section 2 about to end, being pressed very hard to find a home by SW

[mrdoodah]

SW putting pressure on to find a home, one week left under section two. She told me if she goes to section 3, LA will have to fund her and I will have no say on where she goes and she cannot top up ( dont understand the significance of this )

1. I mean, can I top up from my funds for example. If section two comes to an end what really happens next ? She has worsening mental health problems, everyone in the home is stealing from her ( normal ) she doesnt really understand anything ( why the doctors try to explain things in jargon when she's clearly lost capacity is beyond me )

2.......I cant see her detailed notes only her care plan. She was sectioned after attempting to confront my daughter accusing her of theft of money, hammering on the door, daughter rang me in great distress. ( 18 years old )

3...... The day section two ends does she automatically go to section three and be nhs funded ? or is there some intermediary stage of 'no mans land'

4.......She is self funding, would her mental health issues require 'nursing care' would that qualify her for nhs funding. I think whichever home she's in all the residents will be potential victims of her delusions.

In her doctors words they have been impressed with my pro activity in trying to find her a home (rejected twice by homes reccomended by her SW ! )

I cared for her for three years and that had its moments but this new web of unravelling laws and conditions surrounding section two and three is now frying what little brain I have left., regards Mr D, obviously help appreciated

 

[snedds57]

Hi, why not give the dementia helpline a ring 0300 222 11 22 as they have experts in this kind of thing. The social care system is very confusing, and it might be better to have a conversation with someone (I like to ask questions and get answers) rather than plough through masses of paperwork. And every area seems so different. Just a thought. Others may happen along soon who have been in the same situation.

 

[mrdoodah]

awaiting call back from AS.

 

[LYN T]

Hi my OH has just finished his section 2 and he was then put on a deprivation of liberties ( DOL). From my understanding section 3 is only issued if further assessment is needed. If the assessment has been completed (i.e diagnosis and medication sorted) then it's a DOL which stops someone leaving a hospital

I too have been looking for a CH for my husband who has complex needs. One care group in the south has , for want of a better word, 'blacklisted ' him as the last time he was in one of their homes chaos reigned big time.

Pete's social worker also gave me a list, but the carer/resident ratio was so ridiculous it was scarey. Today I'VE found a CH which has only 15 residents and 5 carers at all times. This is what he needs -a CH where he can get some one to one time as his anxiety is off the scale at times. Now this CH is not the smartest I've seen but it didn't smell of any thing nasty and although it's small it has everything needed. A TV room/a quiet room/a conservatory a little garden and rooms which have 'alzheimer friendly colours' I've never heard of that before. Ok so there are no en suite bathrooms but to be quite honest Pete wouldn't know how to use a toilet without direction anyway.

So what I'm trying to say to you is try looking in the phone book and phoning. Be honest about needs and ask for carer/residents ratios and anything else you want-it will save time.Don't rely on the SW. Pete's sent me his care plan and it stated that Pete needed a lot of one to one assurance-so how he was going to get that when there was one carer for ten residents-couldn't work that out.

Sorry if you have done this already it's a very stressful time I know.

Take care

Lyn T

 

[nitram]

Also try contacting http://www.mind.org.uk/ for advice.

If her condition warrants it she will go onto section 3 after section 2, if she is discharged while on section 3 it will most likely be under section 117

http://www.mind.org.uk/mental_health_a-z/7851_aftercare_under_section_117_of_the_mental_health_act

As s117 is NHS funded it cannot be topped up, this is what the SW was on about.

Her placement in a home has to be in her best interests, as well as receiving the correct care it is important that she is near relatives/friends who can visit her.

Don't be railroaded by the SW, don't sign anything without taking advice, both AS and MIND will help you with your legal rights.

 

[mrdoodah]

Had call from AS , very helpful. If mum needs no further treatment, she can go into appropriate home or stay in hospital untill that home is found, section 3 only comes in if further treatment is needed, not just because section two has ended.

 

[FifiMo]

Mr Doodah,

In your position the position I would take is to merely discusses homes etc with you is ...IT IS ALL TO DO WITH MUM'S HEALTH NEEDS, NOT FUNDING.

Please do not let them lead you off down a path that is motivated by money!

Some of us more cynical people might consider that the SWs motives are driven by the fact that your mum is self funding. Rush the poor woman into a home before the section 2 ends so that no one has to consider if she needs to continue to be assessed and move to Section 3.

I would want to know what is best for my mum's health. End of story. If that means she moves to Section 3 and leaves under a Section 117 Aftercare order then so be it. The law states that this is what SHOULD happen if your mum's health warrants it. Yes Section 117 Aftercare is funded in full by the state..because that is what the law requires and the state of her health warrants.

It worries me greatly when the SW is not hiding their motives and have £££ signs in their eyes. Not only that your mum pays but that you might pay, by means of top ups also! To this end I would remind the SW that any Section 117 Aftercare has to meet your mother's healthcare needs and that this is what you will be pursuing and not whose bank balance should be affected by this.

These are matters of law. Not matters of blackmail.

Fiona

 

[Wirralson]

My father and I faced a similar situation to Mr Doodah in connection with my mother. I'd be wary of suggesting the agenda is simply to avoid funding under s117.

However, the decision to say "section 2 is ending, find a nursing home" is defensible, and I think the following may be what has happened. Section 3 can only be used if the person needs further treatment. If there is no appropriate treatment, then my understanding is that section 3 isn't engaged, and so Mr Doodah's mum can't be detained under section 3, as non of the conditions in section 3(2) are met. Link to the relevant section of MHA83 here:

http://www.legislation.gov.uk/ukpga/1983/20/section/3

Psychiatric hospitals are audited on the use made of the powers in MHA83, and there seems to be a (in my view understandable and proper) professional reluctance to use s3 if it can be avoided.

Mr Doodah's mum could be detained using Deprivation of Liberty Safeguards (which allow for detention if MHA83 is inappropriate), Link to the relevant Alzheimer's Society factsheet here:

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1327

What this highlights is the lottery over local authority funding. If a person is suffering from Alzheimer's, detained under s2, then s3, s117 is triggered and their aftercare needs funded. But they can only be detained under s3 for treatment. This seems to me to be likely to lead in practice to very few Alzheimer's sufferers being eligible for s117. My reasoning is that only a small proportion of Alzheimer's patients will be detained under s3 as many will remain cared for by families, or go into care voluntarily. Where they are detained under s2, treatment may inappropriate in a proportion of these cases. LAs anyway seem to have assumed (until a series of court cases) that they could charge for s117 aftercare (if residential) using the powers in s44 of the NHS and Community Care Act 1990 (NHSCCA90). It looks to me as though the (probable) failure of the NHS policy makers and/or the Bill Team and/or the Parliamentary draughtsman to pick up on this point in NHSCCA90 created a loophole. While I'm grateful for it, it does make the whole process more of a lottery.

Wirralson

 

[mrdoodah]

OK, heres an update with happy ending. Section two about to expire, Care plan notes said fit to leave no further treatment needed. Mums behaviour got worse towards the end of 28 days, further seessment taken. Had call from doc, saying could they keep her in, ie wanting my permission. Doc called next day she was now under section 3. Her SW rang for me to visit a local home she had found, id seen 11 already, this last one was perfect. They accepted mum, panel meeting to up the LA contribution, i will top up final amount. Sorted, bingo, bingo , bingo. Unbeleivable, from spending my savings, seling my camper, guitars wedding rings etc it all came to this. I cannot believe where i stand now compared to one week ago, I have a life ahead of me, mum has a wonderfull home, and I can put my savings back in the bank. In the end the sectionings just fell into place whilst i was care home hunting. My thoughts are with you all, i am not ashamed to say my care days are over, I have her worsening behaviour to thank for that, strange world eh !!

 

[nitram]

If your mum is on section 3 she should be discharged under section 117, in this case all care has to be free top ups cannot be made.

"...Section 117 states that aftercare services must be provided to patients who have been detained in hospital:

For treatment under Section 3
Under a hospital order pursuant to Section 37 (with or without a restriction order) or
Following transfer from prison under Section 47 or 48.
This also includes patients on authorised leave from hospital and patients who were previously detained under Section 3 but who stayed in hospital after discharge from section..."

http://www.mind.org.uk/mental_health_a-z/7851_aftercare_under_section_117_of_the_mental_health_act

 

[hopeful56]

Nitram is spot on. The LA have no involvement in someone who has been discharged under 117 following Section 3 detention. Can you clarify with them that this is how your mum is detained? Perhaps you could print out the reference from the link that Nitram has provided and show it to the LA? No one is permitted to top up NHS care.

JJ

 

[nitram]

Note

"...2. Who is entitled to s117 aftercare?
 People who have been detained under what are known as ‘treatment’ sections of the MHA. These are sections 3, 37, 45A, 47 or 48.
 This includes people who are discharged from the above sections, but who remain in hospital voluntarily before leaving the hospital..."

http://www.rethink.org/resources/s/section-117-aftercare-factsheet