Residential/Nursing. Who decides?

brambles

Registered User
Sep 22, 2014
257
0
NW England
My lovely mum, 93 with Alzheimers has managed well in her own home with lots of support from me and my brother until 3 weeks ago when she fell during the night and has take a massive downturn.

We already had her name down for a carehome so approached them to be told it would many weeks or months before a place would be available. I approached SS for help, but was told it would take weeks to appoint a social worker and I should sort something out myself. She will be self funding.

Mum is quite poorly at the moment. She has chronic constipation with overflow diarrhoea and is understandably very weak and helpless at the moment. She may improve once this has been sorted , but who knows?

The residential places I have approached have all looked askance when I have described mums condition as well as not having places ( I have put her on several waiting lists, but am not sure they will take her even when she gets to the top). I tried ringing some nursing homes but was told if she could walk (she can, very slowly with a frame) and feed herself (she can) then she is not nursing care but residential.

My brother and I are both exhausted , mum is now incontinent , but is up and needs assisting to the toilet and cleaning up dozens of times during the night.
I had the doctor out today and half hoped she would be admitted to hospital so I could get some help, but it didn't happen.

Who decides what type of care is suitable for mum?
Can I insist SS appoint a social worker now, not in several weeks time?

I would be so grateful for any advice as I just don't know what to do next.

Thankyou

Brambles
 

Mrs W

Registered User
Nov 3, 2012
34
0
I’m sorry things are so hard for you and I feel your pain if it helps!! My MIL can walk unaided (on a totally flat and level surface she could probably go for a mile!!) and is just about to be moved into a nursing home so I don’t think those criteria are true at all!!

I’d tell SS you’re at breaking point and can’t cope any longer. It will become a crisis and they will need to appoint somebody ASAP.
 

love.dad.but..

Registered User
Jan 16, 2014
4,962
0
Kent
My understanding is if your mum will be self funding and has adequate funds now then you don't unless you want it need input from a social worker. You can go ahead and find an appropriate care placement. Perhaps NH have their own individual criteria but the two examples you were given cannot be the limit...often other medical conditions require nursing care and monitoring. I would imagine if LA funding was required as NH dementia care is more expensive it would have to be agreed for a very valid medical reason and assessment rather than solely residential dementia care. Dad had dementia..was mobile...was a self funder..and had an unstable medical condition which required nursing monitoring.

If SS do need to be involved for whatever reason I would knock very loudly on their door and tell them you are heading for a crisis and carer breakdown.
 

Beate

Registered User
May 21, 2014
12,179
0
London
If she's self-funding and you already told them that, I doubt a social worker will do much, to be honest.

I always thought nursing care is when someone needs to be given medication or be helped with something like incontinence. Walking doesn't come into it! Unfortunately all care homes can basically pick and choose who they accept so there are no general criteria they have to observe.
 
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nitram

Registered User
Apr 6, 2011
30,084
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Bury
In theory the LA should assess your mums's needs irrespective of funding.
In practise .when they know that your mum will be self funding delays can occur.

This means that it is up to you to search for appropriate homes and ask them to assses your mum.
 

Amethyst59

Registered User
Jul 3, 2017
5,776
0
Kent
From my experience I wouldn’t wait for a social worker. I had a crisis, phoned several times to get help and got a return call from them three weeks later. They only tried to contact me once. I had sorted the crisis by then, didn’t return the call and have heard nothing else from them.
 

Kevinl

Registered User
Aug 24, 2013
6,064
0
Salford
"but was told if she could walk (she can, very slowly with a frame) and feed herself (she can) then she is not nursing care but residential" Well my wife's been in an EMI nursing home for over 2 years and she can still walk without a frame, about half the people in there can still walk unaided.
She can't feed herself but I counted 12 people in the dining room at lunch today all feeding themselves but others have their food taken to their rooms or eat while they're walking around.
Homes can make their own rules about who they will and won't take, there doesn't seem to be a fixed definition it's whatever the home says it is.
Currently there are a couple of empty rooms but I've found out that the staffing levels work on a points system, residents are assessed and points given so self feeding, toileting, fully mobile no challenging behaviour score low, incontinent, need feeding, immobile etc score high.
If they take anymore high scoring residents they will need one more carer on both days and nights and that means hiring 5 extra staff, that's what it takes to cover the 168 hours in a week as not all the staff work the full 40 hours a week plus holidays, sick days and all the rest.
Not surprisingly the last 2 new residents have been very low maintenance and I think could quite easily be in a residential home and I guess the empty 2 rooms will stay that way as letting out the rooms wouldn't cover the extra wage bill.
Sadly that's the way it is out there, social services probably won't do much unless you can get her in hospital in which case they might.
K
 

brambles

Registered User
Sep 22, 2014
257
0
NW England
Many thanks everyone for your prompt replies, with lots of good advice.

I think I will call SS again tomorrow, though I am not at all hopeful they will help. I cried when I called them first time (not on purpose)
but they didn't change their stance.

One problem is , that the Carehomes will only assess mum once a place becomes available, and then they will decide if she is suitable or not. They all have long waiting lists. The only one that did have a room, I nearly ran there to look at it, but the room was 3 floors up, no lift, down a long rambling corridor with no toilet nearby and both the care manager and I agreed mum would not be safe there.

I also feel I have more than enough to do just looking after mum without trailing round visiting places which are unsuitable , or just not interested in having someone in mums condition.

All I really need is someone to come and see mum and say " these homes will be appropriate" and I can put her name down knowing that once a place becomes available they will take her.

There are only 3 nursing homes in the area and they all quoted me the same criteria about walking and eating.

Brambles
 

nitram

Registered User
Apr 6, 2011
30,084
0
Bury
Your mum has a legal right for an assessment of need, this should be done before any financial assessment. You may also have a right to a carer's assessment

If mum is self funding the result of the first can be largely irrelevant although you may have some success on the second.

Sadly it's up to you to find a placement, only a major crisis will force SS to become involved in which case you may have no choice of placement.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
When you contact the home ask them what they can not deal with and ask them how they would manage your mums problems. The answers they give will provide you a good idea of whether they would accept your mum.

Not all care home and nursing homes have the same criteria. Sadly, many care homes (even those that say they are specifically for dementia) will only accept people in early dementia stages, but there are places out there.
 

brambles

Registered User
Sep 22, 2014
257
0
NW England
Thanks again for your replies.

Nitram, It is a shame that SS will only help in a crisis, though I feel as though we are approaching one. I had always thought that as mum was self funding we would be able to choose where she went and pick the best place for her, now I feel as though I am scrabbling around just trying to find anywhere that will have her.

Canary, that's really good advice and should stop me getting my hopes up too much every time I phone somewhere.

Normaleila.. how did you find an independent social worker?
 

Baz22

Registered User
Dec 30, 2017
46
0
South West
Thanks again for your replies.

Nitram, It is a shame that SS will only help in a crisis, though I feel as though we are approaching one. I had always thought that as mum was self funding we would be able to choose where she went and pick the best place for her, now I feel as though I am scrabbling around just trying to find anywhere that will have her.

Canary, that's really good advice and should stop me getting my hopes up too much every time I phone somewhere.

Normaleila.. how did you find an independent social worker?
So sorry to read about your situation. In my own case we found the SS to be totally useless and of no help and the NHS to be unsympathetic and only interested in turfing my mother out of hospital and arguing the semantics between social care and nursing care. There is a massive difference in interpretation depending where you live and the NHS play "fast and loose" with their own framework. We have been very fortunate to find a care home that took Mum with mixed dementia, incontinence, virtually no cognition and poor mobility due to a long history of falls. We also are self funding. The Care home are brilliant and have saved our sanity so I truly hope you can find one soon. Good Luck.

There is a lot of good advice in this thread but you need to be prepared for many knock backs.
 

looviloo

Registered User
May 3, 2015
463
0
Cheshire
So sorry Brambles, that you are in this awful position... you have my complete sympathy. I can only echo what others have said about SS since my own experiences have not been great.

I am looking to move my dad from one care home (residential) to another, because his current home can no longer meet his needs. Like you, I am finding it difficult because he is self-funding (so SS are not interested) and because the care system is so complicated. I've had different opinions about my dad's needs depending on who I talk to. He seems to fall between residential EMI and nursing EMI. One thing I've found is the residential homes tend to have lower staff ratios, about 1:6 in general, and if you think that won't be enough for your lovely mum then you'll have to find homes with higher numbers of staff to residents, so probably nursing. Plus, sad to say that your mum will only get worse so her needs will increase. So don't look at homes where everybody looks better than she is at the moment, if you see what I mean.

You can insist on a needs assessment for your mum. Don't let SS fob you off about that. Ring Age UK? I've found them helpful, especially when it comes to practical matters. The Dementia helpline, too? But don't let it bewilder you, take the advice that seems to fit your situation and then knock loudly on the door of whoever you need help from. Good luck x
 

looviloo

Registered User
May 3, 2015
463
0
Cheshire
Hi Brambles
www.baswindependents.co.uk is the website. It's the British Association of Social Workers' directory of qualified independent social workers. You can search by location and speciality.
Particularly useful if you're caring from a distance. I picked two and sent a long email explaining the situation. Both phoned me the next morning. I had a half hour chat with the first one and chose him. I never actually met him, although my sister later did, but his help was invaluable. Good luck x

Normaleila, thank you so much for this... it could be just what I need too since, like brambles, my dad's also self funding and we're having problems dealing with a move of care home. I never would have thought of an independent social worker, I didn't even know they were out there! Thanks again.
 

brambles

Registered User
Sep 22, 2014
257
0
NW England
Thank you normaleila. I will look on the site as soon as I have time.
Thank you looviloo as well and good luck with your search

Shambles x.
That should have been brambles but maybe it's more appropriate!
 

brambles

Registered User
Sep 22, 2014
257
0
NW England
Just a quick update to say, that mum moved yesterday into a lovely Care Home. She is in the residential section, but there is a nursing section as well should she require it later.

Unfortunately, there were no private social workers in the area. I think they are mostly located in the big cities.
Luckily a place became available at this care home, just as well I think I would have cracked up if it had gone on any longer.
They assessed mum on Monday and she moved in yesterday.

Now, I know mum is being properly cared for day and night and though I didn't sleep last night thinking of her lying alone in a strange room. hopefully I will be able to catch up in the next few days.

Thanks again everyone for their kind input.,

Hope I'm not back too soon with another problem.

brambles x
 

Witzend

Registered User
Aug 29, 2007
4,283
0
SW London
As I understand it, a nursing home is for people who need the sort of care or attention only a qualified nurse can provide. Problems of incontinence or mobility don't usually come in that category. Ordinary residential homes whether dementia or not, won't normally have a qualified nurse on the staff.

We had to move my FiL from a residential home to a nursing home after he developed health problems and needed a catheter, among other things.

I can't think it applies in the OP's case, but there does sometimes seem to be confusion over descriptions - people do quite often refer to 'a nursing home' when they just mean a residential home.
 

Primrose19

Registered User
Nov 27, 2016
68
0
That’s great news, brambles. I remember the awfulness of trying to find a home quickly for my 89 year old mum who had previously been just about managing at home. She was self-funding so had the hospital and SW breathing down our necks to choose one. All the good ones are full and the others seem awful. Like you, a place suddenly became available at one of our preferred options. Hope all goes well for you all.
 

vicx

Registered User
Sep 11, 2017
22
0
It's so confusing, and I'm the carer!!
Mum had her SS home assessment 1 week ago. The s worker, said that mum was quite bad, and she could benefit from extra care housing, bearing in mind my mum thinks she is a1 normal. She went on to say, I would have to put mum on the local authority housing list, even though she is self funding. She also said the waiting list is bad, and if it goes to long she may by pass and need a care home. All this in front of my mum who believes there's nothing wrong with her. I received insider info yesterday, that there are 4 flats available at our 1st choice, and you shouldn't need to go on housing register. Then today i received letter from council asking for confirmation of my mum, and is need to supply either an in date passport or birth certificate. My mum has never possessed a passport, and a birth certificatecertificate. I felt like screaming, she has dementia, where do you suggest i start looking for her birth certificate. So tonight after reading all these posts i have contacted the housing association who own these flats, I need to clarify if there is a process. Plus if this waiting list is long, but it has been accepted by SS that the pwd needs help, what happens. Clearly nothing. I'm not asking for free care.