Community Psychiatric Nurse exceeding authority?? - HELP!

Discussion in 'Legal and financial issues' started by WalkingLad, Apr 6, 2015.

  1. WalkingLad

    WalkingLad Registered User

    Apr 3, 2015
    #1 WalkingLad, Apr 6, 2015
    Last edited: Apr 6, 2015

    Does a CPN have the authority to decide and organise the relocation of my 95 yr old dad from his current home, without a single word to me or family, to one over 10 miles away - (and that has repeatedly failed inspections for over 4 years (have visited it - it is very VERY grim!!)- and have previously told home staff that would not even consider it as a short term option!!

  2. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    #2 BR_ANA, Apr 6, 2015
    Last edited: Apr 6, 2015

    Sorry, I don't know (I don't live on UK). On your other post are some answers.

    if the CH feels that your dad has worsened and it couldn't care for him it may ask family/ SS to move him to a more adequate CH.
    If you didn't like the CH, maybe you can visit other ones and found one good for your dad
  3. lin1

    lin1 Registered User

    Jan 14, 2010
    East Kent
    #3 lin1, Apr 6, 2015
    Last edited: Apr 6, 2015
    Hi walking Lad . It does sound to me that the CPN is not acting properly especially in not discussing And deciding things with you. Is this CPN aware that your Dad has family that cares about him ?

    Do you have a Health and Welfare LPA (lasting power of attorney ) for your Dad ?

    Here is a link to your other thread which has a couple of replies
    Back in a mo as I haven't read it properly
    You can if you wish, have your two threads amalgamated , if so just leave a message on here for a moderator .

    I am wondering why your dad is being moved, from what I have read you are reasonably happy with his care there and your dad is happy there , IMO unless the home now considers they can no longer meet your Dads needs, then he should stay where he is, after all he has been there two years.
    Ah could it be that dad is no longer self funding and social services want to move Dad to a cheaper placement

    One of the things they are supposed to take into consideration, is the right for the person to a family life, that mean not so far that family cannot visit regularly

    I certainly dont think a very smelly place suitable either, though even in a well run place their is bound to be the occasional whiff.

    assuming you in the UK
    Contact Admiral nursings helpline, do have a browse around their site .

    Alzheimer's national helpline
    Amongst other things their number is here

    please let us know how you get on.
  4. SugarRay

    SugarRay Registered User

    May 5, 2014
    Sunny South East
    Surely any "decent" CPN would ask the family first for their opinions? It begs the question about how much they know about you and the family, and what are the reasons behind the move. My gut feeling is that they aren't acting correctly.
    I would make a telephone call on Tuesday and ask the CPN and or their manager. SR
  5. Bree

    Bree Registered User

    Oct 16, 2013
    I would complain in no uncertain terms that they have no right to move your dad without involving you. Say his is not to be moved before consulting you with reasons for said move. When my dad was looking for a care home, I visited some places I wouldn't put a stray dog into ! There are good and bad, if you're not totally 100% happy with the new home, don't allow the move. Good luck. :mad:
  6. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    To be honest, WalkingLad, I find this extraordinary!!!

    There is usually a lot of discussion and negotiation before a move can be agreed - though it is not unheard of. I agree with others, get on to SS and the CPN at first light tomorrow to unravel this. If a move is planned, they should be able to explain the reasons quite clearly and easily. I really hope it's either all a misunderstanding, or that there's a good reason for such a move.

    Good luck :)

    Lindy xx
  7. PeggySmith

    PeggySmith Registered User

    Apr 16, 2012
    I don't understand at all why a CPN would be involved in the first place. Surely they're not involved in funding?
  8. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    I don't understand it either. I could only think they might be involved if the patient were funded under section 117 - but even so, it would be a long shot.

    Best perhaps to simply ask the questions...
    Is a move planned?
    If so, who organised it?
    And why?


    Lindy xx
  9. SandraBetty

    SandraBetty Registered User

    Apr 4, 2015
    The simple answer is no. No one person can move your dad. The cpn might be the care co ordinator and if this is the case then other professionals are involved to. Try contacting nurse assessors at your local health board and ask them to look into your problem.
  10. WalkingLad

    WalkingLad Registered User

    Apr 3, 2015
    #10 WalkingLad, Apr 7, 2015
    Last edited by a moderator: Apr 7, 2015
    Hi, Keith here - many tks for support.!
    I understand that Dads personal health is deteriorating - and will need more support shortly - and we have all been searching in northwales area for suitable place with vacancy.
    WE have already organised his next care home - they have reserved a bed open waiting for him - but current bed holder in hospital - is a question of time, if you get what i mean.
    Are relying on a "friend of a friend" , who visits and has a lot of business with many care homes to visit there today - and try to persuade home to defer relocation until our "reserved" bed can be accessed.
    Honestly, have travelled probably hundreds of miles and visited more than 20 homes - but either unsuitable or too far away, or too expensive.

    The Inspection reports for the undesireable care home are on - repeated failures for same issues for inspection after inspection after inspection.

    It was only by accident that my sister in new zealand phoned home, that a care worker accidentally let slip that dad was "going to be moved" on Wednesday.

    Dont have Health and welfare POA, so first call this morning will be Social services - who have been noticeably very quiet and uncontactable during this time - and demand explanation and a hold. Then demand answers from care home - Managers and CPN.
    Dont believe that CPN will have authority to do this herself - but not really interested - will demand to see and be advised who signed/authorised it.

    Really shouldnt be happening to a sweet gentle 95 yr old "proper Gentleman"
    Always has bright white clean shirt every morning and wears bright vivid coloured ties, nice cardigans and pressed trousers - the highly polished leather shoes have unfortunately been replaced with more comfortable slippers nowadays and just enjoys company and family - with a cup of tea of course.

    Thank you all for your support.

  11. Wirralson

    Wirralson Account Closed

    May 30, 2012
    #11 Wirralson, Apr 7, 2015
    Last edited: Apr 10, 2015
    Like other posters, I am puzzled by the reference to a Community Psychiatric Nurse (although things are slightly different in Health Boards and Local Authorities in Wales from the set up in most English NHS CCG areas and Local Authorities.) You mention "a care worker" which implies social services. A CPN would have little or no involvement (even if it was s117 funding) in arranging such a move. If the funding is under s117, responsibility for funding and action normally still lies with the Local Authority, so again the CPN should have little or no involvement in the choice of care home, although they might advise on whether the home has the relevant skills and registrations to cater for the needs of the patient concerned. Their involvement is only usually in advising the team responsible for the patient on the patient's general state and wellbeing and, together with social services and the patient's GP whether it is viable for the patient to continue living in the community, and what support may be needed to ensure this. It is almost always the LA that has responsibility for the mechanics of the move - the only exception would by NHS-funded Continuing Health Care (CHC). The CPN (as SandraBetty points out) may be the care co-ordinator responsible for co-ordinating onward care referral after discharge, but this is unlikely to extend to having an absolute choice over the the care home involved. That said, they may be the voice that says: "Only this care home in this area is capable of handling this patient." That's a different role from saying: "This is where the patient goes."

    That said, there are a couple of other things that puzzle me. You say you have chosen your father's next care home. So is he self-funding? If so social services and the NHS have little or no input into this. If he is not, and either NHS or social services are footing the bill, then they have rather more input.

    It would help if you can clarify the funding position, as this would help work out where best to apply pressure.

    EDITED TO ADD: Is it a CPN or a Community Psychiatric Social Worker (CPSW - they often have a nursing background before moving into social work or even a CPSW who is an Approved Mental Health Practioner (AMHP)? The latter are again often from a nursing background but both work for social services, and it is usually the AMHP who has responsibility for arranging placements as part of onward care referral following hospital admission as an inpatient, or sectioning under s2 or s3 of MHA83. At one stage aspects of the latter were something I encountered in my work as well as in my late mother's care).


    If I am correct in the assumption that your father is LA funded, then the issue here seems to be that he needs to be moved from his present nursing/care home presumably to a nursing home with what used to be termed EMI (Elderly Mental Ill) registration to cope with increasing frailty in addition to the other health challenges which dementia poses. If so, the LA is entitled to call the shots. The nursing home will have informed the LA (who pay the bill) that they can foresee no longer being able to cope, and their first point of contact may well be the CPN. At that point the LA social services department has to arrange an alternative placement, and, depending on the perceived urgency, as soon as possible. THe LA will have an "expected to pay" rate, and provided the home on paper has the necessary registrations, then the LA can argue it has met its statutory duty. Your chosen home may either not take LA funded residents (does it?) or be above the LA "expected to pay rate" (you quote £1220 per week in another post in another thread, which is way above any likely LA "expected to pay rate". But you also need to be clear what decisions are involved: There is the decision (by the present nursing home?) that your father can no longer stay where he is (which I would expect the CPN to have had some involvement in, if only to agree) and the choice of where he moves to (which is an LA decision with advice from the CPN on the suitability of the home from a clinical perspective). The decisions tend to be taken by committees or teams - the mental health world is very "collegiate" or "collective" in much of its decision-taking. The LA may also (at leat in England - I'm not sure how it works in Wales) only buy-in services from a limited number of homes. If the LA is unmoved by your intervention, then, given the timescale, one possible remedy is to seek an interim injunction preventing the move on grounds of unreasonableness. You will need specialist legal advice on the viability of the latter point, and I am not at all sure of how viable that would be as a route. You may succeed in blocking your ftaher being placed in teh "grim" care home, at leasst temporarily, but you are likely to have a more difficult task to persuade the LA to pay the rate in your chosen one.

  12. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    I agree with the above post. WalkingLad, if you are able to clarify the funding, I am sure that people on here will be able to offer even better advice :)

    Hope you're making some progress

    Lindy x
  13. Wirralson

    Wirralson Account Closed

    May 30, 2012
    #13 Wirralson, Apr 8, 2015
    Last edited: Apr 8, 2015
    One other point which puzzles me is that you say you have previously informed "care staff" that the "grim" care home is "not an option". Presumably this referes to the staff at your father's current care home? May I ask why you told them this, as it is really nothing whatsoever to do with them. It is solely the concern with who pays the bill - if LA funded then this is the Local Authority or if CHC is involved the Health Board. If privately funded, I can't see why the NHS or LA is involved at all. I am finding it difficult to understand that you have had no contact with the Local Authority prior to this, especially if the possibility of such a move becoming necessary has been flagged-up for some time. From the LA's perspective, if there has been no prior contact, this will look like a relative "popping up" at the last moment. If there has been, did you raise the concerns you have earlier? If not, why not (as this may affect your ability to raise concerns now)? You say the Social Services have been "uncontactable"? Did you write, recorded delivery and specify a reply deadline? That's pretty much the only way to get a reply from any NHS or LA organisation in such circumstances, and I speak from experience on both sides of the counter.

    Please don't interpret any of the foregoing as a criticism - I know how hard it is to deal with such things and have a life - my mother's care coincided with my father's refusal to cope, my redundancy, forced sale of my home and job-hunting as well as my own physical health issues. But unfortuenately telephone calls aren't a lot of use - low staffing ratios, limited voicemail capacity, and high work rates mean things get missed or "prioritised". Sadly, if you want answers, you need an audit trail of your own actions.


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