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Carers UK Forum •Why care homes don't cut it...
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Why care homes don't cut it...

Posted: Sat Jul 20, 2019 7:02 pm
by Jenne_1907
Hey everyone...

Currently in a battle with the LA over an increase in care costs (due to NMW going up, not due to increased needs) I'm sure I'm not alone and that this is likely to be a battle for many people going forward.

I've been advised to write an official complaint about the proposed reduction in support and provide an argument against the council's "it's cheaper to shove you in a care home" excuse. I'm supposed to outline the reasons why a care home wouldn't be suitable for a family member of mine. We have a few reasons already, that seem fairly solid, but I'm sure there are some I'm not even aware of which will potentially be relevant to the fight, and I'd like to try and cover all bases and pack as hard a punch as I can. This whole ordeal is causing an unbelievable amount of stress and I'm not thinking as clearly as I should be, so when in doubt, shout on a forum for help haha!

Can anyone give me some of the reasons why they personally feel like a care home wouldn't be suitable for the person they care for? Has anyone had any experiences with care homes that have left negative impressions and highlighted why it's not always the best option for people?

Thanks all.

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 7:26 pm
by bowlingbun
Have they told you that "it's cheaper in a care home" in writing?

If not, I suggest that you set them a trap so that they do.


Get them to explain (it's OK to sound a bit dumb in this letter) in simple language why they are not prepared to increase their financial contribution when costs have gone up? Say you'd appreciate a reply in writing/email so that you can explain it to someone else or to help you as you are not good at taking in the spoken word.

(In fact, the statutory guidance for the Care Act says that they must meet the cost of assessed needs, but don't mention this in your letter, whatever you do!)

If they have a set ceiling that they won't go above, that is unlawful. Don't tell them you know that yet!

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 8:03 pm
by Jenne_1907
Thank you, Bowlingbun!

Nothing in writing yet. but it was all said during a "surprise" review (how I wish I'd thought to record the meeting!) with the social worker (also believe this is forbidden as it says in the legislation there are to be "no surprises" during a review, what could be a bigger surprise than having your care slashed by more than half when your condition is slowly getting worse?) but the theme has been maintained during the conversations I've had with the LA since the cuts were proposed too.

They've also spoken with one of the specialist team involved in managing my family member's condition, they're outraged by it and have spoken to the LA. Who made it clear the funding is to be cut as it'd be cheaper to use a care home. Wouldn't provide any figures or anything when pressed, which is fishy as all hell if you ask me.

Thank you for the advice. I've been trying to get clued up on the legislation and I'm very wary of showing my hand based on what I've learned so far. I will take your advice and make my first stop a request for a simplified explanation of why they're proposing the cuts and some figures to go by, if they avoid providing them it'll speak volumes I'm sure.

Thanks again!

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 8:22 pm
by bowlingbun
"Slashed in two"???

That shrieks of being unlawful, they must prove that need has reduced in order to do that, after a new assessment. Did they do a new assessment first?!?! Send a copy to the caree. Update your Carers Assessment?

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 8:38 pm
by Elaine
Hi Jenne
BB is far more 'clued up' and knows the rules much better than I am or do, but a few suggestions from my experience of my Mum’s last few months of life in a care home;-
Communication.
Check out where the staff are from. This is NOT racist. Neither Mum or I were concerned with origin or skin colour. BUT my mum had lived all her life in Wales, apart from the 9/10 years when she moved North to occupy a bungalow near me. She really struggled with the Yorkshire accent most of her main carers had but the Home employed carers from many other countries whom even I had difficulty understanding and she just didn’t know what was being said to her, especially as she was rather (but not completely) deaf.
What is the state of the other residents? When I first wheeled Mum into the residents lounge she waved, smiled and greeted the other residents.
Blank stares.
It was a Nursing Home and the residents were beyond communicating. My Mum was used to chatting and loved company.

Diet. Would the Home’s meals comply with the person’s dietary preferences and times of eating?

Routines. What routines does the person have which won’t be possible in a Home? Everything from how they get up, go to bed, have regular visitors (my mum had a hairdresser, volunteer sitter, library lady, etc). All these things and whatever you else you know the person is used to, relies on and makes them comfortable where they are will be changed and different in a Home.

Also, if this is relevant to the person, the willingness of their current family(?) carer(s) to continue with no detriment to their own health and well being,
the suitability to the person of current Care Provision and the assurance that the providers can continue.(If paid of course).

Any chance of an input from the GP to say all is fine currently and a massive change would be detrimental to their patient? It’s not just the change of address. If the person’s needs are being met by the current situation and no family carer is exhausted, heading for a breakdown or unwell themselves AND are genuinely happy to carry on, then the trauma will affect them too. So maybe that should be added to the argument?
Please remember I know nothing of the circumstances and this is just a thought. If it is certain that the main home carer(s) is in good health, not being guilt tripped, coerced or otherwise made to care and is desperate to continue as is, then an argument as to the affect on their mental health, financial burden (time and travel) and so on could also be put forward?
Hope something above helps a bit,
KR

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 8:41 pm
by Jenne_1907
@BowlingBun That's exactly what I thought - "how can they do this when needs haven't decreased AT ALL!"

From what I could tell in the rules and regs it says "no changes are to be made unless there's a change in need or circumstance". My family member has had neither, so it's all based on saving the council money, which is total BS!

A new assessment was done about three years ago and reduced the previously assessed funding by several hours, despite again being no change in the level of need. (I wasn't around at that time to help question it, so cuts were just accepted!)

This time around they said in the letter setting the appointment that it was a "review" but during the meeting tried to claim it was a reassessment. God help everyone under this council's jurisdiction if it was, because the social worker took absolutely no notice of anything that was said regarding needs. All he cared about was cutting costs and he seemed to be working with some kind of predetermined template of what the council should be paying for care (from an agency which is not suitable for my family member's needs) and how much time individual tasks would take an agency worker. Took no time to understand the new health conditions or declining abilities, nothing!

He literally couldn't care less about what was being said to him regarding needs and struggles, he just decided he was slashing the budget and that was that. Wouldn't listen to rhyme or reason, found it all quite shocking to be honest. I've met some questionable social workers in my time as a carer, but to just not listen at all and focus entirely on costs? Disgraceful.

As for carers assessment, don't get me started. My family member partly employs her sister to support her with her direct payment, and sister provides a lot of "unpaid" care (was paid prior to the cuts made a few years back) when needs fluctuate out of the funding level (which is common due to their condition)

So it's a case of "oh, you should do that because you're her sister..." when it suits the council to save money, but when it comes to providing a carer's assessment since she's supposedly acting as a "sister"/family carer on the regular too, she suddenly then becomes just an employee who needs to put up and shut up! It's all so twisted and a very unpleasant situation to be in.

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 8:52 pm
by Jenne_1907
Elaine, thanks so much for you input, all very useful and the GP idea is a good one, although the GP barely has an idea of what's going on, so I'm not sure how much help they'd be but it's worth a shot.

As for blank stairs and lack of interaction, I relate. My grandfather went into a care home, a real talker and joker, known across town for his humour and friendliness, within a year of being in the home he'd become an absolute shadow of his former self due to the fact no one wanted to interact. They all kept in their rooms and didn't even bother attending the group activities and things. He could only name one other person in the home of 30+ residents, despite his best efforts to interact. Horribly sad! Especially as the council shoved him in a home which was over an hour's round trip for all his family, so rather than being on his doorstep as we'd always been, we barely got to visit him anywhere near as often as we did when he was home. I think care homes are great when they work, but they don't often work, and you don't actually know it's not going to work until you've sold up and moved in.

As for how the carer(s) feels, the social worker who carried out this latest review made it abundantly clear that it's "no concern of the council's how you feel about this". Which was charming! There's never been any consideration for the health and well being of the carer, seems in these direct payment situations if you get paid you're apparently supposed to tolerate everything and not ask any questions.

Thanks again!

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 9:06 pm
by Chris From The Gulag
Hi Jenne ... I'll pretend not to have read that sister being employed bit.

Internet search ... LA CUTBACKS BEYOND CARE NEEDS ... several interesting reports / articles ... one by a community care lawyer.

Worth exploring :

https://www.theguardian.com/public-lead ... -solicitor

https://www.jrf.org.uk/sites/default/fi ... -Final.pdf

( My personal choice ... more aimed at the low millions struggling to eat / heat / roof and now support services.
Has been posted before but .... please don't ask me to find the thread ? )


https://www.communitycare.co.uk/2016/04 ... hallenges/

( A challenge as so championed by BB and others ? )

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 10:11 pm
by bowlingbun
Check the HÇPC register and see if the social worker was qualified. Really easy to do.

Re: Why care homes don't cut it...

Posted: Sat Jul 20, 2019 10:19 pm
by MrsAverage
What does the caree want? If their wish is to remain at home then the Social services can't force them into a Home without going through Deprivation of Liberty safeguards process.
However this may not mean they stay at home with the full packages of care so it may not bring (or keep) the money

It's ironic that many people in hospitals are being discharged home when they need residential care because "it is their wish to do so, no matter how unwise that decision may be"

Really it comes down to cheapest option