Care home not safe for return

Discussion in 'I care for a person with dementia' started by Rosserk, Oct 18, 2019.

  1. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    My father was admitted to hospital last week with Sepsis. When he arrived at A&E he was photographed and found to have multiple bed sores grade 2 and 3. The grade 3 sore is of undetermined depth due to slough in the wound. Apparently slough prevents you from measuring the depth of the pressure sore but it has to be a minimum grade 3. The hospital have raised a safe guarding issue and are refusing to discharge him to his care home when he is medically fit.

    Social services are looking for a new home. My father can not walk, feed himself, is double incontinent and can no longer communicate. He will also lash out during personal care.

    He is fully funded and has continuing health care. The Council are saying they will struggle to find him a care home which will meet his needs for the price they’re prepared to pay.

    In these circumstances what will happen? My father was sectioned on a 117 and has a DOLs in place so it’s not like they can send him home...
     
  2. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,316
    I understand that local authorities have a legal obligation to provide at least one placement in a home which meets the person's needs and is within their fee/budget limits. In your particular circumstances, where they can't use the same home as your Dad was in previously, then they'll have to consider what alternative options they have. I guess they'd have to consider either increasing their budget or looking further afield into other local authority areas. Best thing to do is to ask them as local authorities seem to have differing approaches. Hopefully a place will be found soon.
     
  3. Quizbunny

    Quizbunny Registered User

    Nov 20, 2011
    91
    If your father has been awarded Continuing health care doesn't that make the NHS responsible for his care/nursing home fees?
     
  4. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    I don’t know I wondered the same. It says in his care plan jointly funded?
     
  5. nitram

    nitram Registered User

    Apr 6, 2011
    19,156
    Male
    North Manchester
    It's unclear whether funding is s117 or CHC.
    However in both cases funding is increasingly shared between CCG and LA.
    A split of medical needs and 'hotel costs'.

    In either case it is fully funded however there are differences when it comes to top ups
    s117 is one of the few situations when first party as well as third party top ups are allowed.
    CHC top ups are not allowed although there are now many ways of them being used by artificially separating the services provided by the care home.
     
  6. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    They have called and offered a home rated unsatisfactory by the QCC. It has an amber earring on safety! It feels like it’s out of the fire into the fat!
     
  7. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318

    I can’t clarify. He is definitely on a section 117 and there are NHS payments and LA payments written in his care plan.
     
  8. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    What are top ups? And is there a limit ?
     
  9. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    I don’t know who pays what or what the limits are.
     
  10. nitram

    nitram Registered User

    Apr 6, 2011
    19,156
    Male
    North Manchester
    Top ups are voluntary payments in addition to funding provided by the system.
    There is no limit, they may be increased if the home raises its fees by more than the funding authority will allow.
     
  11. nitram

    nitram Registered User

    Apr 6, 2011
    19,156
    Male
    North Manchester
    This means that either he or you can voluntarily pay extra for a home of your choice.
    Not a decision to be lightly taken.
     
  12. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    I don’t know who pays what or what the limits are.

    Thank you that is the problem. I would also be concerned that if we pay top ups they would expect more and more from us every time there was an issue. For example at the moment he will need a lot of nursing care to address the pressure sores. I also can’t afford to pay a top up.
     
  13. nitram

    nitram Registered User

    Apr 6, 2011
    19,156
    Male
    North Manchester
    In that case don't pay them if asked.

    You said the offered home had a bad CQC report.
    How recent is the report?
    Are the failing ones that would directly influence your father?
    You could go to the home, have a look around and ask questions, how long has manager been in position/what is staff turnover rate/...? How many vacancies are there?

     
  14. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318

    The home went into special measures October 2018 it has just been re-inspected and still requires improvement and safety is main problem. I’ve spoken with people I know who work in the care sector and the home is extremely bad according to them. I’ve found somewhere and they are assessing him Monday they think they can meet his needs. It’s about 25 minutes from me but it’s perfect! I’m keeping everything crossed they will take him!
     
  15. nitram

    nitram Registered User

    Apr 6, 2011
    19,156
    Male
    North Manchester
    Hope the assessment goes OK
     
  16. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318
    Thank you I wish it could be sooner I will be on pins until it’s over. Just keeping my fingers crossed dad behaves himself and is in a good mood!
     
  17. Banjomansmate

    Banjomansmate Registered User

    Jan 13, 2019
    1,248
    Female
    Dorset
    The Banjoman was offered three choices of care home by local Council when he was in hospital, one of which had just received a “needs improvement” rating from CQC. When I commented on this to the commissioning body I was told “We think it is OK”. - tough! There was no way I was going to chance having him moved there. Thankfully one of the other options has turned out to be quite good. He wasn’t too happy at being there but their “end of life care” couldn’t be faulted and I am grateful to them for that
     
  18. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    318

    Thank you

    The Council were really snooty with me because I refused the care home they offered. They said it was unlikely I’d find anywhere else that would take him for the rate they are prepared to pay! I wanted to say on your watch my father came to significant harm and you had a duty of care to protect him from abuse and failed! I will not assist you in failing again! They sent an assessor from the care home to assess my father before they spoke with me they had it all wrapped up until I said NO!

    The Council then made me feel like I was being difficult for not allowing him to return to his current care home even though it’s highly likely he has suffered neglect. They said people get pressure sores and urine infections all the time and it’s not a reason to expect neglect and the complaint would mean they’d be extra vigilant, I couldn’t believe what I was hearing. The investigation hasn’t been completed yet but I fully expect a whitewash! I want to insist every single resident is checked for unreported bedsores and warn relatives to be extra vigilant. I had complained six weeks before that I felt my dad was at risk of pressure sores because he wasn’t being regularly moved. I had also complained he could feed himself and needed help eating and drinking because I was concerned he wasn’t getting enough fluids but the care home didn’t uphold my complaint. It’s not that difficult to monitor the fluid intake of someone who’s permanently static, he was severely dehydrated when he arrived at hospital! Both my concerns were validated by my fathers hospital admission. It’s telling that my father was given the last rights on Saturday and was sitting up eating on Monday.

    I don’t think there’s a home in budget that would be able to provide the care my father needs. His care takes up too much time and resources which then put others at risk, it’s an impossible situation. X
     

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