Paying for 1 to 1 care in a care home

[AMBOG]

Does anyone have experience of this and how common it is. My mum went into a care home about 6 weeks ago and had to be moved as she went from being a bit cognitively impaired to really aggressive and screaming all the time and had to have a 1 to 1 carer. She has now moved homes and is in a home which is a nursing home and a dementia home. The manager says they have sent a CHC form in but she doesn’t think mum will get any funding even though the 1 to 1 is more than the care home fees. Does anyone know how usual it is for nursing home residents to have 1 to 1 and if you are self funding you have to pay it all?
I am just worried about what happens when her money runs out. This is just 1 of my many worries around my elderly parents. I am going to start a few threads today. One is - will this torture never end?

To have 1:1 for all her waking hours, the care home needs to employ 3 care workers. Work out the NMW pa x 3, plus employers NI, training, pension contributions, PPE atm...

I suggest you move this to the "elderly parents" thread - a lot of expertise and experience over there.

I didn't realise there was such a thing to be honest. I wouldn't imagine there was funding for this.

Ignore me. It's too early in the morning. I thought I was on AIBU.

I've worked in the finance side of a large care company for a while and we've not ever had 1-to-1 approved by CHC.
Does she claim nursing allowance?
We would put an extra carer on each shift if we really needed to for a particular resident but in reality the family/resident would have to pay for it entirely.
In all honesty you may be better trying to find a more specialist care home who can accommodate her needs, it might seem more expensive initially but it would probably work out more cost effective in the long run.
I feel for you on a personal level x

Is she under the local mental heath team already? I would request a review and they can work with local authority to request 1:1 if it is a safety issue. They take this to panel. If she is hitting a high score for behaviour on the CHC assessment she will automatically qualify for a nursing assessment for that part of the fees.

So normally if 1:1 is required on top of a permanent placement it is a temporary measure due to a crisis- rarely it is needed more long term but only once all other options have been exhisted.

My advice is: - ask for GP to.compelte full physical review as a simple UTI can really have a impact -ask for the GP to make a urgent referral to mental health team (they will look at behaviours and advise /world with home) -contact your local council and ask for a care act assessment under the care act anyone (self funders included) are entitled to an assessment (this gives you access to a social worker who will liaise with all involved and work with the care home) -contact the council and ask for an urgent DOLs assessment (the restrictions your parent is experiencing needs to be reviewed and assessed to be in their best interests) -follow up the CHC assessment (a LA representative should be part fo this assessment)

No advice but just wanted to send you lots of love.

Been there and it's utterly utterly shit

Have never heard of it. I would be requesting an urgent review by Older People's Mental Health as she needs specialist input into how to manage her dementia, not just non-medical things that the care home should already be good at.

My mum ended up in a specialist nursing home for people with severe dementia and complex health needs and her care was fully funded by CHC but even then she didn’t have any 1 to 1 care and neither did any of the other residents. They just had a team of carers who worked per shift who cared for them. I think you will struggle to get 1 to 1 at all being very honest. They did suggest my Mum could have a live in carer at home fully funded instead but we felt she was safer in the nursing home due to the meds she was taking. I would ring round the nursing homes and see what kind of care they can offer and go from there. (My Mum owned her home outright but became unwell too quickly to sell it to pay for her care so CHC stepped in).

To add, in our company if we have people with higher/complex needs we would just up the over all staffing level generally. However in most cases it's usually the CHC or LA funded residents who require this and it's already been factored into the funding beforehand.

Thank you for your replies. It wasn’t me who requested 1 to 1. It was a massive shock when she went into the first care home as she seemed to go completely bonkers. ( not uti or infection they checked that out.) she went to the new care home with a 1 to 1 and seems more settled and they said they would review it. She was in quarantine and is now downstairs but they are worried she will want to keep going up and down to her room and they don’t have the staff to accommodate that.
I am going to speak to the manager on Monday and find out more. They have sent a CHC form off and they are going to do a review next week. It’s really difficult to know what to think as in the other home she was pulling carers hair and throwing things. They Have put her on some anti delusional drugs ( the dementia is Parkinson’s) so that could be helping. To be honest it’s been such a traumatic year with her and dad that I kind of feel she is tucked away now and I don’t want to have anything to do with it or her ( I am not going to abandon the situation but I find it hard to remember anything good about mum now) Meanwhile dad asks where she is about 20 times a day and cries because he misses her. He can’t remember how awful it was when she was at home.

@AMBOG feel free to PM me if you need any help. I sometimes wonder if it's the group I work for that people are actually writing about. I'm happy to help with any advice or anything x

I've worked in the finance side of a large care company for a while and we've not ever had 1-to-1 approved by CHC.

Yes, DD has NHS CHC funding and she got 1:1 care if I was in the house too - 2:1, if I wasn't there! It was deemed too stressful for one care worker on their own! Care in the house just did not work, because DD was so abusive to the care workers. Four left in tears!

She is now funded for 1:1 in a residential care home; where some other residents may get 2:1, 3:1 and iirc, 4:1. Some are funded by SS and some by NHS CHC - I never know which they are.

Thank you everyone and thank you cherrybakewellard. I will see what they say on Monday and I might take you up on your kind offer. I am having a good break this weekend as my brother is up and staying with dad so I don’t have to worry about him for a couple of days.

@DarkMintChocolate

I've worked in the finance side of a large care company for a while and we've not ever had 1-to-1 approved by CHC.

Yes, DD has NHS CHC funding and she got 1:1 care if I was in the house too - 2:1, if I wasn't there! It was deemed too stressful for one care worker on their own! Care in the house just did not work, because DD was so abusive to the care workers. Four left in tears!

She is now funded for 1:1 in a residential care home; where some other residents may get 2:1, 3:1 and iirc, 4:1. Some are funded by SS and some by NHS CHC - I never know which they are.

Sorry I should have clarified I work in the over 65 sector. I believe funding for younger people works slightly differently. I'm glad your DD has the funding she needs x

A move can cause acute confusion (delirium) particularly if someone is is already prone to delirium (dementia, the medication they take, infection, poor nutrition/hydration, constipation, pain etc.). Hopefully they will be able to use (funded!) 1:1 to get her settled and then withdraw.

If the dementia is Parkinsons then a review of her Parkinsons meds by her neurologist can work wonders. Just the GP having a chat with them and talking about her meds may be enough.

Also being in quarantine is going to be very very confusing for her. It's bad enough being in a new home, without being told she can't walk about, see other people. It will have a bad impact on her behaviours.

I spoke to the Parkinson’s nurse and they kept her meds the same as they had been recently reviewed. I found it very hard as they were telling me about this extreme behaviour and yet when I spoke to her on the phone she seemed normal. In this new home we can only speak via video call which is awful as she can’t hear anything it seems. It looks like we might be able to visit now though so I will be able to see for myself how she is.

Hi
i am waiting for a one to one home for Mum
Mum has sudden onset delireum
They are having trouble finding a suitable place
its so awful
i cannot believe i am in this situation
take care

My friend's Mum had a one to one for the first couple of weeks she was in a care home.

She has had a few other times when she's had to have one for a week at a time but has settled down and become less difficult.

She was self funded and paid for it all. An absolute fortune but it wasn't for ever.

You could ask the Home if they think it will be for a few weeks or longer?

My relative has 1:1 care that's funded by the CCG. They were very high needs at night and there were safeguarding concerns. Initially they had 1:1 from 6pm to midnight. This was extended after a few months to 4pm to midnight and is now midday to midnight. A few other residents also have 1:1 - obviously, I'm not sure if they are self funding or not. Although my relative's 1:1 is funded by CCG now, while they were above the self funding threshold (or whatever it's called), they did pay privately for some 1:1 care for either a week or two weeks (with the aim of gathering evidence that it would help - in practice it probably wasn't long enough to see), this was billed to us by the care home at £21.50 per hour.