Capacity Test


My Mum is 92 and lives alone in one room of her large house. She is completely reliant on carers who visit in pairs 4 times a day - the times of which are quite unreliable. She cannot move or weight bear and is reliant on the carers to move her from her hospital bed to the chair and the commode, wash and dress her and get all her food and drink. She is very deaf and becoming increasingly confused and forgetful when given information regarding everyday things. She constantly uses the telephone at all hours to mobile numbers but cannot hear when we answer. She is becoming incontinent and as a result will not drink in case she has an accident as the carers are limited on the visits they make and the times they can attend. She has temporary carers currently as the LA are unable to find a permanent company to fulfil her needs. This has been the case for 2 months since she was last discharged from hospital and lost her permanent care provider.

She has a medical condition which limits what she can physically eat and had a heart valve replaced 30 years ago which limits the pain relief and medication she can have. she has a visit from the district nurse every day to give her an injection in respect of her heart medication.

She is adamant she wants to stay in her own home but is becoming more confused and does not understand - or want to understand that she is not really safe there and the impact the wish has on everyone and that her safety is at risk. The Social Workers are less than helpful and say while she has capacity to make a choice this must be paramount. While my brother and I agree we do not believe that a proper capacity test has at any time been undertaken and the simple fact my mum says she wants to stay at home without understanding the impact makes the social workers life so much easier.

I need to understand what a capacity test involves, if there is a formal test and how and if we as relatives with POA are entitled to see the results. Also if there is a test are we entitled to challenge the findings.

I would be grateful for any advice on this as the daily needs and demands of my Mum on our families that live some distance away from her is becoming to difficult to manage. Social Workers push responsibility to us when it suits and remind us of our responsibilities legally but are unwilling to consider our feelings and thoughts when it comes to her safety. We are at a loss on where to go or what to do next.

It’s a difficult situation you are in.

In terms of any alternative accommodation for your mum - and I’m thinking ‘care home’ here at the moment - what is her financial situation? That will determine her options. If she owns the house she currently lives in, or has savings etc of over £23,500, then all her residential care will have to be self-funding. As a self-funder, she (or you for her) can choose anywhere you want for her to be - it’s a private matter for the family.

If, on the other hand, she doesn’t, then the council will pay for residential care - but they will choose, or at least, at best give you a limited choice, as not all care homes accept council-paid residents (mainly because the council don’t pay as high fees as private residents do!).

If the council are providing call-in carers/care-workers for her, then they will, as you say, prefer to continue doing that rather than pay for her to be in residential care, as the former is cheaper.

The whole issue of ‘capacity’ is very dodgy! As you have discovered. Others here know better than me, but it is still ‘difficult’ to ‘force’ someone into residential care if they are ‘adamant against it’. Only ,really, if they have reached the stage of mental decline where they lose legal capacity and have a DOLS slapped on them (Deprivation of Liberty), can they be ‘forced’ into care.

Id your mum owns the home she lives in, you also have an alternative option - which is to hire your own permanent live in carer for her. The cost is likely to be around the same as a care home (a care home will cost AT LEAST £100 A DAY for self-funders!), and it would mean your mum could potentially stay in her own home until she dies.

The only ‘issue’ might be releasing the funds to pay for the privately hired live in carer. That may take something like equity release or whatever (NOT wise financially) (a remortgage is less expensive!).

Do I take it that eventually you and your sister will inherit her house? If so, you could maybe ‘lend’ her the money (if you have it or can release it from your own properties!) to pay for her private live in carer until she dies, at which point you ‘get it back’ when you inherit her house jointly.

PS You say the social workers ‘remind us of our responsibilities legally’…

er you do not have ANY legal responsibility for your mother whatsoever!

Councils etc like to make us THINK we do (makes life easier for them, as you point out!), but of course we don’t. Not a single one of us has ANY legal ‘duty of care’ and if we have Poa etc we can renounce it at any time.

Do not be ‘conned’ by social workers telling you that you ‘must’ look after your mum. Not true.

Everyone should be concentrating on what she NEEDS, not what she wants.
Google "Mental Capacity Assessment (often referred to as an MCA).

It is a common trait of the very elderly that they become very self focussed, as their world has shrunk to a room. If the time has come for 24/7 care, round the clock care when there is always someone around to help, then the family needs to have a conference and discuss this.
IF she has over £23,000, then she could have a live in carer, but her money should be used - does anyone have POA?
Does she own the house?