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.

Firstly , Powers of Attorney lay down that the wishes of the person must be ascertained as their past wishes. Do you have financial, welfare or both.

This also applies to Social Workers in training or not.
What does your family member want? AND, what has she told the S.W.I.T.

I agree with The Pure.

Who has now determined that she has capacity at this time. Alcohol Addiction is an illness. She needs a proper assessment, preferably from an Old Age Psychiatrist who has the complete facts of her life before and after her admission. The residential care seems to have helped her avoid relapse. I do not believe she would have the same protection from carers visiting several times a day.
Resident care is not only about the ability to wash and dress. It is also about supporting mental health problems, and giving emotional support.

It would be extremely unfair if she were to be moved, only to break down again.

List all instances of events; ask for her capacity to be determined by a psychiatrist....and once you have all the evidence you need from neighbours , records from previous g.p. records of fire department and hospital,
then ask for a case conference. This should include Psychiatrist, Housing, GP, and a Senior Social Work who has Not been involved in the case. Write to the Care Commission and explain the circumstances.

I really can't believe that they are trying to do this to a person over 80.
Involve your M.P. if all else fails. Good luck.

I can’t see much in any of your posts about what your family member wants. That should be the starting point.

If their not currently drinking to excess to they currently have mental capacity? (I think one of your posts said they did?). If so, and they want to to go home that is what should happen. You cannot stop someone from making an ‘unwise’ decision, going home might be that, getting someone to buy a bottle of whisky might also be that. Hard to accept but unfortunately true.

If then, at a point in the future they lose capacity again then POA will kick in again but their wishes should still be taken to account. I would probably suggest a meeting with the relative, SS and the POAs to discuss what the relative would like to happen if things go tits up again to help the process in the future. Their wishes may not be possible but always the best place to start a plan.

A capacity assessment is a snapshot of the time it was done. Yes, a history is useful but things that has happened when a person previously lacked capacity does not make the person lack capacity now. Some people have fluctuating capacity day by day (or even hour by hour with diagnoses like Lewy Body) but if the person makes a capacitous decision that should be upheld.

An old age psychiatrist could complete the assessment but as an RMN I could do this, I would expect an adult social worker to also be competent to complete this. When the MCA first came out professionals would expect psychiatrists to complete them but times have moved on.

Thank you for your information. Just to say that the S.W.I.T. apparently made two visits on her own. IYO would that allow her capacity to assessed? Amazing how things change.

A Social Worker in Training may be in their first weeks of training or weeks away from qualifying. How much they are supervised and how that is done will depend on how close they are to qualifying.

My mother was assessed as not having capacity in about 20 minutes. It might take longer to determine if you DO have capacity rather than conclude you don’t. But two visits and presumably a debrief with a superior after each sounds pretty thorough.

Thank you all for you help and input it is totally appreciated. Apologies for not answering individually. Just to update, without being too outgoing, relative was in independent living, i.e council tenanted property with a lifeline support which they never wore, they became as family assessed in decline after events mentioned in original post. They have been assessed by the Doctor and they have made some referrals for further tests (said relative is now not eating which the residential home has contacted family members to advise) due to being underweight causing physical symptoms. @SallySuperTrooper it is hard to distinguish as with the alcohol consumption, it went hand in hand with lack of eating so the dehydration was causing many of the mental capacity issues such as disorientation and now knowing where they were. They also could not distinguish between night and day, day and year. Due to the relatives funds, the residential care was being self funded which they wanted and their funds are now well below the threshold due to the delay in the assessment by the social services team. Therefore SS assessed and want to move the relative back into independent living. This is something we would have to accept as a family but there are no vacancies in the wardened independent living facility. The said relative has made it clear that they do not want to move into independent living. The SS are saying they can move back into independent living. The Housing Teams assessment was that independent living was not suitable and they determined that they are a vulnerable adult and it would not fit their needs and so that is where we are. The income that the relative would receive would not cover the cost that they would have to fund to cover the care required if they were moved back to a tenant property. The chances of finding a vacant council property to take a tenancy on are incredibly limited as currently we are told there is no availability here either. The local MP has been contacted but that was approximately 2 weeks ago and no response. @saraclara if there was this availability we would not be concerned, but unfortunately this does not exist in this instance. The options currently are the independent living with wardens which has no capacity or a vacant property with monitoring equipment which there are none available. LPAs are for both Health and Finances. So if there are no alternatives to the current situations what happens next will they at 82 be made homeless?

This is disgusting. As I previously stated, you need to involve someone regarding her capacity. Gather previous and current evidence. Inform S.W. that you wish a case conference. Also, inform them that you will be involving the Care Commission.
Contact your M.p. again....
And keep on doing it until they answer. The stress of all of this is probably pulling her down.
Things may well have changed, but is this really what Social Work has become? I am so pleased that I have written into my own POA that a Psychiatrist must determine my own capacity . I hope this will protect me should I need that.

Please be assertive..
I really have to say that any organisation will close ranks to protect their own.
So be prepared. X

@OLDERME thank you for the support appreciated. This type of situation is not uncommon in this area. Unfortunately due to that closing of council facilities such as the old style council homes and independent facilities with wardens, some years ago, availability is minimal with an aging population and I am not saying just here, I would imagine countrywide. The dependency is now on monitoring equipment not with physical people. What is the saddest thing there is no correlation between departments and you are not sure who has the over riding decision.Who knew that the outcome of your later years is left up to an apprentice. I did not realize that SS has the capacity to handle notifications of any time there was a memory issue, or a fall, or an accidental fire issue, or wandering around at unusual times so that they had evidence to support funding residential care when the time came. I am by nature an assertive person as is my other relative who is helping me so we are double teaming but I can honestly say that the overall feel by both of us is being bullied by SS. I am going to follow your advice now ❤️than you.

I’m a social work apprentice and I feel the need to point out that social work apprentices tend to be very experienced workers who have been doing the job a long time before their apprenticeship- don’t confuse it with a 16yo leaving school apprenticeship!

I’m more experienced than many of my qualified colleagues.

Social services can’t afford to fund people in care homes if they don’t have the eligible needs. We are heavily pressured to find the cheapest way for everything. You can submit a complaint usually via the website and that (where I work) usually gets looked at pronto. MP letters less so as they are usually oblivious of the actual law around this!

Also most adult social work teams will have many ‘unqualified’ (wrong qualification rather than none) workers in the team. I’ve worked at my LA for 8 years as one of those and there’s very little difference other than unqualified can’t do a couple of legal things… otherwise same cases.

They are not going to make your relative homeless. That will never happen. The council has a duty to house them and they will be in priority need as a vulnerable person who is homeless. What is likely is that social care will agree to some interim funding whilst an alternative placement is sought.
Once you have a final decision in writing there will almost certainly be an appeal process and they will probably have to pay whilst that is winding onwards. There will also be an official complaints process that you should follow. I would not recommend majoring on the qualifications of the person conducting the assessment but more on the delay to doing it and on not taking into account all the relevant matters ie past risk history at home.

I would imagine there is a system to make a formal complaint about the decision and you should use it. Complaints are investigated properly and recorded - if you are just having informal conversations with people it is not the same thing.

@canyoudoitforfree @ThePure I understand what you are saying, but ultimately the title is on the tin. Taken from the website:

A social worker apprentice in England does not have independent authority but works under supervision, gaining experience to qualify as a registered social worker. Their role involves applying professional standards learned through their apprenticeship and will exercise authority only upon completing the apprenticeship, registering with Social Work England and qualifying.

What Authority Does a Social Worker Apprentice Have?

No Independent Authority:
An apprentice is still a student and trainee, not a qualified social worker. Therefore, they do not hold the independent decision-making authority of a registered professional.
Gaining Experience:
Their role is to learn on the job, work towards a recognized qualification, and meet the professional standards set by Social Work England.

The title tells the unqualified general everyday person at what level they are in the organizations structure. The expectation is that you should be able to find in this case the person making the decisions on the social worker register which they are not. Just like you would expect to be able to find me with my denoted qualifications on my qualification register.

There is nothing we have seen on the reports sent that an overriding person with authority has been in attendance.

@ThePure thank you for this. We are waiting on feedback from the housing department for their feedback and SS to come back on the recent panel decision.

@canyoudoitforfree I understand that you have to look at the cheapest route but out of curiosity if you have for example a residential place where you have nothing else to pay and the government is saving on Attendance Allowance and your pension is contributed to the cost. In comparison how much would Seven days care x 4 visits + overnight care + petrol at approx 16 miles per visit, + benefits for council tax, + housing benefit + alcohol support, + refurbishing cost, + winter fuel allowance, + monitoring equipment, + lifeline support equipment, If a vacant property was available how much is the saving on average.

The trouble with the way you have tried to tot up the saving is that it’s coming from a lot of different pots some of them centrally funded (winter fuel, AA) or are health expense (alcohol support) Savings on those will not help the council with their over stretched care budget. In general anything up to 4x a day care is cheaper than a care home. 4x double up care calls, waking night carers or live in care are usually more expensive than a care home.

It’s not that I am unsympathetic about your feeling that a trainee should not make a decision that has a big effect on your relatives life it’s just that I do not think it will be a powerful point in a complaint or appeal. It will all be about the risks vs the cost so your best argument is that it is too risky to send your relative home. You would need to say why the decision is wrong and the most likely reason is failure to weigh up the risk of self neglect at home given past behaviour.

Am I right in thinking @ThePure that the trainee social worker won't have had final decision making powers? They'll have someone signing off on their work?

@ThePure I understand what you are saying and to be fair I have taken your advice on board. Thank you for your time and feedback it has been helpful and totally appreciated 💐. When we review the latest feedback from the SS and HT when we receive them, this will determine the nature of the complaint. We will see what the latest decision is as, as I understand it, it was being taken back to panel today. It is just for me and my age and maybe the job I am in there has to be accountability.

I am pleased that you are comfortable in challenging decisions. I would not however even mention that the assessment was completed by a S.W I.T. IMO. this will only serve to alienate the local authority. Doubling down can and does happen. You want to keep the process as open as possible. Do let us know the outcome.

To all you lovelies who have taken time out to message as always appreciated. Totally comfortable in challenging decisions at any level, due to the nature of my own career path/work. The challenge about the S.W.I.T @OLDERME however has already been made unfortunately by my other relative who is a retired nursing sister, she even scares me lol. It turns out from the latest feedback from said S.W.I.T email today, that it did not go to panel yesterday it is tomorrow and that there is only one report so the misinformation she has been supplying is rife, as it was stated there had been two visits before the conclusion was made. They sent me a link to a form to complete to access all the files of which I needed to scroll back 82 months/years to input the birth date to ask for the information which is probably set up that way so you don't bother lol. I in my response (email) asked how many reports had been made and is there any other information to access, the response email was no. I will fill a release of information form just in case. This case is being handed over apparently to a different SW, why I am not sure, but if it comes to light you will be the first to find out. Hope you all have a lovely evening 💐

Latest update SS will not be funding relative from 30th of September. The housing assessment was turned down by said relative so what now? Will they be on the street with their worldly goods in a suitcase on a village road waiting for someone to offer them a place to live 🥺

I guess the trouble is that if the relative has turned down what was deemed to be a suitable offer of housing then the local authority may decide to end their duty to house them as they will consider that a suitable offer was made. I am not sure that age will be a barrier to that I’m afraid

Also two visits would indeed usually only result in one combined report which would report evidence from both visits.

@ThePure I have emailed SS for a meeting funny thing is that it potentially turns out that it may of been 1 half hour assessment and there is no confirmation that it was done in person. I am guessing it will be what it will be. I will need to convince Relative to look at independent living options which is not ideal as the one with potential vacancies is opposite an off license. You never know they may revel in it.

@Nomorechipsforme if your relative is assessed as having capacity then they will be expected to attempt independent living. Should they make decisions that you disagree with regarding alcohol then that is simply a poor choice but one they are entitled to make as is everyone else. Capacity is the ability to make good and bad decisions like every other adult, age alone does not mean you should be treated like a toddler. If however they can make a choice but don’t understand the consequences of said choice, that could be deemed as limited capacity and that can mean further assistance is necessary. There’s a fine line being trodden but if they have capacity they can indeed revel in living opposite an Off Licence and that’s the law

You could try to ask for a professionals meeting’ or a multi agency meeting and try to get housing and social care in the same room to thrash out a solution

I suppose the relative could self fund the care home a little bit longer with their remaining money to give time to find something else.

I assume private rental with a social care package would also be an option if they don’t like the available housing schemes?

Is she still deteriorating. If so, do S.S. know this?