Self funded but stalemate

[bikeman]

Hi, my father was recently admitted to hospital. Soon after he was admitted the carehome where he was residing advised the hospital that they would not accept him back. They gave a variety of reasons.

The discharge team contacted me and wanted me to find another care home. However, I am reluctant since a) I'm not qualified to assess his care needs and b) the care home contracts I have seen want the 'notifiable person', me I guess, to accept joint financial liability.

Background,
He was originally placed in the carehome by social services following admittance to hospital during lockdown.
I was never given a contract or asked to sign one.
He is self funded.
I do not have POA but I do have access to his bank account and previously set up a sto to pay the previous carehome's fees.

Some care homes seem to be satisfied with demonstrating an ability to pay for two years. I could show this and I can arrange finance but I'm not prepared to accept any financial responsibility. Not sure if any would accept this without my signing a contract.

Before you ask, why I dont just apply for a deputyship myself now. The answer is, I already have access to his finances to pay his bills and so I have never needed to. I also want to avoid the complexity/bureaucracy and considerable cost of the required indemnity. I know many of you wont agree but I promised to meet his needs and avoid unnecessary costs. It also wouldnt avoid joint liability. So lets park that.

So where does this leave him? Do they have a duty of care to find him a place like they did before? Do you think they will just apply for a deputyship? If they went down this route would they tell me? How long would it take them? If I became aware of them doing this, could I contest it, would my application trump theirs?

 

[My Mum's Daughter]

As the care home refuse to have your Dad back, I'll assume that they've said that they can no longer meet his needs and I'm in a similar position. If it's due to mobility, he'll need a higher level of care which may involve a nursing home. If he's not returning due to aggression, then he's probably going to need a dementia nursing home or an EMI unit. These types of homes are more expensive however, if your Dad is assessed as needing some form of nursing home, the NHS pay towards his care (it's about £200 a week).

I agree that you're not qualified to assess his needs so you need to request a hospital social worker. They will visit your Dad and speak to you and the staff before deciding on what sort of care your Dad needs. You should then be given a list of appropriate homes.

I suspect that the hospital want the bed so they're pushing you to find an alternative home but the last thing he needs, is a failed discharge to the wrong home.

I will also not accept any financial responsibility, either for fees or top up and if I ever need care, I certainly wouldn't want my children to be out of pocket.

 

[mhw]

Askfor discharge to a nhs assessment bed. This will be funded whilst his needs are worked out and insist he is scored for chc or fnc funding by nhs as this is not means tested so whatever his assets that is irrelevant to them paying. If chc fails to find him having a primary care need it's passed to local authority social services to assess his care package and means test him for whos paying. Obviously as he was in a home before, who are refusing to take him back the hospital will regard him as a bed blocker and try to shove responsibility finding a way to get him out on to you. Don't sign anything, legally actually you can't anyway as you have no deputyship or lpa.
It's their duty of care to find him a safe environment for discharge to, and then let them squabble over who's paying ( they been doing this with my mum since she was discharged to an assessment bed mid feb)
As for the money side, sadly if he is tested by them and found to be lacking in mental cognition, and therefore unable to give valid permission for you to arrange any finances on his behalf, you are actually breaking the law. Even if you had an agreement before, any new transactions, are by definition new, and therefore he has not got capacity to give his blessing.
Deputyships are taking up 18mths atm so if they insist you get one, or social services apply for one, any funding will have to be covered by authorities and paid back.
If they do apply you will be served notice by the court and you have rights to apply to be party to the proceedings. You can be joint with the applicant, or you can lodge a counter claim. If you ask to be joint deputy they will still have to do all the paperwork.
The costs for the court case is around £370 and then another £400 for each hearing and annual accounts checks are charged at £320 by opg.
All costs come out of the sick persons funds not yours.
First things first though, insist on an assessment place and a chc test and tell them thats the only way they will get him out of the hospital, they soon set the wheels in motion then 👍

 

[SAP]

Ask for a D2A discharge to assess. This is usually a six week placement to assess your dad’s needs as these have clearly changed. I agree that you are not the expert here and as you also do not have POA for Health and Welfare that is a clear indication that the professional need to step in ( even if you did have this you cannot be expected to assess your dads needs) You can, after all just walk away and stop answering the phone, then what would they do? ( they would apply for deputyship and get in with it)
The contract issue is , I believe, down to poor wording and unclear intention. I think they mean that you would take responsibility to ensure payment comes from your dad’s account but time and again this question has come up. You are under no obligation to pay for your dads care but these contracts as so woolly they are not fit for purpose. Again stand your ground. If the hospital want the bed then let them put pressure on social services to find him an appropriate care home. Again, if you don’t communicate with them , they will have to take the lead.
I had a similar situation with my mum but the funding was different . I just took a step back and refused to be involved in the finding of an appropriate care home.

 

[Bod]

Hi,

Before you ask, why I dont just apply for a deputyship myself now. The answer is, I already have access to his finances to pay his bills and so I have never needed to. I also want to avoid the complexity/bureaucracy and considerable cost of the required indemnity. I know many of you wont agree but I promised to meet his needs and avoid unnecessary costs. It also wouldnt avoid joint liability. So lets park that.

So where does this leave him? Do they have a duty of care to find him a place like they did before? Do you think they will just apply for a deputyship? If they went down this route would they tell me? How long would it take them? If I became aware of them doing this, could I contest it, would my application trump theirs?

Beware, should the Bank discover he is mentally incapable, they are duty bound to freeze his accounts, your "unauthorised" access could be seen as fraud.
Lasting Power of Attorney may not at this stage be inpossible, depending on fathers understanding.
Should the LA take on Deputyship, you might not have any say in any matters regarding your father or his placement.
Yes deputyship is difficult to arrange, but is your only method of having some control of the situation.
The cost of getting deputyship can be recovered from the Doners finances.

Bod

 

[jugglingmum]

There are several points raised:

Many care home contracts include a term requiring joint financial responsibility. I just refused to sign this term and it didn't give an issue. (I actually think it would fail as an unfair contract).

As mentioned if the bank find your father has lost capacity the account will be frozen and your current access is illegal.

You need to apply for deputyship as a matter of urgency. All costs come from your dad's funds. This isn't an unnecessary cost but a legal requirement. If SS find out they would apply for deputyship and you would have bo control or influence and the costs would be considerably higher than if you apply as a panel deputy would be appointed who would charge a high hourly rate.

As to getting your father into a care home, SS don't tend to be interested if you are self funding, there is no guarantee they will accept your request for discharge to assess, and if they do look for a care home, they won't necessarily find the best match and it could be a considerable distance away. ie in the real world he might be dumped in the first home that'll take him. The exception to this is where someone has very difficult behaviour or been sectioned. A D2A bed often isn't set up for very difficult behind would return him to hospital/section him which case the system tends to work.

As to looking for a care home, a starting point is the behaviour and reasons given by the previous care home. Then contact appropriate care homes, eg EMI or nursing etc. I used an independent social worker found via Google when mum's behaviour meant she needed moving to EMI. I used mums money to pay for this. The social worker spoke to her care team and researched local homes, speaking to them to see if a suitable fit. She arranged viewings for me and I then chose a home. Many homes operate waiting lists so in a crisis like this you need homes with spaces.

The system will eventually find him a home but a long stay in hospital is likely to be detrimental to your fathers dementia and despite your lack of knowledge you are likely to find a better fit for your dad than SS.

 

[bikeman]

Thank you for your replies.

I've been reading the 'care to be different website'. One of the things they say is NOT to allow discharge to assess. They say this just allows the hospital to free up the bed and kicks the CHC/FNC assessment down the road so it may not happen. I've read that care homes tend to pocket this funding so it wont affect what he pays anyway. So why bother?

Who should I request CHC/FNC assessment from? The ward medical staff? The discharge team?

I'm interested to know more about joint deputyship with the LA. Would they actually go for this? Would I then be able to leave them to do the donkey work but have full visibility and signoff for what they do?

If deputyship is currently taking 18mths, then there's probably no point my applying anyway as he's pretty frail now.

 

[mhw]

You can tell them he requires chc test in hospital when also insisting on an assessment bed. They will tell you there's no point but TELL them you want it done before he leaves or he doesnt leave! Also ask for an OT assessment and the dementia care team in hospital to do a cognitive assessment all BEFORE THEY DISCHARGE HIM. Then in the carevhome they will then do another chc tick test diagnostic tool approx 7-10 days after leaving hospital as in a care home facility his needs will change. ( my mum marked worse as in hospital they down play how bad they are trying to get out of the funding via nhs).
No any funding either chc or fnc does not just get 'taken' by the home, if full chc funding is awarded basically there is nothing to pay by the patient and if fnc is given that IS PAID directly to the nursing home but has to be shown on monthly invoices and deducted off what's remaining for the client to pay.
Yes depending on how bad and how long the wait time applying for a deputyship may be futile, so hence better to let LA apply. Its their problem then. Also if he is decided mentally incapable it would be a good idea as his bank accounts will be frozen and whatever the result of chc/fnc someone will have to pay ( ie local social services) until the legal side is sorted.
As for would you be allowed joint deputy, you would have to put a good case to the court when you were served the cop14 ( I think it is giving you notice of their application) but the courts usually consider any relative who want to be involved favourably