Once on s117 aftercare, can it be rescinded?

[TaraT]

Mum was sectioned under s2 and then s3 and is now on 117 aftercare. She is now in a care home. We had great support and terrible support from SS and the council in equal measures depending on who we were dealing with.

To top off the numerous mistakes I received a letter demanding the wrong top up fees a couple of weeks ago (would it surprise you to learn that they had doubled the weekly top up?). They had already made an error when mum went into the Home as they said that the home came under a different council to them and therefore she would have to pay more. It transpired that they were wrong there too. If we hadn't challenged it, mum would be paying more money again. I have quite a few examples of this sort of thing happening and I have to say that my concerns go out to those people who have no one fighting their corner - god knows how much they are being ripped off.

Anyway, I had had enough last week so i wrote a long letter to the council, detailing all the mistakes, both advice wise and financial, that we had endured through the process. I have received 2 letters this morning, both in the same envelope. One was a direct response to my queries (I could go on about that letter in a different post...!!!), however the other one was a letter saying that mum would be further assessed going forwards and if she came off the s117 she would be financially assessed. This was a bit random and wasn't in line with my original complaint. I felt like it was a veiled threat....to stop my complaints.... But that's probably paranoia!

So my question is, with AZ being a progressive disease, has anyone had any experience of their loved ones being forced off 117 aftercare ?

 

[FifiMo]

It would be very difficult for them to remove the aftercare from someone with dementia as it is a progressive disease and only likely to get worse..that wouldn't mean that they won't try!

What worries me more is the Top Ups. They are NOT permitted under Section117 aftercare. Not in any scenario!

http://www.mind.org.uk/mental_health_a-z/7851_aftercare_under_section_117_of_the_mental_health_act

This explains that not only should you not pay, but that you can reclaim the money.

Fiona

 

[jan.s]

Just a thought. If 117 funding is difficult to remove, does the same apply to CHC funding? Using the same argument.

R is CHC funded and it is due for review soon. He is now receiving appropriate care and is so much calmer, and my concern is that the funding could be withdrawn. I would argue the case, but am not sure of my ground here.

Any advice would be helpful.

 

[Wirralson]

TaraT

On the question of top-up fees and how they can arise, you may want to have a look at Nebiroth's post at the link below, which I found very helpful:

http://forum.alzheimers.org.uk/showthread.php?58141

In practice my father and I found in my mother's case that it isn't quite as simple as "no top up fees ever". I fully agree that the apparent legal position is that the local authority must meet the patient's assessed needs in full. But the local authority's idea of what the patient's assessed needs are and the care homes that it considers suitable to meet those needs may differ considerably from what the relatives may perceive the needs to be and the surroundings they would wish for their loved one, which is where the issue of "top-ups" may arise.

On the question of removal of s117, I'm not sure it's quite that simple. Yes, most (all?) forms of dementia are progressive and get worse. But s117 covers aftercare following detention under section 3 of the Mental Health Act 1983. The fly in the ointment is s117(2):

117...(2): It shall be the duty of the Primary Care Trust or Local Health Board and of the local social services authority to provide, in co-operation with relevant voluntary agencies, after-care services for any person to whom this section applies until such time as the Primary Care Trust or Local Health Board and the local social services authority are satisfied that the person concerned is no longer in need of such services but they shall not be so satisfied in the case of a community patient while he remains such a patient.​

Note the bit in bold, and the PCTs. no longer exist and have been replaced by Clinical Commissioning Groups. So, in theory at least, if the local social services are satisfied that the person no longer needs aftercare, then they could withdraw s117 funding. The issue isn't the progressive nature of the disease. Although it is hard to see how a local authority could reach the conclusion that all funding was no longer required, they might well review the level of funding and assessed needs. Given the pressure on local authority budgets I'm expecting my mother's case to be reviewed, and my father and I were warned by the solicitor that this was possible, but on the evidence he had, was not likely in my mother's case for some time.

(The reference to "community patient" refers to someone subject to a community treatment order under s17(1) of MHA83. I would have thought this unlikely in the case of a person with dementia but possible, especially where younger people have developed the illness.)

So I'd suggest that the short answer to TaraT's original question is yes, in theory, although not very probable in practice, but you need to watch the issue and be prepared to fight your corner if you have to. The letters sound as though they are standard form letters or templates (the NHS and Local Authorities simply love standard form letters!) or an attempt to provide a clear line protecting their position after consulting within the Local Authority. Given the existence of s117(2) the LA has to inform you of what would happen if your mother was taken off s117 funding. I wouldn't be paranoid but I would be vigilant.

On JanS point about CHC funding, as it is based on clinical need and a scoring system, removal of funding would appear to be possible. If the requirement giving rise to the need for the Continuing Health Care diminishes, then the funding could, theoretically at least, be remmoved. A slightly out of date version of the national National CHC Framework, which may help is here:

http://webarchive.nationalarchives....tions/PublicationsPolicyAndGuidance/DH_103162


Kind regards

Wirralson

 

[TaraT]

Briliant - thanks everyone for your replys and sorry for taking so long to thank you all. Wirralson - the word 'vigilant' is certainly hitting the nail on the head.
Thanks again
TaraT