help urgently needed on the rules on dementia homes

JeanD

Registered User
Sep 16, 2008
96
0
Lincolnshire
Please can anyone out there advise us on whether what we are being told is true. The hospital tells us it cannot discharge to a non-dementia nursing home, and that to do so would be breaking the law.

My father is in hospital, very ill, with failing kidneys. 10 days ago we were told he was being discharged, and we must find him a suitable home. The social worker said that as we were self-funding, she would not help us find one.

I took half a day off last Friday (31st) and went to visit the care home we had chosen. They are not registered as a dementia unit, but occasionally take Alzheimer's patients when the Alzheimer's is not really the main problem. They nursed my father's brother for his last 9 months, and he had dementia. The home agreed to send a nurse to assess dad this week. We were totally upfront with them about the dementia as dad has been moved 6 times already, and the last thing we wanted was for them to take him and then change their minds.

We told the hospital which home we had chosen, the nurse arrived yesterday and was briefed by them, she visited dad while mum was with him. She said he is clearly a very poorly man, and they would do everything they could to help. But she needed to speak to the matron of the home today, as they only had a bed in a double room, and she said dad would need an electric bed and hoist. She was concerned there would not be space for it, but said they would see what could be done.

She phoned mum today to tell her they had arranged a single room for him on Monday, with the electric bed etc. We were to arrange the transfer when we visited the ward this afternoon. Mum was so relieved she cried for an hour.

But when the staff-nurse saw us on the way in today and I asked him about the transfer he said "your father won't be going there on Monday". I thought at first dad had died, or become too ill to move. But what he told us is that it is illegal to send him there as they don't have a licence for Alzheimer's, and we would have to find somewhere else. That would mean a long wait for a bed, and long drives for mum. He said despite dad being terminally ill, his primary need was psychological. The home were not trained to cope and 'he might tip another jug of water on himself'. My sister said, so what, he would get wet, we can take that risk. And anyway no-one would leave things where he could do that. Also that any patient might do that, Alzheimer's or not.

We have tried to reason with them, but all they will agree to is asking a more senior nurse on Monday. We have called the home of course. They are furious that their competence is being questioned. The hospital nurse still says it is illegal, and they will investigate on Monday why the home has other dementia patients. I tried to point out that since they have 48 very elderly patients needing nursing care there is bound to be some element of dementia for some of them. Also that dad's Alzheimer's consultant has withdrawn dad's medication and said his dementia is "no longer the issue". And that it was a fully certificated Alzheimer's home that neglected dad so badly his kidneys failed in the first place............

I would be so grateful if anyone knows if the hospital is right.
 

jenniferpa

Registered User
Jun 27, 2006
39,442
0
You need to talk to Alzheimer's help line - they have a legal advice facility they can call on.

My first thought is - rubbish. Unless your father has been sectioned - has he? Without a section he can live wherever he or rather his family please.

There is I believe no such thing as "licensing" for dementia care - there used to be but not anymore, at least not in England.
 

Margarita

Registered User
Feb 17, 2006
10,824
0
london
As far as I know from my social worker yes a home has to be registered as a dementia to take my mother .

about being illegal I don't know , but if its a rule for social services and there funding the care there not going to send your father any where thats not registered for dementia

Also that dad's Alzheimer's consultant has withdrawn dad's medication and said his dementia is "no longer the issue"

"no longer the issue

How strange for a doctor to say that , even thought the care home he was in was not up to stranded.
 

Margarita

Registered User
Feb 17, 2006
10,824
0
london
There is I believe no such thing as "licensing" for dementia care

They is now with my social services, its called registered for dementia care . may be if its registered it mean they get a license
 

JeanD

Registered User
Sep 16, 2008
96
0
Lincolnshire
Dad has never been sectioned. The consultant said dementia was not longer the issue because dad is dying of kidney failure, and his dementia is stable and not causing any great problems. He is bed-ridden and barely conscious, but very sad when he does talk.. Mum asked yesterday if there was anything he wanted and he said "yes. Rest in Peace". It is heart-breaking.
 

Margarita

Registered User
Feb 17, 2006
10,824
0
london
All care homes must be legally registered. This means that they must have a simple, clear and accessible complaints procedure. The procedure should set out the stages and timescales for the process. Complaints should be dealt with promptly and effectively, within a maximum of 28 days. A good complaints process will not only investigate what happened on a particular occasion but will also identify weaknesses in the overall processes of care and make sure that the same situations or mistakes do not keep occurring.

http://www.alzheimers.org.uk/factsheet/451
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
My first thought is - rubbish.

That was my first thought too!

John is in the EMI section of his care home, but his needs are now nursing rather than EMI, and they would trnsfer him to the nursing section if I wanted -- I don't!

But I know people from the Alzheimer's support group who are in care homes without a separate EMI section.

As far as I'm aware, homes are now registered as Care Homes, and if they can provide for the resident's needs, the choice is theirs. The only caveat is if there is challenging behaviour, which there clearly is not in Jean's dad's case.

Jean, I agree with Jennifer, you should ring the AS helpline first thing on Monday.
 
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Margarita

Registered User
Feb 17, 2006
10,824
0
london
The local authority cannot necessarily dictate which home someone should move in to. If the person with dementia has mental capacity, they must be in agreement about the home it is suggesting. If they do not have mental capacity, then the local authority must liaise with the person's guardian, lasting power of attorney (LPA) for personal welfare or someone who is closely involved with the person (see Factsheet 459, Mental Capacity Act 2005 and Factsheet 472, Enduring power of attorney and lasting powers of attorney). If there is no guardian, LPA for personal welfare or carer involved, the person has the right to an independent mental capacity advocate (see Factsheet 459, as above).

If the person liaising with the local authority does not agree about the home suggested, they should raise their concerns with the social worker, and make a formal complaint if necessary.

http://www.alzheimers.org.uk/factsheet/476
 

JeanD

Registered User
Sep 16, 2008
96
0
Lincolnshire
Thank you so much for your replies. I have phoned mum and told her not to give up hope for Monday. I have read all the fact sheets I can find on choosing a care home, and can't find anywhere that says it must be registered for dementia. The hospital seemed so sure, although the nurse who said it was his decision was very young, and maybe not as knowledgeable as he seemed.

We spent a long time talking to them, and begging them to reconsider. At the end they said "we had wasted nearly an hour of their time"! Our time and worry seems not to matter.

We will not give up on dad. I hate confrontation but would do anything to help him. I wish it was not just one battle after another though.

Jean
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
Jean, it's not up to the nurses to decide anyway, only the consultant can do that. Your dad is not on a specialist dementia ward, so it's quite likely that the nurse has had little training in dementia.

Definitely don't panic. Ring the helpline first thing on Monday, and if we're right, ring the hospital and ask for an appointment to speak to the consultant.

There shouldn't be a fight. The hospital needs the bed, the care home will take your dad, and you want him to go there. I can't see a problem.:)
 

connie

Registered User
Mar 7, 2004
9,519
0
Frinton-on-Sea
Jean, may or not be revelant. The first few times I placed Lionel in respite I chose residential homes that 'took Lionel the man'.

I was told at that time, had he not been self funded , they would not have been considered 'suitable'.

I do not know your circumstances. However Lionel was granted Continuing Care in May of this year, with a strong element of nursing care required. He is still in the same ordinary care home. I have defied them to move him.

Even his consultant said he would propable have died by now, had he been cared for anywhere else.

Sometimes we just have to shout very loud.
 

Margarita

Registered User
Feb 17, 2006
10,824
0
london
We spent a long time talking to them, and begging them to reconsider. At the end they said "we had wasted nearly an hour of their time"!

"we had wasted nearly an hour of their time"!

Blood%% cheek of them , they have given you an hour of distress of wasted energy .

If I was you I would print out those fact sheets for your mother, so you can show them the FACT that they are not up to date with .

If the person liaising with the local authority does not agree about the home suggested, they should raise their concerns with the social worker, and make a formal complaint if necessary.

Never forget Complaint does take up energy we don't have , but its not a wasted energy it a positive energy that keep them on there toes so they don't think they can just walk all over us , when we are feel so Venerable .

Good Luck :) Let us all know how it all went .
 

JeanD

Registered User
Sep 16, 2008
96
0
Lincolnshire
Thanks for the warning Connie. We had planned to appeal for Continuing Care, since dad's care needs are so high. We wanted to do it mainly on principle, as they don't seem to follow their own guidelines. Sounds like we should pay up and shut up, and just make sure dad gets the care he needs.

It is much more important to him that mum can visit every day, than what licences the home has. All the other homes are so far away, and she has recently had a hip replacement. I don't want her driving so far especially in winter. The home we have chosen is only a mile away. The social worker was fully aware of our choice and did not criticise it. We will call the legal help line on Monday.


Blood%% cheek of them , they have given you an hour of distress of wasted energy.
Yes Margarita, and the worst of it is we spent nearly an hour of visiting time on it, when we could have been with dad. He does not have the time to waste.

Thanks again for all your help, I don't know what I would do without this forum.

Jean
 

Margarita

Registered User
Feb 17, 2006
10,824
0
london
I was told at that time, had he not been self funded , they would not have been considered 'suitable'

yes that what I am told , as we are funded, If I choose a respite care home that is not Licenece to take people with a dementia

As I have read from your other thread that you are self funded, also understand bit more where your coming from, you can do as you like because your funding it yourself

It is much more important to him that mum can visit every day, than what licences the home has

Go for it , don't listen to anyone just make sure that they can meet your father Personnel high care needs .
 
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reluctant

Registered User
Nov 8, 2008
14
0
Hi JeanD
I am so sorry you are having such a bad time. it might be that the hospital mean that Dad needs to go into a registered nursing home as domicilliary care homes cannot provide nursing care I used to manage a small care home and my registration actually stated that I could care for up to 4 people who had a learning disability 2 of who may have a physical disability and I was not allowed to take anyone who needed any nursing care I hope this helps
reluctant xxx
 

Lanie

Registered User
Aug 31, 2008
293
0
Surrey
Hi Jean

I do hope it works out for you, I'm sure the home wouldn't say they would have your Dad if they didn't believe they could care for him and surely that will be what counts.

I do hope it works out for you and your family as you really shouldn't be having to go through the added stress at this time.

Take care

Lanie
 

Marianne

Registered User
Jul 5, 2008
301
0
NW England
Hi
They should have carried out a multi-disciplinary assessment of your dad's health care needs before he is discharged. They have a habit of not following the correct procedure hoping you will not know, and that you will follow the advice of Social Services. Until the assessment is carried out Social Services have no business means testing or advising you. Social Services should only get involved if NHS CHC is denied which should definately not happen in your dad's case.

I would be asking when is the assessment of your dad by the PCT Assessors taking place, this should give them something else to focus on.In the meantime the assessment tool and New National Framework for CHC are downloadable on the internet.

Best Wishes
Marianne
 

cariad

Registered User
Sep 29, 2007
89
0
Hi Jean,
sounds like your Dad is entitled to continuing care. Please look into this. Why should he/you have to pay when it is clearly a health need. I got CC for my mam and she is still mobile, eating etc
good luck Berni
 

Margaret W

Registered User
Apr 28, 2007
3,720
0
North Derbyshire
Dear Jean

This is terrible for you. You have my complete sympathy, for what good it does. Why your dad need a specialist unit is beyond me, cos if he does, then so does my mum, so can we invesigate a place together? Mum has AD, the care home she is in is a general care home, and as you say, most of the residents have dementia. Ther is June who asks me the same question ever two minutes, there is Elsie who shouts at everyone constantly, there is is Lena who thinks everyone is a pillock, there is Mary who thinks that every man fancies her. Dear me, a rich mixture, but all manageable. Gone are the days when people went into to care homes cos they didn't fancy being at home alone. Today's care home residents are there cos there is no choice.

I don't think your dad needs a nursing home, and I am not sure what an EMI home is - I am told that term is no longer used.

Phew, I will have to take a break and read your post again. I can't absorb it all in one. Sorry.

Love

Margaret and off to read the rest!
 

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