Continuing healthcare vs Section 3, s117

[tigerlady]

S117 (being the result of a Section3) isn't a 'route' that someone can take for their LO in as much as that there is no 'route'-there is no application process. It's purely down to the Consultant who will decide what will happen after the Section 2 is about to come to an end- be that discharge, DOLS or Section 3.

This is correct. When my husband had been in the mental assessment ward for over 28 days, I assumed he would automatically go on a Section 3, which meant guaranteed funding. This no longer happens, except in extreme circumstances, and they just put a DoLS order on the person to enable them to keep them against their will legally, until you can either take them home or find a care home place. You dont have a choice to go to Section 3. Another tweak in the rules to let the NHS avoid paying

 

[LYN T]

It would be interesting to know how many people advance to Section 3 as opposed to a DOLS.

 

[sl638e]

Yes, in my mum's case I think the SW was trying to take her down the Section 3 route. To be fair, I do think she has my mum's best interests at heart, but it would appear that if the assessment says section 3 isn't appropriate then there's not much you can do.

I think the biggest barrier in all this is lack of information. Nobody ever explained the process to me. I was handed paperwork and told they were holding my mum under the mental health act because she obviously wasn't well enough to walk out. That seemed fair to me, and I agreed. It seemed to be just a formality. They never told me about all the different sections of the act and the implications of being under different ones. How are you supposed to know this stuff if they don't tell you?

In my mum's case, she did suffer quite 'challenging' behaviour problems - scratching and biting during personal care; taking off her clothes in public; going to the toilet in inappropriate places. However, in the mental health unit they SEEM to have settled her down with a combination of tweaks to meds and skilled care. I only have their own reports to go on, of course, so I can't be sure.

So the story is that they feel her condition is manageable by trained nursing staff, and therefore she doesn't qualify for CHC and nor is she eligible for s117. I just don't know what to think...

 

[AlsoConfused]

So the story is that they feel her condition is manageable by trained nursing staff, and therefore she doesn't qualify for CHC

The CHC assessment focuses on the patient's primary healthcare needs (eg intense, unpredictable, etc), not directly on which grade of staff provides the care.

Stanley is the expert caring for his wife at home, for example ... he clearly is expert in caring for his wife and managing her complex health conditions but I don't think he's a qualified nurse with years of hospital / community experience,

 

[stanleypj]

Yes I'm happy to confirm that you are correct AlsoConfused. I'm only an expert on Sue's care in the same way that many other carers are experts in the care of the person they care for.

 

[stanleypj]

But I think s1638e has a point in terms of 'a well-managed need is still a need'.

 

[jaymor]

It's quite true that a well managed need is still a need. With CHC the needs determining the care are primary health needs and so many needs with dementia are care needs, some are extremely difficult care needs but they don't seem to count when it comes to CHC.

 

[stanleypj]

Yes Jean. Personally I think the distinction between health needs and care needs is a pretty blurred one and this alone probably accounts for many of the people who are not getting CHC funding and the 'postcode lottery' - every CCG is able, to an extent, to define the needs, if they wish, in a way that enables them to save money.

 

[Spiro]

It appears there are very few nursing homes around, compared to residential care homes, and a lot of them have poor CQC ratings.

Not sure about the CQC ratings, but you're right about the ratio of residential homes to nursing homes.

 

[Csp]

Unlawful

Yes, in my mum's case I think the SW was trying to take her down the Section 3 route. To be fair, I do think she has my mum's best interests at heart, but it would appear that if the assessment says section 3 isn't appropriate then there's not much you can do.

I think the biggest barrier in all this is lack of information. Nobody ever explained the process to me. I was handed paperwork and told they were holding my mum under the mental health act because she obviously wasn't well enough to walk out. That seemed fair to me, and I agreed. It seemed to be just a formality. They never told me about all the different sections of the act and the implications of being under different ones. How are you supposed to know this stuff if they don't tell you?

In my mum's case, she did suffer quite 'challenging' behaviour problems - scratching and biting during personal care; taking off her clothes in public; going to the toilet in inappropriate places. However, in the mental health unit they SEEM to have settled her down with a combination of tweaks to meds and skilled care. I only have their own reports to go on, of course, so I can't be sure.

So the story is that they feel her condition is manageable by trained nursing staff, and therefore she doesn't qualify for CHC and nor is she eligible for s117. I just don't know what to think...

Don't leave it there. It sounds to me that dols is not appropriate. If your mum is in a psychiatric unit suffering from a mental disorder, and requires treatment for that, s3 is the appropriate legal basis. Ask for another s3 assessment. Are you classed as nearest relative? If so, you can apply yourself. It may be an idea to ask for advice from a mental health lawyer and get them involved. Go on the law society's website as they have a list of people who specialise in this area. Make sure the person you speak to is a solicitor, preferably on the law society's approved mental health panel. The mental health act administrator at the mental health unit will be able to give you a list of local ones. You really need to fight this. Being under s117 is important in your case.

 

[dottyd]

Sl6 my mum got CHC funding for all the sorts of behaviour you've listed.

Watch the video by Luke Clements posted on here and appeal.

Just cos a need is well managed it does not make it disappear.

Good luck but don't leave it there.

 

[sweetmole]

Hi,
I will just keep this short. Do not give up fighting for CHC assessment. Do not accept the social workers advice.

My mums local mental health team nurse was adamant my mum would never get CHC. Please remember it is not their decision to make. They are not judge and jury. And whoever came to do the assessment without you present should not have done so.

Every step of the way people will misguide you, misinform you and send you on wild goose chases.

I am not au fait with sections 2,3 and so on. But I do know about CHC!

We waited an eternity for the assessment 6 months. When it happened I had the framework and my view point ready. The nurse assessors said yes we agree your mum should get nursing care.

I was like hell no, she needs care 7 days a week. Luckily I had mum's care co ordinator on board and a new social worker. It was a multidisciplinary team evaluation. They had to go back with their take between their legs.

I often thought the nurses did not have a clue, not one iota. They are in place to make life changing decisions and they are not God. If you don't agree speak up. Ask why?

At the CHC assessment you should have family members, care co ordinator and a supportive SW. If yours is not ask for another. Make complaints. Sounds like a lot of money is at stake here.

Really sorry you are going through this non transparent complex process. Best of luck.

Xxxxx


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