Social services want to move relative out of residential care home into independent living

Did they say there was no representation from Social Services?

Keep pushing for cognitive assessment. She needs a fully documented care plan by a mental health professional.

Some questions - what is an Apprentice Social Worker? Do you mean unqualified? There are many in Adult services as Childrens services get more funding. The decision will not rest with 1 worker of any description. Secondly please stop referring to a Warden in supportive living. There are many kinds of supportive living and by no means all as good as each other.I advise all people (including the person concerned) to look at the CQC reviews, available online. Also if the client has capacity it is their decision where to live. No one in supportive accomodation or residential care, can stop someone drinking alcohol and many residents get others to buy it for them. Reading the original post, I felt that the views of the person concerned were not being considered and that is a responsibility of any social worker of any status to ensure their choices are respected.

In many areas there is a halfway step between a care home and independent living of ‘extra sheltered’ with an onsite warden and care team. Is there anything like that which might be suitable?

Who makes the final decision? He who pays the piper I’m afraid ie social care. It’s a very great shame they were not at the meeting.

I’m afraid the CH manager will not hold any sway because they have a conflict of interest in that of course they want to keep their care home full with a less demanding resident. Are they willing to put their money where their mouth is and reduce the fees?

I would be surprised if paying for a care home is cheaper than 4x a day calls (and would they need 4x a day if they are pretty independent and can mobilise and toilet). The council will only take into account the direct costs to them of care and not anything else.

Re: memory loss the first step is to ask the GP to assess for dementia and they can refer on to memory services although there will be a wait. At least that way you would have a documented opinion from a Dr and that is a reason to call into question the persons capacity. Although in fact in this case their wishes and feelings are that they don’t want to move. I think it’s quite hard for social care to justify a decision to force them out (the more usual case is that the person themselves wants to leave)

In terms of who makes the final decision:

• social services, if they are being asked to fund. They have a duty to fund care but not in any setting.

• but they need the persons consent, if they have capacity.
• or the relatives consent if they have power of attorney.
• or if no capacity, and no power of attorney, social services would make a "best interests" decision.

In theory, they could say they will only fund independent living, not the care home, and if the person refuses they're on their own. But can't do this if there's no tenancy available!
And in reality, they will not put a vulnerable person on the street especially if there is any doubt about their capacity.

Notice dates always come and go.

And especially If you've requested meetings to try to resolve it and they've not been responsibe to you.

If there now no offer of a flat from housing, they will not stop funding/evict the person from the care home with nowhere to go.

Social services have a duty of care and this would put the person at risk. Imagine the press too!

Hold firm, but I am sure they will not stick to their date of 30/9 without alternative accom.

They would find it hard to argue the person had full capacity and understanding of the situation and was opting to put themselves on the street.

And do they actually have somewhere to go? Sometimes moving into independent accommodation from a care home is simply not an option as the person gave up a tenancy or sold a home and no longer have a home to return to.

If your relative doesn't have capacity to understand and sign a tenancy then I think that rules it out personally.

I think all you can do is ensure they take the previous high risk behaviour into account.
If it were my case I would be doing a clear risk assessment incorporating previous incidents and what is going to be in place this time to minimise the risk.

Ultimately though the person should have the opportunity to try living independently again if that's what they want, and they aren't needing much support from the nursing home.

Sometimes you just don't know until you try, but I would want to ask if they could return to the same place if things don't work out.

Technology could help with monitoring too.

The people who know your relative best in terms of current day to day needs are the care home staff. They are also very experienced in the needs of elderly people and assessment of capacity. If the care plan she has shows limited need for care and they say that they believe she has capacity then the Social Worker would not need to spend much time on an assessment before forming a conclusion. Many people in their 80s do live independently - I think only 1 in 5 elderly people ever need a care home.

The pre care home lifestyle of neglecting themselves, drinking excessively etc was a problem but perhaps after what has effectively been 2.5 years in rehab and given they presumably now have less mobility for trips to the office licence they will be more stable than they were previously and won’t take up drinking again. And if they do, then, as they have capacity that is their decision to make.

Is she still deteriorating. If so, do S.S. know this?

You could try to ask for a professionals meeting’ or a multi agency meeting and try to get housing and social care in the same room to thrash out a solution

I suppose the relative could self fund the care home a little bit longer with their remaining money to give time to find something else.

I assume private rental with a social care package would also be an option if they don’t like the available housing schemes?

@Nomorechipsforme if your relative is assessed as having capacity then they will be expected to attempt independent living. Should they make decisions that you disagree with regarding alcohol then that is simply a poor choice but one they are entitled to make as is everyone else. Capacity is the ability to make good and bad decisions like every other adult, age alone does not mean you should be treated like a toddler. If however they can make a choice but don’t understand the consequences of said choice, that could be deemed as limited capacity and that can mean further assistance is necessary. There’s a fine line being trodden but if they have capacity they can indeed revel in living opposite an Off Licence and that’s the law

Also two visits would indeed usually only result in one combined report which would report evidence from both visits.

I guess the trouble is that if the relative has turned down what was deemed to be a suitable offer of housing then the local authority may decide to end their duty to house them as they will consider that a suitable offer was made. I am not sure that age will be a barrier to that I’m afraid

I am pleased that you are comfortable in challenging decisions. I would not however even mention that the assessment was completed by a S.W I.T. IMO. this will only serve to alienate the local authority. Doubling down can and does happen. You want to keep the process as open as possible. Do let us know the outcome.

Am I right in thinking @ThePure that the trainee social worker won't have had final decision making powers? They'll have someone signing off on their work?

The trouble with the way you have tried to tot up the saving is that it’s coming from a lot of different pots some of them centrally funded (winter fuel, AA) or are health expense (alcohol support) Savings on those will not help the council with their over stretched care budget. In general anything up to 4x a day care is cheaper than a care home. 4x double up care calls, waking night carers or live in care are usually more expensive than a care home.

It’s not that I am unsympathetic about your feeling that a trainee should not make a decision that has a big effect on your relatives life it’s just that I do not think it will be a powerful point in a complaint or appeal. It will all be about the risks vs the cost so your best argument is that it is too risky to send your relative home. You would need to say why the decision is wrong and the most likely reason is failure to weigh up the risk of self neglect at home given past behaviour.