Social services saying mil must leave residential care

[Joystir59]

Some of you may remember my previous thread in which I helped arrange residential care for my mil following the death of my wife (her daughter), as it wasn't working her living with me. Here is a link to that thread: www.mumsnet.com/Talk/elderly_parents/4179405-Advice-please-Elderly-mil-cannot-carry-on-living-with-me
Mil has been happy and settled in residential care following a care needs assessment stating that was what she needed. She has been paying for it herself, and now her funds are getting near the LA threshold I referred her for a financial assessment. A social worker has been to see her and decided she can go and live in a flat. Even though at the original assessment it was decided this would not be appropriate- she cannot manage her own affairs, cannot get around with wheelchair/walker, cannot cook, clean, shop, communicate over the phone. How can they decide now that she doesn't need residential care when in April 2021 she did?

@TheWomandestroyed I'm not sure how widespread the Assisted Living schemes are in England - our council has two. A friend of mine recently moved from a fully-independent sheltered housing scheme (council) to AL. She was paying about £110 pw originally (rent/service charge/fees for warden and alarm) and she said it was about £30 pw more for AL. I know her income was above the threshold for any reduction but someone only getting the State Pension would get a full rebate on the rent element of the cost.

I would also suggest calling AgeUK for advice / assistance in how to deal with this.

They were great in helping us get our parents’ needs met and rights upheld

I remember your OT, and thought you were a wonderfully caring, thoughtful person.

I have no knowledge or advice, but that’s appalling! You originally wanted her to live in a supported flat, but SS pushed for her to go into a residential home. Now they’ve got to foot the bill, they have changed their mind. After almost a year, she will have become institutionalised (which is not necessarily a good thing, but means she can’t start doing things for herself). I’m furious on your behalf.

You need to tell them in writing that you will not be providing any care or support if they relocate her to a flat, that you do not accept transfer of any responsibility to you, that whatever her needs are they must be met by adult services and ask them to confirm in writing that they have received this information. Send it tracked and signed for.

I know how they work.
They're looking for the cheapest option and that option is you. If they can manipulate you into feeling like you have to step in they will.

Make it clear from the start that you will have no involvement whatsoever. You should also tell them to remove your details as a contact.

This does not mean you actually walk away btw, if you want to visit you visit. This is about letting them know that if they put her in a flat, they are responsible for meeting her needs.

@Silvershroud did you read in the original thread that the OP is the DIL and is widowed and was left with her MIL to cope with? Despite the fact that MIL has a surviving daughter who refuses to get involved? Save your judgement for the MIL's actual relative and NOK who refuses to be involved or take any responsibility. Situations like this are exactly what social care is designed for.

OP, I remember your previous thread. You are going to have to be very firm and clear with the SW. Tell them you are not her relative or NOK therefore it is inappropriate to involve you in this. Hard as it is, you are going to have to stand back and detach. The more you advocate for her the more you will be treated as her carer, which is a role you have said you don't want. No judgment from me - I care for my mum and I know how bloody hard it is so can't imagine doing it for someone who is not family. But you have got to be very firm and consistent in your message to the social workers; otherwise you are going to end up being included as a resource within her care plan whether you like it or not.

It's an awful situation to be in, but it really is a case of not blinking first.

Do you think the tax payer should provide what you are not prepared to offer? And why should you pick and choose where her care should be? Social care is not there to provide the kind of bespoke service that wealthy people can afford, it is to provide good, basic care on a budget if someone does not have family support.

Why should OP offer? She isn't next of kin and has no legal or moral obligation to give up her life to care for someone who isn't family.. Social services has already assessed that residential home care is what this person needs, and is exactly what we all pay taxes for. SS have to justify this decision by reference to the evidence, and if they still believe a flat is needed they will have to sort it out plus appropriate care arrangements.

Don't back down. They'll try and fob her off with the cheapest option. You have to battle hard and be polite but firm, raising objections, everything in an email so there is a paper trail.

@TheWomandestroyed they are usually referred to as "Extra Care Schemes". Our Local Authority has 22 which is very high, most have fewer. There is 24 hour staffing from care workers and a communal dining room, but everyone has their own flat with living room, kitchen, bedroom, wet room.

OP, if the social worker means an Extra care flat, ask why this wasn't considered an option when the original needs assessment was done. I always look at it as a possibility when assessing people, as often it's a better option than residential care. What has improved in your MiL's functioning which means it is now possible for her to live more independently? In my experience, unless there is a dementia diagnosis, Extra Care is often more suitable than residential care for many people. So if it wasn't deemed appropriate last March, why is it appropriate now? If there are good reasons why its now appropriate, then you need to accept that.

And very good advice from @IncompleteSenten

If you show any hint of what looks like support then this only strengthens the case for you being involved in care. She's worried about being left alone? Well you can visit her daily. And being her shopping. And sort out her GP appointments and so on. And you'll end up tied to doing all the care you were providing before except this time it will be harder as she won't live with you. Social care is underfunded so they will be relying on guilt and obligation to make you give way.

Visit her and spend time with her if you want, but beyond that do not get involved at all. Don't talk to the care team, don't challenge or question anything, don't respond. Just keep saying "she is not my relative and not my responsibility, I am not getting involved".

I’m in this business…
I would also say that -

• take no part in attempting to find her alternative accommodation, let them sort it if they want
• unfortunately it can be really subjective and different individual social workers have different views. But hard to assess how she would cope now she’s been in care for a while. Surely the more useful evidence is how she did actually cope before. So if you want I challenge on her behalf get a copy of the most recent assessment and make sure what they’ve written is accurate and they’ve not overstated her abilities/understated the risks.

Finally - frustratingly sometimes where I work, our managers seem fairly quick to back down if someone has complained to their local councillor and/or MP who then raise the case with our team.

If you challenge jt on her behalf I would make the point that the move into care was based on their original recommendation, and it would be unsettling for her to move out again, especially as chances are her needs might increase in future.

Thanks EMMA and DOLCE for the explanation. I think there should be more of these types of places, so many people could benefit. In my experience most people in care homes have Dementia nowadays , and the maximum amount of help at home is four carer visits a day. There must be a lot of people who have needs that fall between these options.

Morally, it is not acceptable to expect a person in their later years, who six months was assessed as needing residential care, to now undergo the physical upheaval of moving and settling in a new and unfamiliar setting; with the attendant psychological trauma of being forced to break trusted bonds made with people in the residential setting.

This is morally abhorrent

@Kenwouldmixitup

Morally, it is not acceptable to expect a person in their later years, who six months was assessed as needing residential care, to now undergo the physical upheaval of moving and settling in a new and unfamiliar setting; with the attendant psychological trauma of being forced to break trusted bonds made with people in the residential setting.

This is morally abhorrent

It is. But sadly not uncommon. Private Eye has been writing for years about care homes going bust and very elderly and frail people, including some in the very end stages of their lives, having to find new homes. Sometimes at only a few months' notice.

From the OP first thread in Feb "Mil is 87, poor sight, poor hearing, bad mobility, not able to manage her own affairs or communicate without extensive help, struggles to use the shower. I support her with shopping, laundry and overseeing things like GP reviews. She hasn't left the house for years. She is reclusive and uncooperative, will not grant her surviving daughter LPA, hasn't written a will, doesn't like anyone coming in to provide care or support e.g. if I want to go away. She is scared of being left alone at night and not able to leave the house unaided."

That does not sound at all like someone able to live independently in a flat. I would question the needs assessment which evaluated her as able to leave residential care. I would ask for the new needs assessment so that you can advocate for her as a friend but state whenever required that you are not a relative, do not have LPA and are not able to take on any aspect of her care.

@Choux
Thank you. This is precisely what I need to do.

Given you said in your other thread she was unco-operative about her care I wonder if actually she is saying she wants to leave and, as she is judged to have mental capacity the care home and social worker are trying to make that happen for her.

I can imagine she might not be an easy resident in a care environment. Then her money runs low and her current home is told the council will pay less for her than she was paying as a private resident. She keeps saying she wants to leave anyway so the care home calls back the social worker and they start trying to arrange what she wants. And they are yet to realise she has no outside support and it's totally unworkable.

No she wants to stay. She is happy and settled in the home.

@Joystir59

No she wants to stay. She is happy and settled in the home.

Encourage her to be very definite and emphatic about this with SS.

They are trying to push the responsibility onto others, as that’s easier for them. She’s their responsibility. Push it back onto them.

Where I am in Scotland they're called 'very sheltered housing'.

OP I read your previous threads and you are an amazing person, please stand your ground.

Thank you for all your responses and suggestions. I feel really defeated, guilty and a failure. Back at square one after thinking I'd helped bring about a great solution for mil and for me. There has even been progress in the relationship between mil and her daughter who made the effort to come and visit her which I know she found difficult. Anyway, the care manager at the he is prepared to fight mil's Corner and I'm going to stay in the background for now. After all, mil isn't capable of sorting out a move anywhere, and I'm not going to facilitate it. Such a mess. I cannot sleep.

I just want to wish you well. You must be feeling so defeated after all your hard work last time. Social care is such a minefield and you thought you had navigated it; very disappointing a and exhausting for you.

How are things going?

A friend of mine had similar with her grandmother who had stayed with her temporarily. Basically the local authorities are skint so they skew the care needs assessment to pretty much try and guilt who they are living with to look after them. They even suggested my friend could claim benefits as she was caring for her grandmother and then in the other hand saying GM didn't need care.

Basically there is an advantage as she is already in a home. Just stay in the background

@Weenurse
@Roystonv
@JazzTheDog
So I wanted to give all who have been so supportive an update.
Mil has had a second care needs assessment, which confirmed that her care needs could be met in an extra care living unit. However, the care manager at the home is fighting Mil's corner and manage to gain I formation from the GP that mil has been diagnosed in the past with a very serious mental health condition. This fact was picked up by the social worker at the second care needs assesssment. So the social worker is now concerned that because there is no overnight care provided at extra care living, and because of Mil's mental health fragility she may not cope with a move to Extra care living. He's requested info from her GP, and also asked me for a detailed account of her mental health history which I've provided. Fingers and everything else crossed that SS now decide she can stay where she is. Of course I've already provided a full account of her mental health for the first assessment, but this magical official diagnosis seems to be doing the trick. Bless the care manager! She thinks a move would be ridiculous for mil. And no, she doesn't care about the loss of revenue if mil goes, before anyone says anything, because people are queuing up to get into this particular home.