Care Home Eviction

[Tom R]

Hi everyone,

My father had a fall at his Care Home on Christmas Day. He was a farmer and despite having late stage Alzheimer’s he is still remarkably physically robust. Nevertheless the CH sent him to A&E to check for possible broken hip.The hospital confirmed painful bruising but no broken bones.

Unfortunately due to his Alzheimer’s he struggled to walk after the fall. Hospital provided some physio and CH has an in-house physio. However, CH is now refusing to take him back as they say they don’t have the funds for an extra member of staff to help him get up.

One month on he is still in hospital despite the doctors all saying there is no medical reason for him to still be there. Next step is a ‘multi-agency meeting’ to decide way forward but we are still waiting for Social Work to organise it.

My questions are;
1. Can the CH just refuse to take him back? He is in a specialist dementia unit. There are several residents with mobility issues, it is just that he is physically much larger and so needs more staff to help him up. Do we have any legal protection to force the CH to look after him?

2. What happens to him if the CH won’t take him back? Surely he can’t just be left in hospital indefinitely? But if one of the ‘best’ CHs in the area won’t accept him I can’t see any other agreeing to either!

3. Has anyone had a similar experience and have any tips on how to navigate the ‘multi-agency meeting’?

Thanks so much for your help.

Tom

 

[sdmhred]

Hi @Tom R
I’m sorry to hear this has happened to your Dad. You must all be v stressed and worried.

Care homes sadly can refuse to take people back if they don’t feel able to meet needs ….although I have to say it sounds odd as most homes can manage reduced mobility.

Is your Dad self funding? If not SS must find him somewhere…..I would hassle them to get on with it to reduce his hospital stay further.

im afraid I have no experience of the multi disciplinary meeting but i would advise you are clear and upfront about all the care your Dad needs.

 

[Grannie G]

I feel shocked by this @TomR

Many people with dementia lose their mobility as the dementia progresses. My husband lost his mobility and was provided with a wheelchair to take him to and fro and a hoist to move him from chair/bed to wheelchair.

I would question this decision for further informaton

 

[Sonya1]

I find this really shocking! Especially given that his fall happened whilst under their care. When my father went into hospital, his CH also refused to have him back as they said they couldn't meet his needs. This resulted in him going to a 'discharge to assess' or D2A bed in a care home where his needs were assessed very thoroughly over (in his case) the maximum 6 week stay. This was funded by NHS as it was part of his hospital discharge requirement. Ask the discharge nurse at the hospital about D2A/Discharge to Assess as I believe this to be a standardised norm in the UK. (if you are in UK?) Also, the CH your Dad is/was in would not have to fund additional staff themselves so that sounds like a very wishy washy reason to give. If your Dad is assessed as needing additional support, then this would be funded by social services, or by Continuing Healthcare (CHC) if he is eligible. Sadly, the longer he remains in hospital, the more his mobility is likely to decline. Definitel question everything!

 

[Jessbow]

lso, the CH your Dad is/was in would not have to fund additional staff themselves so that sounds like a very wishy washy reason to give. If your Dad is assessed as needing additional support, then this would be funded by social services, or by Continuing Healthcare (CHC) if he is eligible.

why would it? Why would SS have to pay for the additional help? big assumption.

Simply not being able to get up rom a chair wouldnt qualify you for CHC either.

If the home he was in can no longer meet his needs,and if they feel they cant they are right to say so.. the discharge team need to find him one that can.

How could you force them to have him back?

 

[Tom R]

Hi @Tom R
I’m sorry to hear this has happened to your Dad. You must all be v stressed and worried.

Care homes sadly can refuse to take people back if they don’t feel able to meet needs ….although I have to say it sounds odd as most homes can manage reduced mobility.

Is your Dad self funding? If not SS must find him somewhere…..I would hassle them to get on with it to reduce his hospital stay further.

im afraid I have no experience of the multi disciplinary meeting but i would advise you are clear and upfront about all the care your Dad needs.

Thanks for your advice. My dad is self funding but the home manager says that the local authority must find him somewhere else to go. But I don’t see why another home would accept him. My worry is that he is going to remain stuck in limbo.

 

[canary]

But if one of the ‘best’ CHs in the area won’t accept him I can’t see any other agreeing to either!

What is the criteria forit being "one of the best"?
Most expensive? Having an outstanding CQC rating?
Unfortunately, neither of these is very accurate for assessing care, especially for dementia residents.

Many "lovely" care homes maintain their reputation by spending their income on facilities and décor that look good in their brochure/web site and not on staff numbers/training - especially in their dementia units. Then they get rid of the residents who start to show "difficult" behaviour (in reality, normal dementia behaviour) as their dementia advances.

When you go looking for another care home, look beyond the décor and see what the actual care is like and if there are people with very advanced dementia there, then they can probably deal with the behaviour associated with the more advanced stages of dementia. It is also worth asking them what behaviour they wont tolerate.

 

[Rayreadynow]

My understanding is that the care home are probably still being paid full rate whilst he is in Hospital and not providing any service.

The discharge co-ordinator in the Hospital is the key contact and they are the ones who should be organising the discharge in discussion with all relevant parties.

 

[Tom R]

T

I find this really shocking! Especially given that his fall happened whilst under their care. When my father went into hospital, his CH also refused to have him back as they said they couldn't meet his needs. This resulted in him going to a 'discharge to assess' or D2A bed in a care home where his needs were assessed very thoroughly over (in his case) the maximum 6 week stay. This was funded by NHS as it was part of his hospital discharge requirement. Ask the discharge nurse at the hospital about D2A/Discharge to Assess as I believe this to be a standardised norm in the UK. (if you are in UK?) Also, the CH your Dad is/was in would not have to fund additional staff themselves so that sounds like a very wishy washy reason to give. If your Dad is assessed as needing additional support, then this would be funded by social services, or by Continuing Healthcare (CHC) if he is eligible. Sadly, the longer he remains in hospital, the more his mobility is likely to decline. Definitel question everything!

thank you. I have sent SS an email asking about DTA. There has been some talk about him going to a specialist NHS rehabilitation centre but nothing confirmed yet.

 

[Tom R]

What is the criteria forit being "one of the best"?
Most expensive? Having an outstanding CQC rating?
Unfortunately, neither of these is very accurate for assessing care, especially for dementia residents.

Many "lovely" care homes maintain their reputation by spending their income on facilities and décor that look good in their brochure/web site and not on staff numbers/training - especially in their dementia units. Then they get rid of the residents who start to show "difficult" behaviour (in reality, normal dementia behaviour) as their dementia advances.

When you go looking for another care home, look beyond the décor and see what the actual care is like and if there are people with very advanced dementia there, then they can probably deal with the behaviour associated with the more advanced stages of dementia. It is also worth asking them what behaviour they wont tolerate.

This is the second CH my dad has been in as the first was just awful. I really thought we had found the right place for him this time. My suspicion is that this has to do with the fact the CH was sold to another care company while my dad was in hospital and the new management is trying to save cost (just a hunch and I can’t prove that)

 

[Jaded'n'faded]

This is the second CH my dad has been in as the first was just awful. I really thought we had found the right place for him this time. My suspicion is that this has to do with the fact the CH was sold to another care company while my dad was in hospital and the new management is trying to save cost (just a hunch and I can’t prove that)

This happens a lot! And this is why you need to take any CQC rating with a pinch of salt.

Just as with schools, care homes can change a lot if a key staff member leaves or a new, good one, takes over. Ratings only reflect how the place was at the time of the last inspection. You are also not told if the home is improving from previous inspections or is slipping from a previously good rating.

But residents can change things too and I think this may be what you are up against. If 3 residents die in one week it frees staff up to spend more time with the other residents. If 2 new residents arrive and prove to need a lot of staff care, others will get less as a result. Homes only have a limited ratio of staff to residents which is why they are able to refuse or evict people if they don't think they can meet their needs.

But I don’t see why another home would accept him. My worry is that he is going to remain stuck in limbo.

If he's self-funding, social services might expect you to do the groundwork and find another home. You could insist on Discharge to Assess first - tell SS you can't possibly find him a new home till you know accurately what his care needs are. There will be homes that will accept him but you may have to look further afield.

 

[Violet Jane]

I suspect that as care homes are struggling more and more with underfunding and staff shortages they are increasingly evicting residents and insisting on 1:1 care (to be paid for by the resident). They want compliant residents who stay in their chairs! My mother had repeated falls but her home never suggested that this was too much for them to cope with. However, this was 6 to 8 years ago. Wandering, falls, agitation and resistance to personal care are part and parcel of dementia and homes should be expected to manage these.

Like @canary, I think that hotel-style homes don't / won't cope well with people with dementia except those who are exceptionally compliant. Naturally, those homes, with people who don't look 'too bad', are going to be more appealing to the relative looking for a home than those with people with very advanced dementia as advanced dementia is shocking to see when you first encounter it. Most relatives feel that their PWD isn't as bad as the current residents of the home. That may or may not be the case but, in due course, their PWD will become as bad because dementia is a progressive illness. Eventually, their PWD will be the one that other relatives see as much worse than their own PWD.

 

[Ash.]

Hi everyone,

My father had a fall at his Care Home on Christmas Day. He was a farmer and despite having late stage Alzheimer’s he is still remarkably physically robust. Nevertheless the CH sent him to A&E to check for possible broken hip.The hospital confirmed painful bruising but no broken bones.

Unfortunately due to his Alzheimer’s he struggled to walk after the fall. Hospital provided some physio and CH has an in-house physio. However, CH is now refusing to take him back as they say they don’t have the funds for an extra member of staff to help him get up.

One month on he is still in hospital despite the doctors all saying there is no medical reason for him to still be there. Next step is a ‘multi-agency meeting’ to decide way forward but we are still waiting for Social Work to organise it.

My questions are;
1. Can the CH just refuse to take him back? He is in a specialist dementia unit. There are several residents with mobility issues, it is just that he is physically much larger and so needs more staff to help him up. Do we have any legal protection to force the CH to look after him?

2. What happens to him if the CH won’t take him back? Surely he can’t just be left in hospital indefinitely? But if one of the ‘best’ CHs in the area won’t accept him I can’t see any other agreeing to either!

3. Has anyone had a similar experience and have any tips on how to navigate the ‘multi-agency meeting’?

Thanks so much for your help.

Tom

I had similar to this but dad did break his hip . His dementia declined in hospital due to confusion of where and why he was there and being moved from ward to ward .
Care homes that will take someone that can’t walk are few and far between . Social stepped in and it looked as though he was going to be sent miles away so impossible to visit .
Start looking yourself and ask the questions then maybe they can sort something between each other to help . It does no good being left in hospital for the person with dementia or anyone else on the ward or waiting for beds . Goodluck

 

[Kevinl]

Care homes are not nursing homes and it sounds like a nursing home is what is needed here.
Staff levels and particularly qualified staff differ, and different funding may be available to you/him.
Other option is put on your best poker face and say, not my problem and threaten to walk.
Very ugly suggestion I know and I apologise, but sometimes it is a case of your love and their legal responsibilities, when to hold them, know when to fold them as us poker players say.
K

 

[Violet Jane]

I thought that nursing homes were for people with complex medical conditions. Lots of people with dementia have or end up with poor mobility. Lots of people without dementia but with poor mobility live in their own homes.

I really do think that the problems with care homes meeting ordinary care needs are to do with underfunding and staff shortages.

 

[Kevinl]

If a care home says no they cant meet the needs then a nursing home is he next option, after that hospital care.
I think the care home are being very responsible admitting they can't meet the needs of a patient, turning down business, refusing to take the cash, you decide.
Take someone back but supply what they believe they cant adaqueltly supply care for...well done them.
Some homes aren't so...professional.
K

 

[Hartwick]

This is so worrying for so many people myself included. Today it was mums 6 week review in her new CH she has now been officially diagnosed with Vascular Dementia the problem is literally not sleeping at night she is constantly up and down. She is on Trazodone & Promethazine from the GP but made no difference so they are contacting the Crisis Dementia Team for a look at meds but CH did say it was proving to be to much of a challenge at night even though they think she’s lovely I cannot bear the thought of her being moved after going through a unsafe discharge .its like a shadow hanging over us.

 

[Kevinl]

So the other X number of residents in the/their home have to put up with shall we say challenging behaviour from one person to suit you.
Sorry cant agree.
K

 

[Rayreadynow]

Care Homes and Care Staff want a nice easy life....I visited one care home and saw a resident laying in bed alseep with oxygen feed on. To think they will be getting £1500 a week for someone in that position maybe indicates why disruptive residents who need lots of staff support are asked to leave.

Its a business and I suppose these business decisions have to be made.

 

[Kevinl]

Sorry bit I dont agree about and Ive, oxygen feed in a care home or was that a nursing home.
Staff want an easy life, tell that to my late wife, what you nurse is what you get, she got early onset AZ and I ve no issues about the care she got treated.
K