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 cssiw.org.uk - 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.
Keith
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).
EDITED FURTHER TO ADD:
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.
W
