Threatening suicide if made to go home

[Decisionfatiguequeen]

Lots of backstory to this so will try to be brief. My Grandad (90s) had been managing at home with 3 x carers per day. He was recently admitted to hospital for 3 weeks, then discharged to a rehab care home where he has been for 6 weeks. We were hoping that social services would assess he needs a permanent care home place and he could stay, but they say he needs to go home with a care package. He lives in a council house so no property to sell and there is no money to self fund.
His mental and physical health is poor, and has deteriorated since going in the care home and he is manipulative. When he was at home he rings my parents 10-15 times a night and when they don't respond he calls the police. My parents are at burn out, my mum has cancer, my brother is just recovering from cancer and they cannot cope with him any longer.
He doesn't want to go home and wants to stay in the care home. So far social services have tried to get him home 3 times but he has refused to leave. He is now threatening to kill himself if SS make him go home and his mental state is so poor and anxiety level so high he may just do so. We already suspect him of fiddling with his catheter to prompt the original hospital admission and of throwing himself out of bed to prevent discharge from the home.
He really needs professional care and there is no way 4 x carers a day at home is going to be sufficient.

The social worker is awful, communication is non existent and my parents are at their wits end. SS have said he may qualify for Continuing Healthcare funding but the assessment has been cancelled and not yet rearranged and I know it is very difficult to get and is a long process. Also is he doesn't meet the criteria for a council care home place how on earth will he meet CHC criteria?!

Where do we stand if he continues to refuse to leave the care home? Can they force him? Will they call the police to evict him?

As he has threatened suicide (in front of social worker) if he is made to leave, doesn't social services have a duty of care to him - will they be liable if he does kill himself or self harm?

No idea where to go next with this. We are intending to escalate to the social workers manager to ensure they are aware of the threat to self harm but what can else can we do?

Escalate it in writing to social services management. Make sure you clearly set out his threats and you think he's capable and likely to follow through.
Say if he needs assessment for CHC funding his needs are clearly so serious that sending him home before that assessment would be negligent and a breach of their duty of care to him.

Thank you so much for responding. I have drafted something to send, not holding out much hope that anything will change but we have to try.

Great advice. I think you also need to make it clear that your DM is ill and there is nobody to help him outside of the times that the Carers are there.

Have I misunderstood?

He's in a care home and doesn't want to go back to his actual house?

What's the problem? Why do you want him to go home rather than stay in the care home, if that's what he wants?

Sorry just re read he has no money to self fund it and SS think he doesn't need the home.

From the information you have given, your Grandad doesn’t have a primary care need that requires nursing care. His health needs can be met via community services, district nurse for example. So it’s unlikely that he would meet the criteria for a full health assessment under CHC process. And he would be unlikely to be awarded full health funding from what you have said in your post.

Firstly, the residential home need to be contacting the Care Home liaison team and asking them to come and assess his mental health status. This may add weight to the decision with SS.

Secondly, the Care Act includes eligibility criteria for a persons well being. This is equally as important as the need to have physical needs met.
Has he had a full Care Act assessment? It was it a Discharge to Assess assessment from hospital?

Insist on a full assessment. Ensure that you or other family members are present, and write down all of your concerns.

When he was at home, did he have any telecare installed? So a pendant alarm/falls detector etc?

Does he have any condition that affects his cognition? Diagnosis of dementia? If so, ask for a referral to be made to the Independent Advocacy service that the local council
will have a contract with.
If he doesn’t have a diagnosis, he may be entitled to an advocacy assessment as he had mental health issues, although I believe this is usually around mental health treatment.

It depends on the area I think, but there may be a Care Home Psychiatry Liaison Service who could assess him (GP or social work may refer). Someone who is suicidal should have a psychiatry review imho.

X post

Thanks all - we have sent the email so will see what happens.
Not sure what sort of assessment he had, but nothing we have been present for, although I believe they have been testing things like walking up and down stairs.
He has a pendant alarm/carelink at home which he presses regularly to get them to call my parents several times a night. He has been told off for pressing it for none emergencies. The community nurse agrees he should be in a home, as does the local mental health nurse. No diagnosis of dementia and he has a good understanding of what is going on.
Will see what tomorrow brings...

Just wanted to update, following my email my Grandad has been reassessed by someone more senior and they have agreed to fund, so relieved common sense has prevailed, almost daren't believe it. Just need to find him somewhere suitable that will accept a council funded place with no top up...
Thanks to all that gave advice.

Thank goodness for that!

That's such good news

This sounds about right to me. My experience a few years back with my DM was that SS will do everything they can not to admit to a home. We were appalled at them saying mum (vascular dementia) would be fine at home with 4 carer visits a day, thankfully as self funders, we could make our own arrangements and did.

I'm pleased for you they've agreed to put him in a home.

Thanks all, I wouldn't do a social services job for all the money in the world, I'd just spend the whole time feeling like I was failing everyone - its an impossible task...

Thanks all, I wouldn't do a social services job for all the money in the world, I'd just spend the whole time feeling like I was failing everyone - its an impossible task...

Or a Discharge Clerk in Hospital. I'm gearing myself up for a "chat" about my 89 yo DCousin who is being discharged into the care of her 89 yo DH. Can't weight bear or stand alone and he's supposed to get her out of bed and onto a commode.

Think the phrase unsafe discharge might be used a few times...

Oh no, thats terrible. Social care is broken and its not going to be fixed any time soon sadly...

I'm so happy

I honestly don't k on how that message got there! Think I was pocket typing but what a weird thing for it to type!