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Advice re EMI homes and finance

JillandCarolyn

New member
Oct 21, 2020
7
Hi, I wondered if anyone could offer some advice please ? My father, 91, is currently living in a retirement care home where he has been for around 3.1/2 years. He was diagonised with dementia around 6 yars ago, although the signs were present a few years earlier to be honest. To be honest, my sister and I had concerns about the level of care dad was receiving as there often didnt seem to be any staff present in the lounge were my dad sits. It wasnt unusual for us to run and get help when a resident tried to walk and looked unsteady. We asked for a desk to be put in room, rather then in dining room were stafff did paperwork. Things came to a head late last year when a resident "attacked" aresident one night in her room and she was admitted to hospital. The home subsquently failed the CQC report on all levels. My sister and I began to look for another home for my father just before lockdown. We have seen my father twice through a window but have remained in contact with the home, taking biscuits ect every few weeks and were told my father was fine. Then last week, I had a call to say my father had had a fall and was taken to hospital. During the afternoon, my sister received a call from the hospital saying the care home had refused to take my father back saying he was aggressive., clmbing over chairs and sitting on people. He had macular degeneration when he went into the home and we dont know the state of his eyesight now. This came as a complete shock and we both went into panic mode. Later that afternoon, we were phoned again to say dad was now back at care home. We were told the manager would ring next day. She didnt. In the meantime, "Find me a home" contacted us and told us they had 3 possible homes that may take dad. My sister contacted the manager and we were told a report had been done on dad by the mental health team and i was thought dad needed more care. She admitted that she should have told us and "held her hands up". The homes suggested by Find me a home (something to do with hospital I believe) asked for copy of report but the care home couldnt find a copy and mental health team had no knowledge either. Eventually, after several phone calls my sister tracked down a lady that said she had seen my father. Im not sure how this lady is to be honest., I believe a social worker? The homes suggest then refused to take my dad based on the care home managers opinion. So, now the social worker has arranged an "assestment" for tomorrow and then we will have a zoom meeting with her, the manager of the home and both my sister and myself. A EMI home has been mentioned and we have been told this will be approx 3 times the price we are paying now. My dad is self funding. The social working did mention possible help in funding this which isnt means tested. So, sorry for the ramble but I think both myself and my sister are very naive and feel this is all out of our hands now. Especially with Covid, as we havent really seen dad for 7 months. We took a long time and visited many homes before settling on the home my dad (and my late mother) went to and now dad will go somewhere we havent vetted. Any help and advice is more than welcome. Thank you
 
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Bunpoots

Volunteer Host
Apr 1, 2016
4,941
Nottinghamshire
Welcome to Dementia Talking Point @JillandCarolyn

My dad was in an EMI home and it was one of the cheapest carehomes in the area. We were quoted £650pw (the average for my area was £750) but actually paid only £614 as SS negotiated the rate when dad went in for his 12 week property disregard. This was 2 years ago. I don’t understand why you’ve been told it will cost 3x as much.

Dad’s carehome wasn’t fancy, it was homely and comfortable and the staff turnover was low, and they knew how to deal with dementia behaviour and which residents to keep away from each other!
They had activities and residents decided for themselves if they wanted to join in. They were also allowed to retreat to their own rooms if they wanted where they were checked regularly. The food was plain and old fashioned but dad always enjoyed his meals.

Perhaps you could phone some carehomes in your area and find out what is available at what cost. Be completely honest about your dad’s behaviour and his EMI needs. I know there was a wide range of prices in our area and not all carehomes that day they cater for dementia can deal with the later stages.
 

canary

Registered User
Feb 25, 2014
13,893
South coast
A EMI home has been mentioned and we have been told this will be approx 3 times the price we are paying now. My dad is self funding. The social working did mention possible help in funding this which isnt means tested.
I have a feeling that this home is an EMI Nursing home (rather than an EMI care home - which is where my mum was), which is the highest level of dementia care, not many of them about and always more expensive than an EMI care home as you are paying for nursing staff. Im guessing that the part payment is Funded Nursing Care, which is only payable to a Nursing home. I expect that the reason that they are looking at this home is because of his aggression/violence.

You could try looking at EMI care homes in the area to see if any of them would accept your dad. I know that mums EMI care home would accept some level of aggression - when mum first moved there she hit one of the carers with her walking stick and I was appalled, but the home shrugged it off as just one of those things and the carer wasnt hurt. Eventually mum settled down and the aggression went. Look for homes that "accept challenging behaviour" and talk to the manager on the phone. It all depends on how bad your dads aggression is.
 

Weasell

Registered User
Oct 21, 2019
749

This link may be of interest.
 

JillandCarolyn

New member
Oct 21, 2020
7
Following dads assesment by mental heath nurse, her report states dad isnt really agressive more "responsive" , meaning that he reacts when told to do something the doesnt want to do. She said that the present home felt that they may have problems dealing with dad longterm. We are going ahead with looking for another home for dad. However, my sister had a phone call from his present home today stating they are applying for a DOLS, "for their safely and my fathers" . Does anyone have any information about this please?
 

Sarasa

Registered User
Apr 13, 2018
2,002
Hi @JillandCarolyn , it does sound as if your father might be in the wrong sort of home, as his behaviour sounds the sort that any home used to people with dementia will have come across. Below is some information from the Alzheimer's Society about DoLS. My mother's care home applied for this shortly after she arrived as she kept on trying to leave and she didn't have the capacity to make informed decisions any more about where she should live. Mum was assessed by a social worker and psychiatrist, who both agreed that she needed to be in the care home as she'd be at risk if she tried to live independently. That was in June last year and it was re-assessed in December. I guess in normal times it would be checked again this year, but I'm not sure if that will be the case.
 

canary

Registered User
Feb 25, 2014
13,893
South coast
A DoLS is a routine thing for many care homes. Mum was in a secure home and every resident there had a DoLS.
Please remember that this is a safeguarding order which is done to ensure that their deprivation of liberty needed to keep them safe is reasonable and appropriate.
 

JillandCarolyn

New member
Oct 21, 2020
7
Im just a bit concerned that dad may be restanded/strapped down in some way as he has never shown any signs of waiting to leave. In fact the opposite, he seemed to get upset if taken into a different room from the one he sits in all day, asking when he was going back. I think Ive just lost all faith in the home as it was a bolt out of the blue when hospital rang to say he couldnt return (although he did eventually). We hadnt been told of any issues.
 

JillandCarolyn

New member
Oct 21, 2020
7
Im also concerned this might effect if hegets a place with a new home as he has already been refused 2 homes after they spoke to Manager of current home. The mental health workers report last week was much better than we were expecting to be honest.
 

canary

Registered User
Feb 25, 2014
13,893
South coast
Im just a bit concerned that dad may be restanded/strapped down in some way as he has never shown any signs of waiting to leave.
No, they dont do that - it is illegal.
It just means that they are allowed to stop him going out unaccompanied.
It may just be because the home he is in is a secure home and its routine for all the residents to have a DoLS.
 

Sarasa

Registered User
Apr 13, 2018
2,002
No they won't strap him down. My mother's behaviour can be challenging, but her home has various strategies to cope, that involve trying to get her onside. Like @canary said I expect all the residents with dementia have one in place.
 

Weasell

Registered User
Oct 21, 2019
749
Does he have a behaviour management plan?
could you request to see it, if it is something they do ?
 

JillandCarolyn

New member
Oct 21, 2020
7
Thank you everyone for taking time to answer. I think im panicing a bit as it was a bolt out of blue that home no longer wanted him. Unfortunately the 2 homes put forward by mental health advisor as potential dont do Emi care, so we are back to square one. Apparently very few homes do EMI care and are very, very expensive (approx £6,000 a month), He is self funding. Its such a worry thinking dad isnt getting the care he needs.
 

canary

Registered User
Feb 25, 2014
13,893
South coast
Apparently very few homes do EMI care and are very, very expensive (approx £6,000 a month),
Wow! My mum was in an EMI care home and it was nearly half that. Are these EMI nursing homes that are being talked about as being not many around and very expensive? There is a difference between the two - EMI nursing homes are thin on the ground and very expensive, but EMI care home are not. Does he need nursing care?
 

Lone Wolf

Registered User
Sep 20, 2020
56
Wow! My mum was in an EMI care home and it was nearly half that. Are these EMI nursing homes that are being talked about as being not many around and very expensive? There is a difference between the two - EMI nursing homes are thin on the ground and very expensive, but EMI care home are not. Does he need nursing care?
My Ann is in a standard nursing home in Surrrey at £5600 per month. She has severe dementia, as do most of the residents. For that money the care is no more than acceptable. My biggest complaint is insufficient staff numbers, particularly on weekends, and I worry constantly but it would be too difficult and disruptive to change homes now, with no guarantee that another would not have issues. Before lockdown I would visit daily to monitor adequacy of care, but now have been unable to do that for 8 months. It is a neverending torment and worry.
 

Palerider

Registered User
Aug 9, 2015
2,115
North West
Hi @JillandCarolyn

Just want to iterate what @Bunpoots mentioned -let the social worker deal with finding a new EMI unit (nursing) as they will negotiate better fees for your dad. Try not to worry as it sounds like your dad will be better off in a nursing EMI unit anyway, residential dementia care is very basic often with many residents and few staff whereas EMI is well staffed with nursing and a very different approach to dementia care