Can the local authority just decide to reduce care?

[Nigel62]

Hi...I would really value some input on a bit of a situation that has developed (I guess we are all used to dealing with a 'situation'!).

Basically my mum (82) was diagnosed with mixed Dementia in Jan 2015. She is very stubborn and wants to be independent and was moved from a respite home back to her council bungalow. She lives alone. I live 100 miles away and have LPA for her financial affairs. I sorted out her finances which were a terrible mess and they are now all good. I got care sorted but it was clear the daily visit wasn't enough. Around Easter time, after discussions with her social worker I upgraded the care package to one recommended by the LA. Payment is made via the Direct Payments system.

Mum is now visited twice a day. She gives every impression of coping but things are getting worse...soiled sheets, no personal hygiene, no cleaning, not cooking or washing (I have meals on wheels arranged). She is very isolated and clearly is very depressed.

Mum doesn't see the point in carers coming as she says she can cope without them, which she clearly can't. Mum also refuses any medical help or assessment and will turn people away if they try to visit.

My suspicion is that the new care company simply are not trained in dementia care. I was very concerned that her bedding was so badly soiled and hadn't been seen by a carer. They come in, chat to her, and usual run an errand such as getting her cigarettes. I've been there on occasion when the carers are there and one two occasions the visit was only 5 minutes (it should be 30 minutes per visit, that's what is being paid for).

On visiting last week I noticed in the carers log book that 4 times in the last week only one daily visit had been made. I contacted the care company and the social worker about this. I was told in no uncertain terms that mum was unresponsive and the care company in particular seemed frustrated by the situation. They had decided (without contacting me) to cut back the care to one visit a day. I'm furious about this and have told them so, they said I should have been consulted and are investigating how it happened (!) but are still adamant it's going to be one daily visit.

Mum resolutely refuses the notion of a care home but isn't coping alone. However, I do feel with the right care she could be taken into town, given things to do etc, a more proactive response. Sadly her funds are very limited and we rely on the care providers the Local Authority suggest, searches in the area where she lives (Grantham, Lincs) haven't revealed much.

Mum's social worker said mum's response was very unique and he had many years experience of working with dementia patients...I find this hard to believe. My fear is that collusion between the care companies and social worker will cut mum's care and/or they will ultimately take this to the Court of Protection to force her into a home.

If that makes sense is there any advice anyone could give me at all?

I understand budgets are pressured, people are poorly paid and the whole arena is under resourced...but even so I've been disappointed in the attitude of the social worker and the care company (whose lack of professionalism extends to not giving me correct bank details for payments, giving me forms that can't be opened by anyone and even spelling 'invoice' wrong...small things but they say a lot!

sorry to ramble on but any thoughts would be gratefully read!

many thanks

Nigel

 

[nae sporran]

Not too sure how the direct payments scheme works. When we had problems with a care agency and social services were bouncing us from one office to the next, I wrote to our local councillor and the Social Services Manager was in touch fairly quickly to help sort out a new agency.
Are you registered as your mum's carer, or just next of kin. I was going to suggest a full carers assessment and a care review for your mum. That takes a bit of time, but it's the best I can suggest. Hope it helps you Nigel.

 

[Beate]

I would have thought that once a care package is agreed upon the social worker has a duty to implement it, so if a care agency takes it upon themselves to change their frequency, he should help find another one? Of course it is very difficult to give care if care is refused, but that is by no means a new or unusual problem with PWDs.
But I also have to say that given your Mum's situation and how little she is doing for herself, plus her feeling of loneliness, a care home should not be dismissed as a valid option right away. You never know, she might thrive in one!

 

[Spiro]

However, I do feel with the right care she could be taken into town, given things to do etc, a more proactive response. Sadly her funds are very limited and we rely on the care providers the Local Authority suggest, searches in the area where she lives (Grantham, Lincs) haven't revealed much.

Have you tried the local Age UK? According to the Lincoln branch website they offer a lot of different services and even they can't assist directly, they may be able to suggest another local service.

 

[Lindy50]

Hi Nigel, I am sorry you are having these problems. It sounds as though your mum needs more care rather than less, frankly! And as you say, of a more pro-active type.

I gather that the care was set up following an assessment involving a social worker? If so, it definitely should not be reduced without a review meeting being held, at which you can raise your concerns. A new care plan should be made, detailing her needs and how they are being met ( or not!)

Having said that, do have a good think about what you believe her needs to be, and as Beate says, whether in fact she does need a care home. If so, the funding for that would be a whole other issue!

I think the idea of contacting Age UK is a good one. Also, have you heard of Admiral nurses, who have a national helpline that you may find useful?

Good luck x