Hostile "Best Interest" meeting

[Alex54]

At an MDT meeting, our social worker said my wife should not leave the hospital and instead should permanently be placed in a nursing home. This was a total surprise as my wife only went into the hospital to get an assessment for CHC funding. So we have ended up facing a "Best Interest" meeting which we are going to have to fight to keep my wife at home.
So here is my question, is this normal? I always thought Social Services supported the family and would follow their wishes as far as practical.

 

[Beate]

I'm afraid it isn't about the family's wishes but what is best for the person that needs looking after. SS usually advocate home care first as it's cheaper for them, so I wouldn't just dismiss these considerations. Your wife didn't just go into hospital, she was sectioned and assessed for five weeks. Something must have caused the section, and while I can understand your desire to have your wife home, you also said she doesn't accept carers so I'm not sure how the care home recommendation would have come as such a surprise. A CHC assessment alone doesn't usually require five weeks in hospital, and while you can get it approved for home care, it is much more likely to be granted for care home funding.

 

[Sam Luvit]

There is a financial element to the decision, whereby, if the cost of carers coming in exceeds the cost of a care home placement, they will push for the cheaper option

So, if you need a double handed visit four times a day .. that’s four man hours a day x seven days a week.

14 x 4 = 28 man hours
28 x £25 = £700 per week

Depending on where you live, Care Home fees could be around this rate, SS will get a better deal, with possible “top ups” from the family. (You can fight that, but that’s another story)

It should be about what is best for the person, but finances will come into the decision

 

[Alex54]

Your wife didn't just go into hospital, she was sectioned

The team did not have enough evidence to support the CHC application, and asked is she could go into hospital so that they could get written documentation.

Something must have caused the section

As we do not have LPA they said they would need to section her.

There is a financial element to the decision

Yes but currently we are managing successfully with £455 per week direct payments. They said if we go down the CHC route more support could be provided.

 

[Alex54]

i am incredibly torn between wanting to care for him full time but (perhaps) not really being able

63 is really young, my wife is 70.
I have always said:
As long as I can care for my wife I will, however, if she shows signs of distress and/or is unhappy most of the time, then I would have no problem letting go.

 

[Louise7]

It seems very odd that they would deliberately section someone just to carry out a CHC assessment, particularly as I understand (from my Mum's hospital admission) that the intention now is to carry out CHC assessments after someone has been discharged, so that they can be assessed in a non-hospital environment. Couldn't the mental health team have assessed your wife at home? I would have thought that sectioning someone and then trying them on new medications wouldn't be the best time to carry out a CHC assessment. Have they now carried out the CHC assessment? The full DST assessment should be carried out by a multi-disciplinary team including input from the medical team/social services/family. Has that taken place and is that what the social worker is basing her decision on with regards to your wife needing a nursing home?

 

[Alex54]

It seems very odd that they would deliberately section

Yes, I agree, the whole thing was handled terribly and is now under investigation. It was all done in a hurry because they had an empty place at the hospital (one hour away). She was taken by secure transport which caused agitation and confusion. The hospital was not told why she admitted and just assumed she always highly agitated and difficult to control. I asked at the MDT meeting why they had not established a baseline of how she was at home, but they had no answer. They said they can only report on what they have seen, which means the whole thing was a waste of time (unless they don't want her to come home).
The social worker really annoyed me, in the MTD meeting when she pushed for a nursing home. I don't mind that, but I think she should have talked it over with the family first, rather than coming out with it in an important meeting. She is now refusing to talk to us and has broken the trust between family and social worker.
The hospital finished their assessment after four weeks, but because of poor communication, the "Best Interest" was delayed by another two weeks. Then this week the hospital had an infection lockdown and cancelled the meeting which was scheduled for Wednesday. Four days later the meeting has still not been rebooked.
With hindsight, I wish I had asked for everything to be done in writing before agreeing to the sectioning.

 

[canary]

unless they don't want her to come home

It would be highly unusual.
SS usually try everything they can to keep people in their own home.
What grounds would you be looking for CHC? Dementia alone is not usually sufficient - it usually needs there to be other medical problems, or behaviour problems in order to be eligible.

 

[Alex54]

What grounds would you be looking for CHC? Dementia alone is not usually sufficient

I agree, previously in England, she had 32% CHC funding. When we moved county, Wales did not accept this and said they needed to make a new application. Everyone (apart from me) keeps assuming she will get 100% funding.
I have since been told that CHC funding would result in the direct payments being cancelled, which means we most likely lose the carers she gets along with so well.

 

[Louise7]

How did they calculate CHC funding of 32%? I thought that if entitled to CHC they pay full care costs, up to a maximum limit. Have they now carried out a new CHC assessment?

 

[Alex54]

How did they calculate CHC funding of 32%?

I have no idea, but I think partial CHC funding is very common.

Have they now carried out a new CHC assessment?

No, they have been waiting for the medical assessment and may have to start again.

 

[Jessbow]

I have no idea, but I think partial CHC funding is very common.

No, they have been waiting for the medical assessment and may have to start again.

Never EVER heard of partial CHC funding being given.
You either get it, or you dont.

its awarded because you have an ongoing HEALTH need which needs Over-and above carer management.

If you had a need for a nurse in the ordinary sense, you wouldnt pay for it anyway, in the UK