Social services won't help

[Lovelycookbooks]

Hi wonderful Mumsnet community,

I'm looking for some help with my dear parents.

My mum has dementia and is disabled, requiring a wheelchair after an illness. After a long hospital stay, Social services decided she would be best located at home with 3 carers visiting her daily. My mum told social services she would only accept 1 visit a day and they agreed.

Since returning home she lives in her bedroom. Social services did put a starlift into my parents house but my mum cannot comprehend how to use it or what it does.

My dad has Parkinsons and is very frail. He can't clean and won't accept any support from me in terms of shopping or cleaning. I live abroad but have offered to pay and find some help.

My mum's bedroom is filling up with black mould because of the lack of cleaning and i guess something more structurally wrong.

I've tried to raise to social services that this is a terrible situation. That my mum would be better in a home, that she would be trapped in a house fire. That she can't phone for help, so if my dad falls, he will be stuck wherever he had fallen.

They've said they can't do anything because my dad isnt under their care and my mum has capacity. I know my mum doesn't, she had no idea where she is. Anyway, they said I could reach out to a local charity for some shopping help.

What can I do? They are so vulnerable ☹️

Would either wardened accommodation or a retirement home be better options for them? They probably don't quite meet the criteria for a nursing home, but at least if they were in some sort of sheltered accommodation there would be people on hand to keep an eye on them.

Thanks for answering @Newyeardietstartstomorrow that does sound good but how would I arrange it?

Can you get in touch with the care company that are doing in? Ask for their opinion and see if they will report concerns to Social Services from their side.

Also, keep calling SS, ask if your mum had a mental capacity assessment or whether they just assume capacity as no assessment has taken place.

You could also report a concern about a vulnerable adult for your dad and approach their GP too.

Re your mum’s capacity this seems to be key - I would write an email to them really clearly listing all the things she does or doesn’t do which shows she does not have capacity and how she is a danger to herself - if there are any examples of dangerous things she’s done list those clearly , and request an in person assessment at the property

Yes, request a formal mental capacity assessment. But bear in mind that SS can't just put her in a home even if she lacks capacity, if she won't agree to go.

I’d consider putting in a safeguarding referral - just google, it will be the council and they will ask you all the relevant questions - both your parents are at risk but especially your mum. Emphasise the cleaning and your mum being unable to use the stairlift.

Their local Age Uk may have a home help service (paid for).

Are they self funding or council funded for care? Do you have power of attorney for them?

I’m assuming that the social worker who dealt with your mum was a hospital social worker. Their aim is to get patients discharged asap.
Id agree with others - you need to contact the local authority where your mum lives and ask to speak to the duty social worker. Tell them what you’ve said here and ask for a review.
However, the difficulty is getting your parents to be honest with them. It sounds much like the situation my own mum and stepfather were in. It was only when he’d had yet another fall and was sent to hospital that he ended up in a care home because there was no one to look after him. I was very clear to the hospital social worker that he would be alone 24/7 with Parkinson’s and dementia therefore would be unsafe. You have to be very pushy!

As difficult as it may be, I’d be booking a flight home to get this sorted asap.
This is a dreadful situation for your parents and I would have to interject either to source a care home, or get the mould sorted.
It’s obvious your parents cannot do this themselves.

When my dad was taken into hospital, I sourced a care home for my mum and she moved in 2 days later.

Sometimes you have to grip it yourself and bite the bullet.

And you could write to their GP advising them of the situation.

Don't expect a reply but the letter will be on file and, if you are lucky the GP may ask to see one or both of them.

Make sure you put your contact details on the letter.

That is not quite true, a court of protection application can be made if she is at severe risk. It sounds like your mum needs her care package reviewing and if her mental capacity is in question they should be completing a mental capacity assessment.

Yep, if people without capacity still had the right to refuse care then there'd be no such thing as a DoLS order. And probably no point in doing capacity assessments.

However the OP says that her mum doesn't have capacity as she has no idea where she is. Unfortunately it's not as simple as that. It can vary with time and also depends on the choice that's being offered- my mum could still tell you what she wants for lunch or which clothes she'd prefer to wear but she's not equipped to weigh up a decision about her own medical care, or who to bank with and she probably won't be able to do that tomorrow or next week or ever.

It is correct in a way to say that the social workers can't just force her to go into a home as it would have to go through DoLs, in exactly the same way that the children social worker can't just remove the children – it has to go through the court system, and only a judge can order that.

Unfortunately, mental capacity is an incredibly complicated area, and it is barely ever as simple, as saying someone does, or doesn't have capacity. They may have capacity for one decision, one minute and not the next for the same decision, they might always have capacity for some kind of decisions, and never have capacity for others, or they might have no mental capacity to make decisions at all – but that would be incredibly unlikely.

I would be requesting an assessment under the care act 2014, and very specifically highlighting that they need an assessment of mental capacity.

Apologies for some weird punctuation in my post – dictation is not being my friend today

It's not a safeguarding issue though?

It's a very normal bread and butter part of adult social work working with people who are resistive to care or are starting to self neglect because they no longer recognise they need help.

The situation described by the OP is absolutely nowhere near the s.42 enquiry threshold of the Care Act and the safeguarding team will just pass it back to the social work team the OP has already been dealing with to respond to.

Its a bit disingenuous of the OP to say social services have done nothing when it sounds like they have assessed, offered a care package which has been partially accepted, arranged that care package and put a stairlift in. They have very limited grounds to force people to accept care they don't want and it may be they are monitoring the situation and gathering evidence to put the wheels in motion for such action.

The once daily carers will raise issues with the local authority as well. Your best bet is to ask them to request a review of the care package and offer their view to the LA that things are deteriorating. Have your parents got any assistive technology in to manage the falls/fire risks?

You cannot use a DoLs authorisation to force someone in a care home against their will when they have been assessed as lacking mental capacity to make the decision and they are no longer safe to live in their own home. This would need to go via the court of protection to make an urgent decision. When they are admitted to a care home the home can apply for an urgent dols which gives the person the right to challenge the dols via the court of protection which is known as a s21a challenge. A dols assesser considers the restrictions that are in place and if it is in the person's best interests, least restrictive and proportionate for them to be deprived of their liberty. The care home has to use the mental capacity act to prevent someone from leaving the home, the dols authorisation usually will agree that it is proportioned and necessary.

Do your parents own their own home? Are they in receipt of any benefits? They receive care at home, albeit once a day rather than the three times your mum has been allocated. If they were offered a place in an extra care scheme, would your parents move into it? There are carers on site who could respond to your parents' needs. Extra Care is like a halfway between a care home and warden controlled sheltered accomodation.

You can offer help but if they won't accept it, it's hard to get things moving.

It's not easy and I feel for you especially not living in the same country. As another poster suggested, you can make a referral to adult safeguarding via local authority website if you have genuine concern they are at risk. AgeUK is also a good shout.

Apologies for not replying, dad had a huge fall and ended up in hospital, so I did end up returning home.

He Is likely to be in hospital for a while, such mixed feelings but mostly relief that he is getting some care.

It turns out that my mum has been falling out of her wheelchair most days, so now she is in a very difficult situation because when I return home she will have no carer, no food (obvs I will buy her some but she doesn't know how to open the packages or remember when to eat).

I've let social services know and have tried to take on board as many of your comments as possible.

What I really wanted to say to you all is a huge thanks for taking the time to write - MN is an amazing community and you've made me feel a little bit less lost trying to navigate things.