Social Services claim father's 'needs being met' but I don't agree

Spinderella27

New member
Jan 26, 2020
4
My father who has dementia, has been in a care home that I hate for over 4 months. I strongly believe his needs are not being met for lots of reasons (dignity, wellbeing, emotional and physical care) and want to move him to a home that is more expensive but SS disagree, say his needs are being met and won't pay the shortfall. I have asked them what framework/benchmarks they use to judge this and they said they used the 'professional judgement' of our case worker (who has now been signed off sick). How can I challenge this to get him moved? He is deteriorating on a weekly basis so I need to act fast.
 

silkiest

Registered User
Feb 9, 2017
100
@Spinderella27 i've seen on other threads that there are independent social workers around that could be employed to re-assess. Sorry I don't know how expensive they are or how to find them but it worth be at least having a chat with one.
 

canary

Registered User
Feb 25, 2014
11,314
South coast
Hello @Spinderella27 and welcome to DTP

Unfortunately, if the person with dementia is LA funded they only have to find one care home that will accept their rates and can meet their needs, so if you cant afford the top-ups (and, lets face it, not many can) then you are going to be restricted in your choice.

Rather than challenging the SW to show how the present home is meeting his needs, it would be better to show the SW how this home isnt meeting them. Use specific examples rather than woolly phrases like "they are not treating him with any dignity". Instead, explain how they arent treating him with dignity. Dont go for things that could be the same in any care home - eg dont talk about him losing mobility because that could be the progression of dementia and not the homes fault.
Good luck
 

Palerider

Registered User
Aug 9, 2015
1,283
North West
I agree to some extent with @canary, there were issues with where mum was initially and it took alot of delving into in a very short space of time to look at what the CH wasn't meeting in terms of mums needs and a few moments of me making myself clear to the CH. Always leave a paper trail though, don't just rely on verbal exchanges, as the CH and the SW can deny these (not necessarily intentionally)
 

Jessbow

Registered User
Mar 1, 2013
2,948
West Hertfordshire
I agree with Paleride.
You need to be specific, about what is and isn't being done, AND be realistic in you expectation in how things can be changed to make it better

you need to be clear about what is deterioration due to dementia, and what is down to their lck of care/attention ( whatever)

if you want him moved and can afford the difference in fees, go ahead, but you may find things are not a lot different. Sometimes situations are not 100% what we'd wish for for our loved one, but have to sometimes consider the care they recieve is adequate
 

Spinderella27

New member
Jan 26, 2020
4
Thanks everyone for your replies, very helpful. Basically his personal care is very poor and they are not respecting his dignity and or providing any sort of emotional wellbeing. I have seen another care home which I feel will give him a much better quality of life but as I said, initially they said his current home is meeting his needs so they won't pay the top up (we are paying out a third of the monthly fees). They are not which is what I would like to challenge but there doesn't seem to be much transparency about how they are making these judgements.
 

Palerider

Registered User
Aug 9, 2015
1,283
North West
Good point @Jessbow

I would push forward with this and raise each issue bullet pointed on what they are not meeting (by email or letter), this may well force a notice to quit, but if the home does this then you have room to argue for an alternative you have found providing the fees can be resolved. As you are paying I think there needs to be a wider perspective here from the SS. Do you have LPA for finances etc?
 

Spinderella27

New member
Jan 26, 2020
4
These are my notes so far....thanks for your help! Not sure about the detail on the funding - my mother pays.

Personal dignity

  • Being dressed in dirty clothes (not just once but have seen a number of times)
  • Wearing clothes that are not his (that are also dirty)
  • Personal hygiene not being addressed e.g. regular showering, hand washing after toileting - (ignoring physical care needs from the Govt guidelines document 'No Secrets: guidance on protecting vulnerable adults in care' chapter 2.7) - expressed some anxiety today at the thought of a shower and told me that is depended on who ‘administered it’ - no proper shower in en suite, hand spray only
  • Dirty and untidy room - the toilet is dirty, and I found clothes piled in the bottom of the wardrobe, puddle of liquid on the floor (fall risk) broken glass from a photo frame found on his drawers, a glass on the floor next to his bed, messy wardrobe with clothes on the floor.
  • Dirty and worn bedding, two pillows bought for him gone missing - he complained about poor bed quality
Emotional wellbeing
  • Has been placed with advanced dementia patients who cannot speak/hold even a brief conversation
  • Because he has no one to talk to he is lonely and isolated with little social interaction
  • Little stimulation (NICE guidelines 'Offer a range of activities to promote wellbeing that are tailored to the person's preferences’.) -mostly sitting in living room watching endless television, none of which is what he enjoys watching
  • Mood has lowered significantly in the last month - told me he would like to be somewhere nice for the last few months of his life and how unhappy he is
  • He has become more anxious/distressed
  • Cannot access anything that gave him pleasure in his life
  • Little evidence of any personalised, person-centric care. I've never been introduced to a personal carer (or anyone in fact)
General
  • Unhygienic environment - constant smell of urine throughout the home
  • Little choice in any daily decision making
  • Not well kept environment outside, rusty gates etc
  • Needs to be nearer his daughters rather than wife for his wellbeing as they need to be more involved with his care and see him more often (the local authority has a legal duty to meet the needs of the person with dementia and to act in his or her best interests. The family could argue that the person has a need to be near to their family. If this is written into the care plan, the local authority must try to meet this need. Case law states that social services are not allowed to put someone in a home further away simply because it is the cheapest)
 

Palerider

Registered User
Aug 9, 2015
1,283
North West
Ok on a quick look I think you will have to mostly drop the personal dignity issues, these are the biggest problem because a pwd can refuse all of these things and if they genuinley are refusing then the CH has the right to adhere to this. Just to note I bought mum a new quilt and bedding, it went missing because she had soiled it and has to go out to be washed before being returned to the unit same with her pillows and it takes time to return sadly. Have asked about this?

A pwd may well refuse any help with personal dignity, so in what way is your relative different?

I think your points on emotional wellbeing with me strike a higher concern, if lonliness is a real issue then this needs to be acted on, the whole point of a CH placement is to ensure wellbeing including feelings of lonliness and exclusion, which may well be leading to depression, increased anxiety and a general decline that would not happen if these needs were being met appropriately
 

Palerider

Registered User
Aug 9, 2015
1,283
North West
Just to say I had to delve into mums care for more serious matters that came to light. She is now safe and I have to say going with my gut instinct and how mum had become withdrawn about matters paid off. I had to fight with the SW to get my point over to her, but in the end my complaints brought it all to a conclusion. Its not easy but you do have to be an advocate and fight the pwd's corner sometimes and you also have to listen to others experiences
 

Baker17

Registered User
Mar 9, 2016
396
These are my notes so far....thanks for your help! Not sure about the detail on the funding - my mother pays.

Personal dignity

  • Being dressed in dirty clothes (not just once but have seen a number of times)
  • Wearing clothes that are not his (that are also dirty)
  • Personal hygiene not being addressed e.g. regular showering, hand washing after toileting - (ignoring physical care needs from the Govt guidelines document 'No Secrets: guidance on protecting vulnerable adults in care' chapter 2.7) - expressed some anxiety today at the thought of a shower and told me that is depended on who ‘administered it’ - no proper shower in en suite, hand spray only
  • Dirty and untidy room - the toilet is dirty, and I found clothes piled in the bottom of the wardrobe, puddle of liquid on the floor (fall risk) broken glass from a photo frame found on his drawers, a glass on the floor next to his bed, messy wardrobe with clothes on the floor.
  • Dirty and worn bedding, two pillows bought for him gone missing - he complained about poor bed quality
Emotional wellbeing
  • Has been placed with advanced dementia patients who cannot speak/hold even a brief conversation
  • Because he has no one to talk to he is lonely and isolated with little social interaction
  • Little stimulation (NICE guidelines 'Offer a range of activities to promote wellbeing that are tailored to the person's preferences’.) -mostly sitting in living room watching endless television, none of which is what he enjoys watching
  • Mood has lowered significantly in the last month - told me he would like to be somewhere nice for the last few months of his life and how unhappy he is
  • He has become more anxious/distressed
  • Cannot access anything that gave him pleasure in his life
  • Little evidence of any personalised, person-centric care. I've never been introduced to a personal carer (or anyone in fact)
General
  • Unhygienic environment - constant smell of urine throughout the home
  • Little choice in any daily decision making
  • Not well kept environment outside, rusty gates etc
  • Needs to be nearer his daughters rather than wife for his wellbeing as they need to be more involved with his care and see him more often (the local authority has a legal duty to meet the needs of the person with dementia and to act in his or her best interests. The family could argue that the person has a need to be near to their family. If this is written into the care plan, the local authority must try to meet this need. Case law states that social services are not allowed to put someone in a home further away simply because it is the cheapest)
I hope you don’t mind me asking but what does his wife think about her husband being moved further away from her?
 

Spinderella27

New member
Jan 26, 2020
4
My mother and I share the LPA and she is happy for him to be nearer us so we can visit him more often thereby alleviating the burden on her. He would be equidistant between us and her in the new home.