Social Services and care home

hells-bells

Registered User
Nov 16, 2015
17
0
Brighton
Hi

Long story so I'll try and keep it short but would appreciate any advice. My partner and I have been caring for my MIL, who has Alzheimer's, for around 4 years, who lives independently in sheltered housing. Seven months ago we requested a care package to be put in place but due to an oversight by social services and frequent absences by MIL's assigned care manager, they have failed time and again to arrange the package.

We started speaking to an admiral nurse a few months ago, who has been brilliant. She has got on the SS team's case and they slightly upped their game, and agreed to fast-track the care package a week ago.

However in the last few months, MIL has gone downhill significantly and had two A&E admissions, both resulting in a few days' admission to hospital. The last time, we requested respite, but as my partner was available to care for MIL, the discharge team refused it and insisted on discharging her.

MIL went into hospital a week ago, due to aggressive behaviour and borderline psychosis, and is now on a dementia ward, and DoLS has been applied. We have refused to take her home until now, as we have serious safety concerns with her living independently, even with an emergency care package in place. She has been assessed as having no capacity.

SS however have deemed her safe to live independently with carers three times a day (based on two half hour meetings with her). We strongly disagree with this, and feel she needs 24 hour care - since being in hospital, and being cared for 24/7, she has calmed down significantly. I know that if she were to return home, even with three visits a day, it would be a matter of days before she returns to the state she was in before we took her to A&E.

Bearing in mind we have no LPA, and have had no carers until now, do we have a leg to stand on to insist on residential placement? Or do we need to try the care package with a view to returning her to A&E in a week or so? It's very worrying to have her alone for the best part of a day, when her mental state is so fragile.

They have assessed her as being 'at risk' but not so much as to cause concern! They have pooh-poohed any evidence we've provided so far, such as her walking in front of traffic, or the potential for wandering, with 'She hasn't got lost yet. Hang in there.'

We've requested a best interests meeting but need to prepare ourselves for the SS onslaught.
 

Jbob

Registered User
Apr 20, 2016
130
0
Hi hells-bells,
We were in a similar situation when my Dad wandered off and had a bad fall and was admitted to hospital with a UTI and fractured eye. My mum is his carer but she had been struggling to cope before and after his hospital admission his Alzheimer's had detioriated quite a lot. He was hospitalised for 4 weeks and we insisted that he went in residential care whilst Mum had a financial assessment and care package put into place. Now 10 weeks later he is still there and Mum is awaiting her financial assessment. She is away and some of our reasons for residential care was because we knew she would be away for 4 weeks on a planned holiday. My Dad should have gone with her but he can't now. He has mental capacity for some things but not on deciding where is best for him to live. We didn't have a welfare LPA at the time but do now so I'd advise getting one if you can. Fortunately he had signed all the paperwork before his fall. We hadn't had any care plans or SS support before then either.
Insist it is not safe for her to go home and that they have a duty of care to make sure she is safe. They can't discharge her if she won't be safe. I found SS tobe on our side and really helpful but we did get extra support from the Alzheimer's Society too.
Hope it goes well! ☺
 

HillyBilly

Registered User
Dec 21, 2015
1,946
0
Ireland
My partner and I have been caring for my MIL, who has Alzheimer's, for around 4 years, who lives independently in sheltered housing.

MIL went into hospital a week ago, due to aggressive behaviour and borderline psychosis, and is now on a dementia ward, and DoLS has been applied.

Is the sheltered housing complex prepared to have your MIL living there, bearing in mind her condition and the fact that it will most very likely worsen? It's all very well SS stating she can live independently at home but sheltered housing isn't quite the same thing as an "own home". Could you maybe get the manager/warden/whoever of the sheltered housing to state that they can't have her back?

Am guessing your MIL wouldn't be self-funding? If she were, then you can politely tell SS to butt out!

It seems it's partly SS's responsibility that your MIL is now where she is due to their failure to sort out a care package sooner, so I'd be putting all that in writing to them, very strongly worded, and have a whole dossier of evidence prepared for the best interests meeting.
 

susy

Registered User
Jul 29, 2013
801
0
North East
I haven't been in this situation myself but having read previous posts similar to yours it seems the best way forward is to not take any responsibility yourselves. You don't have to and you don't have power of attorney either so they can't even pin that on you. SS have a duty a really duty to ensure your mums safety. 3 care visits a day will not come close to doing that. If she is a wonderer then alarms at doors won't stop her either. You need to insist that they take their responsibility seriously. Do not allow them to railroad you into taking up the care for her and insist she is placed somewhere she will be safe and that doesn't sound like anywhere other than a home.
 

Sterling

Registered User
Jun 20, 2013
69
0
Hi,

I have been in similar situation where although I could evidence risks with situations that had repeatedly occurred, SS didn't have the proof for themselves. They also said that they had to go for the "least restrictive" option according to the law. After a Best Interest Meeting they decided that a live in carer was the best way forward. I told them that I completely disagreed with them but her life/risk was in their hands. I then stood back. Mum is now back in hospital and SS have enough evidence. If you are unhappy with SS decision you can appeal or there is the Court Of Protection option.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
I think that the LAs are so strapped for cash these days that they will try anything rather than pay for residential care. Unless she would be self-funding you may find that you have no option but to accept carers 3x a day - but any sign of problems get back to them straight away, dont try and "fill in the gaps" yourself.
 

hells-bells

Registered User
Nov 16, 2015
17
0
Brighton
Thanks for all your responses. It seems like such a common issue, and we're in that very muddy area between relative independence and 24 hour care. And no, she's not self-funding - this would all be so much easier if she was.

Is the sheltered housing complex prepared to have your MIL living there, bearing in mind her condition and the fact that it will most very likely worsen? It's all very well SS stating she can live independently at home but sheltered housing isn't quite the same thing as an "own home". Could you maybe get the manager/warden/whoever of the sheltered housing to state that they can't have her back?

This is something we've considered - the complex isn't sympathetic towards dementia, and MIL has caused a few problems over the last six months. Other residents give her a wide berth, as she's 'different' from them. The house manager is sympathetic towards our situation but has made it clear that there is a limit.

I think that the LAs are so strapped for cash these days that they will try anything rather than pay for residential care. Unless she would be self-funding you may find that you have no option but to accept carers 3x a day - but any sign of problems get back to them straight away, dont try and "fill in the gaps" yourself.

I think we're going to have to go down the carer route, if only to prove to them that it's too little, too late - and ultimately won't work. We'll also take a step back from caring for the first week, and see what happens.

It feels horribly harsh, and like we're putting her at risk, but don't know how else to show them that without us, she cannot cope with just three carer visits a day. She'll be on her own for 21 hours a day, and the possibilities of her getting into trouble are endless :(

The ridiculous thing is that everyone, aside from SS and the mental health team, agree that she needs to be in residential - her family, the admiral nurse, the hospital staff who are caring for her every day. SS have based their decision on seeing her for two short periods at home, when she was in 'hostess mode'.

They saw none of her anxiety or difficult behaviour - I'd love to install a camera in the flat and show them video evidence...
 

Sterling

Registered User
Jun 20, 2013
69
0
My mum is self funding - it made no difference!!
The hard thing is that because mum is in complete denial and wants to go home, even though she lacks capacity it had to be trialled. If it wasn't the IMCA would have taken it to the Court of Protection. Everyone around the table except SS, IMCA and my mum said she should be in a placement. In the end I worked with SS instead of fighting against them and then they were able to get a true picture of how mum was at home and now they agree with me.