Catastrophe - mum has discharged herself

I’m glad you Mum is back in the home where her needs can be met safely.

heads really should roll over this though. To allow a lady to go home whose capacity to make a decision about where she lives hasn’t been established is appalling. Even if your mum did have capacity, it was clearly an unsafe discharge as she didn’t have any of the necessary equipment or care provision in place to be safe at home.

@Hembria , please do put in a formal complaint to anyone who was involved with this.

I would still speak to the cqc and if she is going back to the same home I would want a written explanation of what happened, a call from the manager and an assurance that the staff receive training in safeguarding and the MCA. It might be worth applying for deputyship for her too and poa for your dad.

That is absolutely disgraceful of the care home. If she was deemed to lack capacity they should have applied for DOLs as soon as she arrived there and never allowed to leave like that!

I’m glad there has been some progress and I hope they are able to get her back to the care home.

Care home’s do have a duty of care and if they did just allow your mum to leave, knowing that things were not in place to support your mum at home, I would suggest they have failed in their duty of care.

I just feel so angry for you OP, no-one understands the shit show that is adult social care until your in it and then its a continuous game of being passed from pillar to post.
What would happen to your poor dad if you wasnt there to call all these different departments / teams.
I really hope that your mums goes back to the home

Thank heavens for that. You must be so relieved. But heads still need to roll for letting her go in the first place.

Good, lets hope the nurse makes it very clear to the carehome that she cannot look after herself, is the nurse putting in a safeguarding concern. Are they arranging all the transport, is the home the right one or is she going to a new one.

will she go though?

Capacity can fluctuate, an individual can lack capacity in one setting and at one time but may have capacity at another time. Most care / nursing homes have DOLs (deprivation of liberty) assessments carried out as this enables them to keep the doors locked & legally prevents their residents from leaving. However, an individual who is deemed to have capacity is allowed to make (what may be judged) to be a bad decision. The whole area is extremely complex and never black and white. This sounds like an extremely frustrating, heartbreaking and baffling situation that the OP and her family are in, I hope community agencies are able to offer a solution before an otherwise inevitable crisis leads to A&E

That’s terrible. She was assessed as lacking capacity? The care home should put the DOLS in place and started the ball rolling with other services. She shouldn’t have been able to discharge herself. They’ve failed massively.
Have you spoken to them since the discharge?

Definitely report them to the regulatory body.

Seconding the CQC here, and go to them with all guns blazing.

That's appalling of the home she was in.

Personally I would contact the cqc

Right, so she's refused a bed or other adaptations - what's the care plan to avoid pressure sores or even to monitor for them? Is your dad supposed to be doing it? Has your mum been able to give any response as to her views on pressure sores and how she feels about dealing with them?

I may say that the thing that caused serious improvement in my mum's situation was my sister writing a HUGE complaint about the first nursing home she went to, copied to Uncle Tom Cobleigh and all. Tbh the manager of the nursing home was OK about it. It sounds like they massively dropped the ball here. Was the GP involved in this plan for her to go home?

What healthcare team do social services claim she is under, the nursing home accepted her knowing she lacked capacity so should have arranged an assessment and a emergency DOLS, referred her to her g.p. either a nurse or a gp should have reciewed ner in the carehome for medication, dressings, etc. Was it a nursing or residential home. I imagine the OT wont be too happy she was sent home, you could ring the community team and tell them, maybe they could visit her at home. Some gp practices have elderly care teams, early intervention teams that might help you. If social services wont get involved then ask for the adult safeguarding lead instead. A keysafe might be a good idea and a care/falls alarm. The last thing you need is for her to fall out the wheelchair or off the commode, your dad tries ro get her up and hurts himself. How was the carehome getting paid, you dont want to end up sorring out a massive bill. What a nightmare.

I would contact her g.p, adult social services and ask the district nurse if she can carry out a capacity assessment. Do social services know she failed a capacity assessment in hospital, do you know how whe was discharged to the carehome, does anyone have poa. If she lacked capacity in hospital then they must have done a best interest meeting and sought cop to discharge her. Have you spoken to the manager of the carehome, they must have arranged her transport, she couldn't have just got herself up dressed, into a wheelchair and out the door.

If they say she does now have capacity and can stay at home would she use a riser recliner chair, some people do sleep in them.
If she has had an amputation then how does she think she is going to get up, use the loo, your dad is too frail and if he tries to help her then they could both end up injuring themselves. Ideally the district nurse will suggest a home needs assessment and persuade her to get help qnd adaptations, if she is worries about the cost then she can get free adaptations to about 3k I think. She can also apply for attendance allowance and your dad can request a carers assessment.
Do you know why she is refusing any help. Do you have power of attorney for her.

Would requesting an assessment of your dad's needs be a goer?

How on earth did she get home, it sounds like the carehome didnt do a capacity assessment and place her on a DOLS. It could have been done in hospital, who authorised her to go to the carehome in the first place if she lacked capacity.

How are you all doing today Hembria? I feel for your dad.

@Hembria then sadly the only option may be ED, (A&E). Make sure they know the full story of what has happened so they can raise a safeguarding referral too. Wheelchairs are not suitable for her to sleep in overnight, nor really is an armchair tbh without risking severe pressure damage to her bottom and she will also need the loo and appropriate pain relief so if social care are refusing to assist either take her or call 111/999 and explain she's an unsafe discharge