Is social work handling my father's care home case correctly?

[IDontLikeMondays88]

My dad as quite advanced dementia and went into a care home in March. Throughout this process I have found there to be a real lack of anything in writing from social work.

for example his care assessment was done but not shared with us (my mum and I) until I asked about it.

the most recent social work involvement is that my dad has been assaulted twice in the space of a week by another resident (the home say this was unprovoked).

my mum was out visiting my dad and social work
happened to be there to see my dad because the care home has made an adult protection order because my dad had been hit by this other resident.

social work didn’t let us know in advance they would be there to see my dad. My dad now can’t really speak (because of his dementia) so I feel a family member should be in attendance if social work are out to see him. To advocate for him given he can’t speak or remember anything.

when I picked this up with social work I was told that despite this being an adult protection referral they weren’t there to see my dad they were out to observe the other resident involved. They also don’t want to provide a copy of the report completed following on from that visit.

they say they can’t provide report due to confidentiality. When I said just to redact all information related to the other resident they then said “they don’t tend to provide this” which is of course different from what they said at first which was that they can’t provided it.

can anyone who works in this field advise whether all of the above seems procedurally correct?

Do you or your mother have a POA for him?

My mum does yes. He has no legal capacity and that has been confirmed by a doctor and social work know that.

I think that they should be including her more. Are they aware she is his attorney?

Yes - I know this as I sent a copy to social work!!

Whereabouts in the UK are you as adult protection order doesn't sound familiar. The care home can refer to Social Services for adult safeguarding. It does sound likely given the circumstances that they wouldn't tell you anything about the person doing the assaulting due to confidentiality, and that the visit was more about that person and processes in the care home than your dad.

That said if your mum has LPOA for Health and Welfare, they should be communicating with her as much as they would with your dad if he were able.

We are in Scotland.
they home / social worker have confirmed that the home made an adult protection referral.

Have you tried asking Alzheimer Scotland for advice? They used to have lots of information sheets and they do have a 24 hour freephone helpline.

I wondered if it was Scotland as in England you would say adult safeguarding not protection, that said I suspect processes are not miles apart. It is likely that Social Services are going to be much more interested in the management and care provided by the home and their ability to keep residents safe, and whether the perpetrator is in the correct placement given their behaviour than speaking to your dad who can't remember the incidents.

They will probably provide very little information about their investigation if it all relates to the other resident.

SW must involve you on his health and welfare.

BUT this visit sounds like they’re trying to boot out the resident who assaulted him, ie it’s not about your DF. SW not really up to multi tasking, but you are entitled to know from the home as well as SW what’s being done to protect DF. Push. Push. They can give you details without naming names.

So I think what is slightly throwing me that social work saying visit is due to an adult protection referral i.e. about my dad but then saying no they were there to observe the other resident
i feel if it’s about my dad we should get to know the outcome. I don’t expect to be provided with confidential info about the other resident of course and would expect that would be redacted

All you will likely be informed is that the referral was managed and closed. The SW could likely be the other gents SW as well so was there to do an assessment of his behaviours. Although your Dad was the victim he doesn't need to be "managed" in any way, the other gent does. You absolutely won't be entitled to the report on the other gent.

This is often the way of adult safeguarding though. Your dad is a nice person who isn't offending anyone and just wants not to be hit.
Social Services are going to be much more interested in what the care home is doing to stop all their residents being hit and if the hitter has needs that aren't being met in this placement.

The purpose of the adult protection inquiry is to determine whether your father meets the three-point criteria and whether anything else needs to be done to protect him. You wouldnt normally be given the write up from this inquiry but they should discuss it in detail with your mother. This sort of situation is very common in care homes and the focus will be on making sure your father is safe. Given that he has been assaulted twice in a short space of time by the same resident the social worker should be discussing in detail what actions they are taking to prevent it happening again. If you are not happy your options are to complain to the social work department, the care home and/or the Care Inspectorate.

I would say that the only information that would be shared with you is that a referral was made, a SW did a visit and advised the care home on procedures. If your DM has POA for health and welfare, she should ask for a copy of his latest risk assessment which should detail how he will be kept safe. Sadly, people with dementia can behave very unpredictably - it could be your DF assaulting a resident next week. I’m surprised he still has a SW - once my stepfather was settled in his care home, his SW was no longer involved.

I should also say here that in Scotland we have the Adult Support and Protection act so this sort of inquiry is statutory. I’ve given only a brief outline below but am happy to answer any questions in more detail.

This isn’t the case in Scotland. The social worker will have been allocated specifically to undertake the adult protection inquiry. They are obliged to discuss it with the POA and arguably also yourself as a closely involved relative. They do not have to tell you anything about the other resident but they do have to tell you the outcome of the inquiry and whether it is progressing further through the adult protection journey.

My mother was in a dementia care home in England, so there will be differences in how it works in Scotland.

She was assaulted by another (female) resident, she was punched in the face and knocked to the ground. The care home manager rang and told me about it, and when I went in to visit my mother the manager spoke to me again. She said the assaulter was being moved to a different care home.

I was not told who it was, but I suspected I knew anyway because I'd seen her being slightly aggressive the previous week to another resident. And she disappeared a week or so later which confirmed it.

All the information came from the care home manager. The role of social services in safeguarding incidents was to call me afterwards, and check I was happy with the actions the care home had taken, and sometimes they would make additional suggestions. But as I say, that was in England so there may be differences.

I teach and sometimes watch/assess GCSE speaking and listening group discussions. The observation notes will literally say
X said "..." to which Y responded with the question "..." and then Z interjected..." "to which X suggested..."
Obviously we could use that set of notes for X,Y and Z because what they had said wouldn't be confidential and they would all know what had been said. I wonder if the observation was written the same way, but obviously with behaviour observations too, and so the staff need to try to write it up separating out who did/said what before they can show it to any relatives?

I understand your concern but it sounds like the social worker was there to see the other gentleman. Might well have been the same social worker but unfortunately you may not see the same social worker for your dad necessarily. They wont be able to share anything about the other man with you. Your best bet is to call the department and ask to speak to whoever is dealing with the adult protection case.

i am in direct contact with the social worker involved though who specifically told me when asked that she was out as there had been an adult protection referral ie she is out as my dad has been referred to them as a vulnerable person getting assaulted. But she then doesn’t want to share the report with me, even redacted. she has said the outcome of the report was “no further action, care home doing what the can to monitor”.

I am well aware this is how it sometimes goes in care homes and not debating that.

someone mentioned my dad being a nice person who doesn’t hit people but I don’t think it’s as simple as that when people have dementia.

The adult support and protection inquiry will be written as a case note and would not normally be shared. Your mum could make a formal request to see the case note but this would take time and I’m not sure it would be helpful. The social worker has told you the outcome which is no further action under adult protection. Simply monitoring the other person seems a bit light in these circumstances. I would want to know what the care home are actively doing to prevent this happening in the future. It would be reasonable to contact the social worker again or their manager to discuss, and the Care Inspectorate would certainly be interested if you wanted to make a complaint to them.

Thank you. I have not been told that they are specifically doing anything other than keeping an eye on the other resident. So very general/vague.

i will leave it just now but am going to escalate it if it happens again.

Social workers visited my mother a dozen times while she was in the care home and I was never asked to be present. I did ask once if they wanted me there and they said no, they would update me afterwards. They were deciding on what measures should be put in place, there was no role for me as was not present during the incident.

It depends how serious the assault was as to what action is taken. My mother being punched and knocked to the ground was a serious assault and the person was removed. But there were many other more minor assaults like hand slapping or shoving, and the only action in those cases was 'monitoring'.

Have you asked the care home manager what actually happened? It's the staff who would have witnessed it and reported it to SS. The staff always described the incidents to me (not mentioning who the other party was).