At home, no capacity and no deputyship - access to money

[roundaboutthehillsareshining]

So my elderly relative is being discharged home with a care package. Fine, it's what she wants and it's the least restrictive option, so it's got to happen this way (even if it falls apart in a few months and she ends up back in hospital for 6 months). Anyway, there's nothing physically wrong and no dementia. Her team believe she has a new functional MH condition, but that can't be diagnosed in hospital and she won't engage with community care, so that's a dead end.

However, it's likely she's going to be found to lack capacity to manage her financial affairs. Her bank account set up is hopelessly complicated (at her choice) and can only be administered in branch, which she's not going to be able to access.

So if she's at home, and unable to access money, how does she pay for food etc until the deputyship comes through? The family can't afford to subsidise her, she isn't eligible for benefits as she's got money coming in, she just can't access it. So what happens? Anyone been in this situation before?

And I’ve told you multiple times that aside from food everything else can wait!

it’s not always 6-8 months. It depends. I had one come back in 4 months a while ago. One came back in 2. Things are speeding up.

The heating oil is a lot harder to deal with than gas though. If she was failing to pay gas bills, there are protections in place for vulnerable customers so she’d just build up debt but still have access to the gas.
But heating oil you pay for when it’s delivered. No payment, no heating oil.

I think from what you've described you are now having to choose the least worst option. Your relative has engineered her life to ensure no one can help her without causing some kind of meltdown. In the interests of her welfare and safety she requires intervention and if that causes her to have a nuclear blowup, then sadly thats part of the price of keeping her alive and well. Yes, family may not like it, but from the sound of it this lady has form! And ultimately it's better to deal with a non speaking relative who is still alive and kicking, rather than a dead one whose death was potentially preventable if she had had this kind of intervention.
The emotional attachment to her or fear of fallout will have to be parked or disregarded for now, unfortunately, to prioritise the difficult decisions that have to be made to literally keep her alive and with some quality of life.
I hazard a guess based on your posts that someone closer to her is tearing their hair out in frustration and not for the first time with her.

@roundaboutthehillsareshining I sort of feel you are going round in circles here. You have had the advice. You need to say to SS, GP, and the hospital this is now a safeguarding issue for neglect and get them to step up. You will need to keep reiterating it. As I said previously we had this for my DM and it was a nightmare at the time but you need to keep pushing.

For as long as you relative is deemed to have some capacity SS will not apply for LPA or Deputyship as it will fail. It needs to reach crisis point before they can step in. And it will reach the threshold of a crisis point the more you flag the issues, in writing to SS.

They aren't being obtuse but they need to legally demonstrate they have done all they can to support your relative to return home as that is their right and wishes until such time SS have definitive proof she is not capable of looking after herself. At the point of crisis, the team can step in and demonstrate to the Court of Protection your relative is not fit to look after themselves and it will trigger a whole load of assessments etc. Up until that point your relative could live naked in their back garden playing loud music as long it didn't endanger either themselves or anyone else.

I am sorry you are going through this, it is horrendous, but you need to buckle up for the ride as it is set to get worse before it gets better when someone is still so adamant they have capacity to look after themselves and won't consider LPA etc.

Edited to add with DM it took 5 days of 4 x daily carers visits before the wheels fell off and SS felt able to intervene properly. I suspect if it hadn't been Christmas it might have been sooner.

I would suggest the CoP apply or appoint deputies if she lacks financial capacity, they can also appoint a health deputy, the family are under no obligation at all, the ss know this.

Social care will pay the care bill if lacking capacity and then the deputy pays it back when it comes through

Hello again OP

does anyone in the family have any kind of constructive relationship with the elderly relative? Is there anyone she trusts?

Unfortunately the reality is that people with mental health conditions who are otherwise deemed to have capacity often end up living very chaotic lives.

what do you think she will do if she is discharged home? what duties are the carers going to be instructed to carry out? And what’s the reporting system if they have concerns?

if family do not want to blow up the relationship by openly moving to take over her affairs, nor are they willing / able to fund her living costs surreptitiously for 6-8 months, then they probably have no option but to step back and leave it to social services - and watch it fall apart. They can certainly be on hand to report the inevitable failures without stepping in to solve them.

Who is paying for the carers and care package

No, noone she would trust to manage her affairs or act on her behalf in any official capacity. She believes LPoA is a conspiracy to allow the state to take complete control (ironically what might happen if she doesn't sign one and it goes to the CoP instead....)

What's going to happen after discharge is probably what happened last time. She'll refuse to allow the carers access, they'll spend a few weeks being shouted at through the locked door (but at least if she's telling them to leave, then they know she's conscious). It'll go back to social services. In the meantime, she won't be eating as she'll have no money, so she'll inevitably fall and be found by police/ambulance, taken into hospital and round we go again...

The difference this time is the capacity issue, this is the first time her capacity to care for herself has been questioned. So she can't just fire the carers. In that respect, I don't know what's going to happen when she refuses to allow them access. SS have just said that they'll fit a keysafe (just occurred to me that I'm not sure the legality of fitting a keysafe to the exterior wall of a listed building and also it seems some councils don't fit keysafes to listed buildings as a matter of policy, so that's another fun thing we have to check......)

We don't know what the reporting mechanism will be, we have been given no information about a care plan, what the carers will actually be doing in their visits, what happens with the money situation, etc. All we've been asked is for our opinion on her being discharged home, any attempt to get further information out of SS is just ignored.

I genuinely don't know. The care package has been deemed mandatory, however if she is found to have financial capacity then she will refuse to complete a financial assessment and will therefore be self funding (which she will refuse to pay for). If she doesn't have financial capacity, then once the deputyship order is made, the deputy will have to do the financial assessment. Then we'll find out who's paying, as noone knows how much money she currently has, so she may well be over the self payment threshold.....

Simple solution does she have a cheque book? Most elderly people do if so she just writes a cheque payable to you for £xxxx and you put it in your bank account and keep a log of what you spend on her behalf then once you reach the amount she has given you she issues you another cheque.

If she doesn't have capacity, then that would be stealing from her.

If she does have capacity, she won't consent to that anyway. Even if she did consent, it would appear as coercion and likely to be treated as theft.

Ss will know who is paying, as there is no lpa in place then I guess they aren't sharing information, there must have been s best interest meeting with ss and imca to assess and arrange the carers. If all they have asked is your opinion just tell them it's unsafe, you are not prepared to get involved and let ss and the cop sort it out. There must be a discharge co ordinator attached to the ward, if they think this is a mental illness issue is there a psychiatrist and cpn involved.

No, they won't diagnose mental illhealth in hospital, so no psychiatric input at all once the dementia diagnosis was excluded.

A functional MH diagnosis has to go through the community team, but there will be no engagement there as psychiatrists are all evil poisoners doing experiments on people (allegedly...)

Is there no card of the elderly mental health team at the hospital? Which hospital is she in. Is she on a dols.

so that's another fun thing we have to check.

Do you? why is that your responsibility?

what would happen if you all just stepped right back? And left it to ss? It doesn’t sound like it’s going to be sustainable in the slightest.

who are the people involved on the family side? I get the impression there are quite a few of you.

Is it possible for someone to make a bank appointment and physically take her to the bank ?

We're going to have to check because if someone in the family becomes deputy, they're going to have to take responsibility for dealing with the local planning department when it comes time for the property to be sold. Social services might do the work, but I don't trust that they'll check if its legal, I doubt they'll even think about it. And unfortunately it does seem that keysafes on listed buildings have to go through planning....

But as you keep pointing out you won’t have any official responsibility for at least 6-8 months, by which time the key safe will be installed and the council (planning control) can take it up with.. the other part of the council (social services). 🤷‍♀️

what would happen if you all just step right back and leave them to it? This is an option.

Just attach it to the front door, I'm sure thousands of people have keysafes, cameras, doorbells, knockers on listed buildings.

If she actually does go home and the carers can't get in they will ring their manager who can ring the police or an ambulance to break the door down and do a welfare check if she's already be deemed vulnerable and has no capacity to look after herself, they can also step in when there's no food and she obviously isn't eating or drinking anything if they do get in the house. The utility bills can wait. Whose been looking after thd house and bills while she's been in hospital. I'd just step right back, she's not your relative or your responsibility.

Worst case scenario with the key safe is come a sale you have to remove it and make good so don't waste effort worrying about that.

How she had money if she was always so anti social. That's quite unusual. Is she just an obstinate quirk ?

If she lives in a listed building it may be inherited money? Don't think there's any correlation between sociability and wealth, anyway!