How to convince the social worker of the need for a care home?

[6hearts4humphrey]

Looking for some advice for my elderly relative who's almost 99. They are in hospital with a broken hip following a fall. The social worker has said she will be discharged soon, apparently the doctor has passed her as fit although the sister in the ward said this is not the case (going to clarify that later). My relative was very distressed when told she was soon to go home, she cannot stand or sit up unaided, wash or care for herself.

The social worker has said she will have 4 carers a day (increasing from 3) but even 2 nurses cannot move her currently.

We would like to push for a care home (my relative has no assets) so it would be paid for by the local authority.

Any advice for me - all the social worker will say is that it's my relative's human right to go home even though my relative was extremely distressed when told this would be happening soon.

You need to speak directly to medical staff, and you also need to speak to the ward's Occupational Therapist. I seriously doubt, in the circumstances you have described, that your relative will be considered fit for discharge home with or without carers coming in.

Ask about an Occupational Therapist pre-discharge assessment. Remember, it is the medical staff who decide on discharge, not social services. Also, social services are desperate to avoid picking up care home bills so will wriggle out of it whenever they can.

You know what's right so stick to your guns. We had this ' We know best because we've spent 3.5 minutes with your Mother ' nonsense. It is your relatives human rights to spend the rest of her life well cared for and free from anxiety. They will give in if you push hard enough. Bloody Hell, at 99 they aren't going to be paying for long. You have feet....get em stamped 😉Good luck.

Thanks both for the advice - it's not actually me talking to the social worker but another relative who is the next of kin. Unfortunately my relative is not coping at all and has been having panic attacks when dealing with this and is now so stressed their own health is suffering (they themselves are in their seventies). I am going to the hospital shortly so I'll see what the latest is.

Apart from the broken hip the relative is healthy, she's not incontinent at all and does not have dementia. She is very frail however and unable to care for herself.

The doctor will be signing her off as medically fit (ie. no longer requiring acute hospital care).

Does your relative have capacity? If so, what's their wishes?

The OT will do an assessment of needs which you should ask to see and also ask who her social worker is and speak to them too.

Although social care can find spaces it's far better if the family calls round and finds availability as them you have control as to where your relative goes.

The relative has told the nurses and other medical staff she is too scared to go home, so we need to get across to the social worker. When she came in she was assessed for capacity and the doctor said she had a better memory than him! However she is getting a bit muddled and upset in hospital as she is out of her weekly routine, doesn't know what day it is etc.

We're happy to look into care homes, but concerned the relative will be sent home too soon - we were first told she was going home today but have now been told she will go home soon even though we've said we don't think this is the right thing.

Also I think but could be wrong that social services would need to agree this given that my relative couldn't pay for this themselves. Need to check that too.

Adult social care only funds care homes up
to a certain amount. Anything more has to be paid for by the family.

Once you have looked around a few homes within budget, you may find she prefers to stay at home with the four carer visits a day.

We had expected her to go to a care home while her hip healed which is what happened last year when she broke her pelvis. That would give us some time to sort out a home or for the relative to feel comfortable about going home. It was a surprise to hear she was going straight home. Our fear of course is with a broken hip she will not be able to walk again.

Anyway, off to see her now. Will update with an outcome when I know what’s happening.

So to update. I put all of our concerns in writing and the social worker agreed that a care home should be found for a temporary period, then my relatives needs would be reassessed. So far so good. However we were told that as it's only a temporary placement we would get no say in the choice of care home, and my relative has a place in one that has a requires improvement rating, up from inadequate last year. Just been to see it and it's not great. Going to be talking to the social worker again first thing, but my relative is due to move their tomorrow. Very stressful.

In what way was it not great and do you know what areas of improvements are needed. Did they only give you one home to look at.

It was like a building site, didn't smell great at all, room was grubby, just generally shabby. No window in the room, which is not the end of the world but will cause a lot of moaning from my relative. Other small things like no parking near it so will make it harder for my mum to visit. I guess the worst of it is that we were told we had another home which looked much better but that was changed due to cost at the last minute.

Social worker said no choice would be offered as it's only a temporary placement.

If its only for a couple of weeks would anyone be able to top up the fee to find somewhere you think she would prefer. Did you only see one room, what do you mean it was like a building site, were they having work done. What a shame, is that the only council funded option.

No window?

So a cupboard then. That doesn't sound good.

We would be able to contribute for a few weeks but didn't get the option just got told the first home option was suspended. It was actually the new care home that said the other one had been too expensive. I will find out tomorrow if we can top up.
The care home were ready to pick up my relative this evening, only the hospital insisted on having the agreement from the relatives first.
They are in the middle of having work done which made it look worse - very tatty with some rooms gutted / boarded up.

You could try contacting the charity Age UK which can give advice to relatives on the best way forward. Sometimes if the Local Authority is funding the care it's a cost exercise and there isn't that much choice of which care home. (that's my opinion) I know you haven't got much time here to act. People can and do stay in their own homes with the four carers a day. But doesn't sound as if your relative wants that. Hope things work out.

I wonder how the new home knew about the other one, j would speak to the social worker and ask about top ups, if you really didn't like the place you should let them know, maybe they would visit it too.

Hopefully my relative will be able to go back to her home if the hip heals and she's able to gain some strength and movement.

It is odd about the new care home knowing about the cost - certainly wasn't mentioned by the social worker but gives me some hope we may be able to get her into the nicer one.

Have taken tomorrow off work to try to get things sorted - thanks everyone for your advice.

Just to update, social services found two alternative places but both care homes declined a place, one due to being unable to meet my relatives needs (one was due to the bedsore the other we're unsure about). Crazy that social services initially assessed her as being suitable for having carers at home but care homes x 2 cannot meet her needs. We are waiting to hear if another place can be found.

Sounds like par for the course, SS desperately trying to minimize the person's needs while care homes maximise them.

Do you have power of attorney for your relative? Recently been in similar situations to you but as had POA they took into account what I said was best for my Dad.

So, finally a place in a nursing home was found and my relative had been moved there today. Just been to see her and she is very happy there.

No POA yet as my relative is still very able to express her wishes. The nursing home has already said she is a character

Good news, 6.

6hearts4humphrey - make sure you or one of your relatives get the POA done for both health and finances. Someone has to sign to say your relative is of sound mind. It's too late setting one up when she is unable to make her own decisions as there's an argument that she could be tricked into signing then. Also she may have specific things she does or does not wish to happen to her and she can only specify these when she has full mental capacity (such as life support/resuscitation etc).

Once the POAs are in place they are only activated when it's clear that your relative can't make her own decisions anymore.

We set one up for my mum when she was diagnosed with Alzheimer's four years ago (both finance and health) and it's been a God send now she's heading into permanent care. Social Services speak direct to me and our views are most definitely taken into account.