Contributions to older adult social care

[InveterateWineDrinker]

Does anyone have any experience in this?

I have POA for an elderly relative who is living in sheltered accommodation but in long term cognitive and physical decline. Long story short she has come onto social services' radar and been assessed as requiring home social care.

There's a whole other story about her needs being mental health related (she is both demented and floridly psychotic, mental health services are bending over backwards to avoid any kind of treatment) but she got a letter a few weeks ago saying that she had to pay for this social care and requesting she attend a financial disclosure meeting.

That's not a problem, there is money there and she probably needs the care. However, the letter didn't say anything more. I contacted the officer at the council about the financial disclosure, who has emailed back to say the care will cost £x per week and if we can afford it we don't need to go through the full financial disclosure.

That's it. Nothing to say how the relative's needs were assessed, what the evidence is for the needs. Nothing about how that cost figure has been reached, how the care is priced, or what that £x per week is supposed to pay for. Nothing about who will provide the care, what outcome measures the provider will be required to deliver, and nothing about how to hold them to account.

I've asked. No reply. I appear to be just expected to start coughing up from Monday without so much as an invoice.

I know full well that if I start transferring hundreds of pounds a month out of the relative's account then other relatives will accuse me of plundering them for my own gain; I've been accused often enough.

I do not have the wherewithal to challenge the needs assessment itself, but I also have no idea what we're being asked to pay for, and therefore whether or not it is actually being delivered. Am I entitled to this information? If so, how to I obtain it?

You are absolutely not being unreasonable to want more information.

Normally the person (or their representative) will be sent a copy of their support plan, where they’ve arrived at the assessment of needs.

if your relative is over the threshold and are paying the entire cost themselves, you don’t have to go via the council and use their approved provider. You could just contract directly with a care provider yourself and it might be cheaper (or more expensive).

insist on seeing the support plan and assessment and asking who the care provider is. How many hours/visits they’ve been asked to do and what tasks they’ve been asked to help with.

If it’s urgent and she’s at risk without the care then it may need to start before all the admin is sorted/paperwork posted but there will be docs they should be able to email to you.

If your relative has above £24500 in savings then they will be self funding for any care they receive.

If below this limit then it’s advisable to agree to a finance assessment so that their client contribution towards the cost of care can be determined.

Client contributions aren’t based on what care is in place, but they are assessed in accordance with savings and income.
There are some disability related disregard, so if the client is purchasing incontinence products, has some telecare equipment etc.

And yes, you as POA are entitled to have sight of the support plan and should have been involved in the planning process, so agreeing with the planned support, timing of calls etc.

As an aside, has a deprivation of liberty in the community been discussed? This is a legal requirement for anyone living in the community but would be at risk if there were to go out alone/abscond from the person they were out with.

Thanks for that 12purplepencils, very helpful. This is all new to me and the only person I know who has gone through similar (albeit different LA) had about the same level of responsiveness and transparency. And that council didn't want to know when presented with CCTV footage showing a five minute visit when they were supposed to have an hour. This is the sort of thing I'm worried about

The SS referral was in September 2023 and the social care needs assessment done over two weeks in October 2024, so I'd be shocked if the situation could be described as urgent or my relative at risk, yet ten weeks later I've not seen a single piece of paper relating to care planning.

Shallysally thanks for that, really appreciate it. I think my relative will be completely self funding, for the time being at least.

As for being involved in the planning process - I was phoned in advance to tell me that they were going to do the needs assessment. They then quite deliberately did it when I was out of the country and not popping in every day etc. I've not had even one phone call from the SW about it since then.

And, quelle surprise, no discussion of deprivation of liberty in the community either. I'll have to generously assume that a risk assessment was done as part of the overall assessment, but I've genuinely never heard of this.

The social worker should be applying for the deprivation of liberty through the court of protection. They should have assessed capacity under the Mental Health Act to determine if this is required. You or another person who knows your relative well should have been invited to this as the person who can provide accurate information.
A person who has cognitive impairment can tell the assessor what happens, which is often very different to the facts.

A deprivation of liberty in the community is required as it provides a legal framework in which to return a person home by the care provider/person they are out with/the police if they abscond from people and/or are out alone and it’s clear they are lost.

The test for this is set out in the screenshot: