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Change in care plan arrangements - who pays

Discussion in 'Legal and financial issues' started by melaniemt, Nov 23, 2015.

  1. melaniemt

    melaniemt Registered User

    Mar 19, 2012
    3
    Hello,

    I am a new member and this is my first post and I am hoping to get some advice.
    Mum suffers from alzheimers and was admitted onto an EMI unit in a home in Cardiff in July. She was assessed by the LA and as far as I am aware, they are responsible for paying her fees (I live in England and so my sister deals with all her affairs). Since being taken into the home, she has had numerous falls, one of which resulted in fractured ribs and a bleed on her spleen.

    I received an email from the home to advise me that they think mum would benefit from 1 to 1 care 24/7 (implying that this was due to her many falls) and have quoted a figure of £12 per hour in addition to normal costs paid to the home. So at this point in time, I am very confused as I thought any change in fees would need to be discussed with the LA as they are responsible for paying for her fees?

    Can anyone offer any advice please?

    Many thanks.

    Mel (The Newbie)
     
  2. lin1

    lin1 Registered User

    Jan 14, 2010
    9,322
    Female
    East Kent
    Hello, welcome to TP
    Sorry I cannot help but thought I would say hi and give your post a bump to the top.
    Others who can help will be along later.
     
  3. Beate

    Beate Registered User

    May 21, 2014
    11,490
    Female
    London
    Wow. I don't know much about the subject but a care home cannot simply decide how much support your Mum needs and try to bill you extra for it. If she really needs that much support, you should be able to apply for CHC. At the very least, social services should be informed and someone would have to formally assess her increasing needs.
     
  4. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    I agree with Beate. However, money aside, I would also be asking if this is the right placement for her. 'a number of falls' and the last one is particularly nasty - it certainly sounds as tho they are not safeguarding her properly. I would also get onto the social worker asap and question what is happening. Sorry you are having to go through this, it is particularly difficult long distance
     
  5. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,561
    North West
    #5 stanleypj, Nov 23, 2015
    Last edited: Nov 24, 2015
    It does sound very odd. But we know that there are some differences between the English and Welsh systems. I hope someone who knows about the Welsh system will come along.

    I agree with Beate that if this were happening in England there would seem to be a least a need for Continuing Health Care assessment, i.e. to see if the NHS should pay for the care in this complex case. Fizzie also makes a very important point about the falls. The care home is being paid to make sure that such incidents are avoided and whilst the odd one could happen in any home (and indeed even with 1 to 1 carw) your mum does seem to have been very unlucky in the home she has ended up in.
     
  6. melaniemt

    melaniemt Registered User

    Mar 19, 2012
    3
    Hello,

    Thanks for all your replies.

    They do seem to concur with what my immediate thoughts were i.e. that the Social do need to be involved. They also do throw up some interesting points about safeguarding. You all probably have better experience of these circumstances than me but trying to get hold of anyone in the right department at Social seems to be a little bit of a struggle!!

    Will keep you all updated.

    Many thanks.

    Mel
     
  7. melaniemt

    melaniemt Registered User

    Mar 19, 2012
    3
    Home has given notice on mums care

    Hello,

    Following on from my post last year regarding the fee issue, we did manage to get hold of Social Services who were extremely helpful and who concurred with what had already been suggested about who was responsible for paying the fees.

    Unfortunately the fee issue has not been resolved as Social Services do not agree with "the home's" decision that mum needs 1 to 1 care and this has resulted in "the home" giving 28 days notice on mums care. The 28 days notice has since expired. A meeting was held earlier this week and a further meeting has been called with "the home", Social Services and my sister to discuss what the best way forward is for mums care. Naturally, we are flabbergasted that this decision has been made but "the home" seems adamant that mum needs this care and Social Services (and us) do not concur.

    Does anyone know of any avenues that we can explore? Ideally we want mum to stay where she is and move onto their nursing unit. Any suggestions to make, questions we should be asking that anyone might be able to share?

    Much appreciated.
     
  8. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    My personal view is that if the home do not want her I wouldn't want her to be there but obviously you have a lot of other factors to take into account too.

    I would be surprised if social services budge on this. It is very unusual in my experience for any care home to charge this kind of hourly fee for extra care. I am assuming that at the moment they are giving her the extra care that she needs ? If not then they are not fulfilling their duty of care but that is a circular arguement.

    I think I would try to speak to Social Services before the meeting to try to get some idea of what your options might be - you don't want to have decisions sprung on you in a meeting. Other than that I can't be much help

    Have you asked for assessment for CHC funding?
     
  9. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,665
    Salford
    At the risk of being unpopular I can see this from the care home's point of view.
    If they believe that she needs one to one 24/7 care (and from the rib and spleen damaging fall it sounds that way to me too) then they really do have to say so.
    What happens if she has another fall and you sued them, would the insurance be valid?
    If they've decided 24 hour care is needed, nobody want's to pay and so they then leave her alone could they be accused of negligence if anything did happen to her?
    Looking at it from the home's perspective I can see where they're coming from in doing what they consider the right thing for your Mum's safety.
    I can understand why the SS don't want to pick up a £2k a week bill but I think I'd be siding with the home and demanding they pay up to ensure her safety and that should anything happen it would be down to them rather than fighting the home.
    If no one is prepared to pay them the home has 3 choices: pay the extra wage bill themselves, do nothing and cross their fingers nothing bad happens or ask you to move her. If I were them I would go for option 3.
    Option 1 you can't expect them to pick up the tab. Option 2 would be morally and probably legally wrong should anything happen it could see them in court charged with anything up to manslaughter so option 3 getting, her moved is in my view the only thing they can do.
    I can't actually work out who's paying the fees "who concurred with what had already been suggested about who was responsible for paying the fees" but if it's the council then I'd be insisting they paid up, if she's self funding they any new home may not be willing to take her without 24/7 care either.
    As I said I do run the risk of being unpopular for saying this but I think the home is being diligent and acting in your mother's best interest.
    K
     
  10. notsogooddtr

    notsogooddtr Registered User

    Jul 2, 2011
    802
    I don't think it's particularly unusual for there to be a difference of opinion between social services and care homes regarding assessed needs.Following a 9 week hospital stay my mother was assessed as needing residential care.Unfotunately it proved extremely difficult to find a ch that agreed.We wanted her to go to a residential unit at the same place my dad is in but they assessed her as needing nursing care.Social services wouldn't budge.We finally found a ch prepared to give it a go,she lived there for the last 10 months of her life and was very well cared for.Downside was that she and my dad were never able to see each other.A sad way to end a 60plus year marriage
     
  11. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,561
    North West
    That's so sad.
     
  12. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    I think that is awful for them and for you, the family, to see them separated. Again they wouldn't separate young people so why do they think they can do it to older people - another case of not putting people first x
     
  13. realist1234

    realist1234 Registered User

    Oct 30, 2014
    108

    Sad indeed. In my case, we found that the hospital consultant was actually pushing for our mum to go into a nursing home as our dad was already in one - she saw it as important that they should be kept together if possible, which is the right attitude to have. And she made the point that with Alzheimers our mum could require nursing care very quickly anyway. Sadly my dad died within a week of my mum moving in but at least they were able to see each other.
     
  14. chrissie121

    chrissie121 Registered User

    Nov 27, 2013
    29
    HI there, having experienced similar experiences with type of care provided for my mother, the first thing you should do is contact your mother's local authority as the home should have contacted them in regards to additional funding for your mother's care as the LA is paying for her care. Secondly, does your mother have an appointed social worker to her case, if not ask the Local authority to put you in touch with Social services as they will be able to advise. If the local authority are funding all your mother's care then its really down to them to agree with the home what additional care/funding your mother requires. Hope this helps
     

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