Elderly father - what rights does he have about coming home from hospital?

[MereDintofPandiculation]

Hospital want to discharge my elderly father tomorrow - all OK. Neighbourhood Occupational Therapist is planning an inspection when he gets home. What happens if his house "fails" the inspection? Can she push him back into hospital? Or into a care home? Can he say "no"? If she says he lacks capacity, can I say "no" - I have a Health and Welfare PoA.

Up to his recent hospital admission he has lived on his own, with no carers coming in. Hospital admission was because his mobility and mental state declined, and OT felt he was no longer safe at home, on the basis of a single visit. He has now recovered both in mobility and mentally, and just wants to come home and get on with life.

I would ask for the capacity assessment before he leaves hospital, if he has capaxity if he gets home he could just refuse any help, adaptations or to go into hospital or a carehome.

The ot will be looking at the home environment, is it safe, would he manage to get to the toilet, kitchen, does he need any equipment that might help make things easier, are the electrics safe, carpets, rugs and things like that. With capacity he has the right to refuse any help or to let the o.t. into his home. Without capacity then you could speak to the doctor about him being able and safe to leave hospital, even if it's just for a home visit. If she doesn't feel his home is safe she can recommend what could be done but what happens if he needs equipment or a carer, it should be set up before he is discharged. Have they discussed a reablement package to help him adjust for a few weeks.

He wants to be home for Christmas. They are planning a reablement package in the home. There's a chance that he may be home tomorrow. And the OT is ready to do an assessment when he arrives. He's always been regarded as having capacity, and hospital have been treating him as having capacity except for briefly (about 24 hours) when he first went in 2.5 weeks ago and appeared rather "confused". She's already been sniffy about the electrics, because he has a 4-way extension lead with transistor radio and 2 chargers plugged in which she regarded as unsafe, so I am apprehensive.

My in-laws hadn't had the electrics checked for years, the o.t. unplugged all the lamps which was fair enough, we bought new ones, when I turned the electric fire on the fuse box blew so they have to be careful. The fire brigade offer free home checks, put in smoke alarms. If he has capacity all anyone can do is check, offer advice, remove items with the person's consent and carry out risk assessments. If his home is unsafe and she feels he is at risk she may suggest he go back into hospital or to a carehome until it's sorted out. Are you going to be there for her assessment. We made the house as safe as we could wirh falls alarms, mats, careline, key safe, bed downstairs, commode.

If he has capacity they can’t ‘push’ him anywhere.

If he has capacity he can refuse to go into a care home. People have the right to refuse things even if it is the best option for them. If he does not have capacity you can say no, but this can be over ridden depending on the circumstances. For example I have known relatives say no when they want to safeguard their inheritance even though it is clear to everyone else that the person is not in any way ok at home.

They cannot keep him prisoner if he has enough mental capacity to make his own decisions www.alzheimers.org.uk/get-support/legal-financial/deprivation-liberty-safeguards-dols
I appreciate that is a link relating specifically to dementia but still might have info which can help.

Where I am social care is under such pressure they’d probably be hugely relieved to not have to find a care home

DF is home, and assessment went OK. All declared safe. Thanks cheesy for keeping me sane in the run-up.

And thanks to everyone else for your comments, which I've only just seen because I've spent the day firstly waiting for DF to be delivered and then talking to assessors. I'm exhausted!

Great update, hope you all have a lovely Christmas

Glad it went well. Keep an eye but contact OT or ssd for a reassessment if concerned.

Enjoy xmas

An OT is only really there to offer advice.If someone has capacity they can choose to be unsafe at home. If they lack capacity we have to act ' in their best interests' which if they can be supported safely at home and that is where they wish to be, would always be first choice. Glad all went well.

We got an electrician to put in extra sockets in places where they weren't noted and plugged things in.
There are lots of things that can be done to enable your dad to manage well at home.

I’m shocked they never had the OT assessment and mental capacity assessment before he was discharged from hospital?!

I work in a hospital and every patient has regular psych reviews to determine their mental capacity. And obviously any patient who needs it has an OT assessment.
I’ve never known a patient to be discharged and have those two assessments done once they’re home

Kenny there is a big push currently for people not to remain in hospital once medically fit, for assessments that can take place at home. The D2A ( discharge to assess) model is very popular, where OT, physio, SW and nursing needs can all be assessed in home environment which is better for the patient. La king capacity does not mean you are necessarily not safe to be at home. Staying in hospital longer than necessary puts you at risk of catching all sorts of horrible things.

Vdbfamily, I can understand it's better to have a home assessment with the patient but if they lack capacity how do you deal with a situation if they refuse to go back to the hospital if it's not safe at home, or they refuse to let the therapist in and just shut the front door, if they lack capacity would they be on a DOLS in hospital.

Cheesy....I agree that in that case, if you had concerns re discharge ( and you can normally tell) you would assess capacity in hospital and have a best interest meeting in hospital. If as in Ops case, the family are keen to get patient home, it usually means they will be fine as families usually quite cautious about discharges

My in law had capacity, got taken home after one of numerous admissions for falls, went inside and refused to give the spare key to ambulance crew to put in key safe, fell, broke his hip, back in hospital, always had capacity but ended up in care mostly because the g.p. and senior nurse persuaded him it was too much for family to keep dealing with.