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Elderly parents

Having a complete nightmare....

22 replies

Hotpinkangel19 · 02/08/2017 18:28

I'll try and give you a short version, My mum died 7 weeks ago. Since then, dad has been taken in to hospital and diagnosed with terminal cancer. Hospital put in a fast track for NHS continuing care, which has been accepted. Viewed a nursing home and was told it was £200 top up per week 😕 Called social worker who said top up fees for nursing homes were pretty standard £100-200 per week. Asked if Dad's pension will cover it - she says he lacks capacity which myself and his nurses disagree with so can't pay so down to me. I can't pay so I tell her. She comes back and tells me while I'm waiting for POA to be sorted, I can take/transfer money from his account to pay his top up fees, and I'm to sign a letter agreeing to pay top up fees tomorrow. This doesn't sit right with me and I'm very unsure, how can I do this when according to her he lacks capacity? What do I do? I'm really concerned.

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hesterton · 02/08/2017 18:29

This reply has been deleted

Message withdrawn at poster's request.

Florriesma · 02/08/2017 18:30

Get in touch with Macmillan nurses or the specialist nurses at the hospital. I haven't heard of this before but I may be out of date. Things keep changing.

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Hotpinkangel19 · 02/08/2017 18:31

She is saying she assessed him as not having capacity so he couldn't make his own payments, then came back with the other solution Confused

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Hotpinkangel19 · 02/08/2017 18:33

The social worker says it's not the doctors and nurses who can make the decision about Dad's capacity - it's the social workers.

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Florriesma · 02/08/2017 18:36

True but Macmillan might be able to offer advice over the top up payments . It was that I hadn't heard of before sorry.

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missyB1 · 02/08/2017 18:38

The social worker sounds a bit iffy to me, don't let them rush you into anything.

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Hotpinkangel19 · 02/08/2017 18:39

Thank you, I will contact them tomorrow x

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Fairymad · 02/08/2017 18:41

Capacity assessments can be only be done by qualified people, usually a mental health professional not a social worker

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cocochanel21 · 02/08/2017 18:43

If he doesn't have capacity then you can't get POA you would need to apply for Guardianship.

It was a doctor who made the decision regarding my mum's capacity not a social worker.

Good luck sounds like a nightmare for youFlowers

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GlitterGlue · 02/08/2017 18:44

They can't force a relative to pay a top up either, I don't think. If the fees aren't covered they will have to find somewhere cheaper.

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Dodie66 · 02/08/2017 18:47

We had a psychiatric worker assessed my dad not a social worker. We couldn't pay the top up fee. They did take money for a top u from his pension. He was allowed to keep £20 a week.
We set his account up as a joint account with me so that I could pay his bills etc

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GlitterGlue · 02/08/2017 18:49

Actually, this suggests you can't be asked to top up continuing health care. www.justcaringlegal.co.uk/nhs-continuing-healthcare-top-up/

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MidnightVelvetthe7th · 02/08/2017 18:49

So sorry about the loss of your mum & your dad Flowers

Top up fees are very common but if family can't pay then they can't pay. I'd be surprised if there was the just the one nursing home that would accept your dad, don't let the SW rush you as what if you signed the letter agreeing to pay the fees & your dear dad had less money in his bank account than you thought.

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LadyB49 · 02/08/2017 18:50

You could try for a free half hour with a solicitor regard how to access your father's accounts. If your dad is in hospital they can't just toss him out so don't be pressured into anything.

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blankface · 02/08/2017 18:54

She is saying she assessed him as not having capacity

Definitely have a word with your Macmillan nurse or someone else who deals directly with these matters, I'd be surprised if a SW had the correct qualifications/experience to be able to definitively state if someone had capacity or not, or to perform tests to determine mental capacity, doesn't it stray into medical territory?

www.nhs.uk/Conditions/social-care-and-support-guide/Pages/mental-capacity.aspx

Extract - How 'mental capacity' is determined

The MCA sets out a two-stage test of capacity.

  1. Does the individual concerned have an impairment of, or a disturbance in the functioning of, their mind or brain, whether as a result of a condition, illness, or external factors such as alcohol or drug use?
  2. Does the impairment or disturbance mean the individual is unable to make a specific decision when they need to? Individuals can lack capacity to make some decisions but have capacity to make others, so it is vital to consider whether the individual lacks capacity to make the specific decision.
    Also, capacity can fluctuate with time – an individual may lack capacity at one point in time, but may be able to make the same decision at a later point in time. Where appropriate, individuals should be allowed the time to make a decision themselves.
    In relation to the second question, the MCA says a person is unable to make a decision if they cannot:
    understand the information relevant to the decision
    retain that information
    use or weigh up that information as part of the process of making the decision
    If they aren't able to do any of the above three things or communicate their decision (by talking, using sign language, or through any other means), the MCA says they will be treated as unable to make the specific decision in question.
    Mental capacity and supporting decision-making

    Before deciding an individual lacks capacity to make a particular decision, appropriate steps must be taken to enable them to make the decision themselves.
    For example:
    Does the individual have all the relevant information they need?
    Have they been given information on any alternatives?
    Could information be explained or presented in a way that is easier to understand (for example, by using simple language or visual aids)?
    Have different methods of communication been explored, such as non-verbal communication?
    Could anyone else help with communication, such as a family member, carer, or advocate?
    Are there particular times of day when the individual's understanding is better?
    Are there particular locations where the individual may feel more at ease?
    Could the decision be delayed until a time when the individual might be better able to make the decision?
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NerrSnerr · 02/08/2017 18:55

Capacity assessments can be only be done by qualified people, usually a mental health professional not a social worker

That is not true. Capacity assessments should be done by the most appropriate person, so for an operation would be a dr, about personal care would be a nurse and about accommodation or finances it would be social services. You can ask for a second opinion and they may ask a mental health professional to do it but capacity is decision specific so one needs doing for each thing.

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historyismything · 02/08/2017 18:59

I work for the NHS and see a lot of fast track patients (my grandad was one too). As I understand fast track continuing health care funding is completely covered by the NHS. I would contact the local PCC and see if what they are saying is correct!

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poisonedbypen · 02/08/2017 19:05

Yes it is covered but if the home say it is £1000 per week & the CHC people say they will pay £800, someone has to pay the shortfall or the CHC will have to negotiate or find somewhere else. This us what happened to us (the home caved in).

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CatCoriander · 02/08/2017 19:18

I honestly thought that Fast Track Continuing Care covered the full costs of the nursing home. My dad was in a similar situation and he was fully funded - the only additional costs would have been extras such as hairdressing, chiropodist, toiletries etc. He sadly died last week but it was such a relief during his last few weeks not to have to worry about money. I am so sorry this is happening to you OP - particularly so soon after losing your mum xx

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bigredboat · 02/08/2017 19:25

Social workers can absolutely assess mental capacity, it is decision specific so if the decision is about accommodation, care etc a social worker would be the most appropriate person to do that. If it's about consent to medical treatment it would probably be a doctor.

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PinkSparklyPussyCat · 03/08/2017 22:08

MIL has Continuing Care and we haven't been asked to top up anything. Luckily DH has POA and a joint bank account with her so if anything changes he should be OK.

I hope you get this sorted out quickly OP, it's the last thing you need at this time Flowers

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whataboutbob · 03/08/2017 22:28

My Dad had chc and it paid for everything.
Re him having/ not having capacity and accessing his money, the best people to contact to check this are the Office of the Public Guardian in birmingham. They will know the legal position.
A whole range of people can assess capacity, certainly not just social workers. The registrar/ consultant looking after him will be able to assess capacity, so could a senior nurse in many cases.

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