So, I had a phone call from Social Services today to tell me that the Hospital has now assessed Mum's delirium as being her new baseline and as such its no longer a Health issue for funding and she can be discharged from hospital. They have decided that her medical needs (terminal bowel cancer, stoma and a tumour that bleeds and risk of heamoraging) are not complex and thus not eligible for CHC or FNC. They have decided that as she needs (in their opinion) 24/7 care she is not safe to be discharged home and they are arranging a temporary placement (for 6 weeks) in a residential (NOT nursing) home of their choosing and location that I have no say over! They will not consider a placement at home with carers for 6 weeks as this would mean overnight care which costs more! So although I have PoA I'm being told that I have no real say in what happens next and I will be told when she is moved. I am supposed to use the 6 weeks to (their words) 'sort my life out' and decide how we will fund this care going forwards as Mum has more than the threshold in savings and she has a 50% share in the house that we live in (my Dad left his half to me in his will but his estate has not yet been settled as probate is outstanding so is a self funder. I asked what would happen if she hates the home and I want to bring her home and they basically said I would have to prove how I can provide 24/7 care before they would consider this option and suggested I'd need to give up work and arrange overnight carers. To add further stress, they advised that I get legal advice & representation re the house as this is unlikely to be discounted and thus I face potentially having to sell the house I live in when mum ceases needing care and they want the equivalent of her share of the house in backdated care fees. To say I'm reeling from this is an understatement, I've never felt so bullied (they refused a joint Discharge Meeting on the basis that there is nothing to discuss) and I'm now struggling to compute the reality that not only will Mum not be returning home to me as she wants, I will have to spend all her savings and probably mine too and lose what my parents wanted to leave me as their legacy! I intend to pursue the CHC / FNC route as when the hospital admit that they drop the diagnosis of delirium in order to get the responsibility for funding switched from health to social services, it feels wrong! It also now seems likely that Mum could be moved over this weekend and I will be told where she has been moved to! I think I need to get some proper help here or otherwise I will go crazy!
Can Social Services really take control and do what they want?
- Thread starter FlyingNut
- Start date
Hello @FlyingNut
Your mum is going to a Discharge to Assess (D2A) bed. Once upon a time people would be discharged to a convalescent hospital, but they don't exist now, so the NHS is using this pathway to be able to see whether they will improve and exactly what their needs are. The NHS has a contract with certain local care homes, so that is why there is no choice. There wasn't any choice when they used convalescent hospitals either, so can you think of this time in terms of that?
At the end of this there will be a Best Interest meeting and I do feel that the SW was rather jumping the gun because it's at this meeting that it will be decided what will happen next - whether she is OK to go home, whether she will need a care home or whether a nursing home is necessary. Both you and your mum should be invited and you will have a chance to say your piece.
If it decided that she needs continuing 24/7 care then if you want her home then you will have to provide details on how it will be provided. The NHS and SS have a Duty of Care to ensure that people are discharged to a safe environment.
Your mum is going to a Discharge to Assess (D2A) bed. Once upon a time people would be discharged to a convalescent hospital, but they don't exist now, so the NHS is using this pathway to be able to see whether they will improve and exactly what their needs are. The NHS has a contract with certain local care homes, so that is why there is no choice. There wasn't any choice when they used convalescent hospitals either, so can you think of this time in terms of that?
At the end of this there will be a Best Interest meeting and I do feel that the SW was rather jumping the gun because it's at this meeting that it will be decided what will happen next - whether she is OK to go home, whether she will need a care home or whether a nursing home is necessary. Both you and your mum should be invited and you will have a chance to say your piece.
If it decided that she needs continuing 24/7 care then if you want her home then you will have to provide details on how it will be provided. The NHS and SS have a Duty of Care to ensure that people are discharged to a safe environment.
Complexity is not required for fast track CHC where an appropriate clinician signs
The individual fulfils the following criterion:
They have a rapidly deteriorating condition and the condition may be entering a terminal phase.
For the purposes of Fast Track eligibility this constitutes a primary health need. No other test is required.
Note the guidance
13. The completed fast-track pathway tool should be supported by a prognosis, where available. However, strict time limits that base eligibility on a specified expected length of life remaining should not be imposed:
a) ‘rapidly deteriorating’ should not be interpreted narrowly as only meaning an anticipated specific or short time frame of life remaining
b) ‘may be entering a terminal phase’ is not intended to be restrictive to only those situations where death is imminent
14. It is the responsibility of the appropriate clinician to make a decision based on whether the individual’s needs meet the fast-track criteria.
15. An individual may at the time of consideration be demonstrating few symptoms yet the nature of the condition is such that it is clear that rapid deterioration is to be expected in the near future.
In these cases it may be appropriate to use the fast-track pathway tool in anticipation of those needs arising, and agreeing the responsibilities and actions to be taken once they arise, or to plan an early review date to reconsider the situation.
Have a read through
https://forum.alzheimers.org.uk/threads/care-costs-if-a-tennant-in-common.149262/post-2065741 . et seq.
You can look into the options of care at home which could be a live-in carer or an overnight carer. Both are expensive but could be slightly cheaper than a care home particularly if you engage / employ the carer directly (which I don't recommend) rather than contracting with an agency which takes on all the legal responsibilities. However, these options would only be available if your mother is funding her own care. Live-in care is actually not much more expensive than overnight waking care but the live-in carer is not expected to get up more than twice a night.
I have arranged live-in care for an elderly friend and I have to say that it's not the easy solution that one might imagine it to be. The carer has a right to breaks and you are likely to be using several carers as many work for a few weeks and then have a week or two off although some do work for longer stretches at a time. However, I thought that I'd mention it as an option.
Unless you are very close to retirement age and have a good pension I'd advise against giving up work. It could be very costly financially and it might be difficult to get back into similar work later.
I have arranged live-in care for an elderly friend and I have to say that it's not the easy solution that one might imagine it to be. The carer has a right to breaks and you are likely to be using several carers as many work for a few weeks and then have a week or two off although some do work for longer stretches at a time. However, I thought that I'd mention it as an option.
Unless you are very close to retirement age and have a good pension I'd advise against giving up work. It could be very costly financially and it might be difficult to get back into similar work later.
