117 aftercare - help please

Discussion in 'Legal and financial issues' started by dizzidancer, Jun 17, 2015.

  1. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Ok so who can help me?!! After viewing over 20 homes, We viewed another home today (which was perfect) they liked dad, he likes them.... Okay, so after 5mths on a mental health unit are we finally seeing the light?? Or are we?? The social worker for the unit is being so obstructive its untrue... Dad is entitled to 117 aftercare as he was held on section 3. So the authority that sectioned him (i.e. Redbridge) HAVE to pay for his care, as they have to,act in his best interest. This bit we know a bit about as I've looked into it & He doesn't own anything (flat is rented) & has nothing but his pension. The home is the right place for his needs etc etc that is agreed but now we have FINALLY got dad to agree and everyone says its right the bloody social worker is now saying he has to have a financial assessment and fill out benefit forms??!! More delaying tactics??! Just don't understand why. (Since January, we have been fighting her against sending dad back home!!! ) She now says as this home £875 a week we have to pay a "top up" and now saying that Essex rate (where the home is) is only £427 a week!!! Now I really want to swear but keeping my cool for the time being as she seems to hold the purse strings.... Can anyone shed any light on this whole scenario? Anyone been through this??


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  2. nitram

    nitram Registered User

    Apr 6, 2011
    19,024
    Male
    North Manchester
    Present the SW with this and say they are causing bed blocking.

    Aftercare under Section 117 must be provided free of charge.

    In 2002 the House of Lords held that this section imposes a freestanding duty to provide aftercare services and not simply a gateway to other community care services. As there is no express power to charge for services provided under it, such services must be provided free of charge[1].


    http://www.mind.org.uk/information-...lth-act/when-does-aftercare-end-and-who-pays/

    [1] refers to

    http://www.publications.parliament.uk/pa/ld200102/ldjudgmt/jd020725/sten-1.htm
     
  3. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,963
    North East England
    As a family, you ought to refuse to pay any Top Up. It is for the LA to pay not you. If this is truely the only home that can cater for your Dad's physical. emotional, spiritual and familial/social needs then there can be no argument.
     
  4. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Thank you so much for the help - we have quoted this Act to her but she is insistent that there is a limit to the Redbridge rate and then quotes the essex rate (much much lower) so she keeps saying we may have to top up dads care but they way I read it, is that they HAVE TO PAY IT ALL??
    I don't want to have to get a lawyer but feeling like we are not getting anywhere with this and she is definitely being obstructive and bed blocking as the unit staff and head psychiatrist have said that too! They are keen for dad to leave asap as they fear he is being 'institutionalised' in this unit and needs to,settle in a more appropriate environment


    Desperate daughter
     
  5. nitram

    nitram Registered User

    Apr 6, 2011
    19,024
    Male
    North Manchester
    As I understand it you are not refusing one home and asking for a more expensive one.

    As this appears to be the only suitable home available the LA/CCG will have to pay, there is no reason for you to pay a top up, you are not requesting anything special.
     
  6. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    The Care Act 2014 now permits people to make top-ups with regard to section 117 aftercare, and I suspect that this is exactly why this financial assessment is being undertaken. But I think this is a red-herring in that, if there isn't a choice of accommodation and this home is the only realistic option bearing in mind his needs (all of them as cragmaid pointed out), then the provisioning body must pay.

    Where was your father ordinarily resident at the time of sectioning? That's the LA that must pay. It's totally irrelevant what the standard payment is in the LA where the home is located. What applies (if it applies at all) is the standard rate for the provisioning LA.
     
  7. nitram

    nitram Registered User

    Apr 6, 2011
    19,024
    Male
    North Manchester
  8. katek

    katek Registered User

    Jan 19, 2015
    191
    #8 katek, Jun 18, 2015
    Last edited: Jun 18, 2015
    I agree, particularly as you also make the point that it is the LA/CCG who will have to pay. In all the other posts there doesn't seem to have been any reference to the CCG, but it is they as well as the LA who are responsible in 117 aftercare. The social worker has made clear the limit of the LA budget but what about the CCG budget? Surely they have to contribute something? Not to mention the fact that meanwhile the patient is bed-blocking at their own expense!

    Also, regardless of whether this is 117 aftercare or not, this particular LA budget limit is not dissimilar to that of other LAs all around the country, in terms of the amount being roughly half the cost of the 'brochure' price of a self-funding place in a care home. The accepted reality is that most care homes accept this LA lower rate as it will be subsidised by the self-funders.

    Dizzidancer - Is this care home actually saying they will only accept the full fees? Surely some compromise can be reached between all three parties - the home, the LA and the CCG.
     
  9. Karjo

    Karjo Registered User

    Jan 11, 2012
    481
    is the proposed home a nursing home or a care home? In my Mum's case (also section 117) they insisted on a nursing home and the CCGs then pay the nursing component of just over a £100 a week and the local authorities fund the rest at the expected to pay rate of around £450. So a maximum of arounf £550. It is maybe the case that you have found a rather lovely care home which is much more expensive but you will have a hard job convincing the local authority to go over their expected to pay rate. They should really be able to give you a list of homes who will accept the EPR rate and have vacancies, which you can then chose from, to enable your Dad to move on asap. Have you had a section 117 aftercare meeting and was the social worker present?
    It does appear to be the case that top ups can now be paid if you chose a more expensive home from the patients own funds but I suppose this is why a financial assessment is appropriate because on just a pension it is unlikely your Dad could afford to pay a difference of around £400 per week if that is what it will cost.You really need to check with the home if they accept the EPR rate and whether the £800 odd they quoted includes a nursing component and if it is the self funders rate they are quoting. You also need to make sure they contact the hospital to do a proper assessment as people on the whole are sectioned for a reason and you have to be convinced they can cope. My Mum has been evicted and also lives under the threat of eviction at the moment (though thank goodness it now seems unlikely). its not an easy thing to go through. A lot of the very nice homes are expensive because of their decor etc rather than the care and not a lot would appreciate the sort of destructive behaviour that my Mum is capable of if thwarted. I dont know what your Dad is capable of but as I say to be sectioned usually involves some pretty scary behaviour.
     
  10. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    It is a three tier care home, respite, secure dementia, nursing. This is the only suitable home - he's been rejected by two others! Ive looked at some they recommended and wouldn't let my dog stay in them to be honest. Im willing to fight all the way but need to know my rights/dads rights. He hasn't got any aggressive behaviour he was sectioned for wandering, self neglect & being financially abused in the community. A nice local off licence were taking him to the bank to draw £200 a time for 2/3 bottles of spirits which he had no idea he was drinking........ All came to a head January when we had to have him sectioned. Due to his confusion, and demanding to leave the unit, being kidnapped etc etc he was placed on section 3 - hence the 117 aftercare. He is now on DOLS but obviously will have to be reassessed in the new home by Essex teams. I just want to be able to tell the SW that shes got to pay, so shut up and pay up and lets get dad outta there!


    Desperate daughter
     
  11. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Ive spoken to MIND lawyers but at the time we were not in a position of dad moving into a care home so maybe I need to call them again - this is such a minefield and so complex - thank you all so much for your support :)


    Desperate daughter
     
  12. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Think I had a eureka moment late last night ..... Chpt 5:1 & 5:2 ...... So can I tell them to shove their forms?! ImageUploadedByTalking Point1434751319.973765.jpg what do you think?


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  13. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    ImageUploadedByTalking Point1434751422.295065.jpg better copy


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  14. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    Well maybe. When was that written? Because some of it might have been superseded by the new Care Act.

    Could you give and actual link?
     
  15. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    After researching/fighting this for months Please tell Me this is good news!


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  16. nitram

    nitram Registered User

    Apr 6, 2011
    19,024
    Male
    North Manchester
    #17 nitram, Jun 20, 2015
    Last edited: Jun 20, 2015
    The document is dated Nov 2008 and due for review March 2010, it appears to have been replaced by >>>MENTAL HEALTH ACT SECTION 117 POLICY<<< on 13/10/14.

    Next review is probably in 2015
    Next Review Date
    Upon parliament making a Commencement Order
    pertaining to Section 75 of the Care Act 2014 and
    when parliament publishes the revised Mental Health
    Act Code of Practice; both likely to be in 2015.


    The new document contains:-

    2.7 Section 117 is a 'stand-alone' duty; it is not a 'gateway' for providing services
    under other legal mechanisms, and because there is no explicit power to
    charge patients for services provided under it, those services must be
    provided free of charge as per the Stennett case [SUP]2[/SUP]. This also means that
    patients cannot be charged indirectly via any state benefits that they might be
    entitled to; for instance if supported accommodation is part of their after-care
    service, housing benefit may not be able to be used to fund that service
    unless it was already in place prior to admission and is deemed to continue.


    There is one problem in that if you reject a placement deemed to be suitable by the LA/CCG my understanding of the Care Act is that top ups may be charged if you demand a different placement, this could trigger a financial assessment.

    Sections 4 and 5 deal with which CCG and LA are responsible.
     
  17. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Not rejected any placements as they asked us to find one ourselves - they did inform us two homes, one failed the cqc and one was £875 per week anyway! So I'm just hoping we are justified. Where do we go from here? Who do we need to write or complain to if the SW complains about us not filling out the forms or digging in our heels over money - is there any legal frameworks or other phrases we can put in writing?


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  18. nitram

    nitram Registered User

    Apr 6, 2011
    19,024
    Male
    North Manchester
    Write two letters or emails.

    One to the head of Social Services asking why you are being asked to pay a top up for a placement in xxxx which is the only home that meets his needs and is prepared to accept him.

    Another to the head of Finance asking why you are being asked to complete a financial assessment in relation to his care which is Section 117 funded.

    Depending on the result be prepared to escalate the matter to the CEO of the LA.
     
  19. dizzidancer

    dizzidancer Registered User

    Feb 23, 2015
    80
    Thank you nitram I will do that ASAP


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