Extra visits for medication

Hi all

TL:CR - What do you do when the council supplies 4 visits but you have 5 slots for taking medications that you can’t manage alone?

My Dad is new to needing care and previously self administered his plethora of medication and his insulin twice daily. Now that he is blind he can’t do either of those things for himself. He currently has a temp live in carer (through NHS Reablement) and the District Nurses visit morning and afternoon for his insulin. They are trying to go to a single dose type and when if / when my brother and I become his official carers, we will be trained in insulin administration. We’ve been trying to work our hours to fit in with meal times and medications but avoid being there for hours when we’re not needed.

Dad will be self funding (so theoretically having to pay us the minimum wage) until his funds dip, at which point he will probably only be offered 3 hours of care over 4 visits. The social worker said the council are only able to supply visits 4 times a day and this has been backed up by adult social care in the hospital (who tried to send him home with this package that totalled 2 hours), and also my SIL who works with adult social services. Dad takes 23 medications over 5 time slots and the SW said the 5th slot would have to be self funded. I asked what they do for people who have NO money and she said they would find an alternative. As well as being totally blind, Dad has Parkinsons, so he can’t see his pill box, or the egg cup he is currently handed. If he felt around he could knock it over, or he could lose the meds through his tremor as he brought it up to his mouth. He is also getting to the point where he is getting difficulty swallowing and will soon need to be supervised when drinking / taking meds as well as eating as he is now. The timing isn’t an issue because we can set alarms on Alexa now that we know he can hear it. It’s getting the tablet to the mouth and swallowing that’s the issue!

Any ideas gratefully received, thanks.

I think it maybe an idea to contact an O/T.

If Social Services are saying dad’s needs are above their maximum level, then they should make a referral to NHS Continuing Healthcare, which would mean entirely free care. Insist on at least a checklist assessment being done, and get a written copy.

Just to be clear: it may be practice and policy across local authorities but there is no legal basis for setting a maximum number of calls.

Needs must be met - they have a duty of care. Those are the only criteria. Ask them where in the Care Act or its guidance does it set limits on the number of calls?

That’s a great point. Other than his meds, he is doing really well - he’s continent, getting some mobility back so able to get to the loo by himself & theoretically not be too much of a risk at night so he’s not near the threshold at all but he could well be by the time his funds run low enough, especially with the swallowing issues.

I’m waiting to hear back from the Parkinsons clinic about the swallowing, the diabetes team about his insulin, and the OT about many many things but nobody seems to want to talk to me. I really worry about those people who don’t have anyone with the time / wherewithal / knowledge to actively advocate on their behalf :frowning: