We are currently about to lodge a complaint with the CSSIW about the EMI residential home that our my mother-in-law, who has vascular dementia and who is currently being reassessed in hospital with a view to nursing provision was in. As part of this process we want to have access to her care plan/plans, do we have a legal right to have copies of these?
access to care plans
- Thread starter kevan49
- Start date
Maybe, maybe not. Do you have any form of power of attorney for her? Does your spouse have any other siblings who may object to the release of such record?
The problem is that while most care homes will share such information with families, when it becomes adversarial they might not. Strictly speaking, no one had a right to another's medical records unless there is agreement to that effect. However, the records should be provided to the PCT for the purposes of her evaluation.
The problem is that while most care homes will share such information with families, when it becomes adversarial they might not. Strictly speaking, no one had a right to another's medical records unless there is agreement to that effect. However, the records should be provided to the PCT for the purposes of her evaluation.
Thanks for the reply Jennifer, we do have an LPA but only for property and finance. Social Services seem to suggest that we should have access and I am trying to check this out further with the CSSIW.
As her care needs increased, sadly the level of support grew worse and the CPN decided that it might be more appropriate to look at an EMI Nursing assessment. The home's response to this was to issue our family with a 7 day notice to quit; despite the contract stipulating that 28 days was the necessary period of notification. In the meantime our relative had to be admitted to hospital, hence our desire to see what happened with regard to care plans, seeing as we were never given sight of one or offered the opportunity to participate in their production or review.
Before we decide on whether we wish to make a formal complaint, we really feel that we should be secure with regard to the facts; we will also be asking the Doctor for access to medical records, is this request also likely to fall on deaf ears?
NB With regard to siblings; all of the family are agreed that this is the course of action which we wish to follow.
As her care needs increased, sadly the level of support grew worse and the CPN decided that it might be more appropriate to look at an EMI Nursing assessment. The home's response to this was to issue our family with a 7 day notice to quit; despite the contract stipulating that 28 days was the necessary period of notification. In the meantime our relative had to be admitted to hospital, hence our desire to see what happened with regard to care plans, seeing as we were never given sight of one or offered the opportunity to participate in their production or review.
Before we decide on whether we wish to make a formal complaint, we really feel that we should be secure with regard to the facts; we will also be asking the Doctor for access to medical records, is this request also likely to fall on deaf ears?
NB With regard to siblings; all of the family are agreed that this is the course of action which we wish to follow.
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Hi
I had the old EPA when David was in the Care Home and I required copies of his Care Plans for his NHS CHC application.
The Care Home refused to give copies to me despite the fact that the Agreement I had signed when David entered the Home said I was entitled to them.
In the end I got a solicitor (who was going to appeal for the NHS CHC funding refusal) to contact the Home and I believe they did eventually get copies. The solicitors told me that legally the Home have to provide them whether they like it or not.
Don't be fobbed off.
I had the old EPA when David was in the Care Home and I required copies of his Care Plans for his NHS CHC application.
The Care Home refused to give copies to me despite the fact that the Agreement I had signed when David entered the Home said I was entitled to them.
In the end I got a solicitor (who was going to appeal for the NHS CHC funding refusal) to contact the Home and I believe they did eventually get copies. The solicitors told me that legally the Home have to provide them whether they like it or not.
Don't be fobbed off.
Hi
Just to let you know that I regularly review MIL's care plans normally just before she sees the consultant for a review.( I attend the reviews as Ian works away) I am fortunate that mum's care home is very open and honest with me even though I am not the next of kin!
Julie xx
Just to let you know that I regularly review MIL's care plans normally just before she sees the consultant for a review.( I attend the reviews as Ian works away) I am fortunate that mum's care home is very open and honest with me even though I am not the next of kin!
Julie xx
access to notes
I think the law is that even if you do not have a deputyship order etc it would be in your mother's "best interest" to see the notes to particiapte in any assessments.That would take priority over confidentiality.The booklet from Counsel and care civer this point,I believe.
I think the law is that even if you do not have a deputyship order etc it would be in your mother's "best interest" to see the notes to particiapte in any assessments.That would take priority over confidentiality.The booklet from Counsel and care civer this point,I believe.
I cannot find any reference in Government legislation to relatives having access to care plans but there are several sites on the web from independant homes, or homes within a chain, who do give relatives the right to see care plans. Some are even put on line daily and can be accessed by relatives via secure passwords!
It would seem that access to care plans varies greatly and is something which should be discussed at the beginning of the relative entering a care home and put into the contract.
A bit like 'shutting the stable door after the horse has bolted' in your case but at least I haven't found any government legislation prohibiting relatives from having access to care plans. I would be fighting to get access to them by all means possible if it were me in your situation.
Sorry I can't be of much more help. Yet again an instance where proper government legislation is needed. I really can't envisage a situation where care plans should not be shown without reserve to any concerned relative but - hey ho - there is always an exception I suppose.
xxTinaT
It would seem that access to care plans varies greatly and is something which should be discussed at the beginning of the relative entering a care home and put into the contract.
A bit like 'shutting the stable door after the horse has bolted' in your case but at least I haven't found any government legislation prohibiting relatives from having access to care plans. I would be fighting to get access to them by all means possible if it were me in your situation.
Sorry I can't be of much more help. Yet again an instance where proper government legislation is needed. I really can't envisage a situation where care plans should not be shown without reserve to any concerned relative but - hey ho - there is always an exception I suppose.
xxTinaT
This is an interesting one. My mother is my uncle's next of kin but she was not allowed to have any information about my uncle's care until the Court of Protection got involved. Now we have copies of more care plans than we've eaten hot sunday dinners! Don't understand the law of this land at all.
I'm not at all sure, but surely the right of confidentiality would potentially trump every consideration? Unless there was a welfare LPA or a court decision or a contractual agreement. I realise it doesn't make a great deal of sense, or that it is reasonable when the person whose records you are accessing has no ability to consent due to dementia, but to be honest, I think there needs to be some level of safeguards.
I would be confident in my own next of kins ability and willingness to act appropriately for me in the event I was unable to make a choice, but I have also heard some hair-raising stories about next of kin making totally inappropriate decisions for their relatives (and it's normally all about money). In other words: it's hard to have rules that fit all unless each case is dealt with separately.
P.S. Say I was doing something that would never have occurred to me to do if I was well - I'm not sure I would want my children (for example) to know that.
I would be confident in my own next of kins ability and willingness to act appropriately for me in the event I was unable to make a choice, but I have also heard some hair-raising stories about next of kin making totally inappropriate decisions for their relatives (and it's normally all about money). In other words: it's hard to have rules that fit all unless each case is dealt with separately.
P.S. Say I was doing something that would never have occurred to me to do if I was well - I'm not sure I would want my children (for example) to know that.
The 'confidentiality' issue crops up regularly in my local mental health hospital, especially on the acute wards where young, mental health sufferers with acute mental health problems are cated for. They do not want their family to have access to their records and so relatives, who after all are the ones who have to pick up the care on discharge, are left completely in the dark. Such young people are considered to have the mental capacity to insist on confidentiality.
However, with a dementia sufferer residing in a care home situation the use of 'confidentiality' in most cases is given to concerned relatives in order to safeguard the care home, and not the resident. We have instances of this here on TP on a regular basis and I do think that whatever the motives, be they monitary or genuine concern for a resident's welfare, they should be available as a public record of the care given.
We hope we live in a 'transparent' society and especially within a care home situation where there is a lack of capacity to give consent a lack of transparency makes me think there is something a care home is trying to cover up.
There should be recourse to the laws of the land in such cases.
xxTinaT
However, with a dementia sufferer residing in a care home situation the use of 'confidentiality' in most cases is given to concerned relatives in order to safeguard the care home, and not the resident. We have instances of this here on TP on a regular basis and I do think that whatever the motives, be they monitary or genuine concern for a resident's welfare, they should be available as a public record of the care given.
We hope we live in a 'transparent' society and especially within a care home situation where there is a lack of capacity to give consent a lack of transparency makes me think there is something a care home is trying to cover up.
There should be recourse to the laws of the land in such cases.
xxTinaT
Hi Kevan,
I have deputy ship for my father and am named as next of kin.
I was applying for NHS CC and obtained my Dads records from the Home, Hospital, Doctors and Social Services, though the latter were redacted.
Each of the establishments are allowed to charge up to £50.
The nursing home needed my permission before releasing copies of my Dads records to the health board and solicitors,
but they also let me take the records to the solicitors for them to photocopy them.
I have also read that the care home notes are the property of the person in care, and you are entitled to the original copies though I am unsure of the source of that info.
I have deputy ship for my father and am named as next of kin.
I was applying for NHS CC and obtained my Dads records from the Home, Hospital, Doctors and Social Services, though the latter were redacted.
Each of the establishments are allowed to charge up to £50.
The nursing home needed my permission before releasing copies of my Dads records to the health board and solicitors,
but they also let me take the records to the solicitors for them to photocopy them.
I have also read that the care home notes are the property of the person in care, and you are entitled to the original copies though I am unsure of the source of that info.
Hi Kevan,
Standard 37 of Care Homes for Older People - National Minimum Standards - Care Home Regulations:
page 47 "Service users have access to their records and information about them held by the home, as well as opportunities to help maintain their personal records."
http://www.dh.gov.uk/prod_consum_dh...@dh/@en/documents/digitalasset/dh_4135403.pdf
Standard 37 of Care Homes for Older People - National Minimum Standards - Care Home Regulations:
page 47 "Service users have access to their records and information about them held by the home, as well as opportunities to help maintain their personal records."
http://www.dh.gov.uk/prod_consum_dh...@dh/@en/documents/digitalasset/dh_4135403.pdf
The 'service users' part is where relatives may fall down when requesting care records. Relatives are not the 'service user' and so I doubt this bit of the Act can be interpreted as including concerned relatives.
xxTinaT
xxTinaT
Quote. The 'service users' part is where relatives may fall down when requesting care records. End quote.
Yes you may be right Tina. I can only say what my experience is.
Kevan does have an LPA and is therefore in charge of his relatives affairs, so hopefully he should not have any problem. Fingers crossed.
Why is everything a flipping struggle.
Yes if you are just a concerned relative you probably would have trouble accessing them.
Yes you may be right Tina. I can only say what my experience is.
Kevan does have an LPA and is therefore in charge of his relatives affairs, so hopefully he should not have any problem. Fingers crossed.
Why is everything a flipping struggle.
Yes if you are just a concerned relative you probably would have trouble accessing them.
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Hi Kevan
I realise you're in Wales but I don't think the rules and regs are that different, so this may be of help to you.
Page 86 of the "Essential Standards of Quality and Safety" Guidance doc via the Care Quality Commission:
http://www.cqc.org.uk/_db/_documents/Essential_standards_of_quality_and_safety_March_2010_FINAL.pdf
"All those involved in the care, treatment and support of the person who uses services:
–– cooperate with the planning and provision of care, treatment and support
–– have the documented plan of care available to them
–– have relevant information about the person who uses services available, where it has a direct bearing on the quality and safety of the care, treatment and support being delivered
–– record the key points of the care, treatment and support they have given
–– enable relevant information to be accessed in time to ensure that the needs of the person who uses services continue to be met."
[This reference was given to me by the CQC when I contacted them months ago now, on behalf of another TP member to ask the same question about access to care plans by close family.]
And if your Social Worker thinks you should be able to have a copy of the care plan/plan of care, s/he could perhaps arrange a "Best Interests" meeting with you present, to discuss the fact that it is in your MIL's best interests for you to know exactly what is in the plan. And in any case, a care plan should be put together in the first place with full involvement of a resident's close family supporters, especially where dementia is concerned. Often signed by the resident's close family member too, on behalf of the resident with dementia. And you need to be able to see the care plan, because it must be updated regularly.
There are some care homes that provide 'person centred care' and even 'relationship centred care' and who understand the need for family involvement in the care process. Here's just one provider that makes available care plans and daily reports that can be accessed online, and daily. Perhaps the way for the future?
http://www.cornfordhouse.co.uk/care-plans.html
The care plans and updates are not available to the whole wide world, of course, but secure access on an agreed "need to know" basis, in the best interests of the resident.
Wish you luck!
I realise you're in Wales but I don't think the rules and regs are that different, so this may be of help to you.
Page 86 of the "Essential Standards of Quality and Safety" Guidance doc via the Care Quality Commission:
http://www.cqc.org.uk/_db/_documents/Essential_standards_of_quality_and_safety_March_2010_FINAL.pdf
"All those involved in the care, treatment and support of the person who uses services:
–– cooperate with the planning and provision of care, treatment and support
–– have the documented plan of care available to them
–– have relevant information about the person who uses services available, where it has a direct bearing on the quality and safety of the care, treatment and support being delivered
–– record the key points of the care, treatment and support they have given
–– enable relevant information to be accessed in time to ensure that the needs of the person who uses services continue to be met."
[This reference was given to me by the CQC when I contacted them months ago now, on behalf of another TP member to ask the same question about access to care plans by close family.]
And if your Social Worker thinks you should be able to have a copy of the care plan/plan of care, s/he could perhaps arrange a "Best Interests" meeting with you present, to discuss the fact that it is in your MIL's best interests for you to know exactly what is in the plan. And in any case, a care plan should be put together in the first place with full involvement of a resident's close family supporters, especially where dementia is concerned. Often signed by the resident's close family member too, on behalf of the resident with dementia. And you need to be able to see the care plan, because it must be updated regularly.
There are some care homes that provide 'person centred care' and even 'relationship centred care' and who understand the need for family involvement in the care process. Here's just one provider that makes available care plans and daily reports that can be accessed online, and daily. Perhaps the way for the future?
http://www.cornfordhouse.co.uk/care-plans.html
The care plans and updates are not available to the whole wide world, of course, but secure access on an agreed "need to know" basis, in the best interests of the resident.
Wish you luck!
