meeting ICB for review of elderly father's care, what should I expect?

[measureofmydreams]

In brief:

My 84yr old father was discharged from hospital into a care home (in August))after 2 stokes which significantly increased dementia. His care package was one to one care due to complexity of his needs including challenging behaviour, going into other residents rooms, severe cognitive impairment, hallucinating and a high risk of falls (he has some in the hospital and the care home).

At one point his social worker told us his care was too expensive and he would need to go into another home. He receives NHS nursing funded care.

Then we had a DST meeting for CHC and are waiting for the outcome (6 weeks ago). We've now been invited to a meet with the ICB to review his one to one care.

The care home believe that (from their experience with other residents) there will be a move to reduce/remove one to one care. But they believe that he needs it. I do too. My main worry is that he will fall and fracture his hip and end up back in hospital.

Has anyone had experience of one of these meetings please?

thank you

I'm sorry that you haven't had any responses. We had a meeting when DFIL was in a Nursing Home.

DFIL was much more independent than your DF though. I hope your DF gets the care he needs

Thank you @PinkMimosa We had the meeting, but the care home hadn't sent any reports etc through to the ICB - which they need to review, so we are still wating for a decision. We are also waiting for the outcome of the CHC meeting.

We had a review of DDads one to one care (he has from 7am - midnight). The meeting was similar to the DST meeting (but not as long). What really helped us was the records that the care home had kept. They were able to show all of the incident reports and the file that the one to one carer fills in - one line for each hour of care, explaining what dad was doing during that hour. The incident reports also included times when the one to one had managed to avoid incidents eg "x was walking into other residents room and picked up personal items belonging to y. Y was angry - 121 intervened and distracted x and took him into the dining room for a drink." Some records weren't detailed enough (eg "x was being angry" the assessor said it didn't explain in what way - was he shouting, hitting, looking cross etc - not detailed enough) or the writing wasn't clear enough so couldn't be used as evidence but there was plenty that was ok.

Sorry, just realised that the meeting you had was the one to one review. I thought you hadn't had it yet and that you were talking about the DST one.

Hope for a good result for you.

@JennyWreny thank you for your summary of how the carehome records contributed to the assessment, that's really helpful and shows that they need to be explicit. We've still not heard from either the DST meeting (2 Nov) or the 121 review meeting (28 Dec). thank you for your kind wishes.

Not quite the same situation but i was invited to a meeting to decide on whether my late DM was eligible for CHC under the NHS. I was told I was there as an observer so i was unprepared to be asked to contribute, but luckily i was able to advocate reasonably well for her.
She had multiple problems including dementia and diabetes and was at high risk of falls. She had already fallen (in hospital!) and broken her hip. I emphasised the risk of falls and said that above all I just wanted her to be safe. She did get the CHC.

@SiobhanSharpe I'm pleased that your DM got the support she needed, the meetings aren't easy. At the moment it feels like we are having to fight to mitigate any risks to our DF's safety.

Local to me, CHc and LA are very reluctant to fund 1:1 for falls risk (per an announced decision autumn 23) except in “exceptional circumstances”. 1:1 funding is easier to obtain to manage risk to others/ increased vulnerability eg due to entering others rooms/ invading space etc.
In any future meetings, always highlight a bad day, rather than a good one as this helps with scoring.
As far as records go, we find 2 columns- one for presentation, one for intervention needed- help s evidence the need for and value of 1:1 support. Perhaps you could suggest the home introduce this format?

@Howmanysleepsnow thank you, I wasn't aware of the decision announced in last Autumn - DF was transferred from hospital into the care home mid August - but it certainly will impact his situation. And your two column notes format is a great idea which I'll suggest.