Criteria to judge whether someone requires 24 hour care

Philip2468

Registered User
Feb 27, 2020
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Are there any national guidelines telling local authorities what criteria they should use to judge whether someone requires 24 hour care? Mum is 91 and has dementia and, in the opinion of everyone except social services, she requires someone with her all the time. For the purposes of her own contribution to her social service funded care package, the local authority argues that mum does not require 24 hour care and therefore expects mum to pay towards the five hours per day of care funded by her local authority (and to self-fund the other 19 hours per day). I have asked the local authority what criteria they use to judge whether someone requires 24 hour care but I cannot get any response. Are there any national guidelines on this?
 

karaokePete

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Jul 23, 2017
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N Ireland

nitram

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Apr 6, 2011
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Bury
I don't know of any national guidelines.

The LA have a legal duty of care for your mum as a vulnerable adult, it follows that they must take action if they consider her to be in an unsafe situation.

Do you consider your mum to be a danger to herself 24/7, think of the risk of falls and dangerously incorrect use of appliances?

If so you could document any instances and forward this diary to the LA as proof that 24 hour care is required.

Sadly some LAs are bad at taking pre-emptive action and always wait for a crisis to occur.
 

Philip2468

Registered User
Feb 27, 2020
12
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Thanks to both of you. I will contact the support line.

Mum cannot be left alone because she would be a danger to herself eg via kitchen utensils, gas fires, falling over, and going out of the front door and into the road. The latter was well documented in mum's first needs assessment.

Mum had her care funding increased last April on the back of her second needs assessment but the local authority refuses to let us have a copy of this needs assessment. The authority has used material in this assessment to discredit the need for 24 hour care but, without a copy of the needs assessment and the criteria they use to judge whether 24 care is required, it is difficult to argue our case. How do we get the local authority to let us have a copy of the needs assessment and the criteria they use to judge whether 24 hour care is required?
 

Louise7

Volunteer Host
Mar 25, 2016
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Hello @Philip2468 welcome from me too, you'll find lots of support and friendly advice here. Usually the local authority criteria for considering a care home placement is when someone requires more than 4 care visits per day or there are safeguarding risks (they very rarely fund live-in carers as a care home is invariably cheaper). How many care visits is your mum receiving daily at the moment? With regards to obtaining a copy of the care needs assessment, have you tried submitting a data access request to the local authority? If your mum has lost mental capacity you will need to hold Health & Welfare power of attorney for her but I obtained copies of mum's care assessments that way - the local authority had details on their website of how to obtain records. Plus, if your Mum has not had a care needs assessment since last April then you can request a new one, based on her increased need for more care than is currently being provided - make sure that you have lots of supporting evidence covering what has changed since her last assessment. Hope that helps.
 

Philip2468

Registered User
Feb 27, 2020
12
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Thanks Louise 7. The local authority sent us a copy of mum's previous needs assessment so I do not understand why they are being so difficult now. I will explore how to submit a data access request. How can I go about getting a copy of the criteria that social services use to judge whether someone requires 24-hour care?
 

Philip2468

Registered User
Feb 27, 2020
12
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Dear Nitram and Louise7,
I contacted the helpline but they did not seem to know how to handle this. Instead they referred me to an advocacy service.

Nitram: you wrote that 'sadly some LAs are bad at taking pre-emptive action and always wait for a crisis to occur'. Yes, this is exactly the situation here. Rather than wait for mum to hurt herself, we have taken precautionary measures. But this enables the local authority to argue that there is no evidence that, if left alone, mum would be a danger to herself. How do we counter this argument?
 

karty

Registered User
Jun 10, 2021
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Dear Nitram and Louise7,
I contacted the helpline but they did not seem to know how to handle this. Instead they referred me to an advocacy service.

Nitram: you wrote that 'sadly some LAs are bad at taking pre-emptive action and always wait for a crisis to occur'. Yes, this is exactly the situation here. Rather than wait for mum to hurt herself, we have taken precautionary measures. But this enables the local authority to argue that there is no evidence that, if left alone, mum would be a danger to herself. How do we counter this argument?
I am in a similiar position to you Philip2468. My Mum has been living with us during the lockdowns and we were about to return her to her home with a care package of 4 visits per day which were put in place after she had a fall last year, but was managing OK-ish. Last week she had a fall with us again and ended up in A&E but not admitted as she could return to us for care and support from district nurses. Her new social worker (actuallly case worker as no qualified social workers available) says that she should return to the 4 visits per day, despite this second nasty fall and that she wouldn't qualify for 24 hour care as her needs are not great enough. I am struggling to understand all this and currently requesting a short term care option where her needs can be assessed more fully. It is a slow process indeed. I am getting some advice soon from the local Alzheimer's co-ordinator so may be that is something you could try?
 

nitram

Registered User
Apr 6, 2011
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Bury
But this enables the local authority to argue that there is no evidence that, if left alone, mum would be a danger to herself. How do we counter this argument?

You could start a detailed diary of events when somebody has had to intervene to prevent her harming herself or placing herself in a dangerous situation.
 

nitram

Registered User
Apr 6, 2011
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Bury
This is a checklist for 24 hour care on an American website, it may help you to structure your argument.
 

cammyuk

Registered User
Mar 23, 2023
41
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I have been down so many avenues now for my sister in a nursing home, but today I was given a phone number /website for "Equal Lives" as I am going to go for advocacy as this is too much for me to sort out myself,
I have had some brilliant advice and support from Alzheimers soceity , they have given me so much help and I wouldnt have known where to go and what to do without them, But I now have realised that I need someone who can actually go to the home and see {if possible} what is going on and how my sister can be helped, as there are so many things that dont add up . G