Discharge to Assess and Permanent Move to Nursing Home

Just wondering if anyone on here has had a similar experience. To those who have ever read any of my previous posts - yes I am still trying to look after my mother who is now 104!

She has never had a formal diagnosis of dementia although every profession who speaks to her says she is in the very first stages. However, that is not the issue. She has virtually no mobility, makes dreadful, uninformed choices and has now ended up in the situation I warned her about so so many times. She always refused to let me have POA as she said she did not trust me (long story, all allegations by her have always been discounted by social services and the police). Believe me I have had my fair share or horror with her. Because of her mobility problems, the fact she would never do anything she was recommended to do, kept getting Lifeine to phone for ambulances (2/3 times a week) she ended up in hospital in September last year. She remained there with various problems until 2 March this year when she was Discharged to Assess (because she was bed blocking) to a nursing home. She was eventually assessed as not having capacity to choose where she lives and it was considered that in her best interests she needed full time care in a nursing home - a decision which I fully agree with and had been trying for several years to get actioned.

My problem is that the nursing home for her D2A is the most expensive one in the town where we live and social services have said that she cannot remain there because they will not pay the cost - she has no assets of her own apart from less than £5,000 in savings. My view is that they should never have put her there in the first place knowing full well she could never afford to stay there and as she has now been there for over 3 months moving her now to another home will be detrimental to her mental health. At her age every time she is moved she hallucinates, gets agitated and very challenging - she was moved to 6 different wards in hospital and the effect on her has been dreadful. She is not the person she was when she went into hospital in 2022.

Has anyone else had a similar experience. I have read the National Assistance Act (Choice of Accommodation Directive) but although it alludes to being able to stay where she is there are other parts that contradict that. Of course Social Services are saying categorically that she cannot stay unless she pays a top up of - wait for it £950 a week. Any thoughts or can you point me in the right direction to get some advice - it would be appreciated.

Demanding top ups is unlawful. Demand an NHS Continuing Healthcare Assessment. If it was D2A what is the outcome of the assessment???

The outcome of the assessment was that mum could not return home again with a carers package because the support she now needed could no longer be provided by a care agency in her own home and social worker felt that she did not have the capacity to make the decision herself therefore it was in her best interests to stay in a nursing home. I do fully agree with this. I have enquired about NHS Continuing Care but as mum does not have on-going medical needs she would not be eligible. She is very frail, immobile etc. but medically is reasonably OK. My concern is around moving her from the place she is in at the present time where she has now settled. She is the most content I have seen her in the last 5/6 years and I know that moving her now after all this time will cause real problems with her. I think as it is the system that has put her there, kept her there for more than the stated 6 week D2A assessment period because of their resource issues it is unreasonable to now want to move her - I actually think that if they do it could well be the end of her now. The home that in which she is currently living do have the capacity for her and are willing to let her stay it is just the issue of finance.

Fluffy, I’m glad they acted in her best interests.

Have they said they want to move her?

Fluffy, talk to our Carers UK helpline. Also look at the Continuing Healthcare Framework. I know you said mum didn’t qualify, but there is a section there about moving people after they have settled in. Also ask the council where they want to move mum to? Again, the CHC Framework has interesting information about ensuring that people’s human rights are respected and it must be somewhere that is near enough to your home so you can visit easily. I used this argument when they wanted to send my mum somwhere which would take me an hour to drive to. On the computer it may have appeared near, but Southampton Water was in the way, and I didn’t own an amphibious vehicle. Also ask Social Services, in writing, the maximum amount they will pay towards mum’s care? And ask in writing, for a list of local homes WITH VACANCIES who charge less than the ceiling amount? Setting a ceiling is actually unlawful, there must be places with vacancies at that rate. In the meantime, ask them to allow mum to remain where she is while you “consider her financial situation”. Do you manage mum’s money as her Appointee? Presumably mum doesn’t have over £23,000 in savings or property? Do you think mum is nearing the end of her life? Given her age and frailty, if you think moving might lead to death, then say so, in writing. I know it’s an awful situation to be in. I had so many battles when my mum was ill.