Transferring to another LA area & Funding

[Mimi1977]

Evening all

Can I ask for any advice on where I stand holding my ground on a new placement and the issue of money.

Background.
My mum is under Section 117 mental health after care. For two years she has been in a residential home. She's quiet, mobile but gets depressed as she wants to go home. This year between Jan to now she has been on a psychiatric ward 3 times. Her current home gave her notice to quit a month ago. A new placement has to be found. The LA found 3 but from CQC website 2 don't look good to me. My mother has EMI needs as she apparently has behavioral problems, cant say I have witnessed much of these when she is well and not low/depressed.

I do not live in England, I have to fly in, travelling time from my house to her is 7 hours. I have a family member on the other side of London who has a good home on her doorstep, has had her father and mother in-law as residents - CQC have Outstanding & Good assessment for the Nursing and Care home on this site.

I would like my mother to be placed there. The benefits are that my cousin will visit every other day when I am not there - she'd visiting her mother in-law, so she can keep an eye on my mothers needs - new clothes etc and I will have somewhere to stay when I come over, currently have to stay in hotels or BnB - all costly.

My mums present LA have said that the shortfall between care cost of new home and what they pay is 720pwk. I am willing to top up but not that much per week. I understand that after a year, my mum would revert to the funding support of the LA in the new area.

My issues:-

Right now they want my mum out of hospital, but they cant even find a suitable interim placement. I am sure the LA is under pressure from the hospital. Should I stand my ground and say I want her to go to the new place and ask them to come up with more money. I know from a relative who did the same as me, that the LA eventually relented, it was taking 6 months and still no placement but they found a place and they eventually agree to pay. Plus I could negotiate with the home, I dont think the placement people in the current LA do much of that and of course they want to pay the minimum.

Under section 117 can I top up? My mum has some money and her pension and work-place widows pension. I have EPA.

Any advice/strategies gratefully received.

 

[nitram]

Under section 117 can I top up?

Both third and first party top ups are allowed when s117 funded.

 

[Kevinl]

As she's section 117 then first party top ups are allowed so you can use her money to pay at least part of the top up.
If the LA can find somewhere that can meet her needs then they've fulfilled their obligation, if you want to put her somewhere that cost £720pw more that's up to you, the LA may up the budget a bit in certain circumstances but that's rare in my experience.
K

 

[jenniferpa]

I understand that after a year, my mum would revert to the funding support

You may be correct as this is 117 funding but I'd want this in writing because if that was "normal" la funding she would remain "ordinarily resident" in her original la even if she was be placed out of area. It's quite possibly different in this situation but I'd want more than an understanding.

 

[Beate]

I can only go from what our SW said and that is that they could place OH anywhere in the country and his original council would still be responsible for him afterwards.

 

[jenniferpa]

I know that's the case if you are being funded in the normal way by your local authority: you remain the responsibility of the original la. I just don't know how it works with 117 funding.

 

[jenniferpa]

19.65 Although any change in the patient’s ordinary residence after discharge will affect the local authority responsible for their social care services, it will not affect the local authority responsible for commissioning the patient’s section 117 after-care. Under section 117 of the 1983 Act, as amended by the Care Act 2014, if a person is ordinarily resident in local authority area (A) immediately before detention under the 1983 Act, and moves on discharge to local authority area (B) and moves again to local authority area (C), local authority (A) will remain responsible for providing or commissioning their after-care. However, if the patient, having become ordinarily resident after discharge in local authority area (B) or (C), is subsequently detained in hospital for treatment again, the local authority in whose area the person was ordinarily resident immediately before their subsequent admission (local authority (B) or (C)) will be responsible for their after-care when they are discharged from hospital.

I don't find this entirely clear tbh but I think it's saying that the original la remains responsible.

 

[allchange]

The rules re responsible LA/CCG changed from 2016 to stop them moving S117 people out of borough then dumping their costs on the new LA/CCG

Google dacbeachcroft.com/en/gb/articles/2016/august/section-117-aftercare-the-changes-at-a-glance

The key bit is

Summary
The legal position for patients discharged onto Section 117 aftercare on or after 1 April 2016 is now relatively clear - i.e. responsibility for Section 117 aftercare services falls to the Local Authority and CCG for the area where the patient was ordinarily resident (or resident, if they had no ordinary residence) immediately prior to being detained under the Mental Health Act. Neither GP registration (for CCGs) nor the usual deeming provisions around ordinary residence (Local Authorities) come into play for cases going forward.

However, the position in relation to Section 117 remains complex, with a number of issues still unclear, particularly when trying to unravel CCG/Local Authority responsibility for periods prior to 1 April 2016.

In practice, there also continues to be considerable confusion arising from the mis-match between how responsibility for Section 117 services is determined as compared with responsibility for other health/social services, perhaps fuelled by the hope that changes in the law (particularly the Care Act) would bring greater clarity and consistency than they have.

 

[Pete R]

I don't find this entirely clear tbh but I think it's saying that the original la remains responsible.

What it is saying is original LA are responsible. Doesn't matter how many moves are involved.

However if the person was ever discharged from Sec117 Aftercare and then some time later sectioned again, the new LA would be responsible.

 

[Pete R]

My mother has EMI needs as she apparently has behavioral problems, cant say I have witnessed much of these when she is well and not low/depressed.

I have a family member on the other side of London who has a good home on her doorstep, has had her father and mother in-law as residents - CQC have Outstanding & Good assessment for the Nursing and Care home on this site.

I am going to be a tad blunt but if your Mother does not have behavioural problems it is probably doubtful that she would be under sec117 Aftercare.

With that in mind do you know if this home near your cousin would be able to meet your Mother's needs and be willing to take her?

 

[jenniferpa]

I think we all agree then that despite what she may have been told, @Mimi1977 is looking at an ongoing top-up of 720 pounds a week not just for a year, but for the rest of her mother's time in that home should she choose to place her there. Plus of course the inevitable increases.

 

[allchange]

I'd guess though that the council has in mind that the LA/health pay a total of £500 to £600 a week. However not many homes would take a S117 person for this amount. Many would also want additional 1 to 1 hours which increases the costs considerably. The OP should make sure that her mother is only topping up for the difference between an available viable in borough placement and the one that she wants, as has been said if they have a place and are willing to accept her.

No way should the OP personally agree to fund the shortfall, which as stated may increase rapidly year on year.