Respite care home placement

[Linsac]

Hello I'm new here and could do with some advice. Mum admitted to acute MH hospital 10 weeks ago suffering from delirium. Extensive tests ruled out infection and although the consultant thinks some mild early dementia, no firm diagnosis as yet. We had a dishcarge meeting 3 weeks ago with SW and it was agreed that as the delirium had subsided, she could move to a care home for 4 weeks respite care with a view to going home with a full care package. As she was on a S3, her care will be funded.

Nothing from SW until last week where she was offered a possible placement in a CH in a town not local to either of us. CQC scores were not good so I declined. Today I've been told to look at another home in the same chain which has even worse scores, 4 requires improvements and 1 inadequate. The thing is it is all taking so long. Mum needs to get out of hospital and I can just see this taking forever with them offering me awful homes and me declining them. I have seen a home who have room and will accept council funding but the SW says they have to offer me placements with in the group of homes that they have a contract with. Can I insist on this home or do I just have to sit it out? I am getting the feeling they take so long so that you get desperate and eventually accept one of their crappy homes! However I am beginning to wonder if we should just accept another home just to get mum off the MH ward.

I am so stressed by all this, SW doesn't even sound that clued up on it and is impossible to get hold of. She communicates by message only, you can never get to speak to her. Does anyone have experience of this or any advice please?

 

[Lyn13]

Hi Linsac, I'm sorry I don't have much concrete help to give you, but my gut is saying don't accept a home you are not happy with. I guess eventually the hospital will put pressure on the SW and maybe then you can get the home you want. I wonder as well that the longer she is in hospital maybe they will sort out a clearer diagnosis for your mum as well. Think about what you want - care on a MH ward wwhich will be resolved at some point or care in a under performing care home where it will be harder to move her into somewhere you would be happy with.
I'm sure others will have advice when they can but stay true to what you want.

 

[Louise7]

I have seen a home who have room and will accept council funding but the SW says they have to offer me placements with in the group of homes that they have a contract with. Can I insist on this home or do I just have to sit it out? I am getting the feeling they take so long so that you get desperate and eventually accept one of their crappy homes! However I am beginning to wonder if we should just accept another home just to get mum off the MH ward.

I am so stressed by all this, SW doesn't even sound that clued up on it and is impossible to get hold of. She communicates by message only, you can never get to speak to her. Does anyone have experience of this or any advice please?

Welcome to the forum @Linsac Sorry that you are going through a stressful time at the moment. Do you have Health & Welfare POA for your mum? How old are the CQC reports that you have been looking at? Don't discount somewhere purely on the basis of a CQC report, go and visit if you can to see what the standard of care is like as improvements may have been made, managers changed etc since the last CQC visit/report. If you can't visit due to the current covid situation then try to find feedback from other relatives if you can, look to see if the home has a facebook page etc.

Under the 2014 Care Act new regulations were introduced - The Care and Support and After Care (choice of accommodation) regulations 2014 - giving people the right to choose their accommodation if the local authority are paying for it, providing that certain conditions are met:

Your right to choose a care home and location

If the local authority is paying all or some of the cost of your care, you should be told about your right to choose your care home and its location, subject to certain conditions. This is based on the choice of accommodation regulations. If you express a preference for a particular home and specified conditions are met, the local authority must provide, or arrange for, the provision of your preferred accommodation.

Conditions for approval

Once assessed as requiring a care home, you have a right to choose between different providers of that type of home, as long as:

the home is of the same type as specified in your care and support plan

the home is suitable for your assessed needs

the home is available, and

the home is willing to enter into a contract with the local authority, on the local authority’s terms and conditions.

Your choice must not be limited to settings or individual providers which the local authority already operates in, or contracts with, or those within their geographical boundary.

Written reasons for refusal

If the local authority refuse to, or is unable to, arrange a place in your preferred accommodation, they must provide written reasons.

See these links:

https://www.ageuk.org.uk/globalasse...ding_choosing_and_funding_a_care_home_fcs.pdf

https://www.legislation.gov.uk/uksi/2014/2670/regulation/2/made

If you have LPA for Health & Welfare then legally you are speaking for your mum so they should consider your right to choose the home, on her behalf. Does the care home you prefer know that your mum will be subject to section 117 after care following section 3, and have you provided them with a copy of her after care plan to confirm that they can meet your mum's specific assessed care needs? If you are certain that your choice of home meets all of the approval criteria then it's worth mentioning the legislation to the social worker and requesting written reasons for their refusal to place your mum there. It's always best to put things in writing via email if you can, so that you have an audit trail, particularly as your say that yours 'doesn't sound clued up' about things. Hopefully a suitable place will be found for your mum soon, and keep posting as you'll find lots of support and advice here.

 

[Linsac]

Thank you both for your replies, much appreciated. The CQC report for the home I have been offered was done in 2019. They also had a damning one the year before and it seems not a lot has improved. Normally I would go and visit to get a feel myself but they are only doing on line tours at the moment so I really don't think I could risk placing her here.

The MH hospital she is in is great, I am so impressed with her care and the added bonus is it is 5 minutes from my house and I am allowed to take her out. Mum will miss this when she moves to a care home so maybe I should just sit it out. She is desperate to leave though and get some home comforts.

 

[Weasell]

The staffing in a Mental health hospital is at a level they could only dream about
‘ out there’!
Everything is so risk assessed, and the answer to so many risks is ‘get more staff ‘!

I would definitely Wait and aim for what you want.
If it all fails to work the worst that can happen is you get what they would give you now?
If Covid kicks off again and you can’t visit her anywhere, where would you prefer her to be?
I would be dragging my feet.
Wishing you well
And a final thought if mum starts the ‘ not having a permanent home is making me unhappy’ just say the right things and let it wash over you. People with dementia are experts at hitting you with a guilt stick. Wherever she goes she will probably say ‘ I loved that hospital so much I was happy there’.

 

[Linsac]

Well we have a bit of progress today, support plans have been sent to 3 care homes that I mentioned to SS. The one I want hasn't received it though so I've asked for it to be sent again. SW has apologised for slow progress!

 

[Linsac]

Another question, SS are saying that only third party top ups will be accepted. I thought that first party top ups could be made these days?

 

[Louise7]

@Linsac Firstly, the local authority should provide at least one care home option that meets your mum's needs and does not require a top up. If your preference is for a home which does require a top up, usually these would have to be paid by a third party but there are 3 exceptions where first party top ups can be paid: if the 12 week property disregard period applies, a deferred payment agreement is in place or accommodation is being provided under Section 117 after care. As your mum has been on a Section 3, and her care/accommodation is being provided free of charge, it seems that Section 117 after care applies. In which case your mum can pay first party top ups, but check with social services to confirm that your mum is definitely subject to S117 aftercare.

 

[Linsac]

Thank you Louise, yes she is on a section 117 so it sounds like she should be able to do the top up rather than me. They have offered 2 homes as I mentioned previously which would likely suit her needs but did not have favourable reviews or CQC scores. I have turned them down so I have been told that the homes I have put forward myself would be subject to a to up which would be third party. I've emailed the SW but not heard back as yet.

 

[canary]

Be careful with top-ups as they can and do go up annually by a lot more than inflation.