Council saying I should remove my mum privately to move her closer to me

[flutisy]

Hello, sorry, looking for more help!
https://www.mumsnet.com/talk/dementia/5471968-what-are-the-chances-of-getting-my-mum-moved-near-me?reply=149726957
I've been trying to get my mother moved near me from London. The council won't move her.
They are saying I will have to move her privately if I want her moved, and then wait for a CHC where I live. Does anyone have any idea what this would actually involve? She needs nursing care. Would I have to get her private ambulance? Where would it take her? She has no money and I am just not in a position to pay for care home fees for any amount of time. I have two small children and my house is not in anyway set up for someone needing nursing care. I could probably just about scrape together the private ambulance costs. But it just feels like her current council would be quite delighted by me taking her off their hands and landing her on my council.

She has to move because she's currently in hospital. She can't go back to the residential care home she was in, because they can't take her (she needs nursing care). So she has to go somewhere near anyway.

Hello. To help me advise, can you clarify please:

1. has she been detained under mental health act S3 or other? Anything bar a S2. As she will be entitled to S117 aftercare
2. Is she CHC funded i.e. total cost paid by NHS?
3. Or is it jointly funded? Either LA, CHC or joint under S117

She is entitled to move to be closer to family as that will enhance her quality of life.
When you clarify the funding stream, I can help further with who to contact and what to try to do.
Hope this helps a little in the first instance

• edited to add in a paragraph break

Just seen your update. Info asked still relevant.
But if in hospital currently and cannot reru4n to previous care home this.should make it easier.
Has she been assessed for CHC whilst in hospital for the determination she needs nursing care now?

Was she on Section 3? If so she is eligible for 117 aftercare so you will not have to pay but will need agreement of the ICB and council

Thank you so much.
Her legal status is S3 : Section 3 MHA S117 : Section 117 MHA 1983 (from her notes).
The social services person only verbally recommended moving her privately and applying for CHC when she's down here (I've asked them to clarify this, but they don't seem to want to. They won't send me the email from the ICB that they were reading from).
There's been no other mention of CHC.
She doesn't have any money or property at all.

It should absolutely have been part of the BI meeting. I think you need to say you are unhappy and want another one.

If you can supply details of nursing places near you that have vacancies they should be biting your hand off (or at least calling them)

Talk of the ICB suggests that she may have been deemed eligible for CHC funding which will allow social care to wash their hands of the issue and leave you to the tender mercies of the ICB CHC team who in our area are very poor and ineffective and much worse than the LA. It is of no advantage to her to be awarded CHC just pushes the responsibility for paying from one place to another. If she has been deemed eligible for CHC then you need to find out who the ICB team are

Yes, but the ICB are saying she can only go to a local to them nursing home, because they need to reassess in six weeks. All the doctors think she will need nursing care forever -- there is no chance of her returning to residential care. But once she's settled in a nursing home in London, it really would be mad to move her again to get her down here.

Thanks. I know she's now under the ICB, but (once again!) I can't seem to actually speak to anyone at the ICB.

Apologies, I misread.

Ok so she’s S117 funded. Then the LA are clearly responsible for placing her

I think they are trying to push it off to NHS continuing care.

If someone is eligible for both it often results in unseemly wrangling over who will pay. In our area there is a ‘joint funding tool’ and they both pay a bit.

I think you should put in a complaint about that advice even if it was only verbal. It’s terrible and illegal.

Ok, that's really useful - thank you. They're now refusing to forward the email from the ICB, which is interesting. It's such a nightmare because you just go around and around in circles. I know that it's tricky, but a) would save them money as care is cheaper down here and b) her family could visit regularly. She's so so so isolated at the moment.

I think you are conflating two ideas in a way that might not help

yes she will always need nursing care and thus eligible for FNC (a small NHS contribution)
no she might not always be eligible for CHC (full NHS funding) Very often this does get taken away if the person is ‘stable’ even if at a very poor level.

It’s bad for her that she’s been deemed CHC eligible in fact as it just makes things more complicated and difficult.

She can also never lose her S117 funding though so the LA social worker should not be abdicating this entirely. In our area they agreed a joint funding split but this might vary.

A big problem is that social care funding stays with the home authority but NHS funding moves if you change GP. I honestly have no idea how you get round this but it cannot be in her best interests to move twice and be far from her only visitors.

I guess ask for a new BI meeting with the ICB to be invited and point out that everyone should be acting in this vulnerable lady’s best interests

https://www.mind.org.uk/information-support/legal-rights/health-and-social-care-rights/continuing-healthcare-chc/

In my experience with my mum it was being in hospital that was a detriment. Best to try and get her moved asap.

OP's DM is currently in London it would probably be cheaper for them to pay for a place in OP's LA

I suspect they won’t move your mum as placing her could make them responsible for her care fees. If you move her they are likely going to argue that her fees become the responsibility of your local authority. You will be changing her Ordinary Residence and unfortunately it is the cause of many disputes between local authorities. Also the cost of a private ambulance is huge and the local authority will not agree to pay it. They just don’t have the funds.

Also the RPR has a right to view health records which would include the email from the ICB so you can put in a subject access request for any records the ICB has on her which would include the email. Perhaps they might then find it’s a bit easier to pick up the phone…

The LA social worker might not want to disclose the ICB email without the authors permission I guess so it’s the ICB you need to ask

I think probably LA are saying we are no longer responsible as she now has CHC and is ICB funded

but the ICB are saying that if she moves out of their area then it would be the ICB in the new place that’s responsible and that it might get taken away after the 6 week review anyway. They won’t fund CHC outside their area.

Her S117 entitlement which the London LA remain responsible for cannot be taken away unless there is a S117 review to which OP as the NR under MHA would be invited. They can only take it away if they deem her to have no mental health needs only physical which is unlikely in dementia.

Theoretically if you moved her to the care place near you and the ICB there deemed her not eligible for CHC then the London LA would need to step back in and fund as she still has S117. With the money involved though I would not call anyone’s bluff on that.

I think requesting a new BI meeting and making a formal complaint to both the ICB and the LA is the way forward pointing out that a vulnerable lady is suffering due to their bureaucracy. The hospital she is currently in (physical health hospital) might also be your allies as they will have no desire for their bed to continue being blocked

following a bit of informed googling it should be possible to transfer NHS CC funding from one ICB to another so that should not be the barrier. If the London ICB has agreed she is CHC eligible then they should ask the ICB near you to take a transfer and again they should be happy as they won’t have to pay.
I think your main issue is

1. getting confirmation that the ICB have agreed she is CHC eligible and that they will pay
2. finding a contact at the ICB who will talk to you.

These might be resolved just by being a PITA and calling them every day.

It's to do with ordinary residence and contracts with care providers. Some care homes have contracts with the local authority they're based in so the authority can struggle to place outside of their area. They also will hold responsibility for the person which brings complexity, too far for social worker to travel, not having local knowledge of the area, not having links with local services, placement instability as they don't have contracts with the provider. If the placement does come to an end finding another out of area placement can be a real challenge.

having read all the information it sounds like it's less about dishonesty and a lack of transparency and all about funding and bureaucracy and a SW who hasn't understood that it's outside of their knowledge/understanding.

I've been doing this job years and still find the legal wrangling around CHC/S.117 baffling at times even without the added complication of an out of area placement.

To an extent the OP is going to have to wait for the LA and ICB legal teams to iron it out - my advice would be to submit a complaint and request that a without prejudice funding agreement is reached for temporary 'respite' in a care home near her to be arranged for ...oooh 6 weeks?.... whilst they sort it out.