Adult social care - safeguarding

[Bigsislookingforadvice]

Any thoughts on possible out comes from adult social care on this situation please.

Fil fell in the night last week, Mil aware, attempts to help you, no joy, doesn't call family (at all) or ambulance until morning! Fil taken in as query UTI and on blood thinners so checking for internal bleed. We PTR and I notified by hospital 5 days later, we have since visited and spoken to staff.

Hospital are saying he's almost medically fit but they've referred to Adult social care re safeguarding due to mil decision making and leaving him on the floor.

Not the first time, happened 2 years ago and he was quite poorly as a result due to muscle wasting and kidney issues. Ended in care home for rehab because Mil refused carers in the house.

Both Mil & Fil are 88, he has dementia but ok in the moment, needs 24 hr care, but compliant and very calm. Mil always been a difficult character, never at fault, blames everyone else for problems, won't accept help or support from family or professionals. Accuses people of conspiring against her, trying to split them up etc. I cannot see a social services visit / interview going well with her.

Any thoughts on any possible action / outcome they may take ?
Thank you

I wouldn't be surprised if they discharge to a home on an assessment payhway whole the situation is assessed.
We had issues with mum re dad's care. Mum had dementia and just couldn't understand that extremely frail 94 yo dad wasn't being lazy in not helping with the housework - he couldn't barely stand! Wouldn't accept carers as she thought she could look after him. He was admitted to hospital with delirium after DB went round and found him very ill. Mum just said he was "prattling nonsense" so she'd gone into a different room so she didn't have to listen. In the end the decision was taken that he needed a care home but he died waiting for a place.

@countrygirl99
Thank you
We are convinced Mil has cognitive / memory issues but she's so headstrong and difficult with the drs they rarely ever see her, a call was made from hospital when Fil was in 2 years ago but she shouted and deflected the conversation so much they didn't follow it up !

A care home would benefit him so much physically but after 64 years married he'd be lost without her and if the last week is anything to go buy she wouldn't visit. She's not been in once to see him 😞

I am relieved to think they'll not just send him home though

Does FIL have mental capacity to decide where he goes from hospital? If not does anybody have power of attorney for his health and welfare? If so they will be expected to make decisions in his best interests and if there is no POA then the multi disciplinary team including an advocate will do this.

@Muchtoomuchtodo
He no longer has capacity and MILs decision making is no longer seen as a sound choice given she's not calling help when it's needed. MIL & FIL refused POA when they were able - she's not trusting of anyone and believes she'll make all the decisions forever.
Last time he was in hospital the hospital said her decisions weren't in his best interests so didn't consult her and just advised her of their decisions.

Today hospital called her while we were visiting, she didn't listen, talked over the caller and ended the call when questions were repeated and she'd not managed to deflect enough 🤯🤯

Weve spoken to MIL on the phone when visiting FIL - I'm really concerned for her MH, she's saying my ptr and his sister were there when FIL fell and wouldn't help, that ptr is there most nights hiding and bring sneaky !
We've not been over in months because of the decline in relationship, the accusation is worrying because paramedics and social services have noted this as her response but no-one is challenging that. It's also worrying because for me it shows a real problem with her grasp on reality.

Any advice ? Social services are imo useless - want to impose carers (no problem, we agree) but don't want to listen to the concerns re Mil ability to make safe decisions or understand reality. We worry about him going home and how they'll cope

Ask the team looking after FIL for a discharge planning meeting with dr, nurse, therapists and social worker there, along with family members. It’s so hard for them to get a real picture without everyone sitting down together

I do have some experience of safeguarding due to how DFIL "looked after" DMIL.

Does DFIL have a SW and have you spoken to the Discharge Clerk and made your concerns clear? The phrase that seems to help is "unsafe discharge".

And if you know which GP "D"MIL is under it might be worth sending them a note saying that you don't wish them to tell you anything about her but you'd just like to make them aware that you're worried about her mental health as she thinks that her DH is at home and regularly tells you this when he's been in Hospital for some time.

Has 88 year MIL been providing 24 hour care? That’s a big ask.

Your partner can ask the hospital to be involved in all discharge discussions.

And ‘MIL lacks insight to the situation’ is another helpful phrase.

If Dad lacks capacity there has to be a best interest decision made, ask to attend the meeting. Has he been deemed able to have his needs met with a package at home?

Can your partner apply for deputyshop as he lacks capacity, speak to thecward, ask to be involved in the best interest meeting and unsafe discharge, safeguarding, vulnerable, at risk are all good phrases.

Thanks all. Really appreciate your ideas
We've spoken to discharge coordinator, v dismissive / passive about the seriousness we felt I til we started saying some key words and requested a meeting with them & social worker and wanted OT to do home visit first and an actual physio assessment as it's been requested with a week but nothing yet.
Managed to get surgery to agree to the senior GP calling us tomorrow - he knows them of old so hoping he's helpful. But prepared to get louder if needed - turns out the GP receptionist called ambulance not Mil, she was calling for a urine sample to be collected and just mentioned he was on the floor, when they said he needed an ambulance are said she'd think about it ! Interestingly GP haven't raised any concerns about that or called my DP despite him being on FIL record as main contact.

It's amazing what you find out once you start asking questions that you should have been told.

Interestingly GP haven't raised any concerns about that or called my DP despite him being on FIL record as main contact.

Shocking that she would think it was perfectly acceptable to leave him in the floor, again.

At least you know now though and you can just keep stating that sending him back there would be a safeguarding issue. The "safeguarding issue" that we had was that DFIL was planning a double suicide. Only it wouldn't have been suicide as DMIL didn't have capacity, it would have been murder. He only told us in a moment if extreme stress, he's been reading up on how best to do it so it wasn't a spur of the moment thing.

You would not believe how many times I had to reiterate he was planning to murder DMIL and sending her home was not just an unsafe discharge, it was a very, very serious safeguarding issue, the type that would end up on the national newspapers. I think at one point I was ringing the SW daily.

Good luck @Bigsislookingforadvice and keep pushing