Cate home can not administer medication

[notheretoargue]

PIL live in an independent living flat inside a care home. they have varying needs but being able to live together is important for their mental health. The home has just told me that they are no longer able to administer meds to people living in assisted living flats. Fil can take his medicine himself but mil (who has dementia) needs assistance for her daily meds.

Is anyone else in a similar position? We don’t know what to do. We’ve been given 2 weeks notice. Are there nurse agencies that could do this? We live 1.5 hours away and have young dc. Obviously we could move them both near here but that will take time and will be even more upheaval (they only moved in 18 months ago).

What’s the reason given.

It’s pretty ropey “extra care” without administration of medication TBH.

Are there carers visiting?
What is the medication? I am a social worker and my expectation would be that carers could prompt medications that are prescribed and provided in a NoMAD pack.
The only thing I’ve had difficulty with is insulin or liquids meds like morphine that need to be measured out.

Could FIL prompt the meds?
Could you try an electric med prompt? Sometimes provided either by a telecare provider or by speaking to your pharmacy?
If meds aren’t already in a NOMAD (blister pack) get that done ASAP (pharmacy will do it).

My MIL is in an assisted living place and it's the same there - they don't administer meds. So pretty much all the residents pay an external agency called 'Bluebird Care', which sends staff in every day to give people their meds (and have a chat etc). The agency was recommended by the people who run the residence - they are a trusted outfit and they do a good job.

Is there a similar service available to you MIL? Have you asked the staff or other residents there?

Have the care home explained why?

As mooey says the first step is to get all the meds for both of them put into 'blister packs' which the pharmacy will happily do but it needs to be set up ASAP. If your dad can manage his own medication is he able to prompt your mother's if it is pre set out for him in the blister packs?

Do your parents have a tenancy for this assisted flat or is it commissioned as a place in a residential care home? There can be registration issues with external 'domiciliary'' carers coming into a residential setting.

Is it a privately owned care home or council run? If your parents or any of the other residents in the assisted flats receive any council funding it may be worth ensuring they are aware of the homes new policy.

Thank you everyone for your replies. It’s nividel, which is a type of dementia medication. It’s on blister packs, but she needs someone to help her put it in her mouth. Someone can talk her through it but fil has ms and is sometimes in too much pain to speak. They are saying we have to split them up and move her into the medical care wing. If she was on her own then I’d agree that’s what would be right, but they benefit so much from being together. Also, to be blunt, they/ we can’t afford it (£2k per week, plus the £1.5k people we already pay for her care and meals).

Has the law changed? The manager said that he would carry on doing it for 2 weeks ‘as a favour’ as long as we gave the place a good review to the CQC. I don’t know if we’re being taken for a ride or what

It’s a privately owned care home (barchester) and they own their own flat, with carers coming and going throughout the day to feed them, wash them and carry out other caring duties. We bought the flat in the full expectation that they would be able to live together as their (particularly her) needs progressed.

Sorry for all the typos! On phone and also, frankly, in a bit of a panic.

Doing 'favours' in exchange for positive cqc feedback sounds dodgy!

Doing favours for CQC feedback is more than dodgy - please let the local authority know.

There can sometimes be a problem with carers putting meds in peoples mouths. If it’s put in her hand and she reminded to put it in her mouth would that work?

Do you have use their carers or could you use a different agency/PA?

I think if someone put in her hand and talked her through it she should be ok. But I think at the moment they put it in her mouth

I don’t know about external carers. I had assumed it would be ok, but we only use their carers at the moment.

So it sounds like it might be a bit dodgy. What can I do? Can I call up the cqc? Will they advise? I am very worried about pil if the home finds out I’ve said anything - they are both incredibly vulnerable at times.

I don't even know where to start with your updates.

The whole thing sounds a right mess. Please let the local authority know. I would be extremely interested in getting to the bottom of it if this came across my desk as a social worker.

So they own the flat but are paying £1.5 k (a week!?) for care and meals?

Op
People are right, this sounds dodgy. You don’t give meds as a favour, nor is it reliant on google Cqc feedback. In fact you should alert Cqc to their current practices and behaviour! Also contact adult social care.
A change like this should be in writing.
Are you PILs the only ones affected? What are others doing?
Why are they stopping meds but not other services? Have they had this taken off them for failures? Both CQC and local authority would know.
You can and should get private from care organisation to visit, how are OUL generally?
Has there been a recent inspection? Have you checked Cqc website for their most recent rating?

You are right they are likely to benefit from being together, it’s up to you all if moving closer would be best. Good luck

The top and bottom of it is if they are in a privately owned residence then in theory they can have whoever they like to provide the care.

However, Is Barchester providing some overnight care/response service or something as part of the 'deal'?

Thank you all - putting dc to bed now but will come back later to respond properly.

Barchester provide 3 cooked meals a day to their room, light cleaning, and washing. There is a district nurse who visits the home and sees PIL too, but that's infrequent. There's no overnight care (we arranged it separately when we went on holiday recently and it cost £300 per day just for someone to call an ambulance if FIL fell out of bed).There is also a standard 'peace of mind' package which costs £500 per month for someone to check in every day, plus a service charge of £300 per month.

I honestly feel like the whole place is such a racket. Despite me asking numerous times in writing and in person and going round to show them my power of attorney documents etc etc they still don't send me invoices, but demand money (not kindly) from PIL.

We'll plan of action tomorrow I would say is speak to the local authority about getting a different care agency in. I suspect when you start to explain why a can of worms will open.

Might be worth getting as much in writing from the home as possible as to why they are suddenly not providing medication support.

This sounds like a very odd set up, and the manager who is suggesting that he can arrange medication administration in return for good CQC feedback is dodgy. Please report this.

In our LA area care workers can't administer medication from blister packs, only from original packaging. You need to check what the local policy is.

It also sounds as though the fees are exorbitant. If I were you I'd ask for a clear breakdown of fees and charges.

Barchester? Barchester?!!

To say Barchester is iffy is like saying Bill Cosby is a bit hands on.

My mother was at Barchester's Reigate Beaumont a few years back. They sought to have my sister and me barred from the care home! This is a common Barchester trick, it turns out. They timed it for Christmas Eve, something care homes - and, ahem - local authorities like to do. Hatgirl, I don't know where you do your social work - I hope it's not Surrey County Council! They are the worst. They colluded with Barchester, in fact one social worker helped beef up the manager's letter - on Christmas Eve! A jolly crowd. My mother had nearly died through care home neglect earlier in the year, and they knew about that. Surrey is sick.

Read my review of Barchester here:

www.goodcareguide.co.uk/eldercare/care-homes/surrey/the-reigate-beaumont-rh29jb/

And yes - get everything from Barchester in writing, make sure you have their email address. If they told you it verbally, it never happened. Beware the whole 'would you like to get your parent back to the family home' social services trick. And if a social worker unexpectedly turns up to 'assist' (sorry hatgirl) you'd better covertly be recording that conversation.

The CQC seem to have a dodgy deal going with Barchester homes, perhaps because they are busy building lots of homes, creating new rooms to ease the ongoing, escalating crisis in adult social care, and possibly for more sinister reasons. I sent a big complaint about the Reigate Beaumont to the CQC, and they simply didn't reply! When I pressed them on it, the CQC woman said it wasn't in her remit! She did, however, promptly forward it to Surrey's Safeguarding teams - the very ones who'd joined forces with Barchester to fit us up after I whistleblew one care home to the local press - they'd have been delighted to get the inside track on where we were going with this!

Yep, Barchester are a very murky business though generally very much within context in the world of adult social care. Watch your back.

Sound dodgy to me! If they aren't allowed to administer medication anymore, they aren't allowed. They can't do it for you as a favour! Do the nurses or carers administer it? They shouldn't be putting it straight in her mouth unless using a spoon either.

I'll point out that the whole 'write a good review to the CQC for us' thing may have been simply a jokey aside. In my experience, contacting the CQC is largely a waste of time, and it's for the CQC's benefit not yours. It's not like your 'review' will go on a website anywhere.

What's more, there is a record of the CQC informing on 'whistleblowers' - see Eileen Chubb's Compassion in Care website - she is a registered charity - for more on this. So you may find that if you stir things up with the CQC, it could rebound on you and the Barchester home get to find out all about it. Honestly, I don't know. It can be used as a last resort, and even on then simply on the basis that they don't have plausible deniability if things go badly wrong. Like I say, if it's not put in writing, it never happened.

If your MIL has dementia, it may be they are trying to steer her in another direction, away from your FIL. Watch out for that. Also, watch out for being accused of giving medication yourself and them making out you are a 'danger'. You don't say what state her dementia is.

Anyone who has dementia at these places gets a kind of treatment that is not too wonderful, let's put it that way. They are placed in a different category and you may find it mysteriously hard to get the care home to administer sufficient daily drink - if you happen to notice what is going on. We noticed, and subsequently got it in the neck.

Thank you for all of your replies. Newspaper, I'm so sorry to hear of your experience. Interesting that you mention hydration. MIL is definitely dehydrated, and when I asked them to keep an eye on this I was told it's not something they can do unless (once again) she's in the nursing wing.

The problem is, DH is so worried about his mum and scared of what the care home could do if they take against our family. So he doesn't want to challenge them. For now, my priority has to be making sure MIL gets her medication. I called up two local care services and asked if they could help. Both said they could (and were also really surprised at the attitude from Barchester.) Once all this is sorted, I am going to investigate exactly what Barchester are doing and why.

Unfortunately there is no LA support where PILs live. We had some contact with the LA a few years ago, but they just ghosted us! We were booked in for an assessment and they never turned up. When I called I got an answerphone message saying no-one worked in that department and I should call a local charity. Called the local charity and they had no idea the LA had put them on their answerphone message!

Are you in England/UK?

Local authorities in England have a duty to assess under the Care Act 2014. They can't just ghost you!

many are in a complete shambles at the moment though due to cuts and lack of funding so it wouldn't be unheard of for the assessment to get lost. I know of one local authority where in some areas things got so bad at one point a few years ago that they just deleted the backlog of anyone who had been waiting for an assessment for over 18 months and hadn't been in contact again since the original referral on the assumption they had either sorted themselves out or died.

So it's worth trying again.

Fortunately the vast majority of people's experiences are not the same as Newspaper's but that's not to say that big care home firms like Barchester (and they aren't the only ones, there are many others) are primarily in the business to make a profit.

I am in England, hatgirl. To be honest, I could see the LA were very stretched. They came to make an initial assessment and sent an occupational health adviser round, but they also practically ran away when they realised PIL would be self funding. Then in the end, they basically did run away! Even when they were around they were so unreliable, and they could mostly just tell us what they couldn’t do.

"Local authorities in England have a duty to assess under the Care Act 2014. They can't just ghost you!" - hatgirl.

(Christopher Walken voice: "Actually, it kind of is like that!"

www.compassionincare.com/node/375

Hatgirl, I know you have a duty to hold the line on this board, but I do not see how you can maintain that "Fortunately the vast majority of people's experiences are not the same as Newspaper's..." I mean, I don't see how you are in a position to make that statement. Then again, you are right, most people do not do what I did, which is to attend to their parent daily, alternating with their sister, simply to give their mother drink... And the reason they do not is because most people simply do not realise what is going on via the covert use of the Liverpool Pathway method of bumping people off. If they did, you might see a few more Alfie Evans-style controversies.

Anyone who raises complaints begins to see how meticulously rigged the complaints procedure is.

When did anyone see the contact details of the Council's Safeguarding team on any care home notice board?

As for keeping an eye on her hydration levels in the nursing wing, that's like asking them to keep an eye on your goldfish in the piranha pool (except that has more access to water, so it's the wrong analogy.) You are quite right, you are not on hand to administer daily fluids. That, my friend, is exactly why this method works so well.

Yes, many LAs are in a shambles. And others are corrupt.

I am just going to vent here a bit because I don't know what else to do.

Barchester say on their website that 'assisted living is not a temporary solution' - ie you're meant to be able to live there till you die. PIL spent £440k on buying this flat, and more on putting up shelves, making it more accessible and homely. They were lucky enough to own a house that they could sell to make the move and it's what they really wanted to do so that they could live together for the rest of their lives. MIL starts to get distressed if she even can't see FIL, let alone live apart from him.

At the very least, this is false advertising.

But I think what makes me angriest most of all right now is that the General Manager cornered my DH, who is totally fucking devastated and upset and dealing with all kinds of shit to do with his parents' ill health, to tell him that a) his parents owed Barchester £9k and b) they would no longer provide the care his mum needs. But I have POA (not DH), and I handle all the bills. And I have been chasing Barchester for two months for missing invoices. How can they just ask DH for money like that, when they've been ignoring my phonecalls and emails? And, moreover, how can they just tell us they won't give MIL her meds?

I tried calling the LA today and got put through to a phone line that just rang out. So that's that.

There is nothing to do but watch the care home mistreat PIL and bleed them dry. I honestly think moving them elsewhere would kill them. I don't know what to do. DH is so upset he doesn't want to do anything to upset the General Manager in case he does something to PIL. The CQC website says you should call the LA. But I can't do that because they won't answer. I can't confront the care home. I can't move PIL somewhere else. So what can I do?