social services

[seagull1111]

my dad has prostate cancer which has now spread to the bones, he is 86 and been constantly in and out of hospital. when he was in recently the sister said i should start looking for a care home, my dad was ok about this. he has a small property to sell. i asked social services for the 3 month property disregard and to cut a long story short they have said my dad could go home with care ( mmmmm?!) and does not need a care home. i have a letter from his gp and cancer consultant saying he needs care in a nursing home but social services will not budge. i wrote to my m.p. who took the matter up for me but social services remain adamant and the mp has just accepted their decision... i have written to social services asking for their complaint procedure. the nhs assesment my dad had at the same time states he needs nursing in the middle band so how can social services go against this... any help or ideas please... thanks

[maroondevo52]

Hello and Welcome, Seagull.

Sorry to hear about the situation you and your dad find yourselves in.
If you start a new thread in this forum......

http://www.consumeractiongroup.co.uk/forum/nhs/

There are a lot of people with knowledge of this sort of thing who will be able to help you out. Just give the same details as you have here and I'm sure you'll get the help you seek.

There's a link here that might be of some help......

NHS funded Continuing Care and the Coughlan case

Regards.

Scott.

[seagull1111]

help anyone???? he has been awarded nhs middle nursing band but social services say he can go home, so how do these 2 things link for goodness sake, i am truly at my wits end.....social services come in and do an assesment that takes about an hour and in that hour the decision is made......i don't understand how the letter from the gp and cancer consultant can be so ignored... i am making a complaint but i fear i know the outcome. i have e mailed my local paper and hope very much they will do an article on it !.. it won't help but it may make me feel better... does this happen all the time does anyone know....?????
any help out there please?

[Conniff]

does this happen all the time does anyone know....?????

Not a question you need to ask seagull. You have read and seen on the news the almost weekly errors they make and the tragic consequences of their action.
That's why they are called Social Services and not Social Care Service.

They continue even after the "we will learn from this" statements they make after their growing catalogue of errors in which they think they know better than 'professionals'.

[Rob S]

I would take a look at this group for good information:-

NHS funded Continuing Care and the Coughlan case

And this forum is also very helpful:-

Free nursing care information

The Alzheimers Society also has very useful information with respect to issues over care in the home or in nursing homes.

Another thing to bear in mind is the Health and Social Care Act 2001. Section 49 states: -

“(1) Nothing in the enactments relating to the provision of community care services shall authorize or require a local authority in, or in connection with the provision of any such services, to: -a) Provide for any person, or b) Arrange for any person to be provided with, nursing care by a registered nurse.”

It looks to me that you should be taking this issue up with the NHS and not Social Services, and that your father may well qualify for Continuing NHS Care which should be funded by the NHS in full. He should not have to sell his home to fund his care costs, though Social Services and the NHS may well try and convince you otherwise.

[surprise]

My friend was in the same position with her mother and I advised her to see her local councillor rather than the MP. The councillor was brilliant and got her into a care home quite quickly. If your father is at home in the interim period there are always the MacMillian Nurses, again an organisation that does a brilliant job.

good luck

[DOBBYDOG]

Hi there,

Is your father still in hospital or at home ?

Now then you say that the GP said he needs care in a nursing home but the sister says care home. Is this right ? as it will make a huge difference as to which one he needs.

Does your dad need care from a trained qualified nurse or could his needs be met by a carer who isn't a qualified nurse. For example does he need help with personal needs, making meals, general eveyday things like that or is his condition as such that he would need nursing intervention ?

If your dad has stated he wants to go into a care home ( not nursing ) and he is suitable then social services are not right to say he cant if that is what he wants.
It does get more complicated when it is nursing and not care. Also it depends on what area you are from although its all supposed to be the same different PCTs have different criteria.

McMillan nurses although very good at what they do will not do hands on care. They are there to advise you and your father and they are excellent and well up on what services and monies are available.

Distict nurses will do the hands on care for your dad at certain stages of his condition if his wish is to stay at home. They will visit regularly for symptom control and support and generally keep an eye out. They can get equipment for your dad such as a hospital bed ( should he need one) and other things too.

Also, f your dad wishes to stay at home but needs a little care, then social services should set up a package of care for him. For example a carer to go in 2, 3 or 4 times a day to get him up, washed, dressed and make breakfast and so on !!!

Dont let social services make the decisions for your dad.

Need to ask anything else just ask xxx
Hope you get it sorted.

[Wensley]

hi there
if your dad has been awarded the middle band of nursing care this means the amount of 'health' or 'nursing' element that the NHS will pay to the nursing home. The rest of the fee is made up of 'personal care' costs that are not classed as free nursing care. Off the top of my head i think middle band is approx £80 per week put towards the care home fees which can be anything from £400 upwards per week. That is why Social services will be asking for him to contribute to the cost of the non nursing part. Hope that makes sense.
These days though care homes are not really the done thing as most people prefer to remain in their own homes and there are better quality services to help them do so than care homes. The quality of 'care' in many of these homes is hmmmm - well for example 1 m.o.s. to 12 people on late shift so they start to get put to bed at 6pm and you have bath rotas - once a week is doing really well.
As Dobbydog says he could recieve care at home with input for the 'nursing' tasks from District nurse and Macmillan nurses. Although most areas social servies homecare is subject to a financial assessment - although property is obviously not taken into account.
If he wants to go into a care home maybe he could go for a short stay - respite stay, he would get an idea if he likes it or not.
Regarding the middle band - this will have been agreed by NHS managers following a Nursing Needs assessment done by a district or specialist nurse. - A GP cannot just recommend someone needs a nursing home. There are certain criteria that need to be met to determine the band paid. In cases where there is a very high degree of 'Nursing' needs then they may agree 'Continuing Care' funding which is full NHS funding.
~It might be worth asking to see the nursing needs assessment and remember that if dads condition changes you can request another.
It would definatly be worth contacting your local macmillan nurses too - they may have respite services or other suggestions.

[Rob S]

As of the 1st October there is only one band for nursing care. But this is a red herring as far as the cost of any care is concerned. The main issue is whether or not your dad has a primary health care need. If he does then the NHS should foot the entire bill, not just the nursing element of it.

Social Services will try and convince you otherwise, but they are in the wrong if your dad's needs are health needs. Remember what the Judge in the Coughlan case said:-

"Whether it was unlawful depends, generally, on whether the nursing services are merely (i) incidental or ancillary to the provision of the accommodation which a local authority is under a duty to provide and (ii) of a nature which it can be expected that an authority whose primary responsibility is to provide social services can be expected to provide. Miss Coughlan needed services of a wholly different category."

[Wensley]

hmmm interesting Rob - i knew i was a bit rusty on the bands but didnt realise they had been done away with!
So the one band that there is now - is that an NHS contribution towards the cost of care or is it the NHS paying the full cost as in continuing care?
Or is continuing care altogether seperate?

[Rob S]

The new band is a NHS contribution to nursing costs for those who don't qualify for NHS continuing care.

NHS continuing care is where the NHS are responsible for the entire costs of keeping someone in a nursing home because their needs are primarily health needs. This is something they will try to avoid at all costs and they and social services will tell people that their issues are social and therefore the NHS are not responsible for the costs.

I can still remember the meeting with social workers and hospital staff when my sister and I met them to be told that my father could not return to his very sheltered accomodation and he would have to go into a nursing home. They handed us a list of nursing homes and started on with the usual spiel about the costs having to be met by him if he had assets above a certain level. The look on their faces when I said "So, will you be doing an assessment to see if my father qualifies for continuing NHS care?" was absolutely priceless!! They had to quickly change tack on that one!

[little_star]

Originally Posted by seagull1111

my dad has prostate cancer which has now spread to the bones, he is 86 and been constantly in and out of hospital. when he was in recently the sister said i should start looking for a care home, my dad was ok about this. he has a small property to sell. i asked social services for the 3 month property disregard and to cut a long story short they have said my dad could go home with care ( mmmmm?!) and does not need a care home. i have a letter from his gp and cancer consultant saying he needs care in a nursing home but social services will not budge. i wrote to my m.p. who took the matter up for me but social services remain adamant and the mp has just accepted their decision... i have written to social services asking for their complaint procedure. the nhs assesment my dad had at the same time states he needs nursing in the middle band so how can social services go against this... any help or ideas please... thanks

to be honest with I think he would get better treated at his own home then a nursing home, nursing home cost alot of money and he will get one on one treatment at home