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Help Social Care say "nursing home unnecessary-Care homes say nursing home necessary

Discussion in 'I care for a person with dementia' started by Brenda16, Nov 3, 2015.

  1. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Hi All

    My brother and I are now on the same page regarding where the care home should be,so that's a huge relief.

    However, when viewing care homes and calling them my brother had positive reactions from the care home managers until he mentioned psychosis and the medication that Mum is given.

    The council are pushing for Mum to leave the mental clinic but say that Mum doesn't need a nursing home. When the managers looked at Mum's assessment they said their home is not suitable for Mum's requirements and that she does need a nursing home.

    We're now stuck. We really don't know what to do. I've mentioned here on TP the traumatic situation we were in with my Dad and I'm terrified about where Mum goes to if the very same council place Mum somewhere like Dad's home.

    The Social Care are saying that if we don't find a home they will have no other option than to put Mum temporarily into a home in their council.
    We all know that moves can have a negative effect on dementia sufferers.

    The council have said all along that the homes in my brother's county will not accept the rate that Mum's home county pay but they didn't give us any names and costs for us to decide on regarding a top-up.
    This looks like stalemate with my Mum in the middle and that can't be right.

    What can we do?
     
  2. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    How about getting your Mum's Consultant to advise you in writing what kind of care facility is adequate for your Mum's needs - and what kind of care isn't? The Council can't ignore what he / she says.

    My Mum's Consultant said very clearly only care in a nursing home would do for Mum because she was such a high falls risk.

    Please don't even think about paying top ups at this stage.
     
  3. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    #3 Brenda16, Nov 3, 2015
    Last edited: Nov 3, 2015
    We don't know what to do - we're stuck between the SC and care homes

    Hi

    Mum is in a mental clinic right now, taken under Section 2 and then placed on DoL.
    Do you know if we should ask the docs at the clinic - but no to answer my own question it must be the docs at the clinic who have said she doesn't need nursing care.

    What do we do if all the homes we contact, and/or the counci contact, say they won't take her. What happens to Mum?

    Do you know if there is a place we can contact if we don't agree ( the care homes) to what Social Services is saying?

    Many thanks
     
  4. Pickles53

    Pickles53 Registered User

    Feb 25, 2014
    2,482
    Radcliffe on Trent
    #4 Pickles53, Nov 3, 2015
    Last edited: Nov 3, 2015
    Have the council put forward any names of specific homes that (a) meet your mum's needs based on their own assessment and (b) would accept your mum without the need for any top-up?

    Needs should include the need to have access to regular family visits, so if this means an out of area placement that should be considered.

    If not, refer them to the statutory guidance. Here's a link to the whole document. Will try to add specific link in a minute.

    https://www.gov.uk/government/uploa.../file/366104/43380_23902777_Care_Act_Book.pdf

    Try this from another thread I posted on with a similar theme...

    http://forum.alzheimers.org.uk/show...-about-losing-ones-home&p=1181699#post1181699


    Paragraphs 5-6 in Annex A reference accommodation outside the LA's boundary.

    IF they can offer a suitable home which genuinely meets all your mum's needs but you snd your brother prefer another home, only then could the issue of top-ups arise.
     
  5. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Hi Pickles

    The council has not given us one single name of a home. They just told us that their specialist could not find anything closer to my brother.
    I don't understand it - if the specialists can't find a home how can they expect us to find one?
     
  6. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Pickles: A problem could possibily be in the fact that my brother lives in one of the most expensive parts of England so I imagine everything is more expensive there.
     
  7. Pickles53

    Pickles53 Registered User

    Feb 25, 2014
    2,482
    Radcliffe on Trent
    You may be right, thinking about the reference to the M25. However that doesn't excuse the LA from their responsibility. I wonder what would happen if you simply said you cannot find a suitable home and put the ball back in their court, though I suppose you don't want to risk them arbitrarily placing your mum in a totally unsuitable place.

    I can only think of approaching either AS or Age UK locally as I believe they can act as advocates in these type of situations, or at least may be able to point you in the direction of a suitable home? Or you could try the local government ombudsman, but I think you might have to go through a formal complaint process with the LA before they would look at the issue? Or contact the local MP? Any query to a public body from an MP usually gets very fast attention
     
  8. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Hi Pickles: I read through your thread very quickly and will definately go back to it.

    May I give you some info of Mum's situation?

    1. Mum owns her own property so we know this will be taken into consideration after the 12 weeks.

    2. Mum's savings are below the lower threshold.

    3. We want Mum closer to my brother so it will be a cross-border situation.

    4. She's in a mental clinic (has been for coming up to 10 weeks and they have been wanting to move her for 4 weeks).

    5. No names of homes given to us. Neither in my brother's area nor in Mum's home county.

    6. The homes we've contacted say Mum needs nursing care (she's on 4 different meds) because of psychosis.

    7. Residential care homes seem not to be able to take her and the council is saying it is a residential home that she needs.

    8. There's only so much I can do from where I live (Switzerland). I'm coming over next weekend and thought she's be settled in a care home by now.

    But no. Nothing is happening. They're just saying we have no other option than to place her temporarily in a home in her home county.But they still don't give us a name.
    (Trauma in the family because my Dad was in a home under police investigation because of two suspicious deaths. When he died they did an autopsy on him. Disressful enough losing ones hero but to then have him taken to the coroner's.
    We MUST know where they will put Mum before they do it. We absolutely must see the home first.

    My brother and I can't sleep because of all this and I don't know where to turn.

    Thanks for listening to me and me rambling on. Sorry.
     
  9. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    What is AS?

    Our contact lady is, to add to it all, out of the office until Thursday.
    But I think my brother is leaning towards your suggestion of putting the ball back in their court.
     
  10. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    It's extremely unlikely the doctors at the clinic and Local Authority staff are both part of the same "umbrella" organisation. There's a high probability the doctors and the hospital Social Worker will be part of the NHS. I really feel you need the written advice of your Mum's Consultant.

    The hospital has to arrange a safe discharge. Discharging someone into an environment that can't cope with them isn't a safe discharge; it also has the disadvantage the patient's likely to be back in hospital again very soon.
     
  11. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Hi

    Sorry for sounding daft but I've been away from GB so long. What is a Consultant?
     
  12. piph

    piph Registered User

    Feb 4, 2013
    1,530
    Northamptonshire
    The top doctor of the team who is handling the case, is usually a 'Consultant' - it's a sort of rank for doctors, above a 'Registrar', and way above a 'Houseman'. Sorry I've probably confused you even more! :eek:
     
  13. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    I think I've worked it out. Thanks loads. So we should get a report from the "Consultant"
    from the mental clinic. Is that correct?
     
  14. canary

    canary Registered User

    Feb 25, 2014
    10,536
    Female
    South coast
    I think that there may also be confusion because "residential home" just means that you are living there. It is a general term which covers both Care Home and Nursing Home. So if the consultant says that she needs a residential home he is just saying that she cant go back to her own home.

    I would guess that she needs a nursing Home because of her medication. People with psychosis often need extra medication to be given when needed and it will require nurses around to administer them. Care Homes dont always have nursing staff around and I suspect that this is why she has been refused. I think it likely that she will need a specialist dementia Nursing Home that deals exclusively with people with dementia - they are usually better trained to deal with challenging dementia than the staff in general Nursing Homes.

    I would also point out that if she owns her own home, then unless someone like a husband is living in it (and would therefore be disregarded) she would not be eligible for help with paying for the Nursing Home. She would be considered "self-funding", so top-up fees would not be applicable.
     
  15. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    I feel I should point out that while the ability of family to visit shoul be considered by the L.A. when it comes to placement, that doesn't mean she has an absolute right to be placed closer to your brother than she was before she was hospitalised. They cant move her to Sunderland for example, because it's cheaper, but neither do they have to place her in a more expensive area just to be closer to your brother.

    But as she would appear to be self-funding the question is moot.
     
  16. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    YES!

    Would suggest you don't use the word "report" though - it might frighten the doctor :rolleyes:into thinking you wanted something more profound than a simple letter / email advising where your Mum should go and why it should be a nursing home, not a care home!!!

    Your Mum will be self-funding you think. I'm assuming she wasn't sectioned into the clinic / assessment unit under conditions (Section 3?) that would automatically make her entitled to free NHS healthcare? If you're not sure about this please ask the clinic and / or your brother.

    Please also ask that your Mum be assessed at the clinic for Continuing Health Care funding before she's discharged. It's just possible she may be entitled to it ... only 15% patients are awarded it though.
     
  17. Pickles53

    Pickles53 Registered User

    Feb 25, 2014
    2,482
    Radcliffe on Trent
    #17 Pickles53, Nov 3, 2015
    Last edited: Nov 3, 2015
    Sorry for confusing you with acronyms! By AS I meant Alzheimer's Society, should be a branch somewhere in the area or you could try the telephone helpline. I was just thinking about who might have some local knowledge about which homes might suit your mum.

    As others have said above, if your mum's property is not excluded from the financial assessment, she would be entirely self-funding (after the 12-week disregard) until her capital fell below £23k. If the house takes longer to sell, the LA can set up a deferred payment agreement.

    The advantage of being self-funding is usually that you can make your own choice of home (or at least of those homes which are happy to accept they can meet your mum's needs). My mum was entirely self-funding. She had a fall and was temporarily placed in a care home (taken to A&E but not admitted to hospital) pending assessment. We organised a care home near to us, arranged the assessment by the home manager, and mum's transfer by wheelchair-accessible taxi, with any reference to LA at all. We simply informed her Community Psychiatric Nurse what was happening.

    Of course none of this helps if you simply can't find a suitable home to approach in the first place and having a clear view of senior doctors about the level of care needed would surely help . Also agree that mum should be assessed for CHC funding as even if you aren't successful the process does help to clarify what needs a person has.
     
  18. Brenda16

    Brenda16 Registered User

    Feb 13, 2015
    69
    Not applicable
    Your Mum will be self-funding you think. I'm assuming she wasn't sectioned into the clinic / assessment unit under conditions (Section 3?) that would automatically make her entitled to free NHS healthcare? If you're not sure about this please ask the clinic and / or your brother.


    Hi

    Mum was sectioned under section 2 and then put on DoL.
    The Assessment we got from the clinic says that she will not get CHC.
    But we do think we're right in that the LA must find a home under these circumstances.

    I only wish that they would give us the names of homes which would take Mum instead of telling us that they now only have the option of placing her temporarily in a care home in their county.

    It seems they're beginning to presurise us into finding a home whereby we have no evidence that they have even tried to find one nearer my brother.They know we will be self-funding, so why don't they give us names of homes which will take Mum, let us go to have a look, and then leave the finances to us.
    It seems to be that the LA are stuck in the position that they will be funding for the first 12 weeks and are forgetting that we will be self-funding eventually.But they have so many more resources to find homes than we do.

    Other people are telling my SIL that we should fight and fight all the way."They did the same to my Dad."etc.etc.

    But slowly but surely the fight is going out of me. Tactics? Who knows?
     
  19. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    The local authority handed us a directory of care services - care homes, nursing homes, live-in care services etc.

    It might be worth while to contact the relevant local authority's Social Services department and explain you're after a directory of local care services "like the one they have in Wiltshire". Might shame them into being helpful!
     
  20. marionq

    marionq Registered User

    Apr 24, 2013
    5,855
    Female
    Scotland
    When the SS decided I should look for a care home for my husband they told me to go online and see what was available and visit them. They then came up with two homes which had vacancies and insisted I visit them. They were quite dire - lovely staff but totally unsuitable in every other way. I was later told that social workers do not themselves visit these homes so really have no knowledge of what they are like.

    That was months ago and John is still at home with improved medication. Finding a home that is right and affordable is a very difficult business. I don't think you'll get anything directly from SS.
     

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