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Social Care Assessment and Personal budgets

Discussion in 'I care for a person with dementia' started by emmamac, Oct 17, 2018.

  1. emmamac

    emmamac Registered User

    Sep 15, 2009
    92
    Hello everyone

    Today I am at my wits end. Last night I arrived after work to find mum had lipstick in her hair. Having dealt with that, I found her clean and dried underwear looking decidedly orange on top of the freezer. She infomred me she'd dried it in the oven! I tried explaining how dangerous that was but she couldn't really see why. I became stressed, she became sullen and miserable and I've been up since 2.30am stressing hugely. I am now sat at my desk with the door shut having just had a good cry.

    My question is this...after 6 months of trying we finally got a social care assessment 3 weeks ago. My understanding is that there will be some sort of care package but they are hinging it around food preparation only (she is obsessive to the point of ridiculous about cleaning...superfically the house looks immacualte - in practice there is food put in the wrong cupboards/rubbish tucked in flower pots/and the other day a plate put in the washing machine). When the social worker called last week he asked me how i saw a care package working for her. He tried to suggest we try Meals at Home but I refused as she won't eat a main meal at lunch time and getting her to eat involves more than just leaving the food on the side for her...she needs drinks pouring, food setting out on the table and some kind of encouragement to sit down and eat it otherwise it just gets hidden in a cupboard somewhere or fed to her dog.

    I asked about a personal care budget (mum has no savings or house of her own) as I'd like to use a local agency who are known to be very good. I was told that I couldn't use that agency as they weren't registered with the local authority and were too expensive - surely if I make up any difference that's not relevent?

    Can anyone tell me what I can and can't ask social care to do for mum and how a personal care budget works??

    I am due to go to Scotland next week as my husband's uncle has died so I've just called them to say mum will have no-one there for 4 days (in reality my daughter and a neighbour will go in) but I'm feeling out of my depth with knowing how to move any of this forward and know they will call any time to ask me what I want. Truth is I don't know...all I know is I need help and she needs help.....Emma
     
  2. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,233
    The care needs assessment should have covered all of the areas that your Mum needs help with, and a personal care budget would be provided to cover those specific needs. From what you have posted though, things have changed since last night as your Mum is now drying her underwear in the oven. This is placing her at high risk of harm and social services need to be informed of this - use the words 'vulnerable adult' and 'at risk of harm'. Obviously care visits would be better than meals on meals in view of the need to encourage your Mum to eat but I think in view of the safety risks when your Mum is left alone carer visits are not going to be enough. You need to make it clear to social services that your Mum is at risk of harm if left alone. Her safety has to be the priority now so residential care may have to be considered.
     
  3. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    3,035
    Nottinghamshire
    I feel for you. My dad is now in a care home but I remember the stress of trying to get a suitable care package put in place.

    In my area we have a choice of SS putting a care package in place or a direct payments account being set up so we can choose our own carers. I chose the direct payments method, but dad started as being self funding.

    One piece of advice I was given by dad's CPN when SS were taking a long time to make anything happen was to approach my chosen care agency and start carers myself. Obviously there is an element of risk to this as SS will only fund what they believe to be needed and you may end up out of pocket.

    As @Louise7 has said - your mum's behaviour is now putting her at risk so this needs to be made clear.

    My chosen agency were not on the council list but dad would have made up any difference between what SS assessed him as needing and any extra.
     
  4. emmamac

    emmamac Registered User

    Sep 15, 2009
    92
    Thank you both for replying. Mum is fiercely independent and I think if she went into residential care at the moment she would decline rapidly. I'd like to keep her at home as long as I can or until it becomes untenable for her wellbeing. I will get the oven disconnected - I told her on the phone this morning not to put anything in the oven and she laughed and said 'No I won't ...don't start on at me again' and laughed so hopefully she hs taken on board what happened - for now at least.

    I suppose my big question is this...l.can social services dictate who I use as carers if I get a personal budget? I know I have to spend it according to her care plan etc, but if they allocate say 1 hour a day to split into two half hour visits to prepare food, can I choose to spend 2 hours on one day and none on another if I am able to go in to provide the care on that day? I don't want to stop doing her meals every day and sometimes my cousin will take her out for the day so I just feel I need to have a flexible approach to her needs.
     
  5. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,233
    Here's some useful info about how a personal care budget works:

    https://www.ageuk.org.uk/informatio...essment/personal-budgets-and-direct-payments/

    If the local authority are managing the personal care budget then they decide which care agency to use. If you would prefer direct payments so that you can choose the carers yourself then you will need to request this.

    When my Mum was having carers at home - managed by the local authority - I still had an element of flexibility as to when they attended. Mum was allocated 3 x care visits a day but quite frequently I cancelled some of the visits if myself or my sister were there to help Mum, or she had medical appointments. I just rang the care agency directly and cancelled. However, cancelling a visit one day then requesting a 'double' visit the next is going to be difficult as not many care agencies would offer that sort of flexible contract, regardless of whether you or social services were paying them.

    Personally I found it better for social services to make all the arrangements with the care company and pay them directly as I work full time and didn't want the hassle of having to do that on top of everything else. I still had the flexibility to cancel visits when necessary though.
     
  6. emmamac

    emmamac Registered User

    Sep 15, 2009
    92
    Thanks Louise x
     
  7. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    3,035
    Nottinghamshire
    We always managed the care package to suit our routine. Dad would come to us on Sunday so at first only had a morning carer to help him shower and shave and give him breakfast. On other days this would be 2 or 3 visits. The company were flexible if there was availability but liked to have at least 24hrs notice. We were paying for a set amount of hours per week and didn't often need to shuffle them, usually only to accommodate appointments.
    They were also happy to start the package gradually to see what dad would accept and SS were happy to do this too.

    Eventually this needed to be increased to 4 visits everyday as dad became more and more dependent and could no longer get into the car.

    Every time the care package needed increasing the agency would ring SS to get the OK for increased hours. They also kept me in the loop by text and phone. It worked very well and helped dad to stay at home for a couple of months extra until he had a stroke and suspected heart attack and needed full time care.
     
  8. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,662
    Female
    On a slightly different issue, in view of the fact she's doing things which are outright dangerous (the oven incident) it would be helpful to ask OT to make a visit and do safety checks. They did this for my mother after she set off all the smoke alarms by setting fire to a crumpet under the grill (she had no idea why the alarms were going off and a neighbour had to intervene). I know you're going to disconnect the oven but there may be other safety issues which OT could identify and resolve. My mother stayed at home for a further year after the grill incident, although she had several hours of care a day (self funded).
     
  9. emmamac

    emmamac Registered User

    Sep 15, 2009
    92
    Thank you - that's encouraging to know and how I'd like to see care for mum unfold if possible.
     
  10. emmamac

    emmamac Registered User

    Sep 15, 2009
    92
    Good idea - thank you.
     

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