care homes - where to start

Kevinl

Registered User
Aug 24, 2013
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Salford
I'm not too sure what it all means and I'm of visiting in a few minutes so I'll read it again later, but Para 42 says:
"42) The following section deals with those who are receiving care and support in a care home only."
Then para 46 d says:
"d) Where a person’s property has been disregarded the local authority should consider whether the PEA is sufficient to enable the person to meet any resultant costs. For example, allowances should be made for fixed payments (like mortgages, rent and Council Tax), building insurance, utility costs (gas, electricity and water, including basic heating during the winter) and reasonable property maintenance costs."

My reading of it is that someone in care can get a disregard of part of their income to maintain their (empty) house.
The link below will take the legal beagles on here to the right page (I hope).
K

https://www.gov.uk/government/publi...ce/care-and-support-statutory-guidance#AnnexC
 

jikkie

Registered User
Aug 23, 2015
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But if you read higher up, i think it talks about property disregard because the spouse living there.

If you are right, then I could end up having to sell. I couldn't manage on £50 after bills.

And that opens more cans of worms, what then? A person from Age UK thought I would be allowed to buy, but if I rented, then the LEA would want the appropriate cut. And then if I buy, must it be in joint names, and if my OH dies, do I inherit according to his Will or do the LEA step in... I could do with some legal advice, but i cannot afford it, and also I suspect three lawyers would come up with three different answers.

The problem is caused because we have quite a chunky mortgage, and the equity is tight for downsizing to say the least.
 
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Kevinl

Registered User
Aug 24, 2013
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Salford
Well it might be better if you asked the mods to move this to "legal and financial" where some of the more informed on these matters make comments or start a new thread on there as the title here is about care homes but has moved on a bit from there into a slightly different question.
That said and as I see it the rules you are quoting relate to the Personal Expenses Allowance for some one in care i.e. the £23 a week they allowed to live on but 46B says
"Where a person’s property has been disregarded the local authority should consider whether the PEA is sufficient to enable the person to meet any resultant costs. For example, allowances should be made for fixed payments (like mortgages, rent and Council Tax), building insurance, utility costs (gas, electricity and water, including basic heating during the winter) and reasonable property maintenance costs."
Which does seem to imply that he's still liable for half of the costs of the house he own and you live in while he's in care. All I can say is this runs contrary to advise I've seen given time and again on here that when LA funded a spouse can keep half the occupational pension and half the cost of the house's insurance, perhaps a new thread in L&F might get some more informed advice.
K
 

jikkie

Registered User
Aug 23, 2015
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0
Yes, thread has digressed somewhat.

It is the care home issue I am more interested in. I am quite suprised at the lack of lists etc, I suppose it's all part of the gatekeeping, to make it more difficult for us. Bettercaring.com gives a list of 30 homes in Cardiff, so one morning I will sit down and call them all in turn.

I'd like to find one that does both respite and long term, for the continuity in the future.

Not to mention finding one that the LEA will pay for. lol

And that's without the all important aspect of how good or pleasant it is!
 

jikkie

Registered User
Aug 23, 2015
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Brilliant Jinx, that's a much more useful list. Thank you.

Had a wonderful visit to the consultant today, I have to say I think he is the best doctor I have ever come across, bar none.... all sorts of reasons. Clinically and personally.

Amongst other things, he told me that yes, the speed of decline does increase (so it isn't my imagination!), and that in his experience very few people actually care at home to the extent that I have been getting the impression in this forum, and consequently feeling very inadequate. That made me feel strangely better. I looked him straight in the eye and said that I felt that if weeks like last week became the norm, then I couldn't see me managing beyond say March... obviously total shot in the dark guess. To my surprise he said, it could be a lot sooner. And then proceeded to get on the phone and go digging and sweet talking various people to find a contact for a "Placement Advisor" who would help with the requirements and research. Wow.

I was so grateful. Also frightened of course; it's not nice to have fears confirmed. I think a massive guilt trip will kick in at some point too.

Thanks again to everyone who has responded. I feel I know what I need to do next now.
 

pamann

Registered User
Oct 28, 2013
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Kent
Hello jikkie, you are doing so well, pleased to hear you saw a Dr today, you have taken advice from us to start CH proceedings. We can only do so much to look after our loved ones, you will know when the time has come to go down the CH route. Instead of caring 24/7 l am now visiting and caring 5 days a week for 6hrs per day, the relief and freedom is wonderful, l could not cope any longer, l now have some sort of life. I wish you all the best for the future.
 

Kevinl

Registered User
Aug 24, 2013
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0
Salford
Well the 7 on Jinx's link are interesting, from the CGC reports (and I won't name the homes) bits read like this one the ones I looked at, each para is a different home:

1. We continued to find non compliance in a number of areas which had previously been identified at the time of the March 2016 inspection visits. Consequently, we have issued a new non compliance notice". That report all makes pretty grim reading.
2. Next one no link to the CQC on the page so I had to google it, 3 x require improvements and rated 2 x goods on the CGC report and one comments said "Is the service safe? The service was not always safe.", "Is the service effective? "The service was not always effective", and "Is the service well-led? Some aspects of the service were not well-led. At the time of this inspection the manager was not registered with the Care Quality Commission although they had started the application process."
Another interesting quote was "For example we found eye pads dated May 2005 and some sterile dressings dated June 2013." Hmmm
4. "The language used in the communication books should be professional and retain the person’s dignity at all times." Interesting comment, then further on it says "Some of the language used was derogatory," (still referring to the communications book).

So before you start making the call I'd read through the CQC reports on them and see what they turn up, plus you have to get the LA to agree the funding and see what's in budget as you said originally a top up is out of the question.
I'm glad the meeting with the consultant went well and what the consultant said should help your cause, but the LA may see it differently when you ask for the cash so that needs sorting first, cart, horse and all that. Good luck.
K
 

Jinx

Registered User
Mar 13, 2014
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Pontypool
I agree it is important to read the reports but having got that information, and assuming that there isn't complete condemnation, it is equally important to visit, without prior notice, and get a feel for the place.

The other problem is whether there will be spaces or a long waiting list. When I was looking for my husband's care home I read all the reports for the EMI homes in our area and beyond and I visited most of them. However, when push came to shove there was only one place available in all of the suitable homes in our area. The report wasn't brilliant but I went to visit and got a really good feeling about what I saw. When I analysed the report again it was criticising record keeping and updating care plans. Yes, I know those things are important but I witnessed a very good level of care and to me that is better than residents being neglected whilst staff catch up with paperwork.

Jikkie, I had a trawl through the Cardiff CC web site, which may be where you got your list from but here's the link: http://www.carehome.co.uk/care_sear.../Cardiff/searchchtype/alzheimers-and-dementia


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Florence.

Registered User
Nov 7, 2012
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I agree it is important to read the reports but having got that information, and assuming that there isn't complete condemnation, it is equally important to visit, without prior notice, and get a feel for the place.

The other problem is whether there will be spaces or a long waiting list. When I was looking for my husband's care home I read all the reports for the EMI homes in our area and beyond and I visited most of them. However, when push came to shove there was only one place available in all of the suitable homes in our area. The report wasn't brilliant but I went to visit and got a really good feeling about what I saw. When I analysed the report again it was criticising record keeping and updating care plans. Yes, I know those things are important but I witnessed a very good level of care and to me that is better than residents being neglected whilst staff catch up with paperwork.

Jikkie, I had a trawl through the Cardiff CC web site, which may be where you got your list from but here's the link: http://www.carehome.co.uk/care_sear.../Cardiff/searchchtype/alzheimers-and-dementia


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You are so right Jinx. A good friend whose husband had Alzheimer's and who she cared for died suddenly. His family live abroad and so I became advocate for him. We got him into respite then NHS psychiatric unit for assessment. I read any reports that were on line but went by word of mouth as well. There were four EMI care homes in the area. The biggest someone said don't touch it but at the end of the day after he had been assessed it was the only home with places who could also take up to end of life people. I had as much help as I needed as he was self funding so there was no problem but as it was the only place available he would have had to go there if the Council were paying. I visited twice before he went in and couldn't readily see any problems. After he moved in I was visiting a lot, just walking in off the street outside of meal times, and it was fine but. It did give me a different perspective of what they have to deal with on a daily basis with a large number of people, some with very challenging behaviour. I could raise any concerns I had and there was always someone willing to give time to answer. My overall opinion is that they are doing their best and that's all they can do. I would say dont necessarily go by places because they have the best standard of decor or carpets etc. Go with a list of questions by appointment the first time to ensure someone is available for longer to show you round but at the end if the day it's places available, as you say.
 

Casbow

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Sep 3, 2013
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Colchester
I have just posted a message about my situation. I needed a break as I was a prisoner because my OH doesn't want any visitors or to go out to other peoples houses. So I have a week booked starting tomorrow. I am hoping that it will enable me to recharge my batteries. Feeling very sad about it. I have been caring for him for 9 years but it has been a slow ride downhill and the last 2 years have been getting rapidly worse. So I think respite is a good way to go, to see how you feel and how your OH is in respite. Good luck to you and good luck to me.!!xx
 

jikkie

Registered User
Aug 23, 2015
64
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Good luck Casbow. That's a good point, I hadnt thought of it like that, I am a prisoner, we have no visitors (my daughter once a year) and do not go out at all now, as I cannot leave him for 2 minutes (to order a drink, go to the loo...).

I am pretty sure we are getting 2 days a week day care, and will start the push for a respite week, followed by others at regular intervals as soon as our social worker is back from her holiday.

My OH always says he wants me to leave, or for him to live somewhere else... or I bad temperedly say he should find a hotel with better service!

He quite liked the day care centre when we visited, so fingers crossed.
 

Ann Mac

Registered User
Oct 17, 2013
3,693
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Hiya Jikki,

I'm also in Wales, and am in the process (just at the start) of finding a suitable EMI Nursing home for my Mum in law, who had lived with us for nearly 3 years. Like your husband, Mil suffers from some behavioural issues - severe delusions, often paranoid, sometimes terrifying. She was admitted to hospital, to an EMH (Elderly Mental Health) assessment unit, back in April, the intention being that they would withdraw, under medical supervision, some of the many medications that a succession of consultants had precribed, and try to find something that worked to ease her torment and make it possible for us to continue caring at home.

Unfortunately, even though she now is now considered to be on the 'optimum' medication possible, her extremes of agitation cannot be moderated to the point where we could care for her here at home and we have had to accept that she needs residential care. Initially we were told that an EMI home would be suitable, and we had chosen a home where she was on the waiting list (the home where she had been going for day care, for well over a year), and she has remained in hospital whilst we have ben waiting - but a new consultant is now in place and he has said, very firmly, that it isn't possible. Due to the fact that she has mediation given on a prn basis (administered when needed only, to try and take the edge off the worst agitation) and the fact that she frequently needs one to one support and attention to prevent her becoming violent and putting herself and others at risk, we have been told that she must go to an EMI Nursing home. EMI homes cannot give prn medication, and nor do they have the staffing levels needed to provide care for those with challenging behaviour - EMI Nursing homes can give the prn and have the higher staffing levels.

If either of those scenario's apply to your OH, then its an EMI Nursing home that you need to be looking for, and if that is the case, it may help if you can get the consultant to put in writing that he needs that level of care - that way, it may perhaps help with the correct funding being sorted from the start.

I don't know the situation where you are, but here, EMI nursing places are in very short supply, sadly. I know that pwds locally, who now need that level of care have ended up as far away as Liverpool, Manchester and even in one case, in London. I'm waiting to be supplied with a list of EMI nursing homes in two neighbouring counties, and am hoping against hope that we can find a suitable place for Mil within those counties, so we can keep her fairly close by. But, obviously this means that it is more than possible to go outside of your county to find a place if you need to.

I hope this might help a little - good luck xxxx
 

Jinx

Registered User
Mar 13, 2014
2,333
0
Pontypool
Hiya Jikki,

I'm also in Wales, and am in the process (just at the start) of finding a suitable EMI Nursing home for my Mum in law, who had lived with us for nearly 3 years. Like your husband, Mil suffers from some behavioural issues - severe delusions, often paranoid, sometimes terrifying. She was admitted to hospital, to an EMH (Elderly Mental Health) assessment unit, back in April, the intention being that they would withdraw, under medical supervision, some of the many medications that a succession of consultants had precribed, and try to find something that worked to ease her torment and make it possible for us to continue caring at home.

Unfortunately, even though she now is now considered to be on the 'optimum' medication possible, her extremes of agitation cannot be moderated to the point where we could care for her here at home and we have had to accept that she needs residential care. Initially we were told that an EMI home would be suitable, and we had chosen a home where she was on the waiting list (the home where she had been going for day care, for well over a year), and she has remained in hospital whilst we have ben waiting - but a new consultant is now in place and he has said, very firmly, that it isn't possible. Due to the fact that she has mediation given on a prn basis (administered when needed only, to try and take the edge off the worst agitation) and the fact that she frequently needs one to one support and attention to prevent her becoming violent and putting herself and others at risk, we have been told that she must go to an EMI Nursing home. EMI homes cannot give prn medication, and nor do they have the staffing levels needed to provide care for those with challenging behaviour - EMI Nursing homes can give the prn and have the higher staffing levels.

If either of those scenario's apply to your OH, then its an EMI Nursing home that you need to be looking for, and if that is the case, it may help if you can get the consultant to put in writing that he needs that level of care - that way, it may perhaps help with the correct funding being sorted from the start.

I don't know the situation where you are, but here, EMI nursing places are in very short supply, sadly. I know that pwds locally, who now need that level of care have ended up as far away as Liverpool, Manchester and even in one case, in London. I'm waiting to be supplied with a list of EMI nursing homes in two neighbouring counties, and am hoping against hope that we can find a suitable place for Mil within those counties, so we can keep her fairly close by. But, obviously this means that it is more than possible to go outside of your county to find a place if you need to.

I hope this might help a little - good luck xxxx

I believe if EMI Nursing is required the fees should be paid by the NHS. I am sure others will have more knowledge about that.


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Kevinl

Registered User
Aug 24, 2013
6,064
0
Salford
I believe if EMI Nursing is required the fees should be paid by the NHS. I am sure others will have more knowledge about that.

Not automatically as far as I'm aware, you have to go down the CHC route I believe.
You can get some if the nursing care paid for, the NHS pay the home my wife's in £125 a week for nursing care, the rest is paid for under section 117.
K