can hospital force my husband into care home?

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Hi - I wonder if people can help - we are waiting for my husband to be discharged from hospital,to our own home. We have had a discharge planning meeting and it has been identified he will need four visits a day from carers, I will also be assisting with giving medication and overnight peg feeding. I’m fine with that and we are both looking forward to him coming home. However the hospital have now said that they would like him to have an “interim placement” in a care home whilst the care is resourced. I have a meeting with them on Monday about this and am desperate for some advice. Please tell me they can’t force him Into a care home in this way?
Hi Sam.

First step ...the BIBLE on hospital discharges :

https://www.nhs.uk/using-the-nhs/nhs-se ... -hospital/
If you're unhappy about your suggested discharge or transfer date, talk to the hospital staff. You have the right to discharge yourself from hospital at any time during your stay in hospital.

If you want to complain about how a hospital discharge was handled, speak to the staff involved to see if the problem can be resolved informally.

Alternatively, speak to a PALS member at the hospital. ( See below. )

PALS offers confidential advice, support and information on health-related matters. You can look up local PALS offices on this site.

You could also contact an NHS Complaints Advocacy service. Your local council will be able to tell you who the local advocacy provider is.

If you wish to raise a formal complaint, follow the NHS complaints procedure.

You can rate or review a hospital on the NHS website – simply use the Services near you tool to find the hospital you wish to comment on. You can either leave an overall star rating or post a review for other patients to read
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In essence , it reads as if the " Care plan " is yet to be put into place by the Social Services team within your local LA ?

If so , would explain why , perhaps , the half way option ... temporary move into a care home ( Nursing ? ) ... has been muted.

In which case , said discharge would NOT be " By the book " ... all NHS staff are governed by the same Book.

Shortage of beds , perhaps ... to suit them and not your husband ?

I assume no one has mentioned either CHC or NHS Continuing Health care to you ... as a possible option ?

Main thread for both :

https://www.carersuk.org/forum/support- ... inks-32532


PALS ... within the hospital ... recommend liasing with them as a first port of call ... as per the guidance given in the Book.
Each hospital will have its own discharge policy. You should be able to get a copy from the ward manager or the hospital's Patient Advice and Liaison Service (PALS).

Once you are admitted to hospital, your treatment plan, including details for discharge or transfer, is developed and discussed with you. A discharge assessment will determine whether you need more care after you leave the hospital.

You should be fully involved in the assessment process. With your permission, family or carers will also be kept informed and given the opportunity to contribute. If you need help putting your views across, an independent advocate may be able to help.


I trust the above will prove to be of assistance ?
Hi Sam
If they were putting him in a care home permanently there is procedure called "Deprivation of Liberty Safguards" that is supposed to ensure no-one is put in a Home against their will
However I'm not sure it applies to temporarily or interim placements
They are obviously having problems finding suitable home care and wan to free up the bed.
So the 'choice'(if that's not a misnomer) is likely to be between staying in hospital (which neither NHS nor SS want) or interim care.
You can try and push to get the home care set up, but if there's no one suitable and available, would you want someone 'unsuitable'?
If they are saying interim care you need to find out if this is rehabilitation or reenablement care, because that would be free for 6 (I think, but check) weeks.. if they say it's just care he needs, then they will be charging for the care.
What's the situation with his financial assessment?
Hi Sam,

I was up very early today, just off to bed, back tomorrow. If you could give us a bit more information it will be easier to work out how to best reply.

Can I ask what is wrong with your husband, and how old is he?
What disability benenfits is he receiving?
Are Social Services currently involved?
Does he have over £23,000 in savings? Yes/No
Are you aware of NHS Continuing Healthcare?
https://www.nhs.uk/conditions/social-ca ... -hospital/
Arranging care before you leave hospital

If you or someone you know goes into hospital, help and support should be arranged before you go home (are discharged).

This means:

any extra help is arranged, such as visits from a district nurse or paid home help
any equipment is fitted, such as a raised toilet seat
any home adaptations are made, like grab rails in the bathroom

What happens while you're in hospital

Hospital staff should contact social services to arrange a discharge assessment. This is so they can find out what help you need when you go home.

It doesn't matter if your hospital stay was planned or an emergency.

The assessment can happen in hospital, or they might visit your home.

It helps to have a key safe at home, or to leave keys with family or friends.
Information:

Speak to staff in charge of your discharge to make sure you have everything you need. This includes a date, care plan and equipment.

You'll be involved in the assessment and agree a care plan together.

This should include things like:

treatment and care when you get home
who's in charge of your care and how to contact them
when and how often you need care

Preparing to leave hospital

Hospital staff should make sure:

you can get home
you have your care plan and your care home has a copy, if you live in one
you have any medicine you need and know how to take it
you can use new equipment, such as crutches
your GP knows you have been discharged
you know how to get help from a district nurse if you need it, or when to expect a visit

When you get home from hospital

Temporary care

If you have had a short illness or an operation, you might only need care for a short time to get back to normal.

This is called intermediate care, reablement or aftercare.

Care is free for up to 6 weeks.

Ongoing care

Soon after you leave hospital, social services will check if your care plan is right.

If you're likely to need care for longer than 6 weeks, they'll work with you to put a care plan in place. This care isn't free.
Information:

Care plans are checked once a year, but if at any time you feel your care isn't right, contact social services and ask for a review.
Thanks for your replies - In nswer to the questions you asked - yes he has been assessed for nhs chc and they said he wouldn’t get it -he passed the checklist but had several highs but no severes on the full assessment - we will,appeal it. The financial situation is that he will,qualify for la funded carers coming to the house at present, but may have to,pay something toward it from the care part of his benefit. The hospital he is in does not have pals on site which is a shame. With the meeting being on Monday morning I am now going to worry about it all weekend and just want to try and find out where we stand beforehand. There was no mention of any interim placement before now and I do,feel it is a bed clearing issue. He has been in hospital for eight months following a severe haemorrhage type stroke and they have said they don’t think he will recover more than he has. So they are not suggesting rehab, it’s a care home they are trying to send him to. And it’s not what either of us want
Your welcome , Sam.

You could also contact an NHS Complaints Advocacy service. Your local council will be able to tell you who the local advocacy provider is.


Just in case it's needed ... if nobody available within the hospital :

http://nhscomplaintsadvocacy.org/

Contact details ... telephone / email / text ... all on the front page.

Deprivation of Liberty Safguards ?

AGE UK Factsheet 62 ... most comprehensive there is out there ... in .pdf format :

https://www.ageuk.org.uk/globalassets/a ... ds_fcs.pdf

From the main CHC / NHS Continuing Healthcare thread :



Quite a performance to get a somewhat simple task done ???
Sam, rather than worrying all weekend, spend some time getting more info. That way you will feel calmer and more prepared. Even if there no definite answer available you will be able to respond to most things they bring up at the meeting .
Do ask for and get, a copy of his care assessment. There's probably errors in it. If they haven't written it yet then he shouldn't be discharged.
I also think you are well within your rights to ask why they can't find suitable home care when they've had many months to do so
Keep a note of all dates and times of meetings and contacts as I feel there's a good chance you may have to put in a formal complaint 're the delays at some point in the future

If it helps, I think this will only be the first meeting about his discharge , it need not be the final one, especially if you raise concerns

xx
Are YOU going to have to pay for the care home? If you are, ie, if you have to self-fund, then surely you can choose whatever care home you want, for as long as it takes to get the home-care situation sorted!

Alternatively, I wonder whether YOU could sort out some home-care! If the issue is that the SS can't find sufficient numbers of care-workers available from agencies THEY use, that doesn't mean that 'private agencies' can't supply whatever is needed for him to be able to come home to you!

It really all depends on who is going to be paying for this proposed 'interim' in the care home.

Would it really be so bad, though, if he spent a few weeks - maybe into the New Year - in a care home???

If they really can't set up the home care staff in time (and of course, at Xmas, there is going to be HUGE pressure on availability alas, with care workers taking time off themselves etc etc!), then isn't spending a few weeks in a nice care home better than still being stuck in hospital - if he's been there 8 months he must be stir crazy!

Have they told you WHICH care home he would be sent to? Can you go and visit it over the weekend yourself, to check it out?

Please don't think that all care homes are 'dreadful'. They truly aren't, I promise you. My MIL was in three, and all were lovely, the first two especially (the third was for those with severe dementia, so it was a 'sad' place in itself, though staff made it as cheerful as possible).

I do suspect this is a 'seasonal issue' caused by Christmas gumming up the works. It's clear that the hospital are desparate to free up a bed (for all the drunks etc, sigh) and like I say, a care home really may not be 'too bad' in comparison with being stuck in hospital over Xmas!

If you are afraid that he will 'never come out' of a care home, I don't think you have much cause for worry. If the SS/NHS are paying for the care home, it will be MUCH more expensive than home-care, and they will want him back home ASAP to reduce their costs! In fact, ironically, the situation is usually the opposite, and families have to FIGHT to get SS to fund a place in a care home, rather than limp along with inadequate home care!
If, of course, YOU have to pay for the interim care you can pick and choose - look up on the Internet and see what looks 'nicest' and start phoning to see if they have interim vacancies??