Hi,
Just under 2 weeks ago we had to put my Grandad in a Care Home, and he seems to be rapidly deteriorating since admission. I'm after some urgent advice. We had the Full Assessment for my Grandad 48 hours ago. His scores were 3 High, 6 Moderate, 2 Lows.
Behaviour was scored as High but I argued that the Behaviour domain should be Severe but the SW and Assessor didn't agree. He had been verbally aggressive, made inappropriate remarks on occasion, and kicked out at Care Home staff when it came to personal care (this has all happened in less than 2 weeks).
We had a call from the Assessor to say he wouldn't be eligible for CHC but would for FNC. The current Care Home does not have nursing services.
24 Hours later (yesterday), he grabbed another resident by the throat, threw a hot cup of tea over another resident, pushed another resident over who fell on the floor, and after the staff had managed to get him into the garden away from others, he grabbed a garden fork to use as a weapon and said he will not put it down until a family member goes to him.
Would you say we have a case to argue that his Behaviour should now be classed as Priority and pursue this? Can the Assessor change this score at this point or would we have to wait to appeal?
If you need any more info, please let me know.
Thank you.
Hi
@Camie93 I'm sorry to hear that your Grandad is deteriorating. Like
@Dave63, I've been battling with the ICB for the last 3 years for my mum, who has had 3 MDT's during that time. She was found ineligible at the first two, the second of which resulted in 1 Severe, 6 Highs, 3 Moderates and 2 No Needs and clear evidence of Intensity & Complexity. Using a legal firm, we took this to appeal which was successful.
My mum has always scored 'High' in the Behaviour domain which manifests itself as verbal aggression, abusive language, lashing out during personal care (causing minor injuries to herself and carers) and intractable noisiness (shrieking and screaming for hours on end and all through the night). I thought (and so did my legal caseworker) that 'high' was the correct score.
From what you have described, it sounds as though there has been an escalation in your Grandad's behaviour since the MDT. Now, if the ICB do their job properly (which is unlikely) your Grandad's DST and subsequent decision for ineligibility should be reviewed 3 months from the date of the MDT. At this review, if it is considered that there has been a change in needs, then the ICB must conduct another full assessment - your Grandad's behaviourial deterioration should trigger this.
It is likely that the 3 month review period will come and go and you won't hear from the ICB, in which case you may want to consider contacting them, explain that there has been a change in needs and ask them to please get on with the review. In the meantime, insist that the care home keep Behaviour Charts for your Grandad so that you have the necessary recorded evidence to prove your case at the review and/or appeal. Everything is evidence based and if it isn't recorded, it didn't happen. Make sure the care home keep comprehensive records - many of them don't.
You can still go ahead with the appeal. Some of the legal firms offer a free initial telephone consultation. That's how I got started on this CHC journey.
Good luck.