Elderly Lady Moving from HA Accommodation to Nursing Home

Lou1973

I’m looking for some advice regarding an elderly lady who may soon need to move permanently into a nursing home.

Over the past year she has been in and out of hospital and has recently been transferred to a temporary nursing home for assessment. We are close friends and effectively the nearest thing she has to family, although we now live some distance away.

She currently lives in a housing association property and, as far as I’m aware, has around £2,000 in savings. Her only income is her state pension and a small private pension. My main concern is how the costs associated with a move into a nursing home would be managed — both the practical costs of moving her belongings out of her current home and the ongoing cost of care. I’m unsure what support might be available to her given her financial situation.

As we are not family members, we’re finding it difficult to get clear information about what is happening or what the next steps might be. Does anyone know how long the process usually takes from assessment to being required to vacate her current property, including removing her possessions?

Ideally, we would like to explore whether it might be possible for her to move closer to us, so that we can visit her more easily and continue to support her. However, we’re unsure whether this is realistic and have no experience of how to begin researching nursing homes or care options in our area.

Any guidance or advice would be very gratefully received.

elsien

I can only tell you how it works in my area - processes vary geographically.

If she’s in an assessment bed it is likely that she has been sent to a nursing home on a short-term placement while waiting for a CHC assessment. This looks at where her needs are primarily health or social care related. The assessment should happen within four weeks.

https://www.continuing-healthcare.co.uk/continuing-healthcare-checklist-and-process/?utm_source=google&utm_medium=cpc&utm_campaign=Continuing%20Healthcare&utm_id=231079810&utm_term=chc%20assessment&utm_content=38754276859&utm_source_platform=Google+Ads&gad_source=1&gad_campaignid=231079810&gbraid=0AAAAADkrHQaG_3A-L8dVIO1v7ahbabjYc&gclid=EAIaIQobChMI8ayHi6XwkgMVyZNQBh1L0RO2EAAYASAAEgJf8PD_BwE

The assessment will be carried out in the nursing home. If she has mental capacity she would be part of that assessment although she may wish someone like yourselves to support her. If she doesn’t have capacity, they should look for someone independent to take part on her behalf although that doesn’t always happen.

Once the assessment is completed the decision is then whether she can realistically go home with support such as care calls, whether she needs residential care or whether she needs nursing care. Just because she’s in a nursing home now doesn’t mean she needs to stay there. If her needs are primarily social care then the local authority social worker would have to carry out a care act assessment. They have a particular timeframe to do this after the outcome of the CHC assessment.

I would also add that if she has capacity to make her own decision about where she lives there is nothing legally stopping her just upping sticks and going back to her home, however unwise the professionals consider that may be. Although housing with care may then be saying that they cannot support her if her needs are too high and they may look to end her tenancy on that basis.

If she claims housing benefit for her rent then that will carry on being paid whilst she is in a short term bed pending a long-term decision.
if she wishes/needs to remain in some sort of 24 hour care because of her low level of savings that will be funded for her but her pensions et cetera bar a £30 a week personal allowance will have to go towards her care.
There are pages on the Age UK website explaining about how care at home or in residential/nursing is funded.

Because she won’t be funding her own care the local authority or health would have to be involved in looking at the cost of and sourcing a care home near to you, if that is what she wants to do. If she’s not able to say, it would be a best interests decision with the funder (very likely the local authority unless she has serious health needs) being the decision maker. Under the mental capacity act they must consult with people who know her well and are not a paid professional so that could be you.. They do have financial limits on what they are willing to pay for care settings so you need to find out what those are for her local authority in order to see what types of place she may need to be looking at.

That is a very brief overview, but if you have any more questions, please ask.

so some of it comes down to what her needs actually are and some of it is down to her understanding of her current situation.

The cost of moving and emptying her property would be down to her. However the local authority would normally have a company that they could point you /her towards who could do the practicalities for her.

UnsureAboutthis

Phone to local social service and ask to chat to a social worker specializing in the elderly/housing/nursing homes.

They will put you trought to a duty doc worker or answer the phone—they will come back to you and guide you but dpeending on the area you live in, it may take a while for them to get back to you. Register your interest in the lady at the same time and tell them what you told us. This cuts out the guesswork, as you'd be speaking to the horse's mouth.ie tell you whats what, what may be possible/not and indications of times etc to action needs etc

Soc service support with the move, i.e., arrange/pay, etc., is often needed when a frail person has no one to look after their needs, or locally so subject to their assessments.

silvercar

I know of 2 people in similar situations. They are stuck where they are until a social worker is appointed and can make an assessment of their needs. Once that is done the social worker will be responsible for finding a place in a suitable nursing home that offers the care she needs and accepts LA funded places. She’s actually lucky she is in a nursing home, some one I know is stuck in a hospital bed awaiting social worker allocation.

elsien

Again specifically referring to where I am, you won’t get an allocated social worker until the CHC assessment. And sometimes not even then -someone who is fully health funded won’t get a social worker at all.
Local Authority social workers are leaving or going off sick in droves. People who are safe are not top of the list until the point where responsibility transfers from health to local authority. That is the current reality in some areas.

dnpark38

@elsien

Towards the end of last year I was caring for my wife at home and my "batteries went flat" and was almost in a state of collapse our family called local Social Services and within 4/5 days my wife was in a care home. Following 6 weeks assessment it was decided best for both of us for her to stay in the care home with financial help from the council. 4/5 months later I'm awaiting financial paperwork with details of how my wifes pensions are paid over and top up payments made.

I do not know what CHC assessment is.

Lou1973

https://forums.moneysavingexpert.com/discussion/comment/81896537#Comment_81896537

Thank you for responding. This is great information! Thank you!

The example checklist on the link you sent me is interesting, as I'm not sure that she would necessarily meet the criteria to be in a nursing home.

I had a call from the nursing home yesterday to explain a bit more. They want to put a DOL in place for her until the full assessment can be done. It sounds like she is pretty adamant about wanting to go home, but the reality is that she is not capable of looking after herself. The main concern is self-neglect.

They have also said that we may need to seek power of attorney, which makes me a bit uncomfortable, considering we aren't family and have no involvement in her financial affairs. They said that it will most likely be raised during the assessment meeting.

I may well have more questions, so I appreciate your help.

Lou1973

Thank you! I will get in touch with local social services and see if they can

https://forums.moneysavingexpert.com/discussion/comment/81897030#Comment_81897030

Gosh! That's awful!

I think where we are, it's the opposite - at least that's what the home told us. They want to move elderly patients out of hospital beds as soon as they can, which is sometimes too quick.

Lou1973

I'm very sorry to hear about your situation.

The CHC assessment is for ongoing health care. In my situation, it will determine whether my friend meets the criteria to be moved permanently into a care home, residential home or is safe to go back to her own home with a support package in place. The link that @elsien provided gives a lot of information and also a link to an example checklist to be used for assessment.

elsien

https://forums.moneysavingexpert.com/discussion/comment/81901216#Comment_81901216

She has to have capacity to complete a power-of-attorney and she has to want one and it is her choice who acts for her. It’s not as simple as saying she needs a power of attorney, even if she might benefit from one because she might not be capable of doing one, or if she is, she might simply refuse. It would also be completely your choice as to whether you wish to take on that role or not.
It is a big responsibility, more so if she decides she wants a health and welfare LPA because then that would be you making the decisions about where she lives and any medical treatment.

With regards to accessing her money, she would need a capacity assessment around finances if there was any query about her ability to carry on doing so. If she does lack capacity then someone can apply to be her DWP. Again they may suggest you do that, you don’t have to and then the local authority would have to put alternatives in place. It gets a bit more complicated when it comes to her bank account and bills, but that may be a bit premature at the moment. People just out of hospital are generally not at their best and she may gain more understanding as her health improves.

The care home will have requested a DOL because they think she may lack capacity to agree to stay in the care home for now. That doesn’t automatically mean she won’t be able to go home in the future with support.

elsien

@Lou1973 That isn’t quite what it means. It is to assess nursing/ needs. The decision about where she lives is outside of that - people with nursing needs can still return home in some circumstances.