Dad wants to live in my brother’s rental house. How realistic is this?

[Denimes5]

My father is currently living in my brother’s house, paying him the full government rent a room scheme amount of £625 a month.

As expected, after a short time, he’s now decided he wants Dad out in the next few weeks.

Dad uses a zimmer, has a full package of care, has a urinary catheter, wears slip pads, often doesn’t get to the toilet in time to open his bowels and so there are faecal accidents.

He gets up at night to use the toilet a couple of times and my brother has to help him.

He doesn’t seem to have much recent memory at all and yet his recent brain scan didn’t show any dementia.

My brother wants to move him into his vacant rental house and charge the full market rental value.

There is no downstairs toilet in this house and I, as POA, would be expected to put a stairlift in.

My father says my brother has shown him round and he would like to live there.

The social worker says it’s actually worth exploring the funding options for this as the council might decide to contribute.

Dad would need a live in carer with support overnight. The cost would be extortionate. Then utilities, council tax, a cleaner, food, no doubt.

I am taking Dad to see a care home tomorrow as I think it might be more realistic.

How likely is it that my Dad’s wish to live in my brother’s rental house will actually be fulfilled?

I have my reservations about my brother’s plans but as POA, I have to consider all views and options.

I’ve spoken to Dad about how quickly his own funds would run out but he forgets.

I’m finding the whole POA situation a stressful place, providing so much support without any support.

The DN’s wanted to check his catheter before handing over to a new team. No doubt they were confident that he’d tell us they’d been in.

It’s what happens when you’ve tried and failed to get concerns across to the relevant teams, but no one’s actually listening.

That's great news, I'm sure he will settle in quickly and make new friends, what a relief for him and you.

There really does need to be a nationwide system for sharing medical and care information about vulnerable people with trusted family and friends.

At the moment, the official position is that no matter how frail and forgetful someone might be, it's up to them to remember stuff and that's just not realistic.

It wouldn't fix everything - some people are sadly very alone in the world, others will insist they are and refuse to nominate anyone - but imagine just being able to check the "who did what with my relative" app and being able to see the DN has been and what they did.

Dad’s previous care company had a system in place to share their notes with me. I found it impossible to access though. Gave up in the end.

What happened to the paper written notes folders we used to use, they were left in the clients house. Now that he's in a carehome, as poa you can be involved in his care plan, assessments and overall care, we used to update careplans if anything changed but always monthly and poa were invited to come along

Oh, that’s interesting. I’ll find out about that.

He should have risk assessments for fire, evacuation plan, bedrails, mobility, everything really which should be read and signed, also the contract, fees, bank , any extras, use of social media and photographs of him, and terms & conditions, these should be signed by a resident with capacity or you as poa. Is he placed on a dols as he lacks capacity.

Thanks for sharing all this, really helpful.

I would like to see his risk assessments and care plan. I can see that if you’re self funding, you don’t have OT’s and physios assessing and implementing the correct support.

We quickly realised Dad’s toilet seat wouldn’t fit, so after a night with his commode frame around the toilet we got the correct seat from Argos.

Dad’s own loop rail didn’t fit the bed so the care home is supplying a different bed.

He can’t work the bathroom pedal bin so I got him a swing bin instead.

I think I’ll get him some private physio to see how he navigates the environment.

Not sure how all this works without family to advocate for your needs when settling in.

It can be difficult for people, that's for sure. We had to pay for private physio, was he assessed by physio in hospital and given a frame or stick if he needs it. A private physio will assess his mobility and tell the staff but they don't visit every day like in hospital. Have you signed all the paperwork and set up payments on his behalf. Ask about a visiting dentist and optician too, the carehome may arrange it. They should also assess his continence and use of pads if he's using them, they can either buy them in or you'll need to. Make sure all his clothes are labelled and any valuables safe, he shouldn't need any money but we gave the administrator money to buy toiletries, treats. As he's self funding he may still get his attendance allowance 2hich goes to the home towards the costs. Good luck with it all.

You're doing really well @Denimes5

It's been a bit of a roller coaster for you, but you've succeeded.

Thanks @MissMoneyFairy . When the people from the care home visited Dad at my brother’s house to do their assessment of Dad, I’m not sure what they learned about him.

It all happened so quickly, I only found out they were going in when I phoned Dad to be told they were with him.

They don’t appear to know much about Dad’s functional abilities as they haven’t been helping him to wash and dress, to get ready for bed, and so on, even though they’ve done a skin check on arrival and established that he has red groins.

We can’t have grab handles in the bathroom as the walls won’t hold them, apparently, the towel rail is behind the sink, which involves turning with the zimmer with wet hands to use the towel.

I’ve asked for a towel rail to be put next to the sink which they say they can do.

He can sit on the toilet seat for a strip wash but the sink is a bit of a stretch from it.

I’ve explained that Dad had a full package of care with help to wash and dress so I don’t understand how they’ve assessed him as self caring.

He’s full of wit and liveliness in conversation with the carers but that doesn’t translate into functional capability to manage on his own in the bathroom.

Of course, my brother is still pushing for Dad to go to his rental house and even suggested that Dad could lend my brother the money to have a bathroom built downstairs in his house and that he could ‘pay him back later.’!

He was referred to reablement after a recent hospital but haven’t heard from them yet. I’ll chase them up first.

Failing that, I think the next step would be to get a private OT to look at Dad’s functional abilities and the environment and a physio to assess his mobility and liaise with the carers.

They should do a full assessment, they can't say he's self caring if they haven't assessed him, is there a care manager there. Are you able to visit the home to see yourself, I would try and see his careplan, assessments, dols as he lacks capacity, are you sole poa? Have you had a chance to visit

A care home that's unable to fit grab handles in the bathroom?

Find another home.

Sorry, that sounds a bit glib. I know finding a home is hard, so once you've got a place I understand the desire to give it chance. But that's a major structural disadvantage, on top of a serious failure of their initial assessment. It won't get better.

Have you had a chance to visit the home, this all sounds a bit odd, where are you getting your information from. You have poa so you really need to think if the home is suitable, who is your brother discussing this with?

Two people from the care home went out to assess Dad’s suitability before he went there. The SW did her own assessment apparently and I thought that would then be accurately handed over to the care home.

I have rung the duty social worker and explained that dad has gone from a full package of care with help with washing and dressing and personal care to no help with this.

Dad’s SW, has just messaged to show me an email of her assessment to the care home that includes Dad’s need for assistance with personal care but aside from that, has ended her involvement.

I will ask the care home coordinator to share it with staff. Seeing as they already seem to have the information to support Dad, I will start looking for another place for Dad as I’m not sure it can be resolved.

They have been giving Dad a lot of support overnight as he’s been very restless, getting up and going out to the toilet to empty his catheter, open his bowels, and they seem to have a lovely rapport with him, so I don’t understand why that support isn’t being followed through with washing and dressing support and getting ready for bed.

The only thing I can think of is he doesn't want their help but this should all be documented. If they help him during the night then they should help him during the day. As a new resident he should have a GP visit, there will also be district nurses, ask what GP practice they are registering him with and call them. There will be a responsible person/manager at the home, their name will be on their website or cqc report which you can read online. If he needs a higher level of care then he needs to move to a nursing home rather than residential. As poa you can request a vest interests meeting, you are in a position where you can make decisions on his behalf. Have you paid upfront for a set length of his stay. Do you think you'd like to visit him yourself? Your brother if he doesn't have joint poa has no legal rights to move him or ask him for money. The home should have his capacity assessment and a dols as he lacks capacity and all his care is given in his best interest. Did you sign all the paperwork and payment details as poa.

If he needs a higher level of care then he needs to move to a nursing home rather than residential.

If he needs nursing care. Not necessary for needing a lot of help with personal care. Residential homes should be able to cope with full personal care and much higher mobility needs than he seems to have.

I have emailed Dad’s care plan from the council that was put in place for his full package of care.

This evening, someone popped into Dad’s room to ask if everything was alright when my brother was there.

The carers used to call in and explain what they were going to help Dad with and he was happy to cooperate.

They’re still not doing that for Dad here. I would like to sit down with the manager and run through the care plan with them but the care coordinator said it wouldn’t be possible. I need to see what their understanding of dad’s care needs is.

I can see I’ll have to start looking elsewhere for Dad’s care. I think it’s awful that once someone has been put in a care home the SW’s involvement stops, even though I’ve highlighted omissions in care and support that aren’t being addressed. Still no bed handles and no chair raisers.

I expect this would have all been put in place if Dad had been a funded resident. If you’re self funding, it seems you’re also expected to be self caring.

Are you sole poa for his health and welfare, if so you insist on reading and contributing to his care. Who is telling you what is or isn't being done? Self funding residents are not expected to be self caring, if you need help then your funding status doesn't make any difference, who recommended bed handles and chair risers, usually the bed has controls so a bed handle isn't needed. Social workers won't be involved but if you have concerns you can ring adult social services safeguarding.

Yes they should, we don't really know who has sole health and welfare poa, if op has visited the home or what is really going on, it does seem quite confusing. Sometimes it just doesn't seem to add up.

I have the sole POA for health and welfare. My brother is telling me what isn’t being done and I am noticing that things haven’t been / aren’t being done when I visit Dad.

Yes, I know that self funding residents are not supposed to be self caring. I’m just observing that they really need to be to be able to cope with the lack of initial support offered.

I thought there would be steps put in place to ensure Dad’s safety in his environment before going to the care home.

He had a bed handle in my brother’s house that doesn’t fit the care home bed. I didn’t understand that they would accept him without ensuring he had one in the care home. An accurate handover and a transfer of seamless care is what I thought would happen, because Dad’s not that complex in his care needs.

I will insist on seeing the care plan.

What exactly doesn’t add up? I’m not spinning a yarn.

Gosh OP this really sounds like a substandard care home - very much hope it's unusually bad. Have you looed are reviews online (they all have them, on something like care.co.uk or similar)

Well, I have forwarded the previous council care plan in full to the care home so that they can see exactly how Dad was supported by his full package of care at my brother’s house.

He now has chair raisers and a bed handle on the side he gets out of bed the most. Still waiting on the other.

His community reablement referral (for physio from a recent hospital admission) has been redirected to the care home.

The care home asked the GP to refer him for an OT assessment.

He is now being assisted to wash and dress in the morning.

The carers all seem lovely, very willing to help. The main problem is the environmental issues that I’ve explained, and how the care home assessment of Dad pre admission didn’t involve looking at his community care plan and how it supported his needs. Hence, his care needs were not automatically transferred over.

A bit concerned that this wasn’t a basic prerequisite, and I think this must be a management problem. I’ll keep looking to ensure that I don’t overlook a more suitable option for Dad.

The care home was rated excellent in all areas and there’s a lot to like about it too.