Social Services Visit

[hawaii50]

Just an update on the social services visit. Had a really nice social worker visit today and she agreed that we can look at putting mum into long term care. Just need to decide which home we want and put them in touch with the social worker.
She was very helpful and I learned a lot about how to negotiate for NHS prices in homes that have higher private costs - especially when social work agrees that it is time for your loved one to be placed in a home. She sees no reason why I shouldn't be able to place my mum in the home I really like for the same cost as any other home - she knows others who have done so - so that was interesting and I will be breaking out the negotiating skills from the closet!!
She has agreed to the personal care weekly allowance (Scotland system) and then the nursing home assess whether she is due the additional allowance for nursing care. Of course this is able to happen as quickly as I want as my mum has a house to sell and is regarded as "self funding" for the rest of the weekly nursing home payment. If she wasn't self funding she would have had to go on a waiting list for at least 6 months - hardly seems fair this system for people with AD who have no assets. Mind you working hard all your life, struggling to buy and pay for your home only to have it taken to pay for care doesn't seem fair either. But I have to say that I am grateful that my dad took the plunge to buy their local authority house 15 years ago - he didn't know then that he was going to give my mum the ability to pay for her own long term care and be admitted in a timely manner!!! Bless him!
I will wait till my brother comes back from his holiday before we make any decisions - don't know how I feel now - when it comes to the crunch decision it is really hard to make as so many of you know. However I am running out of stamina fast......

 

[Skye]

Hi Elspeth

Glad you had such a helpful SS visit. I didn't know you could negotiate care home fees, so that's something I'll bear in mind.

Thanks for your post, it's very helpful for those of us 'north of the border.'

 

[noelphobic]

She has agreed to the personal care weekly allowance (Scotland system) and then the nursing home assess whether she is due the additional allowance for nursing care.

I know there's a lot of differences between Scotland and the UK, but am curious as to why the nursing home would decide on whether your mum was due the nursing care allowance. Is this also another difference, as I believe in England it would be decided by the PCT?

 

[hawaii50]

Hi Noelphobic
I am not sure that it is the same thing as in England. In Scotland you get a Personal Care Allowance of $145 per week towards the cost of long term care (attendance allowance is taken away) plus an additional £60 per week if nursing care is deemed necessary - this can also include heavy involvement in dressing etc and care because of reduced mental capacity. I thought social services decided if you were due the extra £60 per week but according to this social services person they rely on the opinion of the care home who assess if the person needs that extra level of care. So this was also news for me today.
It is very confusing the different system and legal differences between Scotland and the rest of the UK - and I think this forum allows you to see differences that you had no idea existed.

Skye
I am a sales person by profession and I would never have thought to try and negotiate fees in a care home - but having that information doesn't half give me the confindence to try and negotiate!!! It is worth a serious try anyway.

 

[Margarita]

an additional £60 per week if nursing care is deemed necessary - this can also include heavy involvement in dressing etc and care because of reduced mental capacity

I have always wonder how they deemed necessary in UK if they need Nurseing care , as My SW said my mother does not need Nursing care when she go to
Respite.

what does

heavy involvement in dressing etc

mean , as in helping them dress .

Glad to read that all went good with your mother SW

 

[noelphobic]

I am a sales person by profession and I would never have thought to try and negotiate fees in a care home - but having that information doesn't half give me the confindence to try and negotiate!!! It is worth a serious try anyway.

Yes, I found that very interesting! I know my mum's nursing home charges self funded residents £125 more per week than Local Authority funded residents, so it does seem as though you are penalised twice over for having assets. Good luck with your negotiations!

 

[jenniferpa]

I really think it must be different in Scotland. As far as I can find out (and I know it varies from pct to pct), nursing care is when you need a trained nurse (i.v.'s etc) Needing two people to lift you is social care.

 

[noelphobic]

I really think it must be different in Scotland. As far as I can find out (and I know it varies from pct to pct), nursing care is when you need a trained nurse (i.v.'s etc) Needing two people to lift you is social care.

I don't think you can actually have an IV in a nursing home. My mum is in a nursing home and she went into hospital a few weeks ago. They gave her IV antibiotics and fluids. You can be PEG fed in a nursing home and they can also look after people in wheelchairs, which I don't think care homes do. Also some people in nursing homes are on oxygen. Mobility may also be a deciding factor. The reason my mum's EMI home gave for not taking her back after breaking her hip was that she was not weight bearing.

Conversely, I have seen people in my mum's nursing home and wondered why they need to be in a nursing as opposed to a care home. However, appearances can be deceptive and I obviously don't know the medical history of these residents.

 

[jenniferpa]

There are people in my mother's nursing home with i.v.'s in them (well one anyway) but they do have a registered nurse on duty 24/7 - maybe it varies. They also do regular injections etc. However, the point is that nursing care (i.e. paid for) in England seems to be restricted to people who need the attention of a registered nurse. I know the "guidelines" talk about all sorts of things like whether the person is medically stable etc. However, since every PCT is different YMMV.

 

[noelphobic]

There are people in my mother's nursing home with i.v.'s in them (well one anyway) but they do have a registered nurse on duty 24/7 - maybe it varies. They also do regular injections etc. However, the point is that nursing care (i.e. paid for) in England seems to be restricted to people who need the attention of a registered nurse. I know the "guidelines" talk about all sorts of things like whether the person is medically stable etc. However, since every PCT is different YMMV.

Yes, you're right that a nursing home does have to have a registered nurse on duty around the clock. It would have been better if my mum could have had an iv in and then she wouldn't have had to stay in hospital.

I think being medically stable comes into the equation for fully funded continuing care rather than getting the relatively small amount of nursing care paid towards your fees. There are 3 bands of nursing care. There were supposed to be national guidelines coming in this year so that criteria for fully funded continuing care wouldn't vary between PCTs but not sure what happened over that.

 

[Grannie G]

Hi Elspeth

It is good to hear you had such a positive visit from the Social Worker, Scotland or not.

I hope you find the type of home you want for your mother and aren`t too traumatised by selling her house and clearing it out.

Take care

 

[Kayla]

Wheelchair use in a care home

When my Mum was in a Care Home and able to walk with a stick, I was told that they could take somebody in a wheelchair, providing the person could stand up, with the help of only one carer and transfer easily. Some people can walk a short distance indoors, but need a wheelchair outside, or to get to another room in a Care Home.
If two people are needed to help transfer a patient from a wheelchair, then a Care Home is not allowed to take them, and they have to go into a Nursing Home.
It is possible that a severely disabled person has no real nursing needs, so I wonder if there is another catergory of residential home - perhaps a "Care Home with Nursing Assistance".
It does seem a shame that people have to be labelled and pigeon-holed. It can be upsetting when elderly people are transferred from a Care Home, where they've been for some time, to a Nursing Home because they have become frailer and they don't know the staff or other residents.
Kayla

 

[hawaii50]

I have read all the replies with interest. I really can't say - it is as much a mystery to me. One of the nursing homes I visited said as far as they are concerned all dementia patients are in need of "nursing care" (not the one I want to use) I think it is another question of how long is a piece of string!!!
The care home I want to use has varying degrees of care - the ultimate dementia unit that they reach when in stage 7 of AD has access to one registered nurse who serves the whole of the care home.
It would be good to know a definitive answer wouldn't it. I am not sure my mum will receive the "nursing allowance" at the moment as she is perfectly mobile for now- just can't do anything for herself. I will await her assessment at the care home with interest!!! For the moment I am still confused even although I am in the middle of the loop of finding a care home and finding out how much it is going to cost!! will keep you all posted. I need to fill out the financial form for social services as the next step even although we all know the outcome!

 

[Skye]

You don't actually have to fill out the form if you know you're over the limit. If you leave the financial section blank, they assume you're going to pay.

On the other hand, if you think that at some stage your mum will fall below the limit, it's better to fill it out now, so that you have evidence of how her resources have fallen.

 

[hawaii50]

Thanks Skye - that was useful information - I hate that they dig into your financial affairs especially when you know you need to pay.
Elspeth