Hospital social workers and the Care Act 2014

[pinkdonkey]

I have a relative in hospital following a severe accident that has left him with a complex mixture of physical, cognitive and mental health needs. A friend has pointed me in the direction of the care act and my understanding of this is that his social worker should be completing his full needs assessment of all his needs including maintaining personal relationships and parental responsibilities to his young daughter and that the social worker should also offer a carers assessment to his wife.

The social worker has told us that as a hospital social worker she will only be assessing his physical needs and will only provide support for these. She seemed to be unaware of the care act requirements and had no idea who could or would assess his wider needs. She told his wife that she could not refer her for a carers assesment and she would need to organise this herself (she has already tried and was told this could not start whilst he was in hospital). My understanding is that the social worker is failing in their statutory duties based on the information on the government website. I wondered if anyone else had any experience in this area.

is the social worker employed by the local authority or by the hospital?

Is your relative ready for discharge from hospital?

I believe she is employed by the local authority, but then I thought all SW were so that is an assumption. My relative is close to reaching hospital but the hospital team (including the psychiatrist and OT) have have expressed concerns about needing support for his wife and child in place before discharge. Previously he was a SAHD and his wife works full time, their daughter is 3) Part of his injury involves a head injury and this has caused problems with his understanding and behaviour.

Close to leaving hospital, notvreaching hospital.

I'm watching this as I am visually impaired and have some other difficulties and in August I injured my foot. I was told that the hospital should also provide a social worker since I live alone and would not be able to cope with daily activities. My mother, who lives in Florida had to come and help me. Someone on another thread mentioned to me that I needed to ask.

Assuming it's a local authority social worker they sound awful (and that's coming from a social worker!)

The Care Act 2014 places a duty on local authorities to assess all the needs you describe, it doesn't necessarily place a duty to meet all of the assessed needs with formal services however. It may be that the local authority can only provide services to meet his physical needs, but that shouldn't stop them assessing all of his needs.

His wife absolutely is entitled to a carers assessment. That is non negotiable. The social worker doesn't have to complete that themselves (in my local authority we would refer it on to a specialist carers assessment team) but they should be arranging it especially if one has been requested.

There is no excuse for the social worker not to know about the Care Act.

Has the community Acquired Brain Injury (ABI) team got involved yet?

Complain.

www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance

The link above is where I've got my information from on the Care Act from for anyone following who wants more info.

hatgirl

Thanks for the reply. It's interesting you say that all needs must be assessed but that they don't have to be met. The info I was given by a carers group local to me was that the services should be built arround the needs rather than the needs being shoe horned into existing services, and also that lack of funds was not an excuse for not meeting needs the LA could be taken to court if assessed needs were not met.

I am also feeling the SW is a bit rubbish, she seemed stunned to even be asked about any of the non physical needs.

No one has mentioned an ABI team, we have been told that the hospital services are liasing closely with a community team for physio and OT follow up which is likely to start either the day he goes home or the day after though could this be it?

His wife feels she may have to give up work (she has been off sick since his accident) to care for him and their daughter, but is worried that handing in her notice may voluntarily may impact her ability to claim benefits. She is also worrying about how she will manage to care for both him and their daughter full time as his behaviour caan be quite challenging at times. We were wondering if she can access any help with childcare. They were just about managing on her wage before so it's a big worry financially too. She has been asking to speak to the SW for weeks but been told she doesn't get involved until he is ready for discharge.

Identified needs do not necessarily need to be met by funding from the local authority no, because for very good reasons the NHS are responsible for some needs, and some needs could be seen to be able to be met by the person themselves or by family and friends. Some people occasionally have needs identified that they are happy not to be met. Any needs identified also have to be 'eligible needs'.

So usually its very easy / clear cut to assess and meet someones physical needs as eligible needs.

But in terms of meeting someones social needs, the local authority could offer day centres etc but these aren't for everyone. Alternatively they could signpost to local groups or charities. Or a person's social needs could be being met perfectly well within their own exsiting family and friends without the need for any further intervention from social services. If social services identify a need but also identify a reasonable way that need can be met without the need for formal services they will. The need will be classed as met even though it is not social services that is meeting it.

Social Services with the best intentions cant meet needs with services that increasingly don't exist sadly. As long as they can reasonably demonstrate how the need can be met they are working within the law, even if the need isnt met in the way the individual would have liked.

An infamous (and quite old) example of this was a woman who wanted carers to come and take her to the toilet during the night in her own home. The local authority said there were no care agencies in the area willing to provide a night time service so her options were she could either use incontinence pads and stay in her own home or they could find her a place in residential care. The woman took the local authority to court and lost as the local authority had identified how they could meet the need.

if its any comfort Its likely that the hospital social worker will be looking to put in enough of a service to get him home in the first place, and then the case will be handed over to the community teams for more in-depth support planning. Its not right, but unfortunately hospital teams are expected to have a fast turn around.

Have the family considered that he will now be eligible for disability related benefits and factored that into any decisions?

Thank you, that makes a lot of sense.

Oh that's good I didn't have chance to check it as was in a hurry and thought it might be a bit of a ramble.

It's unlikely social services would provide substantial amounts childcare (I.e full time nursery) given that one of the parents is physically capable of looking after the children, after all there are many single parents out there that have to manage somehow. However, your relative's previous role as a SAHD should be taken very seriously and he should receive support to maintain his parenting role as far as possible. So for example if he was previously responsible for making them meals and is no longer physically able to, but is still able to supervise them otherwise he could receive paid support for a carer to come and make the children meals at certain points in the day.

It depends completely on his capabilities and the age of the children etc.

It's also worth being aware that family and friends can be paid to provide any assessed support funded by social services if appropriate, providing that they don't already live with your relative. It's called direct payments and worth asking about if it's something that the family would be more comfortable with.

Depending on how severe his needs are he may also be eligible for some funding from the NHS as well.

Is there any chance he may receive any compensation at some point in the future as a result of his accident?

No compensation, he fell off a ladder working on the house.

I think his wife's concerns are that his care needs are significant (the only think he can do unaided is feed himself at present) and it's how she will cope with caring for him and their child full time. He cant cope with noise which won't be easy with a 3 year old so it wont be like being a single parent really.

It's great to know that his role as a SAHD should be supported though. He is still improving, so we do hope he will be able to return to parenting his daughter in a full a capacity as possible, right now I don't think he would be able to supervise her alone but we are hoping this may be possible in the future.

Thanks for all your help.

His wife needs to be absolutely clear about her line in the sand about what she is and isn't willing to do. It's sort of reasonable that she would be expected to do the food shopping, most of the cleaning etc rather than having carers funded to do it, - it's not reasonable for her to have to give up her job if she doesn't want to. He needs to be assessed on the basis that during work hours she is... at work.

I would hope that if there is any chance of further improvement and rehabilitation that the acquired brain injury team would be involved until he had reached his maximum potential.

Most local authorities offer something called reablement which is low level rehab usually aimed at older people who have had falls etc. The emphasis is on re-learning old skills and getting confidence back again. Often this can be in a residential setting and if nothing else is offered from an ABI rehab point of view I would definitely ask if he could be considered for rehab/reablement as part of a transition home.

If the family are happy to consider it it may also be worth seeing if adult services can make a referral to children's services to have his daughter flagged as a possible child in need. This can open some doors around young carers groups etc. Also at 3 she is going to be eligible for the 30 hours funded childcare which hopefully will help a bit?

I would be cracking on with the benefits applications as a priority as well as they can take a while to get sorted out.

Having worked with quite a few people with ABIs over the years I have to say that although it can be a hard road many do make good improvements with the right support. It can be really really tough on families though so his wife needs to accept all the support going and be honest with the professionals involved if they are asking too much from her.