Advocate(for who?)

[julieann15]

We have having a best interests meeting (again) next week.Mum's SW has appointed an advocate. if this person is toatally impartial then they need to take on our views too and not just those of mum. Been told by CPN thta advocate is only for mum

believe SW has been in today to do a mental capacity test and is returning tomorrow afternoon to do the same again. Looking at the Mental Capacity framework this may be bacause mum did lack capacity today and they need to confirm it?

If anyone can shed any light it would be really appreciated.

Love Julie xx

 

[1948NHSBaby]

No qualificatiosn required!!! apparently

Quite worryingly, General SW do not have to have special training for capacity testing.
Up to 2007, there was a grade of ASW, Approved SW, this person was approved to assess under the mental health act 1983, from 2007 the extra qualification has changed to Approved Mental Health Specialist.

You can check the qualifications of your or any registered SW on the GSCC, general register site, check the register:-

http://www.gscc.org.uk/The+Social+Care+Register/Check+the+register/

Also the social workers community care forum site has some fascinating insight into the understanding of how social workers understand and undertake their responsibilities.
Communitycare site:-

http://www.communitycare.co.uk/care...ntal-capacity-in-a-general-hospital-5232.aspx

 

[Brucie]

been told by CPN thta advocate is only for mum

that would seem to be sensible, as it wouldn't preclude the advocate taking advice from relatives. The advocate can only really represent the person concerned; relatives often have their own agendas that may not strictly be in the interests of the person with dementia.

When we had the CC matrix meeting for Jan, our GP came along. He said he was there for me, not for her. There are always potential conflicts of interest, so I can understand why they would have told you that.

You should certainly strive to make your case on her behalf though.

 

[ginger]

Hi
Ask S/W if the Advocate is an Independent Mental Capacity Advocate (MCA)? There is a leafet on the Public Guardian website 'Making Decisions' which explains the role of (MCA). I hope this will be of some help as I have been reading up on the Mental Capacity Act in relationship to an Adult with L/D

 

[ella24]

Hi Julie

yes, the advocate is working on behalf of your mum. The advocate is supposed to put your mum's view across.

However, for the advocate to understand the situation, ideally they should be contacting the rest of the family to work out what the options are. Otherwise you will need to use the Best Interests meeting to state the situation.

At the Best Interests Meeting the advocate should state what your mum's expectations /opinions are - for example, the advocate might put forward that your mum considers it is possible that your mum is able to live in her own home with your care and support - You need to then state whether you are prepared / able to provide that care and support...

My gran's advocate (at the BI meeting) said that on speaking to gran, gran had said she would prefer to live at home, but knew her limitations, and that gran would be happy to consider a home if she felt she had some input into looking at some options. This was teased out over several visits, and was formed because gran came out with different answers (so none were wrong)

hope this helps

 

[Sandy]

Hi Julie,

I believe the IMCA's role is to represent your MIL's views:

What is an IMCA’s role?
10.20 An IMCA must decide how best to represent and support the person
who lacks capacity that they are helping. They:

• must confirm rm that the person instructing them has the authority to do so
• should interview or meet in private the person who lacks capacity,
if possible
• must act in accordance with the principles of the Act (as set out in
section 1 of the Act and chapter 2 of the Code) and take account of relevant guidance in the Code
• may examine any relevant records that section 35(6) of the Act gives
them access to
• should get the views of professionals and paid workers providing care or treatment for the person who lacks capacity
• should get the views of anybody else who can give information
about the wishes and feelings, beliefs or values of the person who
lacks capacity
• should get hold of any other information they think will be necessary
• must find out what support a person who lacks capacity has had to
help them make the specific decision
• must try to find out what the person’s wishes and feelings, beliefs
and values would be likely to be if the person had capacity
• should find out what alternative options there are
• should consider whether getting another medical opinion would help
the person who lacks capacity, and
• must write a report on their findings for the local authority or
NHS body.

http://www.publicguardian.gov.uk/docs/mca-code-practice-0509.pdf

If the IMCA doesn't contact you beforehand, you'll be able to put your point of view across at the best interests meeting. Apart from your views about what is in your MIL's best interests, you can also indicate the impact that caring for her has had on you and your family. You can also indicate that you might not be able to continue to provide that level of care in the future if she returns home.

Take care,

 

[julieann15]

We will not meet the Advocate until BIM although he/she will visit mum. In the meantime I have found out that the person I have been dealing with who introduced herself as a SW at the home today is in fact a Community Care worker. My job tomorrow is to find out whether carrying out Mental Capacity tests is in her Job Description? Something about her just made me dig deeper-perhaps it was her always having to go higher up the chain to get things signed off- no wonder??

Love Julie xx

Just to add that on this mornings performance to the Community Care worker mum has capacity. Yes she could identify all the photos, has now remembered where she lived. perhaps they should ask her to talk her through the steps of having a shower- as clothes off- stand under shower (no soap or shampoo if not prompted) and back out seems to be the way to do it- would save a fortune on gel/shampoo if my lads did it that way-lol

 

[ella24]

Julie

just found this by googling 'communty care worker leics'

e



URGENTLY REQUIRED - QUALIFIED SOCIAL WORKER/ COMMUNITY CARE WORKER!

The successful candidate will need to hold a DipSW or equivalent, must be registered with the GSCC, have a current CRB and be a car driver.

If you are not a GSCC registered Social Worker with a minimum of 12 months UK Social Work experience, you are not eligible for this role so please do not apply!

The roles and responsibilities will include:

* Background of Learning Disabilities work desirable
* Experience of liaising with many different professional Health Education and Social Care services
* Assessments
* Care Management
* Review Care Packages
* Adult Placement
* Undertake Risk Assessments
* Some out of hours work
* Home Visits
* Understand benefits

 

[jenniferpa]

Well if she claims your mum has capacity period, then already she would show that she wasn't entirely aware of what she was doing. Having capacity isn't a cut and dried thing when you're talking about someone with dementia. They may well have capacity to decide what they want for lunch, but not whether an investment is safe. Recognizing photos has nothing to do with capacity - most 5 year olds could recognize a photo of their immediate family and will probably know their own address, but you wouldn't let them live on their own. Capacity is not just about being able to make a decision but about the consequences of that decision.

 

[julieann15]

I thought we were dealing with a fully qualified social worker although inexperienced. I asked her for her Social Care Registration Number and she told me she does not have one as she is not a Social Worker but a Community Care worker!

Ella thanks for that-

"We can always put more care in place at home"- that is one thing mum does not want- she wants and needs social contact. One of the main concerns on the SS care plan in April 2008 was "social isolation" Mum is thriving in the CH with the company but if she goes home she will become socially isolated- there will be noone to prompt things and life will just become the chaos it was and she will never get out as the windows between carers will be too short for mum to get ready,go out and get back? - I won't be able to visit with children 4/5 times a week to take her out to the shops/playgroups. Perhaps the Community care worker would like to take on my role and do most of the caring?

I am totally hacked off with the incompetence of all this on SS side

Love Julie xx

 

[jenniferpa]

Call me suspicious, but I'm not entirely sure that this comes down to incompetence (or not just incompetence) but a strong desire on the part of social services not to have to pay for your mums care.

You are going to have to be really strong, Julie, about being unable to provide any more care, and really, really push the issue of social isolation.

 

[ella24]

Julie

use the Best Interests meeting to say just what you wrote above.

It may sound tough to say what you want to at the BIM in front of mum but what would you rather have - her upset for a day or two at most (and then happy in her current CH) - or continual worry until a crisis happens - and then an emergency admission to a CH which she/you may not be able to choose.

Why not use the example of your mum agreeing to a trial at the last meeting - and then changing her mind as an example of why you are worried about her forgetting what she has agreed to. This example is good enough to demonstrate diminished capacity to retain decisions and rationalise the consequences of decisions...

Is the CH manager attending? It may be useful for the CH to provide an input on how your mum has been

e

 

[julieann15]

Jennifer
I have done the sums
Mum's care package(2 carers am and pm, one day centre place and one direct payments for social activities comes to £210. 2 more carers adds in £115 a week ie total £325

To keep mum in the home they will need to pay £50 a week- this includes mum's weekly "spending money"

I really do not know what the issue is?

Love Julie xx

 

[julieann15]

It really hurts me to think mum could possibly go back to the flat and the isolation. the home say she has fitted in well and loves helping in the kitchen- where she stands chatting whilst wiping up the pots? She is robust but lonely and more worryyingly VULNERABLE and that is what all her friends at her flat complex have said.
This "SW" is a nightmare

It has been decided mum will not attend BIM- Advocate instead!

 

[jenniferpa]

Then you can be as brutally honest as you need to be.

With regard to the cost - it's possible that the home care options come from one pot, but the residential care options come from another. There may also be brownie points if they get her to stay in her own home (on the basis that that is "healthier" for her )

P.S. She's in sheltered housing yes? Is there anyway you could get the manager or warden or even any other residents to write a letter to point out that her vulnerability is potentially endamgering other residents? Because you did suspect that she was the person who let the charity collector in.

 

[julieann15]

Sorry if I am naive-thought SS was one big pot-is there really different pots

My stomach is churning at the thought that she may end up confused and isolated in the flat again with just the carers and coffee morning once a week. There is a very good chance she may not get the day centre place back(like gold dust around her way or the lady for Social Activities- so that just leaves up to four carers a day going in and mum not having the time to go out between them

Love Julie xx

 

[jenniferpa]

It's speculation really, but yes, I would imagine that they allocate certain amounts for in home social care and residential care, and there may be pressures bought to bear on social workers to keep clients in a specific "budget line" rather than moving them to another. If you (the council) have budgeted £x for residential care and you're already over budget, I'm sure there is some pressure exerted that to ensure than only the most urgent cases are moved.

Leicestershire Council has their budgets on line and they do have separate line items for everything, including day care, lunch clubs, you name it.

That's not really your problem but it can be helpful to understand possible pressures (not that you should in any way accommodate them). You need to bang on about safety (hers and other peoples - particularly the other residents of her housing unit) and the council's responsibility, and mum's emotional well being, and your emotional well being. Make it clear without being unpleasant that you will hold the social worker morally and legally responsible should she be returned home against her families judgement and something happens to her.

 

[JPG1]

Julie,

Without wishing to add to your problems:

There is a difference between "Advocate" and "Independent Mental Capacity Advocate (IMCA)" , as in Sandy's post.

The two are not the same; the two cannot be called upon in the same circumstances.

If you, Julie, are willing and able and involved in the life of your Mum, as you are, then an Advocate can be involved, but not an IMCA. (They may be the one and same human being, in their own 'reality', in their daily dealings with people who need an advocate, but not always. And their responsibilities and involvement are totally different, if that person being 'assessed' for whatever has no family/friend members able and willing and involved enough to speak on their behalf.)

http://www.publicguardian.gov.uk/docs/making-decisions-opg606-1207.pdf

There is only one pot of gold for the SS. But there are different priorities within their budgeting systems, as in any other business. That should not concern you, Julie. You follow your Mum's needs and your own ability to know your Mum's need, not the budgets.

I don't recommend that you get other residents to support your cause. The manager, by all means, because it is the manager who wears the Overalls!! Mr/Mrs Overall bears the responsibility for whatever happens in the sh/housing. But not other residents.

Hope you find a way through this all.

Forgot to say that the Advocate is there to support your Mum. Not you. That doesn't mean that the Advocate will be automatically agin you - far from it. S/he will appreciate and expect your own input, otherwise the Advocate will not be listening to those who know best about their relative. So, you may not get to meet/speak/brief the Advocate in advance of the meeting, but that should not be a problem.

Did the SW explain to you whey they felt it necessary to appoint an Advocate? That would have been proper procedure. Is there a history of conflict? If not, then I would ask to know why the SW felt it appropriate to call in an Advocate.

 

[julieann15]

Hi
The Advocate D from Age Concern went in yesterday. Mum today when I saw her briefly was asking about going back to clear out the flat-the big thing about this is she has never referred to where she lived prior to the CH as "home". She has asked the staff if there are any vacancies for permanent care coming up as she would like to stay there if one comes up

CH manager says mum has fluctuating capacity- sometimes rational sometimes not?

Still not good on the laundry front- having got some off her yesterday- it turned out to be clean. Poor T cannot get it off her- he did a sweep of her room yesterday and could not find any- little while after she is caught washing her smalls in the sink-T has no idea where she hid them My guess is that she has been washing most of her clothes in the sink and spinning them in her dryer since the new washing machine was installed in the laundry room at the flat complex? New technology and AD just don't mix at the end of the day do they?

Love Julie xx