Crisis Point after 9 days in a care home

Discussion in 'I care for a person with dementia' started by Elle3, Apr 23, 2018.

  1. 70smand

    70smand Registered User

    Dec 4, 2011
    199
    Female
    Essex
    What a headache Elle! They certain don’t make things easy do they? Hopefully if other residents get chc funding at the home your dad will be able to stay there- it certainly makes no sense to move him. Keep us posted, xx
     
  2. looviloo

    looviloo Registered User

    May 3, 2015
    346
    Elle, I've been following your thread... thank goodness this hitch was sorted out?! Why can't anything be straightforward? Have you heard from the CHC yet? Are you happy with this outcome (if happy is the right word)?

    I don't know about you, but with regards to my dad I live on my nerves these days, so little situations like this can make me anxious and stressed. It's been a slow build up over the years, but I don't think people in authority (who no doubt have enough stress of their own) realise how much this sort of thing can affect those of us in caring roles. That's certainly how I've found it, anyway. Just my thought for the day ;-)
     
  3. Elle3

    Elle3 Registered User

    Jun 30, 2016
    363
    Thank you looviloo, no it isn't sorted yet I'm afraid, but I've managed to get our amazing Social worker involved even though she was supposed to be handing over to the CHC team. She offered to help and has told me not to worry. She has said she's never come across this problem before so it's an experience for her and today she has emailed me to to let me know that she has spoken to the CHC team and they have advised that it is a contractual issue, which has been raised with their manager and is now being raised with the Assistant Director. So watch this space.

    Why can't life be easy sometimes?

    Elle x
     
  4. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,316
    Salford
    I didn't know that someone getting CHC could make a first party top up, I'm sure a social worker told me that when I was talking about CHC. I also remember her saying that any CHC top up was only to be used to pay for services over and above what the home provided and should not be carried out by the home's staff.
    I hope the social worker has got it right about using your dad's money as a top up, does anyone know? I thought it was only section 117 and when entering a DPA you can do it.
    K
     
  5. Elle3

    Elle3 Registered User

    Jun 30, 2016
    363
    First of all it was the lady from the CHC who mentioned a third party top up, not the SW, but I later found out you can't do this with CHC funding, it isn't allowed. However, the lady who deals with the finances at the care home told me that sometimes the CHC will only pay for a certain amount of care and any additional care can be paid for by the resident or the family, it's not exactly a top up it's a payment for special services and apparently the CHC turn a blind eye to this not being provided by the home's staff. I still don't like this idea as it doesn't seem right and I mentioned this to our SW and she agreed, that there should be no need for a top up, dad is in the correct care home and in normal circumstances the CCG pays for this. It also brings up concerns regarding when dads funds run out, because if his funds pay for the additional services there is no higher and lower limit when the LA funding steps in, so dads funds would go down to zero. The question then is what happens regarding his care when there is no money left.

    I have since had an email from the SW and she has been told by the CHC team that it is a contractual issue, not a funding issue, it's currently being escalated to the Assistant Director of the CCG. Personally I think it's because my dads care home is within a different LA to the one that is funding his care and that's the problem. However the SW said this can happen especially if there are no suitable places for my dad within the LA, which there aren't.
     
  6. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,316
    Salford
    Sorry Elle, I'm more confused. You say you want to use your dad's money, that is a first party top up, a third party top up has to be paid by a family member, friend or a charity not from his money.
    He isn't (as far as I'm aware) able to use his own money for a first party top up them money has to come from a third party like you or the family not him.
    The CHC have to pay for all of his care and if he's high maintenance then the CHC has to cover that and the budget adjusted accordingly and the CCG shouldn't be "turning a blind eye" to anything that is not above board.
    Quite frankly I think they're conning you into paying something they're actually liable for, but if you're happy with that...it's you're money...as his money can't be used to pay for his care, legally.
    It'll be interesting to see what the AD of the CCG makes of all this, will they kick it back to the funding panel for a budget reassessment or accept your dad making payments that are...shall we say not what the law allows for rather than what I'd like to call it.
    When his money runs out, should you go down that route then the LA can move him to a cheaper home of their choice or they could then up the budget to keep him there so the only loser will be your dad. Might as well bite the bullet now and see what the CCG offer you without a top up because when his money runs out like as not that's where he'll end his days.
    When the lady from the CCG suggested a third party top up that was your money she was talking about, not your dad's money his is first party money so can't be touched other than for extras the care home don't normally supply, as I say I think you're being conned here.
    K
     
  7. Relder

    Relder New member

    Tuesday
    2
    Hi Elle3
    So sorry to hear about your Dad
    Your story with echos mine with my mum.
    To cut a very long story short, my mum was placed in a care home as an emergency measure when my stepdad who was her carer was hospitalised after suffering a stroke.
    The home was on one floor and had fire doors with push bars. My mum exited the building several times every day. The care staff had limited knowledge of alzheimers and would run after mum trying to get her back into the home which caused mum to become threatening both verbaly and physically. I was called daily by the home at all hours to drive there and calm my mum, get her back into the home and on the final weekend she was there, we were asked to provide 24 hour cover as the home could not cope with mum and didn't have enough staff. This went on for 2 weeks trying to get help, not knowing where to turn.
    Eventually my mum was assessed and moved to a home that said they could deal with her behaviour. She was there for 3 days untill the home realised they too were unable to meet her needs. Mum was sectioned and taken to hospital for assessment. After 4 weeks in the hospital dementia unit, she is better now than i've seen her for ages. Of course she still has dementia but her meds have been thoroughly assessed and tweeked by staff who have a thorough understanding of her illness.
    We are now in the process of finding a care home for her and feeling anxious about the next steps for her. We hope she will settle when we finally find the right place and doesn't end up back in hospital, Ive found out quite a bit about the limited number of homes that will accept residents with challenging behaviour also that they are very pricey due to the level of care needed.
    Sorry to go on this really is the short version.
    The things I was thinking when I read your story is that unfortunately your Dad can no longer make rational decisions regarding his own welfare therefore even though it is probably the hardest thing ever, you have to step in and insist that social services listen to your wishes regarding your Dads welfare. They have a duty of care. If he has a social worker she should be your first port of call. Also i'm assuming he has a mental health consultant. They will have a CPN who could come out and assess him.
    I was very reluctant about my mum being sectioned but in hindsight it should have happened at the outset. She would then have been assessed by experts in the correct environment and her medication looked at. It would have saved her (and us) so much stress.
    I truly hope you and your Dad get the help you need very soon x
     
  8. Elle3

    Elle3 Registered User

    Jun 30, 2016
    363
    Thank you Relder for your post, I’m sorry to hear about your mum too, our circumstances do sound like they were going down a similar path.

    I am not sure how much you have read in this thread, however things have moved on quite a bit since I started with the crisis. What helped was that we have a very good and experienced Social worker who has been very supportive. Dad is now in an excellent Dementia+ care home and has settled there very well, even though he is still challenging and unpredictable the staff know how to handle him and have lots of experience in how to deal with more challenging behaviour. It is only a small unit which suits dad, it is part of a bigger care home though. It has coded doors, locks on windows and fortunately the residents no matter how hard they try, they can’t get out. There is less noise and crowding, no mirrors (mirrors can cause lots of issues) and there are more staff, but as you said this kind of care does comes at a higher price which was a bit of a shock.

    Fortunately with the help of the SW we applied for NHS CHC funding and dad was awarded it a couple of weeks ago now.

    I hope you find somewhere suitable for your mum and everything works out ok.

    Elle s
     
  9. Elle3

    Elle3 Registered User

    Jun 30, 2016
    363
    I met dad’s GP today at the care home and we had a discussion about DNR’s and hospitalisation, not that dad is in bad health apart from the Dementia, it’s just that they like to be prepared if anything in the future happens and CPR is required. I feel that it’s not something I would like to put my dad through, I know how traumatic and damaging it can be, so I agreed that it wouldn’t be beneficial. But I did agree to hospitalisation though if dad falls seriously ill. Dad’s never been in hospital, so I don’t really know how he would react, especially with the Dementia, but I felt it was worth trying. Not the best discussions to have early in the morning.

    I’m off on holiday tomorrow for a week, this is our first holiday in 3 years. We’ve not been able to leave dad for any period of time, but now he’s being taken good care of in the care home I felt we could try a short break. For some reason though I still feel guilty for leaving him and not seeing him.

    Take care.
    Elle x
     
  10. Relder

    Relder New member

    Tuesday
    2
    Hi Elle
    Yes I'm sorry I am new to the forum and didn't realise that since your first post things have moved on quite a bit for your Dad which is great news.
    I'm glad you found him somewhere that can look after him. Yes I'm looking into NHS CHC funding too and trying to find the right place to meet mums needs.
    regards x
     

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