Care Home Fees- questions about LA contribution

All about caring
21

Thank you for all your response. It’s good to know it’s not just us but so sorry you’ve all had to go through similar experiences.

It’s now three months since the hospital said Dad was fit for discharge. The council are still refusing to pay for the additional care that the hospital OT says he needs so we’ve had to start legal action on this as well as the personal injury claim (for the broken arm) but I understand it could take ages to resolve. In the meantime relations with staff on the ward are a bit strained (they cancelled another family meeting this afternoon an hour before it was due to proceed and then, after I had left the ward, tried to reinstate it- went back to the ward and they had left: agh). I feel like we are treading through treacle it’s awful. Dad is very depressed and getting a bit ratty ( said I looked like a tramp today - but I know I do look exhausted as I’m not sleeping and he can’t really see so trying not to take it personally). It’s so hard - I feel very lonely, can go days/weeks without anyone saying anything nice or asking how I am. When Dad is feeling okay im fine but when things aren’t so good it’s so hard not having any support. I know I need to be strong and pull myself together - just a bit weepy at the moment but will get there. I know I need to focus on what Dad needs. Anyway sorry for offloading- I just meant to say thank you!

22

Faye, it feels like the loneliest place in the world. Does dad have an advocate to deal with Social Services? You should have one too. Make sure you request them in writing from SS, sent by Recorded Delivery.

23

You are definitely not alone, we’re all here to help, share experiences. Your post has helped me realise what happened to my Mum is probably illegal. I received a phone call on a Monday morning, TELLING me that the hospital Mum was in needed the bed, she was on her way to a nursing home. No choice, just your Mum is being taken here, deal with it.

It seems everything nowadays is so difficult, especially when local government is involved, they are desperate to save every penny possible.

Persevere, keep fighting and I also looked like a tramp for near on six months, nothing wrong with that as long as you are polite, forceful and determined to reach the end goal. Which is your Dads best interests and safety.

24

Thank you for your responses- it’s so good to know we’re not alone.

Social services haven’t appointed an advocate for Dad (or me) yet. But as they don’t turn up for meetings, haven’t done a care assessment or much else in the past few months I am not holding my breadth. Fortunately we’ve got a very good solicitor helping with the care package (a different one for Dads injury claim).

Stephen- your comments about also looking like a tramp did make me laugh. Am thinking of doing photos of life before and after being a carer (like they do for drugs- would also be truly shocking!!).

I’m sorry the hospital have been treating your Mum so badly. Tonight our solicitor sent over a letter they had received from the council saying they still want Dad to go into a home - neither Dad not I want him to go there. I appreciate he might have to one day but hopefully it will be when he needs to go rather than because the council can’t find / won’t pay for carers in London! Anyway we are going to keep pressing back- just need to get the energy together. It’s so hard when you are doing everything on your own. Thank you.

25

Faye, you are NOT alone. You have many of us here on your side, armed with knowledge, and now you have not just one but 2 solicitors, that’s a huge improvement from where you started.

Just try to post a little more often so we can help and support you, even if it is just one word “surviving” or “drowning” and that will prompt messages of support.

You are doing incredibly well in some of the most difficult discharge circumstance I’ve ever heard of. When it is all resolved the fallout from the official complaints will be massive. Just stick in there. We are rooting for you
Xx
MrsA

26

Thank you - that means such a lot. I’m so grateful.

We’ve had a horrid few days - the local authority have now questioned my fathers mental capacity to make a decision about going into a home. The social worker first suggested the idea to me - I said I didn’t think a residential home would meet his current needs or be in his best interest (obviously may well be different in the future). They then said as I don’t have power of attorney they would get a decision from him. They asked Dad, whilst I wasn’t there /he didn’t have an advocate , but a nurse who was present said he was very clear he wanted to go home not into residential care (as he says every time it’s raised). Apparently the social worker subsequently did a mental capacity assessment (the hospital claim they weren’t involved and haven’t got a copy) and she concluded he doesn’t have capacity to make a decision about where he lives. As a doctor in the hospital only recently (literally I think the day before or after) said he had capacity to agree /sign up to an eye operation Im hoping this will be challengeable.

Although I appreciate each decision is made on its own merits i would have thought that given he was assessed as okay to make a big risky decision one day(he’s blind in one eye already) it would at the very least be an indication that he could at some point make his own decision re: living arrangements? I suppose it will end up with the court of protection? One for the lawyers I imagine…

It’s so frustrating and seems like putting Dad though unnecessary upset (he told the dr today ‘I’m not a vegetable. I might not know what the year is or where exactly we are but I know I want to go to my home, not a residential home, and I will need carers to be safe’) - I couldn’t help crying (in anger and sadness?)

My Dad has heart and renal failure. We know he will eventually most likely end up in nursing or palliative care. However he’s not ready for that yet. He was managing well at home and is only in hospital as the ambulance contractors broke his arm (negligently) and now the council , understandably, don’t want to pay the extra care costs. Unfortunately we are told legal action with take a long time and Dad is stuck in the hospital with all that entails in the meantime!!

I’m sorry for ranting it just all feels so frustrating and unfair. Oh well- at least we have each other and , as you have all shown, it is possible to get through these things. Thank you for all your support and kind words. It really means a lot. Thank you.

27

Hi Faye,

Cutting through all the rubbish that is going on, the bottom line is that dad’s injury was caused by the actions of the hospital. I would write to the CEO of the hospital, threatening to go to the press if they don’t sort this out within 2 weeks. They won’t want the publicity.

Legally, there is a duty to put dad back into the position he was in prior to the accident, i.e. living at home. The hospital had a duty of care, they breached that duty, and there was resultant damage. Therefore they have a duty to do everything it takes to enable this to take place.

Remember this and just keep repeating it like a stuck record player.

None of the usual involvement with SSD is relevant.

28

Thank you. I did write to the Chief Executive of the NHS Trust. His response was not helpful. He said that he was sorry to hear about what had happened to my father. That the Trusts committee on safety would be considering the serious incident report that the ambulance company had produced and would ensure lessons would be learnt. He said that he understood that the ambulance company had spoken to us and apologised. That was it.

My father has been in hospital for nearly four months and they are threatening him that he can’t go home as the council say the additional care he would need as a consequence of the break breaches their cost limit/ he would get more care in a residential home.

I tried to go to the Ombudsman but they have been really slow and are querying whether Dad, despite him having signed authorisation forms has the capacity to say he would like them to investigate his broken arm!! His MP is saying something similar.

To take this forward I think we will probably have to challenge the mental capacity issue through the court of protection and then other avenues of help (like the MP and Ombudsman? ) may be opened up??? It’s like some mad kafkaesque nightmare!!

29

Hi Faye,

Sorry this post is all jumbled but in a hurry to go out. Some comments may be relevant, others not.

If they are saying your dad ready for discharge they will probably be classing him as (described in a horrible term) a ‘bedblocker’, which means hospital will be getting charged daily for his bed. This is NOT your problem though but theirs. The main thing about any care supplied is that your dad is safe. As much as you want him home, and so does he, if an unsatisfactory care package in place, this leaves door open to all sorts of further problems in the future.
Does the hospital have a rehabilitation ward that your dad might benefit from whilst investigations continue about his future?
Would a temporary respite stay in a nursing home be worth considering? This would need be in writing.
You have a right to be there if a mental capacity assessment is done on your dad.

His doctor/consultant can advise on whether he needs residential care/EMI residential/EMI nursing care. Lists of places can be supplied by local soc services. They should include details of what each home is registered as. I was given a list of 33 places, and yet there was only 5 that would meet hubbys needs. Even when you look at any, staff will then visit your dad and go through his care records to ensure they can meet his needs and have the relevant staff.

Advocacy has been mentioned by other members and is available from variety of places, depending on cutbacks. Our choices in this area are getting less.

Try a local carers group to see if they offer the service.
Contact your Healthwatch for your dads area.

CarersUK have a helpline, details here Get in touch with us | Carers UK

Enquire if your hospital have a PALS service. Explanation here What is PALS (Patient Advice and Liaison Service)? - NHS

As you have already contacted the CEO at the hospital, you may want to consider taking it higher and contacting the Secretary of State, Matt Hancock Contact Matt | Matt Hancock

Not sure if you already do this but I know other members on here do it, and that is keep a form of diary. Keep copies of all letters, emails sent. No matter how many times you share something, always keep a copy for your own records.
Make a note of all phone calls, ensure you get the name of the person you speak to. Write down dates and times. Same goes for conversations held with staff at the hospital, Write a summary of the event as soon as you can or even during any meetings.

Any formal meetings there should be minutes, request a copy as is your right. When you are alone among several ‘professionals’ not easy to remember all the names or roles. If any such meeting opens and no minutes seem to be getting done, request it. The sad thing is it’s like building a case for the future, if ever needed. Plus if it comes to even more formal complaints, the more info you can give the better.

Whilst your dads care and safety will be uppermost for you, remember you need time for you too. Use the forum to offload. Whilst all our situations are unique to each of us, many of the emotions and problems faced are the same. We wont walk in front of you or behind you but right alongside you.

Good luck and hope some of my waffling makes sense :confused: :wink:

x x

30

Faye, that letter from the CEO might appear unhelpful, but in fact it’s quite the reverse, it’s VERY helpful indeed.
Firstly, he has apologised, and you only apologise when you accept that something you did was wrong.
Secondly, he’s told you that there is an accident report.

In that case, I would just send a brief note, saying

"Thank you for your letter.

Please may I have a copy of the accident report?

Yours sincerely, …

31

BB is right, the letter is an admission of wrong-doing (guilt). I would just for fun, contact a no win, no fee, Solicitor who would love to take your case…

There is so many similarities in our cases, my Mum went into hospital fully mobile and came out on a Zimmer frame after they told me about a fall in the toilet. The head Nurse literally jumped on me before I got into Mums room and told me she had a bad fall in the toilet, I had to sign a health and safety form confirming this.

Mum is back home with me, but she no longer walks… we have carers 4 times a day, standing aids and a commode…

My advice, Challenge Everything, Question Everything, Don’t Take No For an Answer. Don’t let your Dad end up like my Mum

32

Thank you so much for all your responses- they are really helpful. Much appreciated.

At 5pm yesterday the Matron said they would like a family meeting today at 3pm. I can’t sleep - am very anxious!! So scared and alone!

I have received a copy of the serious incident report into my father’s broken arm. The ambulance contractors have admitted negligence and the driver has been sacked (he’s okay- he’s got a new job which he says he is happier in). Our solicitors have put in a personal injury claim but apparently it can take years to resolve. In the meantime my father is still in hospital (three months after they said he was medically fit for discharge). He wants to go home , the council are saying double handed care will cost too much and they would prefer him to go into residential care which neither my fathe nor I think he is ready for (I appreciate this may change in the future but even then we think nursing or palliative care would be more appropriate for his needs). The local authority are now querying whether he has the capacity to make such a decision - we think he does so I assume it will now have to go to the court of protection to make a decision. It’s utterly exhausting and so very stressful. I am worried the hospital (who seem to be putting all the pressure on us rather than the local authority to resolve the situation) will simply try to discharge him to a residential home. I have read that they shouldn’t do this (think we’d have to threaten an injunction to prevent it) but am so very, very scared they will try regardless. PALs/the Chief Exec etc have not been helpful- refusing to get involved /saying it’s between us and the Council / nothing to do with the hospital despite him being in their care when his arm was broken by their contractor.

Has anyone else been through the court of protection or involved in disputes over mental capacity? It’s never been an issue before - Dad was mentally fine before admission: he has acquired fluctuating delirium whilst in hospital (we are told it will probably lift at home) but to be honest I’m not really surprised he has it. I’m so stressed my GP has prescribed medication and I’m now off work sick : goodness knows how he feels. It’s far worse for him - They were concerned that he may have caught an infection from another patient (he hasn’t) and put him in a isolated room (door closed,minimal contact, no physio just stuck in bed). As Dad is blind and can’t hear very well being on his own with no stimulation (I was just visiting after work) for days on end is bound to impact on his mind and well-being. He has days where he is fine but moments where he is confused. That said he has never once said he wants to go into residential care - only ever that he wants to go to his flat with carers. I think his health would only deteriorate if he was to go into somewhere new at the moment.

As Dad didn’t have problems at home prior to admission (only when carers or patient transport didn’t turn up ) I think he should be given an opportunity to try being at home even if just for a trial period.

If anyone of you have had similar experiences, especially over the court of protection/ mental capacity it would be great to hear about them. Thank you once again for all your help/support and kindness.

33

Faye, that is less than 24 hours notice. NOT ACCEPTABLE. Dad should have his solicitor present, has he been invited. I’d contact the CEO again, PALS too, and ask them to rearrange it. However, if they say it’s a Continuing Healthcare Assessment, then let it go ahead.

34

Thanks. Unfortunately PALs and the chief execs office won’t get involved. Dad’s solicitor is on holiday but has said to go along to hear what they have to say. I’m not very optimistic

35

I’m sure others on here have more experience, but the Court of Protection (I’m currently going through this process with Mum), is for people who have been deemed to have no mental capacity in order to safeguard the money of the vulnerable adult.

It seems in your case this is way to early, there is no safeguarding issues money wise, you just want to get your Dad home, where he belongs and wants to be.

In Mums case I paid £200 for Mum’s mental capacity to be decided by a neutral, un-biased DR, when he said Mum has mental capacity, the Local Government didn’t have a leg to stand on.

The one thing I don’t understand, generally four - doubled up calls by carers, is WAY cheaper than residential/nursing home care, so why your LG is dragging its heels like this I’ll never know.

When I said I’d have Mum home, my Social Worker almost bit my hand off:-)

36

Faye, how did the meeting go?

37

I hope the meeting went well, but the sceptic in me thinks the hospital would have done a rushed discharge to a Home day before bank holiday when no one else available to complain to.
I hope it wasn’t, for Faye’s sake

38

I’m sorry that I haven’t provided an update sooner- things have been really difficult. So I’ve just tried to keep my head down, focus on Dad and work but it is so very hard and lonely.

We met with the hospital and social services on 18 April. After lots of discussion they agreed that my father has mental capacity and ,again, he clearly articulated that he wants to go home. The council said that the double handed care that the hospital OTs have said he would need exceeds their limit for an individual (apparently a new residential home is opening where he could share a room that would be cheaper than agency carers - we live in central London so the carers are expensive and hard to come by, the home is not in the local area so is cheaper). My father is clear that he doesn’t want to go into a residential home or move to an area he doesn’t know/away from me/anyone he knows. I know that as he is terminally ill he will most likely eventually need hospice or nursing care (the Council have rejected this for now saying it’s not needed - which I think means it’s too costly?). The social worker is meant to be putting a case to panel for the increased care but said she doesn’t think it will succeed. The hospital Discharge Nurse said he won’t qualify for contuing care at the moment as he might receive reablement and improve?

My father’s solicitor has now written to the Monitoring Officer in the council to escalate the case. It’s now over three months since Dad was told he was medically fit for discharge (his arm was broken in December and repairing by January) and he’s still stuck there.

I feel so sorry for my poor Dad - these are likely to be his last few months and he’s stuck in hospital. He’s on a cardiac ward and they just can’t/don’t give him the personal care he needs. Today, for instance, I arrived and he was covered in blood (they hadn’t cleaned him up from dialysis); was lying in his own pooh (the patient next door said Dad had asked to go to the toilet four hours before and the nurse had said she was to busy and just to do it in the bed but no one had been to help clean him) and didn’t have his hearing aids in so couldn’t hear a thing (he’s blind). It’s all so very depressing. I spoke to the Matron and he said they were short staffed and they are not set up to care for disabled people like Dad. I understand that but it just feels so sad- there’s no dignity or compassion (like he’s a sack of potatoes?). I feel like we aren’t being listened to nor any action taken. Have got no where with the Chief exec or Ombudman- am going to try and speak to his MP again tomorrow. I’m hoping she might be a bit more sympathetic this time - according to the Ward Manager the cost of keeping him in hospital since they said he was fit for discharge would have paid for over 4 years of double handed care at home. It’s all just so frustrating- we can’t get anyone to listen. Thanks for all your help and support - don’t know what we’d have done without it.

39

Faye
I’m seething as I read this. All I can suggest now is going public and involving press amd/or social media. How about ringing the Guardian who seem to take an interest in such matter?. ,
Maybe public embarrassment will get something moving.
Playing by the rules isn’t working, so drastic measures needed!

40

Faye
I am attaching the Care Statutory Guidelines which clearly state Social services cannot set arbitrary limits on care plans, nor send someone to inappropriate care because it is the cheapest option.
Paras 10.17 and 11.7.
https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance#person-centred-care-and-support-planning

I really struggle to see why no one (Pals, solicitor,a dvocate, MP) seems to be willing to help you and Dad when the situation is so clear. He has capacity, he has needs, SS must meet those needs

The lack of basic human care he is receiving seems cruel and need to be officially complained about. Take photos. Heads should roll over all this.

Kr
MrsA