Social Services refusing a Needs Assessment

Discussion in 'I care for a person with dementia' started by Fleabag155, Feb 11, 2016.

  1. Fleabag155

    Fleabag155 Registered User

    Dec 30, 2015
    11
    Hi All

    Mum is deteriorating and her community mental health nurse has told me to apply to Social Services for a Needs Assessment under the Care Act.

    I have had two long, frustrating chats with social services, and they have refused to assess her at all because she will be self funding. They have told me they will only be interested when she has less than £23,250 in funds.

    I am not asking for a financial assessment, but a care assessment.

    Has anyone else had problems getting an assessment? Is it because she has dementia so they are basically not interested ? Can they refuse to give one at all? Can they charge me? I understood the 2014 Care Act put them under an obligation to do a needs assessment regardless of funding...has this changed?

    Is it worth the hassle? If so, how do I make them assess her?

    Thanks!
     
  2. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,776
    Salford
    They can't refuse under the 2014 care act; Section 4 for example says
    "4 Providing information and advice
    (1) A local authority must establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers."
    I'd go to the LA's website and find out what the complaints procedure is and copy your local MP in on anything you send.
    K

    http://www.legislation.gov.uk/ukpga/2014/23/section/4/enacted
     
  3. lea1611

    lea1611 Registered User

    Feb 11, 2016
    1
    Hi

    I have been experiencing something similar with my grandma who turns 91 next week.

    My grandma is currently refusing care- or more to the point she isn't willing to pay for it herself (she's to classed as a self funder)

    Over the past 6 months her memory has started to take a turn for the worse, she gets things mixed up, wanders out into the garden at all hours, contacts family members all hours of the day and night but physically she is still very fit she lives alone her house is spotless and for a 91 year old everyone cannot believe how well she's doing - aside from the memory loss. When she has good days she's great.

    A doctor from a memory clinic came out to visit her before Christmas and said that whilst she does have dementia she is too well physically and has the funds available that social services wouldn't be able to help - so i left it at that.

    Fast forward to a few weeks later i receive a phone call from her GP and was told I had 3 days to get some home care in place or she would be reporting me to social services as my grandma was being neglected - this is far from the case.

    I called the social services to explain my situation and express that she wasn't being neglected and that she needed care but wasn't willing to pay for it and was told pretty much the same as you - although they said they would be willing to come out and do a care assessment however as she was a self funder they then wouldn't be able to do anything - which then made me feel like i was wasting there time.

    There has to be some sort of help out there for people who can self fund but are unwilling to admit there's a problem and need the help?

    I feel your frustration.

    The GP cant seem to get her head around that council aren't able to help if the person has funds readily available.


     
  4. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    #4 Pete R, Feb 11, 2016
    Last edited: Feb 11, 2016
    No. Unless the person has capacity and refuses.
    No.
    & No nothing has changed. Some parts of the Act that affect self funders has been delayed but the obligation to undertake an assessment is not one.

    "Needs assessment
    6.13. Local authorities must undertake an assessment for any adult with an appearance
    of need for care and support, regardless of whether or not the local authority thinks the
    individual has eligible needs or of their financial situation."

    https://www.gov.uk/government/publications/care-act-2014-statutory-guidance-for-implementation

    Page 5 of this AgeUK FS also gives good advice.....
    http://www.ageuk.org.uk/Documents/EN-GB/Factsheets/FS6_Finding_help_at_home_fcs.pdf?dtrk=true

    Maybe time to start the "painful" complaints process.

    Good Luck.:)
     
  5. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    The GP can request an needs assessment if they really want to help.
     
  6. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,776
    Salford
    Hi Lea, welcome to TP
    The council can come and do an assessment and could suggest or recommend some help but it's up to you to organise it and fund it too.
    The GP sounds as much use as a "chocolate teapot" where did the 3 day deadline come from or indeed the allegation of neglect and it they're not aware of the attitude Social Services take maybe they need to get some training.
    Either way both you and Flea have the same problem getting them to accept help, they have a perfect right to refuse and it's very difficult to make them.
    K
     
  7. Fleabag155

    Fleabag155 Registered User

    Dec 30, 2015
    11
    Thank you people...that's what I thought! Looks like its complaints department in the morning then!

    Lea- Oh, how I feel your frustration. We have been trying to convince Mum that she would be better off in a home for months- myself, her morning carer, the GP, Practice nurse, mental health nurse, consultant, everyone, and it has got us nowhere.
    She has now become so convinced she is being threatened by imagined phone calls and strangers in the house that she has finally agreed (providing she can take her cat!), and now I'm hitting this social services problem......
    It's hard enough as it is, without them refusing, and being rather nasty about it to be honest, what they are legally obliged to do.

    After dealing with Mum, I don't know if I have the strength for a fight with the authorities..maybe the assessment just isn't worth it .
    I'm just so tired....
     
  8. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    This is a massive problem and boy do your Local Authority know it.

    The assessment is worth it. Get them on record as having been involved as soon as you can even if they decide they cannot help. If you need their help in the future the fact that you didn't need them now will be held against you and the battle will be so much more difficult. (Bitter experience:().

    Do you have Power of Attorney?
     
  9. Fleabag155

    Fleabag155 Registered User

    Dec 30, 2015
    11
    Hi Pete

    Yes, for both Health and welfare and financial...I got that just in time!

    Their whole attitude is just so pointless....I'm not querying her funding position, and if I complain, as it looks like I will, they will have to do the assessment anyway. Why not just do it in the first place, and save us all this hassle!!

    Thanks for the advice though....I'm worried about what will happen when the money runs out, and anything I can do to try to make life a bit easier then is worth it.

    I understand Kent (where Mum is) have a social services care home rate of about £400 per week- which is almost exactly 50% of what the fees are. If I get Mum on their books now then maybe it will make it better when we need their help- I think she can last about 3 years including money from the house, but that's about all. I am worried that they will come back on me for the shortfall if I don't tick absolutely every box now..... and I don't have that kind of money, so what would happen?..woiuld she be out on the street? placed in a cheaper carehome far away in a less expensive area? I need to protect her, and me, but heavens, they don't make it easy!
     
  10. bemused1

    bemused1 Registered User

    Mar 4, 2012
    3,402
    What are you expecting to be the outcome of a needs assessment?
    My husband has never been diagnosed, never had a needs assessment because he flat out refused. We are self funding and I look after him myself with the aid of carers. Social services are aware and we have never had a problem getting help with equipment to which he is entitled.
    We were told much the same , that it they did a needs assessment they would then do nothing because he refused. So carers have been arranged by me, and believe me it wasn't easy in the beginning.
    So I'm just wondering what it will achieve? Your mum still won't accept it and cannot be forced unless she is deemed not to have capacity.
     
  11. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    Excellent news on PoA and I agree their attitude is pointless but also against the law.

    As your Mum has a house may be reason why your LA don't want to help. If she stays at home and does not have substantial other funds then the LA may have to contribute as the house is disregarded. If you decide to place your Mum in a home and sell her house then that option is no longer available and she will become self funding till you reach the £23,250 threshold. The New Care Act states that people should be kept in their own home for as long as possible but that option normally costs an LA more.

    Since you say her funds, with the house will only last 3 years you have to be careful where you place her and try to find somewhere acceptable for as long as you think she will live. (horrible isn't it:mad:) Once the LA become involved they are obliged to offer you at least one home that can meet your Mums needs within their budget.( I thought my LA was bad at £410 and for that they could only provide a shared room.:mad:)

    If you do not like this placement then it is only then that they can ask for a top up.

    Please keep posting on how you get on.

    :)
     
  12. Fleabag155

    Fleabag155 Registered User

    Dec 30, 2015
    11
    Hi Bemused

    I'm trying to protect Mum in the future. I'm sure I've read that if you don't have a needs assessment as early as you can, it will be looked on against you when you need to apply for state funding. Since Mum can only fund herself for maybe 3 or so years, I need to make sure nothing interferes with her claim for state funding when the time comes.

    At the moment, I have organised all her care, which, such as it is, is privately funded, and I am aware care home fees will be met by her until her resources are almost gone. I'm just trying to make her position as safe as possible for the future
     
  13. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    #13 Pete R, Feb 11, 2016
    Last edited: Feb 11, 2016
    If you can afford to self fund for the duration of the persons life then I totally agree that if you also have the will and spirit then do your own thing and leave the LA well out of it.

    My suggestion to fleabag155 is based on the fact the money will run out in just 3 years and from my own experience.

    I had moved back to the UK to help my Mom 12 years ago. When she broke her hip in 2011 I was initially told she would be in for 8-12 weeks. After 3 weeks she refused SW help at home and I stupidly agreed that I could look after her, even though she was doubly incontinent, so she was released. It was not easy but we coped.

    In 2014 her health got much worse and she needed to go into a NH. Thankfully her Dementia means that most of the time she still thinks she is at home.

    As she is not entitled to an automatic disregard for her house so I could continue living there I will eventually be made homeless. Even though I applied for a discretionary disregard because of giving up my own home and then caring for my Mom for 12 years the LA refused as there was no record of my Mom ever needing SS help till 2014. I just thought I was doing the right thing, not only by my Mom, but also the state.

    That is why now I advise that even if you will never need help from the state you should always request it as soon as you need it even if you decide to go your own way.

    The law states you are entitled to a needs assessment. Declining one (or not insisting) may come back to bite you in the "but" and there is no going back.

    :)
     
  14. bemused1

    bemused1 Registered User

    Mar 4, 2012
    3,402
    SSorry fleeabag and pete I wasn't being critical it was a genuine question. It may vary from area to area but I'm still not convinced that it's a necessary stage. As to whether you think you have enough money, that's a bit of a 'how long is a piece of string'question. I'm still not convinced it's a valid exercise where it can cause more upset for the pwd. But that's my opinion based on our situation with our council
     
  15. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    Never thought for the slightest moment you were being critical.:)

    Just my opinion that it is better to have some thing you may never need that regret never having applied for it.

    A needs assessment doesn't have to be intrusive although unless I am there Mom steadfastly refuses to participate, much to the annoyance of SS, and does get upset.

    She soon forgets though and it shows to me that something of her past life still shines in there if only a flicker.:)
     
  16. Fleabag155

    Fleabag155 Registered User

    Dec 30, 2015
    11
    No offence taken Bemused, and thanks for your input Pete. Sounds like you are in a rotten situation.

    I know the NHS is in financial trouble, but a lot of the problems we, as dementia carers seem to have are not money related- just a system with so many basic cracks, both procedural and substantive, that it is a wonder we don't all fall through them and disappear. Surely it doesn't need to be like this???? Wish someone, somewhere would actually THINK about what they are putting into place before doing it....perhaps actually asking those of us who use it might be a start! Making life as difficult as possible for as many people as possible for no apparent reason, seems a fairly rubbish reason to go to work every morning- but clearly it works for some of the people who design the system and others who get to put it into practice.

    Sorry, rant over....
     
  17. Chrissie B

    Chrissie B Registered User

    Jan 15, 2019
    80
    Female
    North Yorkshire
    Firstly Lea and Fleabag, my best move so far in a similar situation was to get a support worker. I got one because I went to a memory clinic held at my doctor's surgery, but if they don't do one, then ask at a local Alzheimer's daycare centre if you can visit for a chat, and ask them. Perhaps someone who lives in your area and is on this forum knows how to access one. A support worker will help you apply for everything you are entitled to, it's a first step you need to make.
    Ask their local council if your mum/grandma has to pay council tax, even if it doesn't seem like any big savings, you need to apply for these things along with attendance allowance.
    Lea, it may seem to you that your doctor is not being on your side, well that's what it looked like to me, until I thought about it from an outsider's point of you. Don't take it too personally if your grandma has been putting in a complaint about you to him. My mum came up with some horrific stories about her friend in her early middle stages of Alzheimer's. claimed her friend had a baby out of marriage and had sold it so her husband wouldn't find out, (she actually had a miscarriage and could no longer have children because of it). Claimed I should be grateful because she and my father adopted me, (not true in case anyone is wondering about smoke and fire). My sister has been accused by her of neglecting her small children, ( her youngest is 35 years old, and has just taken a year off work to travel around the world) Sounds like doctor has either been hoodwinked or has concerns that you may not be aware of, speak to him. Wouldn't hurt to ask him if he would be willing to sign a form from the council to back you up that your grandma has severe mental problems when you get the form from them. Try and find out what his concerns for your grandma's health are, use your Power of Attorney of Health to get an appointment with him at a time your grandma is not with you.
    Best way to get a needs assessment if you want one, (and why not, it really doesn't hurt, provided you know that they won't pay for anything) is to ask about something you know they will provide. Certainly in Lea's case, I would ask if they would come and give you a needs assessment because you would like to find out about a panic button because you are worried that your grandma might get lost whilst wandering, or fall over and be unable to get help because of her mental disability, and that you wonder if she should have an alarm on her front door in case she wonders off at night. Don't do this online, don't go through any other source except for the Social Services, if they tell you that you will have to pay for it, explain to them that you do have power of attorney and you feel that this should come out of your grandma's money if necessary. You don't have to sign up for any of this unless you feel it's a good idea, but it should persuade them to come and listen to you. Ask for a meeting at your grandma's house if at all possible, and don't ask for her permission, sounds like she's not going to be very compliant.
    I don't know what it is, but certainly round here this seems to be something that Social Services are trying to push regardless of how suitable it is. If they ask about your Grandma's money, tell them you will look into it, but can they come and do a full needs regardless. It doesn't really matter if they want to do a financial assessment as well, you already know it will tell you that your grandma is self-funding and is not entitled to very much, but actually, it is a very painless procedure, so if they want to make a few quid for doing one that they already know the answer to, let them. Having said that she would be entitled to handlebars to get up and down stairs, or into the shower, possibly a seat if it's a walk in one, a rail around the toilet seat if she is a little unsteady getting on and off the toilet. She should also be entitled to equipment to help her get in and out of the bath. Anything that is small is usually a freebie which strangely is not means tested, and if they have nothing left in the kitty for these things they will tell you to apply for them from Welfare, but let them decide on that during your needs test.
    £400 a week sounds very cheap for a care home. Round here the cheapest room is £850 a week, and I live in the North where apparently it is supposed to be so very cheap. Whilst my mum is self-funding, I have opted for a live-in carer, which may be slightly more expensive than a care home because of bills as well, but it's not my money, it's my mother's money. I did put her in respite care for 1 week she hated it, I had to go down every day to sort her out because they kept ringing me, so I opted for live in-home care for her. You may feel right now that your grandma has 3 to 4 years left before needing help, but I think anyone on this forum who has had this going on for longer, will be able to tell you that things can change quite dramatically over a very short period of time without much warning, and the more they need help the more expensive it becomes.
    Now you would think that Social Services would be keen for you to save as much money as possible so that you don't run out of funds, but I actually found during my mum's needs test, their main goal seemed to consist of advising me on how to spend as much money as I could out of my mum's money so as to get down to the capital threshold as soon as possible.
    I have been told by the needs assessor that once my mum is no longer self-funding that they will recommend that she goes into a care home, and since she doesn't own a house, I think the decision is irrelevant of that.
    One of the things my support worker told me, was that if you don't think you are getting listened to by the person doing the means test, you are allowed to ring up the Local Authority and ask for a second opinion, so if there is a clash of personality, you don't actually have to put up with it.
     
  18. Beate

    Beate Registered User

    May 21, 2014
    11,746
    Female
    London
    You do realise this thread is three years old?
     
  19. Rosettastone57

    Rosettastone57 Registered User

    Oct 27, 2016
    1,062
     

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