Discharge from Hospital to "Inadequate" Care Home

Mum’s care home has just been rated as “Inadequate” by the CQC and placed into special measures. One of the (many) failures highlighted was poor care plans.

All residents are now having new care plans drawn up and these should be completed by the end of November (as per CQC instructions).

However, the new manager has informed us that if a resident were admitted to hospital in the interim, they would not be allowed to be discharged back to the care home unless the care plan was satisfactory - possibly meaning an extra one or two weeks in hospital (with a resultant possible downturn in mobility etc.) while the care plan was approved.

I have read up extensively about what happens when a care home goes into special measures, and have Googled the above scenario, but can find nothing about it! The manager even referred to the fact that the local hospital now has someone on the staff who deals with these situations.

Has anyone experienced this situation, or have any knowledge of it? (It came as a total - and very worrying - surprise to the relatives present at the meeting.)

Hi Pennie.

I share your frustration is searching for a practical answer !

In the absence of which , either the CAB or AGE UK would be my best guess for an answer ;

Citizens Advice


( Would you trust an answer from the LA or the care home ??? )

I hope either will be able to assist.

Is there any point talking to the cqc person who deals with that geographic area?

Contact detail options on the CQC site seem to indicate complaints only … not a general help service.

There is a phone number for general enquiries … 03000 616161.

Nothing ventured , nothing gained ?

Isn’t this a complaint?
I’ve complained to CQC previously, then the local officer has rung me for a chat.

If what the new care manager described actually happened, surely that person’s care plan would need to be reviewed and revised if appropriate, and wouldn’t that particular careplan’s review take priority over the other care plans? Surely it doesn’t take two weeks for that to happen?

Did the cqc report indicate just how inadequate the careplans were? Do you have a copy? It seems that this new manager may be attempting to temper your expectations so as to make life easier for themselves. Hopefully your relative will not be impacted. I think BB is right (again!). I’d complain to the cqc about the prospect of people being kept in holding bays in hospital for 2 weeks whilst they get round to implementing an adequate careplan that ought to have been in place all along! Hospital patients ought not be prevented from returning to their carehome for lack of a plan!!! Can’t they mitigate against that?

Do not hesitate to inform the CQC about the care plans. This is a serious safeguarding concern that must be addressed properly. Can you write a strongly worded but polite letter or send them a email? None of this is appropriate. Is it possible to move your mom to another home or not?

Why are they not being released? Is there a valid reason for that? Who is the owner/manager of the care home? My advice is to request a meeting with him or her to discuss your concerns as well. Be a advocate for all residents of the home not just your mom. The Care Quality Commission has a guide to care plans https://www.cqc.org.uk/sites/default/files/20160519_Better_care_in_my_hands_FINAL.pdf

Care plans are technically a legal document. By not reading them, it is clear that the staff are not interested in showing best practice. There is no excuse given the sheer variety of care plan templates on the Internet these days which can be used. Clearly they do not care and should not be allowed to work in the care sector. Not reading the policies is one thing, but this is another.

Thanks for all your responses.

Well, Chris, I really thought that it anyone could find something out it would be you :smiley: so it seems there’s nothing out there.

The CQC are fully aware of the issue with the care plans (and other matters), which is why the care home was rated inadequate. There are about forty residents who all need to have their care plans redone, hence the time-scale of end November. They have said that they will start with the residents who are most likely to be admitted to hospital so that there should be no delay in them returning. “Unfortunately”, my mother is one of the healthier residents but is unsteady on her feet and could potentially fall at any time, possibly resulting in broken bones, hip etc. (although - touch wood! - has not had a fall this year).

I am wondering if this situation only refers to LA-funded residents - I could understand that if the LA were paying the fees then they could stop the resident returning until the care plan is up-to-date - but my mother is self-funding. If she said that she was happy to go back, could they stop her?

I am reluctant to contact the CQC as we already have an ongoing issue with them which will probably result in the involvement of the Parliamentary and Health Ombudsman, and I don’t really want to “muddy the waters” with them.

Hi Pennie, my guess is that it would apply to all returning residents, regardless of funding source. I would think that ,purely for business reasons, they would prioritize careplan review for those ready to return to the facility.

I know this is horrible, especially if your Mum is settled. But find a new care home for Mum.

It sounds like the new manager is pushing clients away rather than gaining the trust and empathy of family and their loved ones…

If this new manager is laying down unreasonable laws now, imagine how bad it could get.

My paranoia comes from a horrible situation with my Mum and the new manager of her care home. He turned out to be a bully and a horrible piece of work. He told my 72 year old Mum he was going to take her to court unless she paid £35,000 in advance.

Mum was scared of him.

Just be careful, I’m not saying your new manager is the same, unless his name begins with Ste and ends with Ingh.

I’ve never had any caree in a care home. Mum had carers at home and four different care agencies, three of which were rated good and the last one was rated needs improvement and that was up from inadequate. The carers from the fourth agency gave mum good care, no worse than the others and often better.

I wouldn’t be in a rush to transfer your mother anywhere. Often I sense that problems in management can account for the inadequacies and inadequate rating. I’d look at your mum’s care. Is she settled in and what problems have there been with her care? From the cqc report, where do the deficiencies lie?

I’d be cautious and aware of the situation re hospital discharges. I’d be ready to jump in and demand her careplan’s review be expedited if need be, and leave it at that for now.

Did you report him to the care quality commission?

Mum’s Social Worker didn’t fully understand the extent of his depravity, despite seeing letters, texts and an invoice for £35,500 he had “personally” posted through my door.

It wasn’t until our Social Worker decided it was in Mum’s best interests to come home, he threw a strop, very intimidating and made a safeguarding complaint against our Social Worker. From that point on our SW saw his true colours and was 100% behind me.

A complaint was made to the CQC, but I’m afraid to say I took the cowards way out, Mum is home so it’s someone else’s problem so I didn’t follow it up. I wish I had now, for a long time I was scared to answer my front door or phone because of him.

This is the extreme end of the spectrum though, I’m sure the new manager in your case, will settle down and be great.

A brief update.

I phoned the CQC yesterday and explained my concerns. Apparently, this situation does not just apply to “special measures” but to any admittance to hospital from residential care. The care plan would have to be updated on discharge because of possible changing needs and the hospital (NHS?) would have to be happy that all was in order - even more so if the person concerned was being discharged to an “inadequate” facility.



The care plan would have to be updated on discharge because of possible changing needs and the hospital (NHS?) would have to be happy that all was in order - even more so if the person concerned was being discharged to an “inadequate” facility.

Yep … one of the cornerstones of the Bible :

Being discharged from hospital - NHS

**_What’s meant by minimal or complex discharge?

If the discharge assessment shows you’ll need little or no care, it’s called a minimal discharge.

If you need more specialised care after leaving hospital, your discharge or transfer procedure is referred to as a complex discharge.

If you need this type of care, you’ll receive a care plan detailing your health and social care needs.

You should be fully involved in this process.

A care plan should include details of:

the treatment and support you’ll get when discharged.

who will be responsible for providing support and how to contact them.

when and how often support will be provided.

how the support will be monitored and reviewed.

the name of the person co-ordinating the care plan.

who to contact if there’s an emergency or things do not work as they should
information about any charges that will need to be paid. (if applicable)

So will there be a care plan review or not?