Mental capacity and care choices - battle with social worker!

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Champers

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Jan 3, 2019
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Thank you very much for all your replies - they’re so appreciated. This is such a new and unwelcome experience and we’re very much blundering about in the dark.

I have pointed out that very fact to the social worker, that when an elderly person, or one with dementia, talks about going home, it’s often to a time and place rather than a physical thing. I’m not sure this even registered with him. MIL talks about how she wants “everything as it was before” which, sadly isn’t going to happen as her illnesses, both physical and mental, have progressed.

I had no idea you could get ISWs - to be honest, we were resigned to the fact that the authorities would just close ranks and we would be wasting our time and be up against it, particularly as MIL is still sitting there being very adamant that she wants to return to her house. I will look up deputyship too - thanks.

Interestingly, MIL transferred her property, in which she’s living, into our names around 8 years ago when she was fit and well. My understanding is that if someone is receiving domiciliary care, when their savings run out, the house cannot be taken into the equation so I assume they won’t come after us at that point?

In a nutshell, what we are trying to get across is; it is painfully obvious to us that the care MIL received at home was “OK” She was fed (meal plonked in front of her), taken to the toilet, washed, got out of bed, put back to bed...and that was it. For £6500 PM she should have had so much more done for her. The carers would ring us regularly because she’d fallen and needed one of us to help get her up, or was screaming in pain, or if they needed to be taken shopping, or her prescription needed picking up etc. There was no mental stimulation, no attempt to even take her into her garden in her wheelchair. Carer sat on her phone most of the day with MIL asleep in the chair or awake claiming she wanted to die or she was sick of the four walls around her. She has another elderly friend who lives within walking distance, I suggested what I nice idea it might be if she was wheeled around to her - fell on deaf ears.

In the CH we visited there was activities, trips, a beautiful garden and conservatory that the residents were sitting in and enjoying, an upmarket restaurant type feel to the dining room with tablecloths, wine glasses, a proper wet room where she could be washed, rather standing at a barely adequate sink. Private bedrooms, nursing staff always on duty. All this for £3500 PM.

It shouldn’t be about the money but with such a huge disparity in costs and a clear choice of which is the better option, I cannot see where SS are coming from at all.
 

tryingmybest

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May 22, 2015
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@tryingmybest this sounds like very good advice. Who do you get to do an independent capacity test?
@Sirena I would personally consult a professional specialist to do one as GPs and SW are not really sufficiently qualified to do them and an independent one removes all doubt and the report holds up in the CoP. A consultant psychiatrist or psychologist can be arranged to visit the person in their home or at hospital. My Mum had a psychiatrist come here to see her at home. It consisted of a chat and the Addenbrookes Ace iii test and within less than half an hour, he deduced that sadly, whilst Mum initially presented well, it very quickly became clear she completely lacked capacity in all areas of her life. You can google online for a psychiatrist or psychologist specialising in MCAs. The fee can be paid from the PWDs funds.
 

Sirena

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Feb 27, 2018
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Thank you @tryingmybest that's really useful information. Can't really argue with an assessment by a psychiatrist, can you.

@Champers you could consider that. If you also want to access a SW, if you google 'independent social worker' the first link should be to their association which will let you search for one near you.
 

silversea2020

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May 12, 2019
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I think I’d get advice as well regarding the house which I understand was transferred to you, the LA may take the view re: deprivation of assets ...however, that isn’t me saying anything done incorrectly but I’d certainly get advice on this
 

Rosettastone57

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Oct 27, 2016
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@Sirena I would personally consult a professional specialist to do one as GPs and SW are not really sufficiently qualified to do them and an independent one removes all doubt and the report holds up in the CoP. A consultant psychiatrist or psychologist can be arranged to visit the person in their home or at hospital. My Mum had a psychiatrist come here to see her at home. It consisted of a chat and the Addenbrookes Ace iii test and within less than half an hour, he deduced that sadly, whilst Mum initially presented well, it very quickly became clear she completely lacked capacity in all areas of her life. You can google online for a psychiatrist or psychologist specialising in MCAs. The fee can be paid from the PWDs funds.

Ah interesting, useful information.
 

Champers

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Jan 3, 2019
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Nothing like a little bit of financial leverage.

Phone call received from social worker telling us that MIL’s discharge is imminent and would we like to discuss her care package? We declined and said that, as he had a report saying she had full capacity, it was important that she made her own choices.

He also mentioned that there was an outstanding bill to the care agency of another £2200 and when were we going to settle it? I replied that we weren’t. That MIL’s finances were her own business and that he would need to speak to her. He asked whether she had access to a cheque book, to which I replied that I had no idea and again, referred him back to her.

Meanwhile, we have put in a FOI request by email to have access to the individual who reported us as a concern. He was on the phone within two minutes of my husband pressing send. We used a template request supplied by the Information Commissioners Office (ICO) which also includes a phone number for the recipient to call if they need clarification of the notification. It clearly panicked him as he admitted he’d never received anything like it before and would have to refer it on. He did however confirm that it was a verbal concern - not written.

The SW then asked us how MIL’s previous bill to the care agency had been paid? I told him that it was nothing to do with him and he said, “I can find out you know!” I told him that was fine and up to him but again we had no access to her money, were not signatories on her account nor had POA. I think it’s quite possible that he has been questioning MIL and she, predictably, has said that we always deal with her affairs so he’s now caught between a rock and a hard place. I suspect the care agency are snapping at his heels too.

One thing he did say, which was interesting, was that if the house was registered in our names (it is) we could refuse to allow the hospital to discharge her to it and alternative arrangements would have to be made to transfer her to a residential care home.


Is he slowing coming around with the pressure of our non-cooperation?
 

Rosettastone57

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Oct 27, 2016
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Nothing like a little bit of financial leverage.

Phone call received from social worker telling us that MIL’s discharge is imminent and would we like to discuss her care package? We declined and said that, as he had a report saying she had full capacity, it was important that she made her own choices.

He also mentioned that there was an outstanding bill to the care agency of another £2200 and when were we going to settle it? I replied that we weren’t. That MIL’s finances were her own business and that he would need to speak to her. He asked whether she had access to a cheque book, to which I replied that I had no idea and again, referred him back to her.

Meanwhile, we have put in a FOI request by email to have access to the individual who reported us as a concern. He was on the phone within two minutes of my husband pressing send. We used a template request supplied by the Information Commissioners Office (ICO) which also includes a phone number for the recipient to call if they need clarification of the notification. It clearly panicked him as he admitted he’d never received anything like it before and would have to refer it on. He did however confirm that it was a verbal concern - not written.

The SW then asked us how MIL’s previous bill to the care agency had been paid? I told him that it was nothing to do with him and he said, “I can find out you know!” I told him that was fine and up to him but again we had no access to her money, were not signatories on her account nor had POA. I think it’s quite possible that he has been questioning MIL and she, predictably, has said that we always deal with her affairs so he’s now caught between a rock and a hard place. I suspect the care agency are snapping at his heels too.

One thing he did say, which was interesting, was that if the house was registered in our names (it is) we could refuse to allow the hospital to discharge her to it and alternative arrangements would have to be made to transfer her to a residential care home.


Is he slowing coming around with the pressure of our non-cooperation?
Keep posting the updates, this is a really interesting thread. Be strong
 

Sirena

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Feb 27, 2018
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This is all very interesting @Champers - it sounds as if the light is dawning with the SW. Given his final comment, it sounds like he now wants the situation to be turned towards a care home. You shouldn't have had to do all this but I hope this has been a learning curve for him and it will mean he has a different approach in future. Keep us posted.
 

anxious annie

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Jan 2, 2019
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Hi, Champers
It seems like things are moving in the right direction, hopefully it will all be sorted soon.
 

Champers

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Jan 3, 2019
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Visited MIL today in hospital armed with my iPad on ‘record’.

She asked about when she was to be discharged so it gave us an ideal opportunity to broach the domiciliary vs residential care options. She is now totally agreeable (at this moment in time!) to considering residential for an agreed trial period and actually said, “I’m in your hands, I rely on your decisions.” And “That sounds like a very good idea.” She was adamant that the social worker had never told her how much she was expected to pay for care in her home and again asserted that she never had had any carers ever, despite having live in ones for the last two months - and she has full mental capacity?

I got the whole discussion recorded, so when the SW starts telling us tomorrow that she has today told him she wants to go back to her own home and we must respect her wishes, I shall take great pleasure in emailing the said recording to him and seeing what his view is after he’s listened to it.

The outstanding domiciliary care bill will still not be settled until MIL is actually in the residential home either, just in case the SW double crosses us again.
 

Beate

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May 21, 2014
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London
I'm really sorry about what you have to go through, but at the same time I can't help but admire your stance. It really makes me chuckle how you bat the problem back to them - that is exactly the right thing to do, and I wish you success with it. :)
 

silversea2020

Registered User
May 12, 2019
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Visited MIL today in hospital armed with my iPad on ‘record’.

She asked about when she was to be discharged so it gave us an ideal opportunity to broach the domiciliary vs residential care options. She is now totally agreeable (at this moment in time!) to considering residential for an agreed trial period and actually said, “I’m in your hands, I rely on your decisions.” And “That sounds like a very good idea.” She was adamant that the social worker had never told her how much she was expected to pay for care in her home and again asserted that she never had had any carers ever, despite having live in ones for the last two months - and she has full mental capacity?

I got the whole discussion recorded, so when the SW starts telling us tomorrow that she has today told him she wants to go back to her own home and we must respect her wishes, I shall take great pleasure in emailing the said recording to him and seeing what his view is after he’s listened to it.

The outstanding domiciliary care bill will still not be settled until MIL is actually in the residential home either, just in case the SW double crosses us again.
Good for
Visited MIL today in hospital armed with my iPad on ‘record’.

She asked about when she was to be discharged so it gave us an ideal opportunity to broach the domiciliary vs residential care options. She is now totally agreeable (at this moment in time!) to considering residential for an agreed trial period and actually said, “I’m in your hands, I rely on your decisions.” And “That sounds like a very good idea.” She was adamant that the social worker had never told her how much she was expected to pay for care in her home and again asserted that she never had had any carers ever, despite having live in ones for the last two months - and she has full mental capacity?

I got the whole discussion recorded, so when the SW starts telling us tomorrow that she has today told him she wants to go back to her own home and we must respect her wishes, I shall take great pleasure in emailing the said recording to him and seeing what his view is after he’s listened to it.

The outstanding domiciliary care bill will still not be settled until MIL is actually in the residential home either, just in case the SW double crosses us again.[/QUOTE

Good for you - it beggars belief what you have to do !!!
 

RosettaT

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Sep 9, 2018
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Mid Lincs
Yes as an outsider to the situation I find it a fascinating thread. I wish you luck and strength.

But isn't it depressing that every thing is a battle. I am constantly having to ring agencys of various sorts to get up dates and find out how far an application has got, or how much longer I have to wait for a refund.
 

Sirena

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Feb 27, 2018
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As others have said, it should not be such a battle for you - but well done for doing it!
 

istherelight?

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Feb 15, 2017
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Well done @Champers ! So sorry that you are going through this. Although the circumstances were slightly different I had a battle with the SW over the same issue - carers v care home for my mother following discharge from hospital. I should add that she had had a fall while wandering at night.
The doctor said he was recommending carers four times a day but that the LA would not fund 24 hour care (too expensive). I didn't mention that my mother would be self-funding. I don't know if this is true because the SW backed down when I said I could no longer cope and would withdraw all help; added to which my mother couldn't understand the two leading questions "do you REALLY want to go into a care home?" and "do you REALLY want to spend all your money on a care home?". Shocking!
 

Champers

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Jan 3, 2019
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Thank you all again for your continuing support - we’re all in this together and if our experiences can help anyone, it’s been worth it.

The SW must be really starting to hate me.

I’ve checked that there’s still a place available at the really lovely residential home for MIL - there is - so this morning, I’ve emailed him, and copied in the care home, to tell him that MIL has agreed to an unspecified time of respite care and please may he do the necessary arrangements with regard to her discharge into their hands?

I’ve received a lovely message from the managers of the home saying they are very much looking forward welcoming MIL in the near future - but at this moment, I’ve had no reply from SW. I suspect he will go straight to MIL and ask her again where she wants to go. No doubt, because today is another day, she will say she wants to go home - but I have the recording of her agreement up my sleeve, which will be my next move, should he raise it again. If necessary, we can have a little chat then about what exactly mental capacity is in his eyes?

My request for information, under FOI, about the report put in me and my husband has also caused ripples and clearly gone further up the line as we’ve received an email from the county council asking for proof of ID before they disclose it. I get the impression it was a verbal comment made by the domiciliary agency manager but I just want the point made that he can’t hide behind ‘Data Protection’ without understanding the full implication and our right to have access. Hopefully, we can then get anything struck of the record.

Finally, and I’ll only use this if he continues to be confrontational, I know for a fact that no minutes were taken during the original meeting two weeks ago when he ambushed us with a whole party of NHS staff (He’d implied it was going to be a casual chat and instead we were confronted with 8 additional people!) I will embarrass him by asking to see the (non existent) notes and when he is unable to produce them, I will express my dismay at his lack of professionalism.

I’m sorry, and very conscious that my posts are so long and I sincerely hope they are not too boring but I’m hoping that I’m painting a picture.
 

canary

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Feb 25, 2014
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South coast
No, your posts arnt too long and they are, indeed, painting a picture.
I am full of admiration at your strategy.
I know we all say to people in your situation that they need to step back, but you are taking it to a whole new level!
 

Banjomansmate

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Jan 13, 2019
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Dorset
So far at the the three meetings with “professional “ SS workers there has never been a proper verbatim recorder present, just a social worker taking down notes and then putting their own take on things when they produce a report.
 

Champers

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Jan 3, 2019
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So far at the the three meetings with “professional “ SS workers there has never been a proper verbatim recorder present, just a social worker taking down notes and then putting their own take on things when they produce a report.

Exactly. I made my own notes during our meeting, but I was too honest, I told the SW I was going to record the meeting but I was told I wasn’t allowed to. I should have just left my iPad in my handbag on voice memo and typed it out afterwards.
 
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