Need some advice

[2jays]

About 6 months ago, I was talking about mum falling all the time, mainly during the evening/night. I asked did mum need 1:1, and that I might be prepared to help pay for extra 1:1

Move on 6 months, and after CHC meeting on 26th Jan, where it was stated by care home they could manage mum, that she wasn't high priority for 1:1 due to her falls, I was asked today, just under two weeks later, whether I was still willing to pay for 1:1 as she was needing more 1:1 during the night

I asked the cost. £19.50 per hour
They were not 100% sure how many hours were needed as it was still only early days (fishing expedition I suppose)

For financial planning I did a calculation of 3 hours per night, per week.

We already pay over £3,500 per month and 1:1 at 3hrs would push it over £5,000

1) are they allowed to legally ask for payment of 1:1

2) do you think this is their way of preparing the family for the news that mum needs to move care home, despite them telling me that's the last thing they want to happen

3) mum been in care home nearly 3 years, would it be fair to move her now, keeping in mind she does have the finances for 1:1, it would just bring the LA into play a couple of years earlier than existing finance obligations would cause

4) someone please tell me what I should do,

5) or rather, what their opinion is and how they would handle it

 

[Sue J]

Hi 2Jays

I don't understand the finances at all so no help there, but what struck me about your post was that 1:1 was not deemed necessary for evening falls/sundowning and now nighttime 1:1 is deemed necessary. Is it possible that not having 1:1 in evening when it is needed is causing your Mum to have more restless nights? I know this may not be the case but I would ask them to try 1:1 in the evening again first if it were me - nothing ventured, nothing gained and all that.

Don't know if it helps but am sure you'll get lots of other input.
Love
Sue

 

[2jays]

Thanks Sue. That's the point. They want us to finance the extra 1:1

3 members of staff on at night.


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[Sue J]

Thanks Sue. That's the point. They want us to finance the extra 1:1

3 members of staff on at night.


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But 1:1 payment should be paying 1:1 for your Mum, not the rest of the home.

I am amazed at how much you pay already.

 

[2jays]

Sorry sue, I didn't make it clear that up until now I haven't been asked to actually pay for 1:1. Each time I asked what was happening about mums falls, I was told they could manage her needs.

Until, suddenly, now they can't for some reason.

I'm beginning to think it's political financial.....


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[jugglingmum]

I know you probably don't want to, BUT, you do need to ask why they said what they did at the CHC meeting and now are saying something different. The CHC meeting was called as a result of 1:1 comments. Are they just trying to keep hold of your mum as in total she is a good resident? Just doesn't all tie together (only going on your posts - hopefully you know what I mean).

Do they provide 1:1 for others?

Would a home move be the end of the world, does mum interact with carers, or in the right place would she be just as happy?

Are 3 hours of 1:1 enough? What happens when she needs more?

Not got any direct experience (as you know) but just listing Q's to try and help you see the wood for the trees. (probably not a v helpful post - soz)

Edited to add - cross posted and from previous posts sounds political/financial - which is what my first para is getting at

 

[2jays]

I know you probably don't want to, BUT, you do need to ask why they said what they did at the CHC meeting and now are saying something different. The CHC meeting was called as a result of 1:1 comments. Are they just trying to keep hold of your mum as in total she is a good resident? Just doesn't all tie together (only going on your posts - hopefully you know what I mean).

Do they provide 1:1 for others?

Would a home move be the end of the world, does mum interact with carers, or in the right place would she be just as happy?

Are 3 hours of 1:1 enough? What happens when she needs more?

Not got any direct experience (as you know) but just listing Q's to try and help you see the wood for the trees. (probably not a v helpful post - soz)

Edited to add - cross posted and from previous posts sounds political/financial - which is what my first para is getting at

I (sort of) asked about CHC meeting, was told it's not a nursing need, a social need, therefore carer said what they said at the meeting (????)

Mum interacts very well with existing carers. When she was in Hospital, she was very distressed, and only became calm once she was through the door of the care home

3 hours was just a financial exercise for my benefit, to give me an idea of the costs

1:1 has been provided in the past, for a week, and I was never asked to pay

Really thinking its a "gentle" shove out the door time

[thinking noises]

Wondering what will happen if I refuse to play ball

Or refuse find another placement for mum.....

I cannot imagine they will put her on the streets.... I guess they would get LA involved.....

They have LA funded people.... So would have to explain themselves to the LA.....

wonder if it's worth getting in contact with the social worker that was at mums CHC meeting...... She gave an indication that she felt mum qualified for CHC at a previous meeting we had, but also seemed to be bamboozled by the assessor and carer into agreeing mum didn't qualify.....

What is the actual law on this situation? Nothing I'm guessing, money is ruling this....

Emotional blackmail too.....

[end of thinking noises]







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[jugglingmum]

I (sort of) asked about CHC meeting, was told it's not a nursing need, a social need, therefore carer said what they said at the meeting (????)

I only know snippets I've read on here about CHC - my mum a long way off.

Surely she needs 1:1 as agitated so nursing, a managed need is still a need and all that guff

Surely you would expect the carer from the home to fight your corner - I'm now assuming they would either be paid less under CHC or your mum would have had to move.

Maybe I'm too cynical

And if when you are making thinking noises the whirr gets too loud - please stop so head doesn't explode

 

[nitram]

"I'm now assuming they would either be paid less under CHC or your mum would have had to move."

That's my cynical view as well.
CHC is all or nothing, if a severe on mobility would have meant that CHC was granted there could not have been any topping up for 1:1.

The home would most likely have received less for care plus 1:1 than they are getting for just care now.

There would have been a strong best interests argument for not moving elsewhere.

An additional problem is that if 2Jays agrees to 3 hours/night what happens when the need increases to 4 hours/night, maybe progressively increasing even more.

Assuming that 1:1 care would be available on demand for the whole night being triggered by some sort of movement alarm it just looks like an additional carer will be on duty overnight.

I'd be inclined to call their bluff and say that as things have obviously changed since the CHC meeting you will approach the CCG for a review of the decision, whether or not this would be within the guidelines does not matter, you just want to shake them up a bit.

 

[2jays]

I'd be inclined to call their bluff and say that as things have obviously changed since the CHC meeting you will approach the CCG for a review of the decision, whether or not this would be within the guidelines does not matter, you just want to shake them up a bit.

I have not had any "official" paperwork stating the CHC outcome
Only the opinion of the nursing assessor that she will not qualify. If the care home have had any paperwork, I've not been told

I'm prepared to call their bluff

My son in law - he suggested I move mum. To my house and get carers in. How He is still alive I don't know....

Family are either going ballistic about THIS situation, without any really constructive thoughts

or they are telling me to walk away as there is nothing I can do, I should leave it up to them to sort out, without being able to explain who "them" are or any understanding that it's always been me that sorted things

I'm prepared to walk away from all this.

I've had enough. I can't keep on like this. This emotional blackmail and utter lack of support I feel I'm getting

I've obviously protected the family too much....






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[Sue J]

Sorry sue, I didn't make it clear that up until now I haven't been asked to actually pay for 1:1. Each time I asked what was happening about mums falls, I was told they could manage her needs.

Until, suddenly, now they can't for some reason.

I'm beginning to think it's political financial.....


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I realise 2jays that you offered the 1:1 payment and that you'd not been asked but to me if she is only falling in the evenings indicates whatever is causing the falls is happening then due to brain tiredness, sundowning and 1:1 care in the evening may help her settle better so not needing so much help during the night.

I don't understand the political finances at all but assumed (something one should never do!) that your proposal was about getting a private 1:1 agency carer in to assist in the evenings to see if it helped.

I think you need to have a straight talk with the manager as fearing they may be planning to move your Mum might not be on the agenda at all, and I don't think should be but understandably is causing you worry and distress.

Sorry if my take has missed the point completely but thinking of you, just take it easy and try not to jump the gun.
xxx

 

[Saffie]

I don't understand about the CHC funding meeting. Was it the full DST meeting or just the checklist?
If the former then you should have received an official letter from their decision.
If the latter, then I assume the assessor's view was supported though still think you should have received some form of notification. You should also be able to see the completed checklist.

If this is all piling up on you 2jays, just tell the home they have to sort it out for themselves. Would 3 hours be enough anyway? Will it then become 4 or 5? I can see an extra carer would be helpful but would it be just for your mother and how will you know?
Sorry, this probably isn't helping. xxx

 

[Soobee]

Having read it, it seems to me to be unreasonable.

If they were two weeks ago saying it wasn't necessary, they can hardly turn around and say it is now!

To be honest with you I have never heard of anyone paying for 1:1 care. It is provided in hospitals for free where necessary (health need). I would call their bluff. Get the family to look elsewhere (try not to do it yourself) but see what happens in the meantime. The care home will carry on as they are or they will say in a month's time that they can't meet her needs. The only way you're going to find out which is true is to hold off and see.

I can see you are so weary. If you do need to step back then do it. The important people know how much you've done over the years and how it takes its toll. The rest don't matter. You have always done your best for your mum but there is a point for everyone where the load is too heavy. Don't get squashed by it xxx

 

[2jays]

I don't understand about the CHC funding meeting. Was it the full DST meeting or just the checklist?
If the former then you should have received an official letter from their decision.
If the latter, then I assume the assessor's view was supported though still think you should have received some form of notification. You should also be able to see the completed checklist.

If this is all piling up on you 2jays, just tell the home they have to sort it out for themselves. Would 3 hours be enough anyway? Will it then become 4 or 5? I can see an extra carer would be helpful but would it be just for your mother and how will you know?
Sorry, this probably isn't helping. xxx

Full dst

No paperwork received about any meeting

My feelings/only my opinion (legal speak).....

Care home representative sabotaged the meeting. Nurse assessor already had decided outcome, was a very dominant personality, so both supportive social worker (who felt mum was a strong candidate for CHC) and my self were bamboozled into answers, which nurse assessor was careful to note on the form our final responses after their strong bamboozling

3 hours is just a figure I pulled out of the air to get an idea of how much it could cost....

It's helping. It's making me want to contact social worker, burn the boats, then walk away and watch what happens....

Yeah right..... Walk away..... I can walk, but the guilt monster will be walking my way......

I wish I was able to be eloquent when dealing with people (? Are they people or financially controlled robots??) who play on your emotions and don't play nice






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[Kevinl]

I'll address the issues point by point, hopefully it'll make more sense:

1) are they allowed to legally ask for payment of 1:1
If as care home professionals they believe she needs 1:1 care then surely they are duty bound to tell you this under their duty of care. As it happens she's self funding but if she were to be LA funded I'd expect them to do exactly the same thing.
Should you not want to pay and they believe that would compromise her care and possibly invalidate their insurance if anything did go wrong I wouldn't blame them for stepping away and asking you to move her on rather than give her substandard care and possibly be sued.

2) do you think this is their way of preparing the family for the news that mum needs to move care home, despite them telling me that's the last thing they want to happen
Not too sure, she already is in a care home isn't she do you mean a nursing home?

3) mum been in care home nearly 3 years, would it be fair to move her now, keeping in mind she does have the finances for 1:1, it would just bring the LA into play a couple of years earlier than existing finance obligations would cause
Moving is generally best avoided, if all is going well and would anywhere be prepared to take her on without asking for 1:1 care too?

4) someone please tell me what I should do,
5) or rather, what their opinion is and how they would handle it

Ultimately you don't sound like whatever money gets spent is not an issue to you, however, it sounds like other family members my be a bit more concerned about the cost hence the suggestions you take her in or walk away and let "them" sort it, both of which are a bit "cheeky" and sound like a bit of inheritance watching rather than actually caring about her.
Personally I'd do the best for her now and pay for the care as should the LA ever become involved in funding it would be harder to change a long standing set up of 1:1 care, to stop it may make them open to a charge of negligence if they did and anything happened so it might be a short term cost for a long time benefit.
K

 

[Saffie]

I didn't mention walking away as I don't see that as an option.
She is your mother and you care.
However, it is the home's responsibility to keep her safe and so they have to find a way of doing so.
If they - or their representative at the meeting - didn't support the application for CHC funding, why are they now saying she needs the one to one care which presumably was the main reason for the application.
My concern would be what the one to one would be doing all night and is there a set period when your mother is likely to wander? If it can be anytime then that's a lot of hours to be paying for and not all of them will be used solely for your mother.
If it always between set times of a couple of hours then it might be worth a try.

I really don't think inheritance enters into this at all, Kevin.
It's surely more a case of not knowing where committing to the extra payments will lead.

It could be that a nursing home would better serve your mother's needs now 2jays. They usually cost more anyway, over £1,000 a week here with the nursing supplement already deducted. I know that won't deter you but the crucial point will be how a move would affect your Mum.
Another dilemma to disturb you. I am sorry. xxx

 

[fizzie]

I think there is some funny business going on but can't work out what. CHC meeting 26 Jan - no 1:1, 2nd Feb now 1:1 - really not acceptable practice

I agree with Nitram

I'd be inclined to call their bluff and say that as things have obviously changed since the CHC meeting you will approach the CCG for a review of the decision, whether or not this would be within the guidelines does not matter, you just want to shake them up a bit.

 

[Kevinl]

I really don't think inheritance enters into this at all, Kevin.

I said:
"whatever money gets spent is not an issue to you, however, it sounds like other family members my be a bit more concerned "

as a reply to the OP saying:
"My son in law - he suggested I move mum. To my house and get carers in. How He is still alive I don't know...."

"or they are telling me to walk away as there is nothing I can do, I should leave it up to them to sort out, without being able to explain who "them" are or any understanding that it's always been me that sorted things "

So what I said is that 2jays has no issue with the money being spent, the SIL wants 2jays to take care of the mother (and presumably save all the care costs) and others in the family suggest she walks away. That to me makes it sound like the rest of the family are on a cost cutting exercise at 2jays expense where as 2jays just want how to spend the money best.
I haven't said 2jays has the slightest interest in inheritance in fact I said exactly the opposite, I'm saying that other family members seem to be watching the pennies and 2jays just wants to do the best thing, irrespective of the costs.
K

 

[tigerlady]

I would definitely contact the social worker again - she was of the opinion - like you - that your mother qualified for CHC. If the meeting was on 26th January, I'm not surprised you havent received anything in writing, as the CHC people are very slow to respond to anything in writing. I think with the help of your social worker, you can ask for another meeting in view of the care home manager denying there was any need for 1:1 at the meeting, yet 2 weeks later says there is.

I agree with nitram and fizzie - something's not right. Could it be that your mother is a good resident and as a self funder, they can charge more? Could it also be that they are worried that if your mother does qualify for CHC, the CHC people will insist she has to move to a nursing home if the one she is in now is just a residential care home, and therefore they would lose a good self funding resident?

When my husband qualified for CHC, he had to go to a nursing home, because although he didnt need nursing care, the number of staff is higher in a nursing home and therefore would be better equipped to monitor him due to his wandering and aggression.

 

[2jays]

Nail on head. What affect will a move to nursing care cause mum

Money isn't the object. If mum was able to, she would happily be spending her money any way she wished, no thought of leaving much/anything for us to inherit.

With that in mind, it's obvious that I agree to the costs of 1:1

With that in mind..... Paying for 1:1 when they say 2 weeks ago they can manage..... Scammers actually comes to mind. Smack them whilst they are down....

A move to somewhere, at £1,000 a week, therefore £ 4,000 (+-) a month, to get 24/7 1:1 sounds cheaper than what is being offered

As POA with financial responsibility.... It's Financially cheaper....

The question has been asked by care home. The question now is..... What to do

I know the logical answer.....

From thinking we were totally supported by the care home..... The realisation that we were supported, only because we paid our bills on time and she wasn't a problem......









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