Social services want to move relative out of residential care home into independent living

[Nomorechipsforme]

Any help advice appreciated. In a nutshell relative wasn't looking after themselves. Not eating, sleeping, not getting up and dressed, drinking alcohol in abundance, not taking there medication, house untidy and dirty, generally depressed, disoriented and not aware of what time or where they were. Family decision due to age early 80's put them in residential care as they had the money to self fund (I think it was the fourth call to the fire brigade and the found wandering at night by neighbors that was the deciding factor). Now the money is at a level where funding can be taken over by the Government. Social service apprentice has been to visit twice and has advised that they can be moved back to independent living, because their care plan with the residential home show they are independent. They are as they are being looked after and they can wash and dress themselves. The family don't agree with the social services opinion.This has been referred to the housing department who have advised they have no independent living vacancies. After their visit and seeing how frail they are and listening to the history and the family concerns they are quite understanding and agree with the family. Does anybody know where we stand? There are two family members that are POA but ultimately who has the over riding authority as the care services are telling us it's the Social worker apprentice. Thank you for any advice or knowledge.

First person to decide is the person themselves. If they don’t have mental capacity to make the decision about where they live, the next decision maker is the person or persons who hold PoA.

Thr difficulty here is that a person who is being cared for properly is more likely to regain mental capacity. I’m assuming if the family were pushing the decision to go into care, that the person lost mental capacity at that time. Ask the social worker when they regained capacity for this decision and how the assessment was done.

If they cannot self fund then the council will not fund a nursing home if they are assessed as capable of independent living. Remember council equals you and I funding it. Ask for a reconsideration and re assessment but they will not change it their current setting says they don’t need full residential care

If the Council is funding it they will go for the cheapest option. You could get in touch with Age UK and see what they advise as a way forward.

How long have they been in the care home? Was the GP or social services involved prior to the admission? Did you try carer visits in own home before deciding on residential care?

My mum is self funding but at the time she went in I involved social services. They visited her to check if she had capacity and also asked me how long her money would last before the council would need to start funding. I guess they get more involved in the decision of whether a care home is needed rather than at home care visits and also the choice and cost of the care home if they are going to be asked to take over the funding within a few months.

Social services have limited funds so want to try independent living with care visits. I think they can refuse to fund as they deem it not necessary. The longer they have been in the care home the more you are likely to be able to make a case for them staying.

I had this, but years ago now. Distant relative had gone in with husband from council housing and been in residential care for years. They’d originally moved when it was a lot easier to get a place in a care home. Virtually no savings and tiny pensions.
Husband eventually died.
On paper/computer categories she appeared to be capable of living independently, and each new social worker raised it and started the process. Then they’d meet her and realise just how frail she was. Plus presumably a very limited amount of supported living accommodation available.
She eventually died there.

Ss aren't stopping the relative from living in a care home, they're only saying they won't fund. If privately funded of course they can stay.

Do you have GP notes covering how they were while living independently? Also statements from the neighbour re the wandering and fire brigade calls? Depression and drinking alcohol are not reasons to be in a care home in themselves.

I have to say that when my parents couldn’t wash and dress themselves they still lived at home with carers coming in each morning to help them do that plus do breakfast and meds. They also had a lunch and tea visit and a bedtime visit for more meds. I used to clean and then I eventually got them a cleaner.

Are they still mobile or have there been any falls in the care home? That’s a good indicator of underlying frailty.

relative wasn't looking after themselves. Not eating, sleeping, not getting up and dressed, drinking alcohol in abundance,
How were they getting the alcohol?

I'd very much avoid facilitating finding them an independent living place. The site would have to agree they are suitable, so point out all the reasons why they aren't to the independent living place.

Make the point you won't be able to support with organizing their medicine, medical appointments, food or care.

Point out the risks associated with self neglect etc and insist that everything is written down, actively making the point to the council that you want you want there to be evidence if anything goes wrong because you believe the decision is unsafe and not in the best interests of the person.

And then ultimately if all that fails make a complaint and involve your local councillor.

Thank you all for your help it is really appreciated apologies for not answering individually. I completely get what everyone is saying and I do understand it is taxpayers money. The said relative has been in the residential home for 2 and a half years self funding. The SS are looking into the reports for call outs to the fire services however we are based on the border of two districts so do they do cross border checks as I know generally that service as the ambulance can be despatched from two if not three districts. The doctors assigned to her are not very good and don't even keep up with the standard entitled checks for the patient list and have not visited and assessed as was required. As I said the said relative is an alcoholic and has been diagnosed, so the residential home monitor alcohol intake. One of the medication that has to be taken is an opioid which wasn't been taken as it should of been due to a historical cancer condition. So due to being in residential care as @PermanentTemporary has said she has regained mental capacity as she has been looked after. I understand about independent living but there are no warden monitored places available and the other available place is in a town opposite an off license where as she would be vulnerable especially in the area it is cited. As we are rural we kind of get on with things so that is why the family decided it was the best option for and as services of any kind are limited where we live social services weren't really involved from the start. SS were contacted last year when funds were depleted and then contacted again and again and again. So all this situation is having to be back dated by 8 months. Had they told the family all this 8 months ago the place could still be said self funded whilst the background information and assessments could of been done.

@SallySuperTrooper the relative was asking different neighbours to get shopping and online shopping is quite easy and over 18 😳

@Ineffable23 Thank you for your advise appreciated. In my opinion social services are trying to offload the "issue" to the housing service, but after the initial meeting with the housing service, they do not agree with SS that the relative is suitable for independent living as HS determined on their initial meeting that they are a vulnerable adult. SS have made a decision and are trying to pass it back to the family to discuss with the Housing Service. We are all aware that most of the independent living areas now where we reside don't have wardens like the old days.The local councillor has been contacted twice with no communication back but that is another issue. So I am not sure if anyone that has read my post knows the answer, but who makes the over riding decision is it a sole report of an apprentice social worker, the housing service, the care home, the relative or the family? Are unregistered apprentice social workers qualified enough to make such decisions. I had read that they are not and can't override POAs unless it is detrimental to the duty of care to the the individual but the social care team are saying they can?

So social services are saying he/she doesn't need any intervention at all? That they can live unaccompanied with no care or support whatsoever?

I'm not sure how I would deal with that other than complain and keep complaining. Have you got a local carers charity? I would try them as a strong point.

@EmotionalBlackmail sorry for that situation it is very sad and stressful for all involved. I am hoping that this is how it plays out as there is no availability in the rural areas only in the town and that is limited.

@Ineffable23 SS are saying that they could live in independent living with minimal support. So a carer calling in up to 3 times a day which would have to be funded partially by them. Unless they went to a place which had a warden which would be a home with multiple occupation a bit like a residential care home but you look after yourself. Concern from family is that by moving to this, they would no only be a risk to themselves but to other residents. They used to have a council bungalow. As my post has said they are very good at creating fires, putting food on and then forgetting or going to sleep and setting the kitchen area on fire especially where grill pans are not cleaned. They would also had an alarm provided, one they wore round the neck, they had one whilst in the bungalow, never wore it. Family visitors could never get in if they were asleep so they put a key safe on the external wall. Apparently as none of this is logged with SS it's not true in their eyes. I have advised that SS were contacted numerous times but only paid attention when a financial assessment has been mad.

This sounds really stressful. All I can add is that it won’t be useful to focus on the assessment being done by a student, because they will have oversight from someone qualified. It sounds like you might need to pile up as much evidence as you can from when they were living at home, especially if there’s issues with different area emergency services being involved.

To answer your question social services make the assessment of capacity and recommendations re levels of care needed for elderly and vulnerable adults. If they say that residential care isn’t needed then the council won’t fund it.

If there isn’t suitable housing locally for your relative then the housing officer may say they disagree with or are surprised by the assessment but they are not the ones who have the final say as they are not social workers. They should be looking for suitable accommodation or putting your relative on a waiting list. The care home may have some input to social workers doing the assessment but social services make the decision. If the relative has capacity the POA is not needed so family can also have some input but are not the decision maker as they relative is not self funding and has capacity.

You mention that the relative lived on the border of two or three districts. Is your relative now in a care home which is in a different district to the one their council house was in? Again this will complicate the decision about which council should pay any care home fees. Are the care home fees currently being paid or are the care home letting them stay there as they expect the council to pay eventually? You may find the care home is forced to give notice to your relative if the fees aren’t paid and they then need to be given emergency housing by the council plus a care package.

@Anotherplant thank you for this advice. The only thing I would add there was no one else in attendance at these two short meetings due to us all being on various vacations. I would of thought you would of had to off been qualified and registered on the social worker register to make these types of decisions. I am guessing not then.

@Choux thank you for this appreciated.This is what I have taken from this . So to clarify as there is a meeting next week. The council is back dating the funding to when the relative went under the threshold and is funding until next week. So in effect by default the family have made her homeless, as the housing service will put the relative on a waiting list if they are deemed to have capacity to move to an independent living facility or property. Which we have been aware that there is none available apart from potentially an independent living facility which has multiple occupants. The care facility is in the same district but the other end of the district to her ageing family. Due to being on the borders the emergency services do cross borders when emergency situations come in as it's about capacity and availability which is why if SS investigate they would need to cover three districts. If this is the case then it is what it is. So if the relative is put in a multiple occupation or residing independently whose fault is it if anything happens. If there are no vacancies and the residential home chooses to evict the relative what does that mean, that they will be on the streets? Just to confirm the apprentice social worker had no other person in attendance?

Supervision for the social worker means they’ll have a lighter case load than one who has completed training, and they’ll review their cases with a supervisor regularly. It doesn’t necessarily mean the supervisor will come to meetings with them.

As POA you can’t insist your relative is in a care home funded by SS. You express what the person would have wanted, but there’s many people having to live at home with daily carer visits because SS won’t fund a CH.

You can be very clear about what you can and can’t do though to support them. The social worker is having to follow a process to determine where your relative is best cared for, so they have to look at the other, cheaper, options if it appears the person is able to live independently.

We had this with my mum, a stroke victim who was paralysed.

She was moved to an Extra Care facility. A block of flats which were all occupied by people who needed care or supervision. From people like my mum, to those with learning disabilities etc.

Downstairs there was a care office and a team of carers who only worked within that building. Mum had five visits a day, and a call system to the office/carer on overnight duty should she need help.

We weren't convinced, but she was happy to have her own space and belongings instead of being surrounded by people with Alzheimer's etc.

So if try to find out more about where she'll go. An Extra Care block with resident carers and the right safety equipment is likely to be the best option, and the one you should push for

This is a not uncommon situation when the issue is alcoholism as the person will of course function much better and be cognitively better having been away from alcohol. When they get home they will usually go back to it and all the problems start up again.

There is the consideration of public funds and if the person is not currently deemed as having needs that require residential care then social services are required to look at the cheaper options with council budgets as they are.

However I would suspect that capacity and wishes and feelings are also at play here. What does the person concerned want? If they are able to express an opinion, even if not a fully capacitous one, and they want to go home then social care will be pretty duty bound to facilitate that.

Is the LPA for health and welfare or just for finances? Even if it is for health and welfare the social worker can challenge the LPA holders by reporting them to the office of the public guardian if they are deemed not to be acting in the persons best interests.

My advice is to make a document with dates of all the incidents that happened at home; fires, falls, accidents and injuries, wandering out etc as comprehensive as possible (realise this will be time consuming but it’s important) and with any evidence that could back it up eg A&E or GP attendances, police and fire service call outs. Try to find any documents to back it up eg A&E or hospital discharge letters. Ask the GP to write in support of the person being unsafe at home. Ask the neighbours to write statements of what they witnessed when the person was at home. Family members also to write statements of what support they provided and what conditions were like at home. Try to make as factual as possible and less opinion eg ‘there was rotting food and maggots’ rather than ‘it was disgusting’

All you can do in the end is give social care the evident why the person going home is a bad idea. They will of course not want to be responsible for a tragedy or for having to find another placement. They are probably going on what they see now and not taking into account how bad it was at the time and will need to have written evidence from a variety of sources to take that into account

Your Mums living experience and independence will be greatly improved in a supported living vs a residential. Social care and the care act have assessed and to meet their statutory requirements they have determined the level of need, if you want a higher level if need than that then you will need to self fund.

As @ThePure above has said, however have these above incidents happened due to the alcohol intoxication or capacity issues?