to live, work, spend time or go to school, if you have particular needs.

  • Polypharmacy

    When you take a number of different types of medicine at the same time. This is becomming more common as people live longer, and as they live with several different health conditions. Taking a number of different medicines can be beneficial for your health, and can improve your quality of life - or it may be risky, as different drugs do not always work well together. 

    See also:

  • Pooled budget

    When two different organisations, such as an NHS organisation and a council, agree to each put an amount of money into a single pot to pay for a particular health or care service.

  • Population health management

    A way of improving the health of people in local communities by looking at which groups in the local population are most likely to become unwell, and working out how to prevent and treat ill-health.

  • Positive behaviour support

    A method of addressing challenging behaviour, with the aim of improving a person's quality of life. It involves looking at things from the perspective of the person whose behaviour is challenging, working out how their environment could be improved, and helping them to learn new skills. People with challenging behaviour are treated with dignity and are not punished.

  • Positive risk-taking

    Supporting people to take everyday risks as safely as possible, and enabling people to have more choice and control over their lives. It is about looking at the benefits of doing something in comparison with the risk of harm if it goes wrong, and recognising that protecting someone too much may mean they live a less good life.

  • Power of attorney

    A legal decision you make to allow a specific person to act on your behalf, or to make decisions on your behalf, if you are unable to do so. There are two types. Ordinary power of attorney is where you give someone the power to handle your financial affairs for you, but you continue to make decisions about your money. This depends on you continuing to have mental capacity to make these decisions. Lasting power of attorney is where you allow someone to make decisions on your behalf about your property and finances or health and welfare, if the time comes when you are unable to make these decisions for yourself.

  • Practitioner

    A person who works in a skilled job  such as social work, nursing or medicine, providing care or support directly to people.

  • Pre-admission consultation

    An appointment before you go into hospital or a care home to discuss your needs and the care you will receive. If you are going into hospital, it may also include some tests.

  • Pre-assessment

    The point at which you make contact with your local council and a decision is made about whether a full assessment is necessary. This is based on the information given by you or the person who refers you to adult social care. It is often conducted over the phone.

    See also:

  • Premature mortality

    Death from any cause before the age of 75, and not necessarily preventable.

  • Prepayment card

    A way of managing a personal budget that a growing number of councils have introduced. Instead of making direct payments into a bank acccount for you to use, the council puts the funds on a card, which you then use to make payments to personal assistants or for services. In this way the council can see where the budget is going, and potentially restrict the way that funds are used. The Care Act 2014 says that a preparment card cannot be your only option for receiving direct payments, and you can choose not to have one if you prefer. 

  • Prevention

    Any action that prevents or delays the need for you to receive care and support, by keeping you well and enabling you to remain independent.

  • Preventive services

    Services you may receive to prevent more serious problems developing.
    These services include things like reablement, telecare and befriending schemes. The aim is to help you stay independent and maintain your quality of life, as well as to save money in the long term and avoid admissions to hospital or residential care.


    See also:

  • Primary care

    The first point of contact in the health service, usually your GP, practice nurse, local pharmacist, dentist or NHS walk-in centre. Primary care doctors deal with a wide range of health problems. They treat common illnesses, help you manage long-term conditions and refer you to a specialist doctor when necessary.

  • Primary care networks

    Groups of GP practices in an area that work together, and with hospitals, social care, pharmacies and other services, to care for people with long-term conditions and prevent people becoming ill.

    See also:

  • Primary health need

    When your need for ongoing, long-term care is mainly because of your health (due to a disability, accident or illness), and the care you need is provided by health professionals, or by care staff trained by qualified health professionals.

  • Process redesign

    Making a major change to the way something is done, by looking at every aspect of the process and working out how to do it more quickly, smoothly and cost-effectively.

  • Procurement

    The process by which organisations such as councils find and pay for things such as goods and services, check that the service can genuinely be provided, and make sure that money is well spent.

  • Professional body

    An organisation that represents a group of people who are all part of the same profession, such as doctors or social workers. A professional body supports its members and may also make sure that the work they do is of a high enough standard. If you are unhappy with something that an individual professional has done, you may be able to complain to their professional body.

  • Profound and multiple disabilities

    A description of someone's condition if they have severe disabilities and complex needs that mean they need a lot of care and support. People with profound and multiple disabilities often have great difficulty communicating and need a high level of support with most aspects of their daily life.

  • Prognosis

    An opinion about how something such as an illness is likely to develop, and what is likely to happen.

  • Property disregard

    When your home does not have to be sold to pay for residential care. This applies if you are in a care home for a short time, and expect to go back to your own home. It also applies if you have moved permanently into a care home, and the house you own is lived in by your partner, a relative who is over 60, or a child under the age of 16 who you are responsible for. There is also a 12-week property disregard, when the council will not charge you - based on the value of your home - for the first 12 weeks that you are in a care home. You would still have to make a contribution to the cost of the care home based on your income or available capital.

  • Proportionality

    Doing what is needed, without intruding into people’s lives any further than is necessary to meet their needs or keep them safe. It is an important principle in the Care Act 2014.

  • Proportionate assessment

    A way of assessing your needs that tries to find out as simply as possible what your needs are and avoids asking for unnecessary amounts of information.

  • Protected characteristics

    A list of factors that people are not allowed to use as a reason to treat you differently to anyone else. These factors are set out in the Equality Act 2010 and include things like age, disability, marital status, gender, race, religion and sexual orientation.

    See also:

  • Protocol

    A set of rules or instructions about how something should be done. 

  • Provider

    An organisation that provides services, such as care and support services.
  • Public health

    Helping people stay healthy and preventing illness. Public health is about the health of the population as a group, rather than about individuals. People's health is affected by the individual decisions they make, and by decisions that are made by local councils and national governments.

  • Public Health England

    The part of the Department of Health in England that works with the Government and local councils to make the population healthier, prevent things like infectious illnesses and provide information so that people can look after their own health. 

    See also:

  • Public sector

    The full range of organisations that provide government services, such as health, education, police, etc, that are available to everyone.

  • Public sector equality duty (PSED)

    The law says that public sector organisations have to think about the needs of everyone when they make decisions about how they provide services, and must not discriminate against anyone. The aim of this duty is to prevent discrimination, increase people’s opportunities, and improve relationships between people. Private organisations do not have the same legal duty.

  • Public service mutual

    An organisation that provides a public service (such as care or support services), that used to be part of the public sector but is now independent. The people who provide the service are directly involved in running the organisation. The organisation may make a profit, which is distributed to its members.

    See also:


  • Qualitative research

    A type of research that looks at things that can be observed and described, but not measured in numbers. The aim is to understand a problem, or identify patterns in what is happening. This type of research may involve interviews or discussions. Research findings are described using words.

  • Quality and Outcomes Framework (QOF)

    A summary of what GP practices should do for patients and what information they should collect. GP practices get extra money for providing specific services that the QOF says they should, such as keeping records of patients’ blood pressure and making sure that people in at-risk groups receive things such as flu jabs.

  • Quality Assurance Framework

    A structure for explaining, measuring and improving the quality of services provided by an organisation. Quality is measured in a variety of ways, including hearing the views and experiences of people who use services.

  • Quality of life

    Your satisfaction with your life in terms of wellbeing and happiness. The way you define your own quality of life will depend on the things that matter most to you as an individual and make your life enjoyable and meaningful. The care and support you receive should make a positive difference to your quality of life.

    See also:

  • Quality standards

    Statements produced by the National Institute for Health and Care Excellence (NICE) saying what good care looks like for a particular condition or type of need, and how health and care providers can measure their progress towards providing better care for people. They are based on evidence about what works best. 

  • Quantative research

    A type of research that collects information that can be measured. It involves collecting information based on numbers. This type of research may involve surveys or questionnaires, as well as things like accounts.

  • Quarantine

    A period of keeping away from other people until it is certain that you do not have a disease.


  • Rapid response

    A service in the community where a health professional or care worker will visit you at home to help you manage a problem or provide emergency support for no more than a few days, to help you avoid going into hospital. Rapid response services may be provided by the NHS or by private organisations. You may be referred by your GP to an NHS service, or refer yourself to a private one.

  • Reablement

    A way of helping you remain independent, by giving you the opportunity to relearn or regain some of the skills for daily living that may have been lost as a result of illness, accident or disability. It is similar to rehabilitation, which helps people recover from physical or mental illness. Your council may offer a reablement service for a limited period in your own home that includes personal care, help with activities of daily living, and practical tasks around the home.
  • Reasonable adjustments

    Changes that public services, buildings and employers have to make to make it possible for people with disabilities to use a service or do a job. These changes include things like adjusting your working hours or providing you with a special piece of equipment to do the job. It is against the law to discriminate against you because you have a disability.

  • Re-assessment

    When you have had an assessment of your needs or your finances, these may be looked at again if some aspect of your situation has changed.

    See also:

  • Reconfiguration

    A change in the way a service or organisation is set up and run. The term is often used to refer to a service moving from one place to another, or to services or organisations merging to become a single one. It may refer to changes to a single local service, or to a major change affecting a wider area.

  • Recording system

    The way in which information about you is collected and looked after by an organisation such as a council or the NHS.

  • Recovery approach

    If you need support with your mental health, the professionals working with you may take this approach to help you live your life the way you want to. Your mental health challenges may not ever go away entirely, but this approach can help you to think about the strengths and abilities you have, and the changes you want to make in your life.

  • Referral

    A request for an assessment of a person's needs, or for support from a social care organisation. A referral to adult social care may be made by your GP, another health professional or anyone else who supports you. You can also refer yourself, or a member of your family, by contacting the adult social care department at your local council.

  • Registered manager

    The person who is responsible for running an adult care service such as a care home or home care agency. The registered manager is responsible for leading the service and making sure that standards are high. 

  • Regulated financial advice

    Financial advice that is provided by an organisation that has to follow the rules set by the Financial Conduct Authority, to help you plan for the future. Councils have legal duty to help you find advice that is independent from the council on things like funding for care home fees. It is likely that you will have to pay for this type of advice.

  • Regulator

    A person or organisation that has legal power to supervise a particular type of service, activity or organisation, and to make sure that services provided to people are safe and good quality. Regulators do not usually investigate people's individual complaints about their own experience, but look at the service as a whole.
  • Regulatory action

    Action that a regulator takes to make sure that services improve, if necessary.

  • Rehabilitation

    When you are actively supported to recover from an injury or illness and regain the ability to do things for yourself. 

    See also:

  • Relational activism

    Using relationships as a way of bringing about change where you can in your own area, by sharing information and activity with friends and neighbours, and changing the way things are done locally.

  • Relational welfare

    A care and support system that is built on connections between people to overcome isolation and loneliness. It recognises that relationships between people are what make things work.

  • Relationship-based social work

    When a social worker makes it a priority to build relationships with the individuals and families they work with, as the best way of bringing about the changes people may need in their lives and circumstances. It involves recognising people’s potential rather than their weaknesses, and emphasises working ‘with’ people rather than doing things ‘to’ them.

  • Replacement care

    Care that replaces the care you normally receive from a regular carer, or would normally give to the person you care for. It may be needed either on a planned basis or in an emergency. Replacement care may be offered by your council, if the person needing care has had an assessment and is entitled to care and support services, or if the carer is entitled to help. Otherwise, you may have to pay for it.
  • Residential care

    Care in a care home, with or without nursing, for older people or people with disabilities who require 24-hour care. Care homes offer trained staff and an adapted environment suitable for the needs of ill, frail or disabled people.
  • Resource Allocation System

    The system some councils use to decide how much money people get for their support. There are clear rules, so everyone can see that money is given out fairly. Once your needs have been assessed, you will be allocated an indicative budget - so that you know how much money you have to spend on care and support. The purpose of an indicative budget is to help you plan the care and support that will help you meet your assessed needs - it might not be the final amount that you get, as you may find that it is not enough (or is more than enough) to meet those needs.

  • Respect

    Being treated well and as if you and your views and feelings matter to the person or organisation you are dealing with. The Care Act 2014 says that your council should always consider your wellbeing when making decisions that affect you, and that treating you with respect is part of considering your wellbeing.

  • Respite care

    A service giving carers a break, by providing short-term care for the person with care needs in their own home or in a residential setting. It can mean a few hours during the day or evening, 'night sitting', or a longer-term break. It can also benefit the person with care needs by giving them the chance to try new activities and meet new people.
  • Responsive care

    Care that is flexible enough to meet your particular needs and can adapt to changes in your situation.

  • Restorative justice

    Where someone who has been the victim of harm such as abuse or neglect has the opportunity to talk to the person who has harmed them about the impact their actions have had. The person who has caused the harm then has an opportunity to try to put things right.

  • Restraint

    When your movements or behaviour are deliberately restricted by someone. Restraint may be used in an emergency, to prevent someone harming themselves or other people. It may also be used in a planned way to prevent someone who is unable to make decisions for themselves causing harm. If restraint is used wrongly, it may be abuse.

    See also:

  • Restrictive practice

    Anything that limits a person’s freedom to move their body, if they are at risk of hurting themselves or someone else. This can include physical intervention, mechanical restraint, use of medication, or seclusion.

  • Review

    When you receive a re-assessment of your needs and you and the people in your life look at whether the services you are receiving are meeting your needs and helping you achieve your chosen outcomes. Changes can then be made if necessary.
  • Rights

    What you are entitled to receive, and how you should be treated, as a citizen. If you have a disability or mental health problem, are an older person or act as a carer for someone else, you have the right to have your needs assessed by your local council. You have a right to a service or direct payment if your assessment puts you above the eligibility threshold your council is using. You and your carers have a right to be consulted about your assessment and about any changes in the services you receive.

    See also:

  • Ringfenced budget

    Money that is set aside by the Government or another organisation (such as an NHS organisation or local council) for a specific purpose, and cannot be spent on anything else.

  • Risk assessment

    An assessment of your health, safety, wellbeing and ability to manage your essential daily routines. You might also hear the term risk enablement, which means finding a way of managing any risks effectively so that you can still do the things you want to do.

    See also:

  • Risk enablement

    Being able to make your own choices and do things that other people might consider 'risky', as part of self-directed support. Organising your own care and support means that you are free to weigh up the potential risks of doing something against the benefits you believe it will bring.

  • Risk management

    The process of working out what situations might be risky for your health or wellbeing, and taking steps to help you reduce or prevent the risk of harm.

    See also:

  • Risk planning

    Looking at the type of risks that a person may face in their daily life, and working out how to keep them as safe as possible while still enabling them to live an enjoyable life.

    See also:

  • Root cause analysis

    A way of investigating something that happened, looking at all aspects of the event: what happened, how and why it happened, and what needs to be done differently in future. 


  • Safeguarding

    The process of ensuring that adults at risk are not being abused, neglected or exploited, and ensuring that people who are deemed 'unsuitable' do not work with them. If you believe that you or someone you know is being abused, you should let the adult social care department at your local council know. They should carry out an investigation and put a protection plan in place if abuse is happening. Councils have a duty to work with other organisations to protect adults from abuse and neglect. They do this through local safeguarding boards.

  • Safeguarding Adults Board (SAB)

    A formal group set up by your council to prevent abuse or neglect of adults in your area who have care and support needs, and to make sure that action is taken if abuse occurs. Every area has to have a SAB, which is made up of different professionals from the council, NHS and police, working together and sharing information. SABs also include representatives from groups that work with older people and people with disabilities.

  • Safeguarding Adults Review (SAR)

    A review that is carried out by a local Safeguarding Adults Board (SAB) when a vulnerable adult has died or been harmed, and someone knows or suspects that they have been abused or neglected in some way. The purpose is to find out what happened, what should have been done differently, and what lessons can be learned for the future, rather than to blame anyone specifically.

  • Savings disregard

    If you are in residential care and you get savings credit as part of your pension credit, some of this will be disregarded. This means it will not be considered when the council looks at your finances to work out how much you can afford to pay towards your care.

  • Screening tool

    A test that is carried out to work out whether someone has, or is at risk of developing, a particular condition or illness. It may be a physical test or a questionnaire or checklist, depending on what is being tested for.

  • Seamless service

    When your care is provided smoothly, with good coordination between the individuals and organisations involved, and no gaps.

    See also:

  • Seclusion

    Restricting someone’s movements by leaving them alone in a room or separate space that they cannot leave, in order to prevent them hurting themselves or someone else. The person should be supervised, and the room will not necessarily be locked. This should  only be done for a limited amount of time, which should be stated in the person’s support plan.

  • Secondary care

    Care that you receive in hospital, either as an inpatient or an outpatient. This may be planned or emergency care. It is more specialist than primary care.

  • Sectioning

    Admitting someone to hospital for treatment, or keeping them there, if there are concerns about their mental health – even if they do not agree that they should be in hospital. It refers to various ‘sections’ of the Mental Health Act that explain how and why a person can be kept in hospital. You have the right to appeal, and to get help from an independent mental health advocate.

  • Secure hospital

    A hospital that provides care and treatment to people who are deemed to be a danger to themselves or others because of their mental illness and who need to be held securely and prevented from leaving. Most people who stay in a secure hospital have committed a criminal offence while mentally ill, or been diagnosed with a mental illness while in prison, and cannot be safely supported anywhere else. There are three main categories of secure hospital: high, medium and low secure.

  • Self isolation

    Staying in your own home and not going out if you feel unwell, if you live with someone who is unwell, or if you are at risk of becoming seriously ill if you are infected with coronavirus, because of an existing health condition you have.

  • Self-advocacy

    Speaking up for yourself about what you want and how you want to live your life. This may be about the care and support you receive yourself, or it may be about the way that services are organised in your area. You do not always have to do this on your own: you can have a supporter with you, or there may be a self-advocacy group in your area. 

    See also:

  • Self-assessment

    A form or questionnaire that you complete yourself, either on paper or online, explaining your circumstances and why you need support. A social care worker or advocate can help you do this. If your council asks you to complete a self-assessment form, it will use this information to decide if you are eligible for social care services or if you need a full assessment by a social worker.

  • Self-care

    Things you do for yourself to keep yourself as healthy and well as possible. It is everything from eating healthy food, to looking after minor illnesses, to managing a long-term condition such as diabetes. It does not mean managing completely on your own without a doctor, nurse or other professional.

  • Self-determination

    The ability or power to make decisions for yourself.

    See also:

  • Self-directed support

    An approach to social care that puts you at the centre of the support planning process, so that you can make choices about the services you receive. It should help you feel in control of your care, so that it meets your needs as an individual.

    See also:

  • Self-efficacy

    Believing in your own ability to do things and deal with various situations, and that your own efforts can make a difference to your life. Research shows that self-efficacy is improved by opportunities to take responsibility for yourself, or to contribute to decisions that affect the details of your life.

  • Self-funding

    When you arrange and pay for your own care services and do not receive financial help from the council.
  • Self-management

    An approach that encourages people with health and social care needs to stay well, learn about their condition and their care and support needs, and remain in control of their own health.

  • Sensory diet

    This is nothing to do with food, but is a plan of activities for children and adults who have a sensory processing disorder. The plan is designed for their individual needs, and helps provide the right balance of sensory experiences throughout the day – depending on how sensitive they are to particular things in their environment. The aim is to help them feel ‘right’ in their environment – either calmer or more alert, depending on their needs – so that they can focus and feel comfortable.

  • Sensory impairment

    When one of your senses - sight, hearing, smell, touch, taste - does not work properly. It does not necessarily mean a total loss of one or more of your senses. You may be born with a sensory impairment, or develop it later in life.
  • Sensory processing disorder

    A condition where the brain cannot pick up or respond properly to messages from your senses, causing problems such as over-sensitivity to the feel of particular things, under-sensitivity to pain, or apparent clumsiness. It is often associated with autism and is usually picked up in children, but can affect adults too.

  • Serious case review

    An inquiry that is organised by the local council after a child dies or is injured and abuse or neglect is suspected. Serious case reviews look at lessons that can be learned to prevent similar events occurring in future. 

    See also:

  • Serious incident

    Something that happens that results in death or serious harm that isn’t expected and may be preventable.

    See also:

  • Service redesign

    Changing the way that health, care and support services are provided in a local area to reflect the changing needs of people in that area. Services often need to change as people live longer, and as more people live with ongoing health conditions.

  • Service specification

    A description given to an organisation that provides a service by the organisation that is paying for the service. The description says what the service should look like, what should be provided to people and what the outcomes should be.

  • Service user

    A person who receives services from a care and support provider. Not everyone likes this term, and may prefer to be described simply as a 'person who uses services' rather than a 'service user.'

  • Seven-day services

    A programme to expand NHS services to make all types of care, not just emergency care, available every day of the week. If you are admitted to hospital in an emergency, you should be able to see a consultant and receive the tests you need within 24 hours.

    See also:

  • Shared endeavour

    The task of commissioning care and support services and 'shaping' the range of services that are available in a particular area. The term is used in the Care Act 2014, which requires councils and service providers to work together, with local people at the centre of all their planning.

  • Shared Lives

    A type of care for people who are unable to live independently or may not wish to live alone, and an alternative to supported living, home care or residential care. Shared Lives carers offer care and support in their own home to older people, people with mental health problems, or people with physical or learning disabilities. This may take the form of regular visits, or the individual who needs care and support may live with a Shared Lives carer on a permanent basis. Shared Lives schemes are usually managed by local councils or voluntary organisations, and overseen by the Care Quality Commission.

  • Sheltered housing

    Your own home, which you either rent or buy, in a development with other older people. You have your own front door, and there may be some shared facilities such as a lounge, laundry or garden. Many sheltered housing schemes have a manager who can be called to assist residents in an emergency. Staff do not provide personal care or help with things like shopping. Any additional care you need can be provided in the same way as if you were living in your own home elsewhere.

  • Shielding

    A way of protecting people who are most at risk of becoming seriously ill if they get coronavirus, by making sure they have as little contact as possible with other people. They should not leave their homes for a set period (currently 12 weeks), and anyone they live with should follow the Government’s guidance on social distancing.

  • Short breaks

    When a person with care and support needs spends regular short periods of time away from their main carer, in order to give the carer a break and to give the person with needs a chance to do something different. These breaks may take place in the person's own home, in the home of an approved carer or in a place such as a hospice. Councils in England are required to provide short breaks services for children and young people with disabilities.

    See also:

  • Significant event audit

    A way of learning from individual cases to improve the care that other people receive in future. It looks at what happened – for example, an unexpected death, missed diagnosis or medication error – and works out what was done right and wrong, and what needs to be done differently next time. 

  • Signposting

    Pointing people in the direction of information that they should find useful. Your local council should signpost you towards information about social care and benefits through its helpline or call centre (if it has one), website and through local services such as libraries and health centres.

    See also:

  • Single assessment process

    An attempt to coordinate assessment and care planning across the NHS and councils, so that procedures aren't repeated and information is shared appropriately. It was introduced because people sometimes have a wide range of needs and can end up being assessed more often than necessary, and information can end up getting lost. The single assessment process is widely used for older people, and increasingly for other adults with care needs.

  • Social capital

    The connections that are made between people who live in the same area or are part of the same community, and who are able to do things with and for each other. Strong neighbourhoods, clubs and groups help create a sense of community, enabling people to trust each other, work together and look out for each other.

    See also:

  • Social care

    Any help that you need, such as personal care or practical assistance, to live your life as comfortably and independently as possible, because of age, illness or disability.

    See also:

  • Social care precept

    An extra amount of money that councils can add to your council tax to help pay for social care for adults who need it in your area. It is charged to every council taxpayer, regardless of whether they use social care services. Like any other tax, the amount you pay is not related to any services you receive. The social care precept must be no more than an extra 2 per cent on your council tax, and the money raised this way must only be spent on adult social care and not on anything else that the council does.

    See also:

  • Social communication questionnaire

    A tool that may be used to see if someone might have autistic spectrum disorder. It is a questionnaire that asks for information about the person’s body movements, use of language or gestures, and the way they interact with other people. It is not meant to provide a detailed diagnosis, but to indicate whether further tests and observations may be needed.


  • Social distancing

    Avoiding close contact with other people during the outbreak of an infectious disease. It is a way of slowing the spread of coronavirus and stopping it reaching the people who are most at risk of becoming seriously ill. It means limiting when and where you can get together with people you do not live with. The Government advises that people should go to essential shops as infrequently as possible, work from home, and not meet up with family or friends or go to other people’s houses. When you are outside your own home, it can help to think of it as a physical distance – you should stay at least two metres, or six feet, away from other people.


  • Social enterprise

    A non-profit business that is set up to improve a community in some way, such as by providing care and support services, often in a different way to the way they have been provided before. The business provides a service - such as helping disabled people get back to work - and receives payments. Any profits they make go back into improving the community. It is an alternative to the private sector and is different to a charity because it is not funded by grants or donations.

  • Social exclusion

    When individuals or groups do not have the same rights and privileges that most people in society have, such as employment, adequate housing, health care or education. This is often because of poverty, disability or because they belong to a minority group of some kind.

  • Social group

    A group of friends you meet with who provide you with company. The group may be focused on a specific activity, but it exists mainly for being with other people rather than for gaining skills.

  • Social model of disability

    What makes someone disabled is not their impairment or difference, but barriers in the world around them. These barriers may be physical, such as lack of access to a building or lack of suitable toilets. Barriers are also created by people’s attitudes to disability, and their assumptions about what disabled people can and cannot do. Removing these barriers creates equality and enables people to have independence, choice and control over their lives.


  • Social pedagogy

    A way of caring for children that combines education and care, believing that children have rights and that bringing them up is the responsibility not only of parents but also of the society they live in.

  • Social prescribing

    A way of improving your health and wellbeing other than through medicine. Your GP writes a 'prescription' for you to take part in activities in your community that you might benefit from.

    See also:

  • Social support

    Various types of support or assistance that you receive from groups of other people or from individuals. This may be emotional support, where you have people to talk to, or help with things like managing your money or looking after your house. Social support may be provided by statutory organisations such as social services, by local groups such as churches or social clubs, or by your friends and relatives.

  • Social value

    The wider contribution something makes to a community, rather than how much it costs or how it benefits an individual person. The law says that organisations such as councils that plan services should consider the wider benefits to their area when making decisions.

  • Social worker

    A professional who works with individual people and families to help improve their lives by arranging to put in place the things they need. This includes helping to protect adults and children from harm or abuse, and supporting people to live independently. Social workers support people and help them find the services they need. They may have a role as a care manager, arranging care for people who use services. Many are employed by councils in adult social care teams; others work in the NHS or independent organisations.

  • Specialised commissioning

    The process of planning specialist services for people who have rare or complex conditions. These types of treatment - such as chemotherapy, transplants or brain surgery - are not available in every local hospital and have to be provided by specialist teams who have the necessary skills and experience. They are planned nationally and regionally by NHS England, not by local commissioning authorities. 

  • Spot purchase

    When a service is bought by or on behalf of an individual as and when they need it rather than as part of a block purchase. Spot purchases can give people more choice about who provides their care and what they receive.        

  • Stabilise and make safe (SAMS)

    Help and support that you are given in your home for a few weeks after a stay in hospital, to help you recover physically and regain your independence.

    See also:

  • Stakeholders

    People or groups who have an interest in what an organisation does, and who are affected by its decisions and actions. When an organisation such as your local council or NHS trust is planning to make changes to the way it works or the services it offers, it may hold a consultation with stakeholders, to find out what you think and what your experiences are.

    See also:

  • Statutory guidance

    Information from the Government explaining how specific laws such as the Care Act 2014 should be put into practice and what they mean for people.

  • Statutory organisations

    Organisations that have a legal responsibility to do something, and whose role and powers are defined by law. They are different to voluntary organisations, which may provide some of the same services but which are not set up by law. Your local council is an example of a statutory organisation, as are the NHS trusts in your area. Local charities, care agencies and care homes are not statutory organisations.

  • Step-down care

    Care that may be provided if you are ready to leave hospital but not yet ready to return to your home. This type of care is offered by some care homes.

  • Step-up care

    Support that may be available if you are unable to remain in your own home for a temporary period, but do not need a hospital bed or a permanent place in a care home. This support may be provided for a short time in a care home, while plans are made to help you return to your own home and live there safely.

    See also:

  • Strategic clinical network

    A way of bringing together providers, commissioners and people who use health services to improve NHS services in a particular part of the country for specific groups of patients or health conditions, such as cancer or heart disease.

  • Strength-based assessment

    An assessment that looks at your strengths and what you are able to do, rather than on your weaknesses. The focus is on your abilities, and on what keeps you well and helps you remain independent.

  • Substance misuse

    Regularly consuming quantities of substances such as drugs or alcohol that affect your mental and physical health and your ability to do the things you need to do.

  • Substantial difficulty

    This refers to whether you might have difficulty in being involved in decisions about your care and support, because of difficulty with understanding information, remembering information, making decisions based on information, or communicating your views and wishes. The law says that you should have the support you need to be involved in decisions. This support may be provided by a family member or friend, or by an independent person arranged by your council.

  • Suitable person

    A person who manages direct payments on behalf of someone who does not have the mental capacity to look after the money themselves. It has to be someone reliable who will manage money in the best interests of person who receives it and make sure that the care they receive is beneficial to them. The council decides if someone is a suitable person, and oversees the arrangement.

    See also:

  • 'Suitable person'

    Someone who receives and manages a direct payment on your behalf. You can choose who this person is, but they must be over 18, must be agreed by your local council and cannot be the same person you pay from your direct payments to act as your personal assistant.

  • Summary care record (SCR)

    A national electronic copy of some of the information contained in your GP's computerised notes about you. This electronic information can be found by NHS staff who have your permission to look for it, wherever you are, and is particularly useful for treatment in an emergency or away from home. It includes information such as which medicines you are taking and whether you have any allergies. It is up to you whether you allow this national copy of your computerised notes to be held. If you do not want your information to be held in this way, you should let your GP practice know and they will ask you to fill out a form confirming this.

  • Support and safety plan (SSP)

    If you have mental health problems, you may have a support and safety plan that sets out the support you need and how to reduce any risks you face.

  • Support plan

    A plan you develop that says how you will spend your personal budget to get the life you want. You need to map out your week, define the outcomes you hope to achieve, and show how the money will be used to make these happen. Your local council must agree the plan before it makes money available to you.

    See also:

  • Support planning and brokerage service

    A service to help you plan and arrange the support you need to enable you to live your life the way you wish. An independent broker can help you understand what is available in your area and what you can spend your money on (either your own money or a personal budget from the council). This service may be offered by your council, or they may be able to tell you where you can find it.

  • Support worker

    Someone who is employed to provide practical help and support to enable you to live as independently as possible and do the things you want to do.

  • Supported decision-making

    Getting the support you need to make decisions for yourself, or to express your wishes or preferences if someone is making a decision for you.

    See also:

  • Supported housing

    A range of housing options including sheltered housing, retirement housing and specialist housing schemes for people with physical or learning disabilities. It offers assistance to enable you to manage day to day while living in your own home. If you have high care and support needs, extra-care housing is likely to be a more suitable option.

  • Supported living

    An alternative to residential care or living with family that enables adults with disabilities to live in their own home, with the help they need to be independent. It allows people to choose where they want to live, who they want to live with, how they want to be supported, and what happens in their home.

  • Supported self-assessment

    A way of working out what your care and support needs are that is carried out jointly by you and your local council. It should be in a format that is easy for you to understand, helping you to work with the council to describe the ways in which you may need care or support.


    See also:

  • Supportive care

    If you have a life-threatening illness, care that helps you and your family cope with this and with any treatment you are having. It should help you to live as well as possible with the effects of the illness, and may include information, psychological support, rehabilitation and complementary therapies.

    See also:

  • Sustainability and Transformation Plan

    A five-year local plan in every area in England to improve health and care outcomes between 2016 and 2021, within the amount of money that is available in that area. The purpose is to build services around the needs of local areas rather than around existing organisations, and to work out how to meet people’s growing need for care within limited resources.

    See also:

  • Symptom

    A sign that you are unwell. The early symptoms of coronavirus often include fever, a dry cough and tiredness.

  • Systemic family therapy

    Talking therapy for people together in families, for people of all ages facing a wide range of situations. Therapists or therapist teams look at family members’ beliefs about each other and at how they talk and listen to each other. From this they help the family to make changes in their lives so that the problems they are facing can be resolved.

    See also:

  • Systems change

    A way of changing the way a system works (such as the way that social care is planned and delivered) by looking at causes of problems, and at how different things affect each other. The aim is to change the way things work in order to produce a different result.

  • Systems to monitor patient flow

    A way of planning services to make sure that health and social care services can meet people’s needs at the right time.


  • Tailored support

    Support that is set up to meet your specific needs and preferences as an individual. This is different to a single, unchanging service that is the same for everyone who uses it.

    See also:

  • Talking therapies

    Treatment for psychological problems that involves talking about yourself to a trained therapist. You may be offered talking therapies (also known as counselling or psychological therapy) instead of or as well as medicine. This type of treatment is sometimes available through the NHS and widely available privately.

  • Tariff income

    A way of working out what you can afford to pay towards the care and support you need, if you have savings or assets (property or possessions, but not your own home) above £14,250 but below £23,250. For every £250 (or part of £250) you have in savings or assets between these two figures, you may have to pay £1 per week towards your care and support.

  • Team Around the Child

    When a group of professionals who are working with an individual child or young person with a disability or complex needs come together to share information and agree a plan – along with parents – to meet the child’s needs. The emphasis should be on the needs of the child and the aim is to provide joined-up support.

  • Telecare

    Technology that enables you to remain independent and safe in your own home, by linking your home with a monitoring centre that can respond to problems. Examples are pendant alarms that you wear round your neck, automatic pill dispensers, and sensors placed in your home to detect if you have fallen or to recognise risks such as smoke, floods or gas-leaks. The monitoring centre is staffed by trained operators who can arrange for someone to come to your home or contact your family, doctor or emergency services.
  • Telehealth

    Technology that sends information about your health to your doctor from your home, to help manage long-term conditions such as diabetes or chronic heart failure. Things like your temperature or blood pressure can be measured and the information sent via telephone line or broadband to a telehealth monitoring centre, where it is checked against information from your doctor. It means any problems can be picked up before they become urgent, and allows your doctor to monitor you in between appointments. It is also known as telepractice.

  • Tendering

    When an organisation such as a council or NHS body is looking for an individual or organisation to carry out some work for them, and invites people to set out formally how they would provide a particular service and how much they would charge the council or NHS for it.

  • Tertiary care

    Highly specialist health care requiring particular expertise and equipment, that is available only in specialist hospitals. Examples include cancer treatment, heart surgery and other things.

  • Third party top-up

    If you are moving into a care home funded by the council, and you want to move into a home that costs more than the council believes is necessary to meet your needs, you will be able to move there if someone (a 'third party') agrees to pay the difference. The third party may be a relative, friend or charity, and they will need to have a contract with the council confirming the arrangement.

  • Time banks

    A system where someone volunteers an hour of their time to help someone in their community and in return can have an hour of another person's time to receive help themselves. Time banks exist in many areas and are a way of building stronger communities and helping people manage their lives.

  • Top-up fee

    The additional amount that someone will have to pay for you if you choose to live in a care home that costs more than is in the council’s budget. The key aspect is that this is your choice: a top-up fee should only be charged if you have requested a more expensive care home, not because the council is unwilling to pay what a care home costs.

  • Transfer of care

    When you move from one place of care to another, such as from hospital to your home, supported housing or residential care. Your transfer should be properly planned and coordinated, and health and social care services should work together. Transfers of care may be delayed for various reasons. For example, you may be ready to leave hospital but end up staying there longer than you need to, while you wait for community care services or a place in a care home to be available.

  • Transforming Care

    A national programme to make sure that people with learning disabilities or autism can live at home, or in their community close to their family home, rather than staying in hospital for a long time.

  • Transition

    The process by which young people with health or social care needs move from children's services to adult services. It should be carefully planned, so that there are no gaps in the care young people receive. Young people and their families should be fully involved in the planning process.

  • Triage

    The process of deciding whether you need urgent medical attention, and how long you are able to wait. When you go to A&E or to a walk-in clinic, you will be asked questions about your symptoms. A decision will then be taken about how quickly you need to be seen, and who you need to be seen by.

  • Triangle of care

    A way of making sure that carers are involved in planning the services that the person they care for needs. The ‘triangle’ should be a partnership between the person who uses services, the carer and the main professional involved.

    See also:

  • Trusted assessor

    A professional who is trusted to make an assessment of your needs on behalf of one or more organisations, such as a council, care provider or hospital, so that you only need to be assessed once.  Trusted assessors may come from the health, social care or the voluntary, community and social enterprise sector (VCSE).  

    Trusted assessors are used, for example, to help you prepare to leave hospital, to arrange support such as equipment and adaptations to help you live at home, or to carry out an assessment of your needs as a carer.  


  • Unconscious bias

    How someone’s background and personal experiences affect what they think or assume about another person – such as a professional or a person receiving care and support services – without them realising. This can affect relationships between people and decisions that are made. 

    See also:

  • Universal design

    Buildings, environments and products that are accessible to everyone – including people with disabilities, rather than specifically designed for disabled people.

  • Universal information and advice

    Information and advice that is available to everyone in your local area. This should cover what care and support services are available in the area, how you can get these services, where you can find financial advice about care and support, and what to do if you are concerned about the safety and wellbeing of someone who has care and support needs. Councils are required by law to make information and advice available to everyone, regardless of who pays for the care and support you need.

    See also:

  • Universal personalised care

    A national plan to extend to everyone in England choice and control over the way their physical and mental health care is planned and delivered.

  • Universal services

    Services such as transport, leisure, health and education that should be available to everyone in a local area and are not dependent on assessment or eligibility.

  • Unmet need

    When you are not receiving the care or support you need, or not receiving as much as you need. This may be because you haven’t asked for it, or you have been assessed and services have not been provided. 

  • Urgent care centre

    Somewhere you can go without an appointment instead of A&E, if you have a minor injury or illness that cannot wait for a GP appointment. Urgent care centres are usually staffed by nurses and GPs.

  • User involvement

    The involvement of people who use services in the way that those services are designed, delivered and run. It may be an opportunity to use your experiences to make a particular service work better, and to be involved in decisions about things that affect you. User involvement takes different forms in different organisations, from voicing your opinion to getting actively involved in the way a service is run.

    See also:

  • User-driven commissioning

    Looking at the needs and views of people who use services, and using these to plan local services and make sure they are available.

  • User-led organisation (ULO)

    An organisation that is run and controlled by the people it serves - such as people with disabilities or older people - to help them live independently and have choice and control over their lives.


  • Value for money

    A way of working out whether a person or organisation has received the maximum benefit for the money they have spent on something. This applies to your own money as an individual, as well as to public money spent by councils and other public sector bodies.

  • Values-based recruitment

    A way of finding people to work for an organisation who have the beliefs, principles and behaviour that the organisation thinks is important, as well as the right skills to do the job.

  • Vanguard sites

    Specific parts of England that have been chosen to develop new ways of providing NHS care. The aim is to bring hospital and community care services together and to keep people well.

  • VCSE organisation

    An organisation that exists to help other people and communities, and operates as a voluntary organisation, charity or social enterprise. It does not make a profit. The letters stand for ‘voluntary, community and social enterprise’.

  • Ventilator

    A machine to help you breathe, when disease has affected the way your lungs work and you need support.

  • Virtual budget

    When your council allocates an amount of money to you as a personal budget, you can take this either as cash through a direct payment or as a virtual budget (also known as a managed budget). If you take it as a virtual budget, the council manages the money for you to arrange the services you choose, and you aren't responsible for paying directly for the services you receive.

  • Virtual market place

    A website where buyers and sellers can find each other. It can be useful for people who are looking for care and support services, and for organisations providing those services. Many councils offer a virtual market place on their website, or have a link to it.

  • Virtual ward

    A way of providing support outside hospital to people with long-term conditions who may need extra care to avoid being admitted to hospital. The 'ward' is run by the hospital, and treatment and care is provided by nurses and other health professionals.

  • Voluntary sector

    Organisations that are independent of the Government and local councils. Their job is to benefit the people they serve, not to make a profit. The people who work for voluntary organisations are not necessarily volunteers - many will be paid for the work they do. Social care services are often provided by local voluntary organisations, by arrangement with the council or with you as an individual. Some are user-led organisations, which means they are run by and for the people the organisation is designed to benefit - e.g. disabled people.

  • Vulnerable adult

    An adult who may need care and support because of their age, disability or illness, and may be unable to protect themselves from harm, neglect or abuse.


  • Walk-in centre

    An NHS centre that you can go to without an appointment if you have an illness or injury that is not serious enough for you to go to an accident and emergency department (for example, minor injuries, infections, stomach aches, vomiting and diarrhoea). Many walk-in centres are open every day of the year.

  • Welfare

    This may refer to the health, happiness and safety of a person or group of people. It may also refer to financial support that the government provides to people who need it.

  • Wellbeing

    Being in a position where you have good physical and mental health, control over your day-to-day life, good relationships, enough money, and the opportunity to take part in the activities that interest you.
  • Wellbeing team

    A team in your local council area that provides information and advice on ways to improve your physical, mental and emotional health and wellbeing.

    See also:

  • Wellness Recovery Action Plan (WRAP)

    A plan you create, and share with others as you wish, to help you recover from mental illness and stay well. It focuses on helping you manage your symptoms and gain control of your life if you have a crisis. It also supports you to spot the early signs of ill-health, and helps you think about what you need to keep well.


    See also:

  • Whole life disability service

    A way of supporting people with disabilities that coordinates a person's care and support between children's services and adults' services. Services such as health, education and housing work together to help the person plan the support they need as they move from childhood to adulthood.

    See also:

  • Whole systems approach

    Looking at every aspect of how a system works – such as the health, social care and housing system – and understanding what each part does, where the connections are and how it all fits together. Looking at the system in this way should help show how things can be done differently and better.


  • Young carer

    A young person aged 18 or under who looks after, or helps look after, a family member or friend who has an illness, disability or drug or alcohol problem. They may be responsible for cooking, cleaning, shopping, personal care or emotional support.


  • Zero harm

    A commitment by organisations that provide care and support to improve the care they provide so that mistakes are not made and people are not harmed. It requires a focus on safety at all times and openness about any mistakes, so that they do not happen again.

  • Zero-day admission

    When you have an unplanned admission to hospital – to a hospital ward, assessment unit or something similar – but end up not needing to spend a night there. It is not the same as a visit to accident and emergency because you are given a bed.

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