Care home refusing to take him back

[Suffolker]

Hi everyone. Not posted on this board before but could really do with some help as we’re panicking about this situation.

BIL has quite complex needs. He’s bed bound and has Parkinson’s, but also has severe mental health problems, which he has struggled with his whole life. Severe bi-polar and OCD. A few years ago he was seriously ill in hospital and when he was discharged, he was no longer able to live independently. He went into a care home, and later transferred to one closer to where we live.

He was admitted to hospital a couple of weeks ago with an infection, but is now ready to be discharged. The care home is now saying that they won’t take him back. We don’t know why yet (DH will be meeting with them), but feel entirely at a loss about what we can do. In the meantime he’s stuck in hospital.

The care home is run by the British Legion (he’s ex-services) and has a dementia unit, so I don’t think they can properly argue that they can’t meet his needs. But I’ve no idea where we stand or what we can do.

I’d be very grateful for any pointers or words of wisdom. DH is in a major panic about it all 😢

Don't panic!

It sounds a difficult situation, but take a breath. The hospital can't discharge him if he has nowhere to go - so he will stay there until somebody finds a solution. It may not be ideal, but they will keep him safe.

If BiL self funding? If he's getting LA or NHS funding there will be more bodies you can rope in to help sort it.

First step would be speaking to the care home and finding out reasons. Don't agree to anything at this stage, just listen to them settings out their case.

Having a dementia unit doesn't mean they can met his needs, especially as from what you say his needs don't include dementia.

Is he self funding or LA funded?

Either way you need to meet the care home and find out why they won't have him back.

It may be he needs a higher level of care than they can offer in which case you/the LA will need to find a home that offers that level of care.

This is a fairly common situation. The hospital will have to hold onto him while a new place is found.

Thanks both. It just seems so unfair, he was settled there and they’ve not even had the courtesy to contact us to explain why (DH was contacted by the hospital). BIL is LA funded, but complicated by the fact he’s funded out of region (by his previous LA). Hopefully someone will help us sort out alternative accommodation but I’m worried that if the RBL say they can’t cope with him, there will be nowhere else for him to go.

I expect that his needs have changed significantly and that is why they cannot accept him. Possibly he needs an element of nursing care. Contact the ward and find out if there is a social worker assigned to him. If not another person will be looking after his case. He will most likely need to see the physio and have a mental and medical check so that they can decide where best to send him.

If he is LA funded it's possible that there are funding arguments going on that you aren't (yet) privy to.

Speak to the care home. They'll tell you what the situation is.

There are care homes offering many different levels of care. Another one will be found. It may take a bit of time, but hospital will be pushing them.

At the hospital, the first person to speak to is the discharge coordinator. They will be able to put you in touch with anyone else - social workers, physios etc, involved in determing his needs and finding a suitable place.

Dementia Unit is often not a Care Home with Nursing. If he now has significant nursing needs then a Dementia Unit won't be the right place for him anymore.

The hospital discharge planner will be very familiar with this scenario and know the ins and outs of assessments and funding.

It makes me so angry how care homes do this. It’s the easy way to get rid of a “difficult” resident: refuse to have them back after a hospital admission. So much easier than trying to get rid of them when they are still in the home.

Does he have behavioural challenges eg physically harming staff? We had this with my Mum who got so distressed with her care she started lashing out. Care home then refused to have her back.

I was furious at the time . But in the end it was the best thing. She wasn’t happy there and the way the care worked made her really anxious . We found a nursing home that was really good with anxious residents and she was so happy. No more problems. In fact the staff there all loved her.

Thanks @Daffidale. He’s not physically capable of lashing out, but he is highly anxious and paranoid so I think sometimes makes accusations against staff of mistreating him (or more often, his belongings). He is definitely challenging so maybe it’s not the right place for him, but he’s really not going to deal with the upheaval. My poor DH has been saddled with everything, the other 2 siblings have basically washed their hands of it all and don’t even visit. It’s very hard for him to manage it all.

Care homes can't just move people in to different units within the same care home. So for example if the care home is both residential and nursing, they can't move someone from residential unit to nursing unit without them being reassessed by both the funder (LA) and the NHS. Otherwise the home won't get paid.

Not all care homes have nursing units, so if his needs now meet a nursing home criteria, the care home cannot take him back as they can't meet his needs.

Lots of neurological problems require quite specialist care, so lots of homes won't cater for them.

Meet with the home, get their feedback on why. Contact the LA and ask for him to be reassessed. They'll then support in finding a suitable home that can meet his new needs.

Yes, first off contact the care home and ask for a discussion about it. Keep it reasonable as it sounds like you'd want him to return there if a way could be found to do that. It doesn't sound that encouraging but worth trying. Do not accept any suggestions from the hospital that he should, or ought, come to you. Start looking for other care homes in your area and preparing to make your case that the existing funding should now move with him to one of those.

It's likely your BIL needs to be in a nursing home rather than care home. Even in dementia units care home staff are sometimes limited on the medical care they can provide for patients, legally. My nan had to be moved to a nursing home once her dementia became so severe she was injuring herself and others (a frail 4 ft something lady in her late 80s).
The result was in our case was better staff to patient ratios and my nan (and others) were much safer, they were also able to administer certain meds the care home couldn't.

Part of the problem I think is that he’s only in his 60s, so a care home for elderly residents is probably not the most suitable place for him. But I’ve no idea what the other options might be. I guess we just have to see what the social worker comes up with. It’s just all extremely stressful though.