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Help with adult services / care home access

Kmb19

New member
Sep 24, 2021
4
0
Hi all

I am really hoping that someone can give me a bit of advice if possible please? I am posting on behalf of my nana who is a career for my grandad with Alzheimer’s. She is at the end of her tether and we have been trying to support her in moving my grandad to full time care. There are many issues, but I’ll start with the most recent. The Sw is newly qualified and hadn’t realised that the assessment in place was a care act assessment and not capacity. Consequently, a nursing needs assessment hasn’t been done either. I escalated this to Sw manager today, who told me to look at temp care homes and we have been told to look for emi nursing because of his meds / behaviour (some violence- not much but increasing). The issue is that 1) there aren’t many emi nursing homes near to us, and 2) they want assessments before they will consider even talking to us! Which will take time, which we don’t have! We are really concerned about her ability to cope for much longer and how / where to go- other than to escalate yet again on Monday! Does anyone have any advice please! I know we could go to a and e if in crisis / he becomes a risk to himself / her but that seems a waste of everyone’s time. Thank you in advance
 

MartinWL

Registered User
Jun 12, 2020
1,125
0
We need more critical information here.
1) Who if anyone has power of attorney for your granddad?
2) Is he self-funding, i.e more than £23250 in savings.

You might need to see if you can find a care home willing to take him short- term and assess his needs in house. As his needs are specialist needs you might have to cast the net widely.

In the short term could you get care staff in to help at his home, to give your grandmother a break?
 

Kmb19

New member
Sep 24, 2021
4
0
We need more critical information here.
1) Who if anyone has power of attorney for your granddad?
2) Is he self-funding, i.e more than £23250 in savings.

You might need to see if you can find a care home willing to take him short- term and assess his needs in house. As his needs are specialist needs you might have to cast the net widely.

In the short term could you get care staff in to help at his home, to give your grandmother a break?
Thank you for your reply.
There are three of us with power of attorney. We have requested a capacity and nursing needs assessment - the issue is the staffing levels in Sw and the time it will take to complete these. There is a CPN involved so that’s one thing atleast! A full financial assessment is also needed. Again, the last one was done based on respite and not permanent care. We have been told to focus on emi nursing as that’s where Sw and CPN feel he needs to go, so we are trying to minimise upheaval 1) in terms of my grandad but also 2) so the home don’t want him to leave in a hurry. There are no emi nursing and residential in our area. We are trying to contact all relevant homes in the short term, but as the assessments haven’t really been started yet - we are hitting walls. It’s more about behaviour to be honest. Feeding / showering / going to the toilet etc and those needs are far easier to manage than the actual behaviour itself. I hope that helps. Any suggestions welcome at this point :)
 

MartinWL

Registered User
Jun 12, 2020
1,125
0
I don't see why you shouldn't assess his needs yourself and write a detailed statement of them that potential care homes can read. You can describe in detail what the care issues are under headings including behaviour, aggression, toileting, continence, mobility, personal hygiene, acceptance of medications etc. Capacity is assessed individually for each and every decision from what colour socks to wear up to decions about where to live or changing a will. To make a decision for himself he must understand information about it, retain that for long enough to evaluate the pros and cons of the choices, and communicate his decision. The big one is a decision to move into a care home, of course, and I guess he doesn't have capacity to decide that. On nursing needs you can list tasks that cannot be done by a kind but unqualified carer. Your statement should pull no punches, do not sugarcoat it. If this is well- written a care home may accept that it is competently compiled and offer a placement.
 

Emmcee

Registered User
Dec 28, 2015
111
0
Hi all

I am really hoping that someone can give me a bit of advice if possible please? I am posting on behalf of my nana who is a career for my grandad with Alzheimer’s. She is at the end of her tether and we have been trying to support her in moving my grandad to full time care. There are many issues, but I’ll start with the most recent. The Sw is newly qualified and hadn’t realised that the assessment in place was a care act assessment and not capacity. Consequently, a nursing needs assessment hasn’t been done either. I escalated this to Sw manager today, who told me to look at temp care homes and we have been told to look for emi nursing because of his meds / behaviour (some violence- not much but increasing). The issue is that 1) there aren’t many emi nursing homes near to us, and 2) they want assessments before they will consider even talking to us! Which will take time, which we don’t have! We are really concerned about her ability to cope for much longer and how / where to go- other than to escalate yet again on Monday! Does anyone have any advice please! I know we could go to a and e if in crisis / he becomes a risk to himself / her but that seems a waste of everyone’s time. Thank you in advance
Hi there, In addition to that which has already been said by others, please don't forget that should you or your Nana ever find yourself at a stage when you simply cannot cope and things have reached a critical stage:
a) If challenging behaviour is an issue and the social worker is attached to the older persons' team, request an urgent referral to the community mental health team. They can assist with the assessment process or even admission if they believe that to be indicated.
b) Phone the GP, explain your concerns and ask that he liaise with the closest pyschiatry of old age consultant/facility
c) Phone 999.
Admission to an EMI unit is most frequently organised via an in-patient unit as opposed to the community.
 

Kmb19

New member
Sep 24, 2021
4
0
I don't see why you shouldn't assess his needs yourself and write a detailed statement of them that potential care homes can read. You can describe in detail what the care issues are under headings including behaviour, aggression, toileting, continence, mobility, personal hygiene, acceptance of medications etc. Capacity is assessed individually for each and every decision from what colour socks to wear up to decions about where to live or changing a will. To make a decision for himself he must understand information about it, retain that for long enough to evaluate the pros and cons of the choices, and communicate his decision. The big one is a decision to move into a care home, of course, and I guess he doesn't have capacity to decide that. On nursing needs you can list tasks that cannot be done by a kind but unqualified carer. Your statement should pull no punches, do not sugarcoat it. If this is well- written a care home may accept that it is competently compiled and offer a placement.
Morning, thanks for your reply. We can do this, however formally they still require those assessments along with their own care plans. I believe the CPN has informally done a nursing needs but is still waiting for the Sw to do theirs - which we are told will take weeks.
 

Kmb19

New member
Sep 24, 2021
4
0
Hi there, In addition to that which has already been said by others, please don't forget that should you or your Nana ever find yourself at a stage when you simply cannot cope and things have reached a critical stage:
a) If challenging behaviour is an issue and the social worker is attached to the older persons' team, request an urgent referral to the community mental health team. They can assist with the assessment process or even admission if they believe that to be indicated.
b) Phone the GP, explain your concerns and ask that he liaise with the closest pyschiatry of old age consultant/facility
c) Phone 999.
Admission to an EMI unit is most frequently organised via an in-patient unit as opposed to the community.
Morning, thank you for your response. A CPN is already involved via Cmht, so would this mean a separate referrral? We are going to call them all again tomorrow to try and speed up the process, we are literally hitting walls along the way! It’s very frustrating! I did call gp on Friday, he was supposed to call back - but never did! I don’t think we are quite st the 999 stage but I appreciate your response. Thank you
 

MartinWL

Registered User
Jun 12, 2020
1,125
0
Morning, thanks for your reply. We can do this, however formally they still require those assessments along with their own care plans. I believe the CPN has informally done a nursing needs but is still waiting for the Sw to do theirs - which we are told will take weeks.
If a care home is demanding assessments from supposedly expert assessors that you cannot realistically provide any time soon, then perhaps you should be looking at other care homes. I appreciate that might mean places that are further away.
 

Emmcee

Registered User
Dec 28, 2015
111
0
Morning, thank you for your response. A CPN is already involved via Cmht, so would this mean a separate referrral? We are going to call them all again tomorrow to try and speed up the process, we are literally hitting walls along the way! It’s very frustrating! I did call gp on Friday, he was supposed to call back - but never did! I don’t think we are quite st the 999 stage but I appreciate your response. Thank you
The CPN should be able to refer onto any other member of the CMHT but sometimes you just have to be a right pain and make a bit of a nuisance of yourself...... or play the "wee daft lassie". (No offence, but it's sometimes those kind of responses that precipitate action).
 

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