Now I'm confused.....

[poppy01]

Hi everyone...

Those of you who have already read my previous posts about my mom going into care etc etc will already know the situation with mom..and the care home she is currently in with the problem with the stairs etc etc..

Well today I had the SW on the phone asking for my dad or moms financial agent to sign the contract for the home and moms contribution towards the cost of her care...anyhow to cut a long story short..we got talking and she said the care mom is getting is continuous care...now I questioned this and the SW told me that because the home where mom is only a residential home..she will have to be moved when this disease progresses....so she is not classed as being in permanent care????

I am totally confused..as I thought this home was for emi care as well as residential..in fact since mom has been a resident here..the staff have told me that there are more emi residents than what they had originally made places for...so they have taken a floor what was originally planned for just residential and now made it for emi residents...

If I had known this I wouldnt have placed mom in this home..at no time did anyone tell us that this home was just a residential home..

So really what I am asking is..the info the SW has given me..is it correct? And where will mom end up...as if we hadnt enough to worry about..the SW springs this on me this morning...

Maybe this is why the stairs are not fastened off...I dont know..
I thought this would be moms home until the inevitable came...it looks as thought I was totally wrong...and now I am so confused I dont know what to do anymore...we're just being bounced from one thing to another lately...

Has anyone else had this happen to them or know whats happening more than I do????

Thanks..

Caroline

 

[connie]

Hi Poppy,

Can the care home give you any clarification on this? I only ask because where Lionel is they offer 'care for life'.

They have a residential side, and a secure EMI unit. Not necessarily for transferring from one unit to another......just everything, including pallative care.

Do hope that you get something sorted for your mum. You do need answers from somone with authority.

 

[Bristolbelle]

Closed stairs....

I don't think that is the reason for the stairs not being closed off, as on the other side of things I know a residential hoome where the stairs are gated even though it does not have a EMI unit, the manager told me clients can opne the gates or ask for them to be opened, They are purely there as a precautionary measure ot prevent any accidental falls. I also know of a lady who was nursed through to her death who was in a "residaential" home but who was so happy and so loved by evryone there they all agreed to work voluntary shifts to look after her when she became increasingly ill. I don't think the rules are written in stone.

 

[Margaret W]

I just don't understand this terminology of an EMI unit. My understanding as that there is nowadays no such thing. There are only two categories of care home, Nursing and non-nursing. Nursing homes have qualified nurses on duty, non-nursing homes don't. I agree that non-nursing homes have all sorts of different facilities for different levels of care, but there is no label to them. Here in North Derbyshire there is no such thing as an EMI unit or home or ward.

I don't want to make a point, but so many people on here seem to be relying on this EMI unit as providing some extra care for their relatives, that I don't think exists.

Can one of the moderators, with more knowledge than me, please tell us all if there is still such a thing as an EMI unit, and if so, what it is?

Poppy is clearly distressed about it all, and I think she, and others like her, need to know what is available.

 

[Grannie G]

All I know from personal experience is even if the term `EMI ` is no longer used, homes which accept people with dementia should be registered for Dementia Care.
My husband has just been admitted to a care home. There is no separate unit for people with dementia but it is registered for dementia care.

 

[Skye]

I don't want to make a point, but so many people on here seem to be relying on this EMI unit as providing some extra care for their relatives, that I don't think exists.

EMI units do still exist, at least here in Scotland. My husband is in one.

It is a separate, keypad-locked unit attached to a care home. The home has three sections, residential, nursing, and EMI.

There are people with dementia in the residential and nursing sections, but when the dementia becomes a real problem, they are transferred to the EMI unit for their own security.

The Emi unit had mental health registered nurses on duty at all times.

Caroline, I think from the way you've described it, the gome your mum is in is similar.

EMI and nursing residents cost more, and that's why people are often placed in the cheaper residential section until that is no longer viable, particularly if LA funding is involved. When the transfer becomes necessary, it has to go back to panel to get the extra funding.

Caroline, you should ask your SW about this. It could be that you have nothing to worry about, and your mum will simply transfer to the EMI wing if this becomes necessary. But different areas will have different arrangements.

Love,

 

[Flower_fairy]

Hi,
You need to check with the home first of all if they have registration for dementia care. This can be called EMI or they may simply call it dementia unit (all the same). There are four different types of homes. Residential- which should just be for people who are older and no longer able to live alone but can do most things for themselves with a bit of help. No dementia and no nursing needs (ie peg feed,) However, most residential homes will keep hold of people with dementia as long as they are not causing any difficulties and if a time comes when they are they will have a nursing assessment carried out and will probably be recommended to go into EMI.
Secondly you have EMI units which are now sometimes called dementia units. This is for people with a more severe level of dementia and most of whom will have some sort of behavioural problems, this could be wandering, agression, shouting out etc. These units will always be locked and there will be a registered mentla health nurse on duty 24hours a day this is because they should be trained to deal with the uinpredictable natue of the illness and are qualified to give out "PRN" medication which means "as required" so if someone is kicking off and hitting out for long periods they can be given some medication to calm and relax them.
Then there are nursing units which are for people who have needs that need to be looked after by general nurses. This can include end of life care, people who need to be nursed in bed and may be at risk of pressure sores if not turned regulary, people on PEG feeds and people who need injecting with insulin daily.
Now here is the confusing part...there is now a small number of EMD units which are inbetween residential and EMI units and are "residential dementia" they are for people with dementia that may wander if the door was not locked but who have no behavioural issues "pleasantly confused". People who will benefit from being around people who are not as cognitively impaired as people on EMI units and there will be a qualified mental health nurse on one shift of the day.

Sounds to me like at the moment the lady in question is in a residential, now the other unit may be dementia but not EMI and therefore that is why she may have to move in the future. I would suggest that until this time comes do not worry about it but do try and find the names of EMI units in your area by going on CQC website and searching for homes in your area with do this by: Going onto the cqc website
Clicking on "find care service"
Click on social care services
Click on care homes and then click Dementia(EMI)
Then you can put in your postcode and it will bring up a list and the ratings from the CQC.

Perhaps visit and keep one in mind for when the time comes xx

 

[poppy01]

Helloo...

Thank you to everyone who replied to me...

I have been up to see my mom today and I asked the lady in the office there and also one or two carers...it is definately not a nursing home and there are no qualified nursing staff on any duty there...the home is 'residential emi'...and should mom require one to one care later on in this disease..then they have said she will have to leave and go elsewhere...also mom is on something called...continous care..which means she is not on a permanent care plan..she remains on short term care plan...the lady in the office explained that this is sometimes what happens with local authority funding??? Again I dont know anything at all about this...she says that mom will have to be assessed every so often and then this continous care just carries on.. she says not everyone has this kind of care only a few..so why my mom has this i do not know...we have never been told this is the case..it was the social worker yesterday when i spoke with her what dropped it out to me..

I have a meeting with the social worker next week so I definately need to get some things clarified I think...I dont like the thought of having to move mom again in the future...she is settling down here lovely too bless her...and starting to put her trust in the carers now...

But I will see what this meeting will bring...

Thanks again to you all..

Caroline

 

[poppy01]

Hi again..

Sorry...I forgot to ask...how do I check if this home is registered emi or not?

Thanks again..

Caroline

 

[Sandy]

Hi Caroline,

Go to the search page on the care Quality Commission website:

http://www.cqc.org.uk/registeredservicesdirectory/rsquicksearch.asp

At the bottom of the page there is an option to search by name.

When you get the listing for the home, you should be able to see if it is licensed to care for people with under the heading of Service Details (example below):



It's possible that the information on the CQC website is not fully up to date. That is, if the home has applied to a different registration status, that might not be reflected in it's online listing.

Take care,

 

[poppy01]

Hi..

Thanks for the link...

OK its says

Care Home Only (Dementia + Old Age - not falling into any other category)

Does this mean that moms home is registered as being for people with dementia then? (Sorry but I'm a bit thick when it comes to taking things in)....

I have asked the carers there if they are properly trained in dementia and they have said they were given 2 weeks training in dementia...now this to me...unless it is standard procedures nowadays...isnt anywhere near enough training...even the carers who came to look after mom at home before she had to go into a care home..got 6 weeks training...

I think it must be me that is expecting too much for my mom then ???

Anyhow once again...thanks very much for your help and advice...

Caroline

 

[Sandy]

OK its says

Care Home Only (Dementia + Old Age - not falling into any other category)

Does this mean that moms home is registered as being for people with dementia then?

Yes, I believe that's what it means. There may be further details regarding how many people with dementia they are registered to care for, out of the total number of residents.

As far as I know, there are not detailed specifications for dementia registration, but the home has to demonstrate that it has the right staff, facilities, skills and systems to meet the needs of its residents. So the burden of proof really rests on the inspection regime rather than any paper-based criteria alone.

In the same way, the best way to judge if this is the right home to care for your mother is to observe carefully over the coming weeks.

Take care,

 

[sue38]

Hi Poppy

My dad's home sounds similar to your mum's. It is a Care Home without Nursing although registered for dementia. In fact all 20 residents have some level of dementia.

We are aware that, if my dad's condition deteriorates to a stage where the home can no longer meet his needs, he may have to move to a Care Home With Nursing. That's not to say a move is inevitable - some residents have passed away at the home (I suppose it's a bit like dying at home), but if he needs nursing care, he would have to move.

Hope that helps.

 

[JPG1]

Caroline,

It’s hardly surprising that you’re confused – the whole world of care is confusing. And in some parts of England, the term ‘EMI’ is never used. I’ll try to explain to you what the CQC have explained to me.

If you go to the CQC website http://www.cqc.org.uk/ and if you enter the term EMI in the “Keyword search” box, you will get the message “No results found”.

If you enter the term “elderly mentally infirm”, you will get the same message – “No results found”.

If you enter the term “dementia”, 10 results will appear. Click on the one called “Older people with mental health problems”. Then, click on “Download the guidance” and a CQC document arrives for you to read:

“This policy and guidance explains:
• How we register care services used by older people with dementia;
• The features of good specialist services for older people with dementia that we look for when reaching our judgements on regulated services;
Where we can find information and good practice guidance about how services for older people who have dementia and/or other mental health problems should be commissioned and provided.”

Our nearest ‘care home’ is a ‘care home with nursing’ and registered with the CQC as being suitable for people with dementia. Not all residents have dementia, but some do, and some residents have very challenging behaviours – even though they may not have dementia. There is a notice on the front door saying that the door is kept locked at all times; please ring the bell; and please ask to be let out when you (for example, as a visitor) wish to leave. Residents who ‘wish to go out’ do likewise – but that does not mean they are always able to leave! But some residents are able to leave whenever they wish to do so – e.g. those without dementia, and we meet some of them in the local supermarket.

There is a ‘nursing section’ for residents in need of nursing care, even if only temporarily (with or without dementia). Not everyone in the nursing section is there long-term, and they may then go back to their own rooms outside of the ‘nursing section’. There is always a Registered Nurse on duty in that nursing section – but not a Mental Health specialist. Whether that is nationwide, I have no idea.

There is also a dedicated ‘dementia unit’, within the care home, and that has one locked door/keypad-only-accessed-door between the ‘main rooms, bedrooms and corridors within the dedicated dementia unit’, and the remainder of the care home. The residents in that dementia unit only socialise with other residents who also have dementia. Unless they are accompanied and ‘invited’ (for want of a better word) to exit from that dedicated dementia unit into the ‘part of the care home that is not dedicated to dementia and not within the nursing section’.

Not all residents with dementia have rooms in the dedicated dementia unit – so they are able to socialise with residents without dementia, and with all the visitors who visit.

The term EMI is never used in this county of England. It is referred to as the ‘dementia section/unit’ of a care home. And if the above is as clear as mud, then – if you’ve got the strength!! – you may want to read the Standards 3 & 4 of the National Minimum Standards, which you can find here:

http://www.dh.gov.uk/dr_consum_dh/g...@dh/@en/documents/digitalasset/dh_4135403.pdf

.... but only if you really feel the need to read it all.

Sorry for the long post, but it is so confusing for people to expect exactly the same standardised experience that other people have. I too used to search for ‘EMI care’ and it took me a while to realise that it just does not exist where I live.

So, when you've seen one care home, you've seen one care home. Hope this helps - rather than confuses you even more, Caroline!

 

[Margaret W]

I just checked my mum's care home. It is not registered for anything other than "old age, not falling within any other category", but it was absolutely perfect for mum's level of AD, and most other residents had some degree of the illness. And it's rated Good at the last inspection.

I also checked another home in the same town, that at the time of placing mum was widely regarded as the best place for dementia sufferers and had special awards for its dementia care. We hated the place as everyone was far more serious than mum. It is also registered for "old age, not falling within any other category". And is now only rated "Adequate".

But another home, that at the time I would not have put a dog into, is now rated "Good". And a lot cheaper than the others!

The Quality Care Commission produced a statement in 2007 (I can't copy it for some reason) to say that some providers may register as DE providers where they specialise in care for Dementia Sufferers, but that most other providers will still be likely to offer the same level of care, perhaps to a smaller proportion of residents. It expects that those registered as DE providers will be providing care only to the most challenging of residents.

Oh, managed to copy it:

· The law says that we must register, in a special dementia category (called ‘DE’), those services that provide care primarily for people with dementia whose care needs are of a degree that cannot be met by general services. · This does not mean that all services that provide support for people who have a diagnosis of dementia must be registered in the DE category. · Neither does it mean that a care service that is not DE registered is unable to support a person with a diagnosis of dementia.

I hope this helps someone.