Hospital to care home part 2 - any advice appreciated

Hi all

Any guidance appreciated here - I think my main question is what the role of social workers is - how much are they expected to do etc.

For background information mum has a serious mental illness - she has been diagnosed with a Delusional Disorder which is apparently quite rare. She has managed at home albeit unhappily for some time - no medication has ever helped but but as she has got older she has physical issues such as bad arthritis in her hands, and although not diagnosed her doctors in hospital and I agree believe she is early stages of dementia which excacerbates the delusional issues. To cut a long story short after a period of absolute chaos and bouncing back and forth from home to hospital she has been in hospital for the past 3 months most of it waiting for a social worker to do a report,

Her previous social worker she had for a briief spell when she was at home was really pushing respite care and probably hoping mum would like that so much she would want to go to a care home permanently. Mum didn’t want to at the time - she wasn’t really engaging and I got the impression her social worker at the time was going to push it a bit harder. I spoke to her again after mum was in hospital and she actually had a care home in mind that she though would really suit mum.

Anyway the case was passed to a different social worker and the weeks have gone by until I got a call today - she is recommending mum goes into 24 hour care - yep I sent her a long email outlining why she needs this some time ago and having spoken to the doctors and nurses they’ve all being saying the same. Now she says I must go and look at them with mum (who has very bad mobility and mental health problems), make the decision and sort out the money as she cannot recommend anything. I guess I can do this but not right now as I am getting married in 2 weeks and about to go out of the country after that for a few weeks. I thought they would at least recommend somewhere I could look at based on their lengthy assessments of mums needs. Is this usual? If this was the case why didn’t shes ask me to do this before instead of waiting weeks and weeks because she hasn’t got any information I didn’t have.

She has also been asking me about money as she seems to think - probably rightly that mum is self funding but no one knows for sure as mum doesn’t know anymore and one of her (probably) delusions was her house wasn’t hers. I am waiting for an LPA to come through but I know there is a backlog there so until then I don’t know. The last social worker also gave me the impression they could place mum and do the financial assessment later which makes sense but not this one - she said nowhere will accept her without confirmation she can self fund. What if she didn’t have any money - a lot of people don’t have a house to sell or a lot of savings so what happens to them? I know a lot of care homes have some self funding residents and some not. Confused.

Can anyone clarify - what can I expect?

I think I am just trying to get it clear what their role is
Thanks for any input!

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Hi @DaisyJo, I would email this over to the carers helpline for assistance as this sounds like a complex case.

1st off is the social worker part of social services or mental health? As you have said your mum has mental health issues and her social worker should be from mental health.

I would suggest contacting the alzheimer society for help as well.
The doctors should have told you about your mum than a social worker as sometimes they can bend the truth.

If the doctors suggested that she should be in a care home then they should have said but also who to speak to about funding the care.
A solicitor should be able to help you with the legal side like mum will, power of attorney and anything else.

Some social workers use respite care like a extended hospital stay and will use it saying your mum is better off there than at home and will use every trick in the book. While your mum is there some social worker’s will make false reports and recommendations so it so wrapped up in red tape that you are stuck.

I hate to sound negative but it sounds like some of these job worths want a easy life and don’t think about what upsets they cause for you and the family.
Do you think your mum needs 24hrs care? As it can get worse as the illness goes on but there are a few others on here who would advise you. You find them in the roll call. Just say a few things and ask them to look at this thread.

Before you or anyone agrees with the social worker have a real thing but contact these place or do a check online about reviews on them. If you are still not happy with the social worker, complain about it and ask for a full review of it

Y ou CANNOT be forced to be a carer. Make it clear to all covered that you are getting married in two weeks and out of the country. You willNOT BE ABLE TO DO ANYTHING FURTHER UNTIL YOUR RETURN. After all, they’ve done nothing in weeks. Until POA is finalised you don’t have access to any money of hers. Have they done an NHS Continuing Healthcare Assessment? Given guidance on suitable homes? Concentrate on having a lovely wedding and honeymoon. They can’t do nothing and dump it all on you! I know how awful this is, I had many battles over mum’s care. They can’t put mum somewhere and expect her to pay without a formal financial assessment and that can’t be done without POA!

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Hi both

Thank you so much for your replies. It is very frustrating and right
now I do want to focus on my wedding. There have been two social
workers, lets call them A and B!

A saw mum while she was still at home and was recommending and would
probably have arranged respite care. At the time mum was so mentally
unwell she was unable to engage in any conversations about her care
but I would have 100% have supported this as mum was deteriorating
rapidly and was obviously going to end up in hospital or worse (which
she has) if she stayed at home. In a hospital setting mum is doing
better and terrified of going home so wants to go into care now so
there is no issue around that. Social worker A was a mental health
social worker but she rang me and told me she was handing over to
social worker B as she did short-term work(?). Since then it all
slowed down - I did assume Social worker B was a mental health social
worker too as this is the real reason mum cannot go home and needs
constant care.

Although she is frail and elderly she could probably manage at home
with support were she not suffering from a psychotic illness which has
been resistant to treatment. Social Worker B hasn’t been helpful and
not really done anything until ringing me today and telling me what we
all knew anyway- mum needs 24 hour care for her mental health needs.
It almost seems as though a complete u turn has happened where mum now
wants to go to a care home and the social worker B doesn’t think she
needed it and has been pondering this for 3 months while mum has been
in hospital waiting to find out. She seems very focussed on physical
care needs. I would like an NHS continuous healthcare assessment done

  • social worker B says it’s only for nursing needs - physical health
    so I am not sure - does mental health not count? As for the dementia
  • no assessment has been done as apparently it is not fair to carry
    one out in hospital but surely it should be done as relevant to her
    care placement. Again, whose responsibility is this?

Both

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Tell SW B that she needs to arrange a checklist CHC Assessment to determine the level of support mum needs. Dementia can be determined by a brain scan, I believe. Scanners are in hospitals not care homes! B sounds to be absolutely useless! Wherever mum moves to, it needs to be her last move.

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@DaisyJo I have little to add to the advice you have received from BB and Micheal. But when my husband was in hospital in April last year I too was told that dementia assessments were not carried out in hospital settings anymore. I too was pushing for one. I think sadly the NHS do NOT want to diagnose elderly people with dementia.

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From reading your update @DaisyJo, it sounds like that social worker A was a short term fix then hand over to B. Normally mental health social workers don’t do a temporary job with a person as they got to build a relationship with the person who they have been given and the only reason a mental health social worker is changed either due to the person going to be on long term sick or a course or either leaving the job or the person being looked after by them request a change. It sounds like it a social worker from social services, dad been in this situation himself, he waiting for a new one. Either a mental health nurse or a diematia nurse can do assessment to see who is to look after your mum care. You should be involved in your mum care all the way as if she got what they are saying, she could agree to something without you knowing until the 11th hour.

When Mum had to go into hospital for treatment, the hospital appointed its own social worker and no one told me. It was only when I enquired of the social worker “where are we with this?” that I received a terse reply to say she was no longer on my mother’s case (which meant back to square one with the particular issue she had been appointed for months earlier). The hospital will want Mum’s bed freed up but if she isn’t well enough to go home, I believe the NHS pays for six weeks reablement(?). In which case, I agree with BB’s initial reply. Tell them you’re off to be married and will contact them in x weeks.

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At the end of the day, there are people in hospitals now whose main job is to get people out of hospital beds and if you back off, those folks will get on and sort out a home for your mum because they will want your mum’s bed freed up pretty quick and they will get on to social services. As others have said, say you aren’t prepared to be your mothers carer, you are getting married and will be out of the country so they will need to sort it out between them. It sounds harsh but someone at the hospital will take charge soon.

Hello DaisyJo

Thanks for posting about your situation in Carers Connect. I have sent your post to Carers UK’s helpline advisers and will post their response in this topic when I receive it.

Wishing you well

Michael