Elderly MIL and battles with social worker

In a nutshell, my 90 year old MIL has been in and out of hospital for the last three with spinal stenosis, diverticulitis and a severely arthritic hip. Before that, she lived independently.

After her hospital admission in April, the NHS decided she needed 24/7 domiciliary care upon discharge. It didn’t go well. The carer received was ok but she was just got up in the morning, stuck in a chair in front the TV, toileted and food put in front of her - all for £6500 a month! Her mental health was clearly being affected by lack of stimulation - she was never taken out in her wheelchair, not even into the garden or for a bit of fresh air. She’s had all sorts of issues with disturbing the carer at night, wanting to get up, go to bed - sometimes up to 8 times a night.when she is in hospital, she is so frail that it takes two physios to help her in and out of her chair to a wheelchair but apparently, one single carer can cope alone in her house. We’ve been called several times to help get her off the floor because the carer was struggling!

She’s ended up back in hospital - 3 weeks ago - and we decided that a care home would be far more appropriate. There would be activities, trips out, everything geared to her needs (she can only have a very basic wash at home because she is unable to get in and out of her bath/shower) However, because she keeps telling the social worker at the hospital that she “wants to go home” they are insisting she does. We’ve persuaded her to give the care home a go for about three weeks, which she agreed to us, but her memory is so appalling that she’s clearly forgotten and told the SW something completely different. Incidentally, she can never even recall talking to him when we are visiting!

They now want to discharge her home and are really pushing to send her back to domiciliary care but the twist is; MIL transferred to the property she lives in into our names 10 hears ago. We really don’t want to do this, but can we refuse to allow her back to the house, as we now own it? It’s a horrible dilemma but it may be the only way we can get the best for her. I could scream at the short sightedness of the SW! He says she’s got full mental capacity which is unbelievable.

First things first. If she needs 24/7 care and so much help, tell the hospital she isn’t going ANYWHERE without an NHS Continuing Healthcare Assessment!

Then explain that they have a duty to ensure that it is a SAFE discharge (especially as she has been in and out of hospital so much). Clearly what they arranged last time was NOT SAFE!

If it is legally your house, then change the locks, and tell the hospital that they CANNOT discharge her to the address given as she does not own it any more. Avoid saying it’s yours. Expect to be bullied into submission, and stand up to them. I had to do this, it was awful.

It’s really SAD, but mum is paying the price of living to a very advanced age and she needs 24/7 care …in some sort of care home.

MMMmmm … hospital dicharges ( Unsafe ? ) and … CHC / NHS Continuing Healthcare ?

Links to both follow … a little late on the hospital discharge front ?

https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/being-discharged-from-hospital/\

https://www.carersuk.org/forum/support-and-advice/all-about-caring/chc-coughlan-grogan-judgements-nhs-contuing-healthcare-nhs-fnc-hospital-discharges-all-under-this-one-thread-35998

Numerous questions will arise from those two threads.

Feel free to ask them !

Thank you so much for your replies.

I asked for a CHC before discharge - and was told that, “this county (Wiltshire) is unique in that we don’t do them in hospital.” :angry:

I quite agree. MIL was clearly discharged previously before she was well enough and consequently, has ended back in hospital - again! She’s allegedly had a mental capacity test done by the SW, which is a joke as apparently she’s fine, yet she can’t recall a conversation from five minutes previously let alone one from the day before. She’s looked to us to make decisions for her for the past 10 years and yet, probably the most important one about her care, our opinion and concerns is being completely sidelined.

We feel incredibly evil by denying her access back to the house, but it’s the only option to get her where she needs to be. I’m absolutely furious too because a concern was put in to SS that we were pressurising her to go into a care home BY THE MANAGER of the care agency that provides her domiciliary care. Of course, that would have nothing to do with the fact that they will lose a very lucrative contract! :imp:

I’ve recorded our last conversation with MIL in which she said what a good idea it sounded to have respite care and could we arrange it for her. I’m not sure whether it will add weight to our case or whether we’ll get a slapped wrist for taping it.

Your welcome.
__

I asked for a CHC before discharge - and was told that, “this county (Wiltshire) is unique in that we don’t do them in hospital.”

Love it !

" What’s the price of apples today ? "

" Pears are 3 for a £ 1. "

That CHC / NHS Continuing Healthcare thread … me thinks ?

Well tell them she’s not going anywhere until they DO IT! The theory is that she might get better after 6 weeks, but this is not mum’s first admission is it?!

Email received from SW. I am so upset and disgusted with this. How dare he tell us to justify our actions and try to pile on emotional blackmail regarding MIL’s mental state!

“My understanding of the situation is that you currently own the property (since 2012) and that you have agreed for 'T’to stay in the property for the remainder of her life (discussed with you last week).

However, in conversations with yourself I understand that you would prefer for 'T’ to move into a Care Home for a short trial to see if she would like it and she could either then stay there or return home. You have also mentioned that you have discussed this with ‘T’ and she agreed to this option during a recent conversation (but she has since forgotten this discussion).

I have been involved with 'T’from early in her admission and there are growing concerns about 'T’s low mood because of her wish to return home and her continued stay in Hospital is having a negative effect on her wellbeing. I know that you would like ‘T’ to trial the Residential Home option - however, it’s quite apparent that not being at home is having an adverse effect on her, and based on her continued wishes I think moving into a Residential Home would only increase her distress and upset.

Throughout my involvement her consistent wish has been to return home. 'T’has reiterated this to me and professionals working in the hospital on numerous occasions. Whilst I do accept that ‘T’ has memory issues, I have assessed her to have mental capacity regarding the decision to return home and she is consistent in this wish. It’s important to also mention that even if she lacked mental capacity the recommendation would still be for her to return home. During a meeting with 'T’on the ward (with both of you present) and other professionals ‘T’ was asked clearly whether she would prefer to move into a Care Home (for a trial) or return home and she clearly expressed a wish to return home.

I have assessed 'T’s care and support needs during her admission and would recommend that she returns home with a reduced package of care - Live in Care (without the two hours carer’s break being covered). ‘T’ is in agreement with this. ********* Care have confirmed that they are able to continue providing 'T’s care (starting this week). I have also explained to ‘T’ that the cost of the care would be £1150 + a small cost for groceries each week and she is accepting of this.

The Occupational Therapist would also need to visit the property to look at any equipment provision.
In discussions with you I understand that there isn’t any formal authority to manage T’s finances and I would strongly recommend that you explore the options that would place the informal support you are giving onto a legal footing.

I am conscious that we have an elderly person in a hospital bed who is becoming increasingly upset at being here and could return home this week.

I have copied in ************** (Head of Integrated Discharge) as T is now medically fit for discharge and is a delayed transfer of care.

If it is your decision for T not return to the home could you please reply to this email with your reasons and be kind enough to put it in writing so that it can be shared with ‘T’ and she will be able to refer back to it on the ward.

Bl***y cheek!

At this stage , Sarah , I will add just one comment.

CHC / NHS Continuing Healthcare … can de done in a home setting !

Main thread … Pointon :

POINTON CASE : CARE AT HOME

The ultimate sanction for a social worker is being struck off the HCPC register, but they can also reprimand a social worker. I’ve just downloaded the “standards of proficiency for social workers in England” from the HCPC website.

Section 2.2 “understand the need to promote the best interests of service users AND CARERS at all times”. I’m not sure how sending mum home to fail again, as she will, and ignoring everything you say, complies with this?!

Sadly, SS have overridden all our concerns and recommendations and are in the process today of moving MIL back into the house. We were threatened with all sorts of legal action if we prevented her return.

We have already received a call requesting that we go shopping for provisions for her arrival as the care agency have no access to her account.

We have responded that as MIL apparently has full capacity they need to arrange it directly with her and the fact they are charging £6500 means they should be providing a gold plated service and that should be part of the package.

If nothing else , Sarah … my immediate reaction is for you to seek URGENT legal advice.

( No help or advice from the PALS team ? )

AGE UK and the CAB both fit the bill … links follow :

https://www.ageuk.org.uk/

https://www.citizensadvice.org.uk/

Their insight into the charges and care package … add safeguarding to that … also strongly recommended !!!

Better late than never ?

You MUST keep a diary of events, because I’m sure this is all going to end very badly, through no fault of your own. The hospital should have made all the arrangements to make sure there was food in the house etc.etc. before discharge. We are here to support you all we can. I was in a fairly similar situation some years ago.

Thank you all for your continuing advice.

Chris, you are right, we DO need legal advice. I had a look at the CHC test case you recommended and it’s heartening to see that some people do take on the authorities- and win.

We’ve been completely bulldozed by SS and this SW in particular. He’s disregarded and ignored EVERY point of concern we raised and has followed his own agenda totally.

I can almost guarantee MIL will be back in hospital within 2 weeks because she has been monitored continuously before discharge but once back in the hands of a young carer will slip back into lethargy, depression and because, when she is at home she becomes stubborn and won’t do any exercises to help her own mobility. She needs a professional to insist and encourage her. This would have happened the residential home.

I’ve meticulously documented everything by date and incident and will continue to do so. When I tried to raise some of the previous issues at a meeting, the SW actually stopped me and said, “Yes, well, we’ve got the general picture.” Oh, how I wish we had both got up and walked out at that point.

Your welcome , Sarah.

Said SW will probably be singing from a different hymn sheet once a legal beagle … preferably rottweiler with toothache ?
… is involved.

Let us know how matters progress.

( Where would we all be WITHOUT the Pointons of this world … ???

A determined lady that got off her backside and did something that changed the lives of many for the good ! )

Have you checked the HCPC register to see if this social worker is qualified?
If not, ask the Social Services department to arrange a reassessment.
If he is, then send a copy of the letter and a formal complaint to them.

It’s already sounding interesting.

Received a phone call from one of MIL’s friends who lives along her road and with whom she had an informal part time care arrangement several months ago. She had a phone call from the care agency manager asking if she could possibly spend tonight with MIL as the carer they are bringing from a distance away hasn’t arrived.

She said no.

You couldn’t make it up.

I hope you’ve put this in the diary? Time, date, etc. etc.

Utter disgrace.

Received a text message from a friend of MIL who visited her this evening.

MIL not happy at all, doesn’t know why she has come home. Her friend told her it was her choice and that we had arranged a lovely residential home for her. Her reply was, “Why didn’t they tell me? It was taken out of my hands.”

The new carer putting her to bed told MIL and her friend that she should never have come home without things in place. MIL said, “there was no choice because they were sterilising the ward.”

Said she wanted to lay down and die.

I’ve screen shot the message, redacted the friends name and emailed the SW and asked him perhaps he would like to comment? And what has he and his team done to her??