Choosing Where to Live, Capacity for Complex Decisions

Hi everyone,

I have been to see my mother today in the nursing home where she has been having community assessment for CHC. The CHC assessment is finished. After an appeal about the checklist my mum has been awarded FNC which is appropriate for her needs.

However, I was not included in the CHC assessment nor a meeting last week at which the CNS, nursing home manager, LA assessor and CPN were present. I was informed after the fact that my mum wants to stay in Kent rather than move to Manchester.

I need to make a case,I think, on the grounds that it will be detrimental to have minimal contact if she stays in Kent (monthly rather than the daily if she comes to Manchester). The care has been inadequate since she has been there and this despite weekly visits (which I cannot do on a long term basis as I live 300 miles away). I also need to make a case for the ‘decision’ she made at the meeting last week. Given a real choice she finds it difficult to make a decision and I feel that there should be a best interests meeting. I understand that the Care Act lays out rights to wellbeing which include having a free choice where to live. I have tried to make a complaint with the LA but they, and the CCG, say they can’t proceed without informed consent or power of attorney, neither of which I have or can get.

I am desperate to get my mum close to me, and I know she wants this too. She was emotionally expressive and with tears in her eyes which is unusual for my mum but I feel stuck and don’t know how I can achieve this. Any thoughts or advice would be appreciated.

Revision: After a somewhat sleepless night I have decided to go to the Court of Protection. I will send an email giving a deadline by which the LA can revise their decision not to move my mum to Manchester. If nothing heard by Friday I will submit my Court of Protection application. This seems appropriate too because I do not have POA and any complaints or submissions to LA and CCG are blocked due to lack of informed consent.

Elizabeth,
I think you should consider applying regardless as it means you will be in a position to make decisions on behalf of your Mum as they crop up.

Good idea though to use it as anchorage to convince those involved you are serious about fighting for your Mum’s rights. It suits them her being where she is, it’s cheap, there are beds and it’s less complicated than moving her.

You shouldn’t have to fight for what is right, so exhausting.

Melly1

Thanks Melly and yes I do agree about the benefits of it. I have decided to do it and will get the prep started for this tomorrow. It feels empowering just knowing that I am doing something for her and that I can be enabled to support her.

As she has just had a mental capacity assessment you just need Power of Attorney. Talk to a solicitor local to the home and get them to do it when you visit next. Then no one can challenge it!!!

No she hasn’t got capacity. I was there yesterday and today and can’t sign forms anyway. Will go down the court of protection route. Thanks for the idea though

Elizabeth
I had to go down the court of protection route for my late husband. Please consult the office of guardianship before you go down that route, and talk through everything. Im not certain but they may not help you with the best place your Mother should live. It’s a very costly situation, very intrusive. I’m not saying it’s not needed but just to be aware of all it entails.
If your Mother hasn’t the capacity then she won’t really know where she wants to live, and is probably agreeing to Kent without the understanding of what it means. I expect you have pointed that out to them.

Thanks Pet66 I hadn’t heard of the office of guardianship so will check that out.

Yes, the problem with my mum is that she can’t make complex decisions, so she can say yes or no to something but may give a different answer depending on what is offered. So during my two-day trip she first said she wanted to stay in Kent, then that she wanted to come to Manchester and when presented a choice said she didn’t know. So the LA no doubt only presented the one option. The other issue for me is that she responds really well when I am there for several hours and she wants this contact, needs it, and so the LA’s argument that she is making relationships with staff members as being a better alternative just doesn’t stand up and they are making these decisions without knowing her and without spending extended periods of time with her so I really need to do something to challenge the LA because they are not consulting me but I am just discovering events and decisions almost my accident after the fact.

Did they even consider mum’s human right to a normal family life, seeing family members regularly? I know that is mentioned in the CHC Framework, I used the argument for my own mum.

Hi Bowlingbun,

My sense is that they didn’t. I can’t understand why they thought it was OK to exclude me from every decision other than it was for their convenience or for financial reasons in terms of funding.

I had a very brief email from the LA assessor which recognised that mum would benefit from regular contact with me but felt that she was forming relationships with staff at the nursing home. This makes no sense to me to compare a few minutes each day of contact with staff to daily visits from me if she were in Manchester.