How to find a nursing home - not self funded / no hospice available

There is no expectation that you will pay for care or that they will pay for care either, so don’t worry about money.

Can you all manage as you are until Tuesday and maybe for a few days after that? If so, then social services is your best bet. It is their job to assess your mum’s needs, liaise with other services and find suitable care for her. It sounds as if she needs residential nursing care. Personally I would consider putting in a safeguarding report today (look on her council website) saying she is at risk of harm through unmet care needs and unpaid carer breakdown just to get the ball rolling.

If she has immediate medical needs (new pain, new worsening symptoms, new evidence of infection) then I would call 111 or 999. They will assess her and may be able to access services like hospital at home/urgent community care or will advise if hospital is the best option for her; they can also put in a safeguarding referral that carries weight because they are seeing with their own eyes what’s going on at home.

Sorry she's so unwell, if she's now semi conscious I would ask for a doctor to see her, it makes her death much easier if a doctor sees her, you can call 111 or the hospice nurse can help you.

I’m so sorry this is very distressing for everyone. If she was my mum I would want her in hospital even if it is a long wait in A & E someone would be able to stay with her. They have access to everything she needs there. Failing that,
I once called adult social services for my dad , it was a bank holiday, they came the same day assessed his needs and provided all night care for four nights plus his carer visits during the day. The very best of luck.

This.
It’s so shocking reading this thread, as things sound even worse than when my parents were nearing end of life.

@Soontobe60 Really ? I had no idea . What about palliative care , is that not available under NHS . How awful . I guess I never had to deal with it and have often contributed to McMillan Nurses but never knew they were completely donation funded .

Fast Track continuing healthcare is for exactly this situation

It's entirely different to fully funded continuing healthcare and has totally different thresholds and assessment process.

Fast Track CHC basically just needs a district nurse to fill in a form and it's pretty much instant funding. It's absolutely nothing to do with Adult Social Care and nature/intensity/complexity and unpredictability are not part of the assessment, it's not about nursing needs it's a simple assessment of whether the person is considered to be end of life or not.

Im sorry your MIL is so poorly. If her GP does not advise surgery for the hip fracture she needs full Nursing care. Are the District Nurses involved?The person who said explore Continuing Health Care funding is right. If your MIL is close to end of life you can ask the GP surgery or DNs to apply for a “fast track” assessment. This would fund a Nursing Home and you should ring round now to get a head start on finding one.
If your MIL is not eligible for “Fast Track” (what lay people think is end of life may not be the same as the criteria) any involved registered health or social care professional can do the “screening” assessment and this is the gateway to full CHC assessment. If there’s an allocated Social Worker it will probably fall to her. I’m certain she will screen in for full CHC assessment. This will involve an assessment meeting
that your MIL and/or family would attend.
If your MIL isn’t eligible for CHC - the bar is very high - and she needs an LA funded placement, there may not be any choice unless family are willing/able to pay a “top up”. The days of three offers are probably long gone though there may be a few authorities that still manage this. The LA are only obliged to find and fund (with a combination of her assessed charge and their contribution) a home that meets her needs.
I can hear that this is really urgent now - in the meantime does your LA have short term care service which aims to find alternatives to hospital?
Good lunch, this sounds like a really difficult time.

Get in touch with age uk. They can also get discounted sheltered homes and nursing. They did for my nana.

Hospices are not NHS funded, they are charities and are full to bursting. Hospitals do not provide end of life care as such.
The whole system is totally broken and the only way to get direct support is to take them to A+E.

Honestly, the quickest solution is to phone 999 and get her taken to hospital. It’s certainly not an ideal solution though. An ideal one would be that adult social care would be able to place her in a nursing home within 24 hours, but that’s never going to happen. I’m assuming she was diagnosed with a fractured pelvis whilst in hospital and they then discharged her with carers being put in place? If so, it sounds like it was an unsafe discharge.
Once in hospital, you then need to keep telling the discharge team that having attempted to support her at home with 3 carer visits that is no longer sustainable, your DF is not able to take care of her and there is no family available. They will then have to look at a nursing home directly from hospital.

My DH is currently receiving EOL care at home, the care package was applied for by the District Nurses. The hospice may provide more advice if you let them know your full circumstances and in our area they work closely with the District Nurses.

End of life care is usually funded. Is she under the local District Nurses? They sorted out the funding for us when we were in a similar position.

They usually sorted out the Nursing Home for you too.

ASC will give you the list of homes that they will pay for. Depending on the area, you may actually get a choice- we were given the list of where our council funded beds and went and looked at two that had spaces and we got a place that we wanted for our relative.

Regarding a charge on the house: they shouldn’t do this if another relative over 60 lives in the house. In our case, the house is discounted from care costs as relative’s wife and adult child live there but that would change if the wife went into care.

I don’t believe it’s the case that because she’s at end of life she will qualify for CHC, though I could be wrong.

Leaving aside end of life, if her needs can be met by carers rather than nurses then she wouldn’t qualify. Her needs are intense but not complex so I would assume she would qualify for CHC. My father was not diagnosed as being at end of life but had dementia, diabetes, was completely bed bound and had to be moved with a hoist, couldn’t swallow, had pressure sores, was deaf, was completely unable to tell if he was hungry or thirsty and he didn’t qualify. He could move his arms (pointlessly) so he wasn’t immobile, and while he had no cognitive ability he wasn’t hallucinating or delirious so didn’t meet the most severe categories.

is anyone in the family in a position to pay for more carer visits or a nursing home while the house is sold? It doesn’t sound like it would be very long term?

Your MIL is nearing end of life. This is not for Adult Social care it is NHS responsibility. You are being let down by the health service.

Appalling isn’t it. It means an adult can be left soiled for hours on end between carer visits. It would(rightly) be considered neglect if we did that to babies.

It’s likely that care will be increased to four times daily first before they even think about a nursing home.

4 times daily is deemed enough to deal with the toileting issues, even if you think it isn’t.

What a terrible situation for her and your family . I can't believe a hospice is telling you to look elsewhere and also being told to not go to hospital. If she is end of life situation then isn't that hospice and if she is critical then wouldn't she immediately be admitted. The fact that she is not financially able to afford private shouldn't matter . This is not America . So much for the NHS .

This situation is the type of issue local MP needs to address , real life that people have to deal with .

I have nothing useful to say but I hope your SIL quickly gets some help .

If the situation is such that you can't cope over the weekend, your only option is to call 111, or push for the GP to support/refer on Tuesday. It sounds like there needs to be an end of life care plan put it in place, with potentially nursing support provided at home in the absence of any specialist care places. Am gobsmacked your GP hasn't discussed this with you. The social care team are likely to bounce you back there anyway as these are all considered health care needs (except the dementia) so my advice is a two pronged approach. Chase both social care and your GP.

That's good news. Who has arranged / is funding the additional care visits?

No they won't. It will be disregarded in the financial assessment.