Legal Literacy for care home managers?

Belinda Schwehr gives an update after the first year of CASCAIDr’s specialist legal advice
service. She says
at least half 

of clients have been people accommodated through public sector funding, in residential care home settings. 

legal issues we’ve engaged with have included cuts, threats to move
people, insistence on families finding top-ups when the person’s capital
has depleted and the shifting of previously inclusive activities onto
the person’s personal allowance, as a source of funding.  People
have been able to access or enforce proper processes, compliant with
the Care Act, after we’d got involved. Threatened cuts to people’s
packages, services or budgets, have been cancelled or reduced. Much
wanted and suitable care home placements have ultimately been
commissioned, when councils had first said ‘We don’t place people
in care homes, ever’ – or ‘we don’t put people in THAT company’s care
homes’. Two people were even saved from being removed from care homes
after living there for over 15 years and 33 years respectively. 

Care Plans that had never been written up before, have been formalised
so that people can see what they’re regarded as needing, and can check
the cost assumptions underpinning the budget This provides a benchmark
for what the provider is actually expected to do for the money – so that
a notion of individualised care then emerges, not just a notional
costing model, as a basis for fees discussions for each person. 

for care home rooms, above the council’s offered budget, that had been
said to be inevitable, have been cancelled and refunded, or the out of
area rate has been taken as the guide price. In one case we got this
feedback, which really warmed our hearts. “I
am absolutely ecstatic myself and cannot wait to tell Mum.  You
are brilliant at your job and I just feel we are very lucky to have
been introduced to you. It has made me appreciate that we are in a
privileged position to have had your help and that for many families
this outcome would not have happened.”

have been threatened with judicial review for cost-capping and have
ended up preparing quasi-Care Act care plans for commissioning an
appropriate CHC service and operating DoLS properly. In some cases,
people have been supported to challenge CCGs’ Continuing Health Care
decisions, and have either succeeded, or got a split package – and some
have even got money back – in one case, £50K!  What all these cases have in common is this:

if the provider’s management is only legally literate enough to spot a breach of the client’s public law rights, as against the public body, the provider can then stand alongside the
client present a united front – on a review, or on a re-assessment, for
instance – and offering crucial evidence as to the likely impact of a
move, or the reasons why the budget cannot defensibly be cut, in legal terms, given the deterioration in the person’s condition.
Being commercially involved does not mean a provider can’t make a
professional contribution to the care planner’s thinking. Involvement
with CASCAIDr means that providers from the private and voluntary
sector can be seen to do more than just bang on about their fees, but
also stand up for their clients’ rights at the same time.

support for our management’s thinking, in relation to what had seemed
like an ultimatum from the council, has really helped turned things
around for our charity.”

Belinda Schwehr

Voluntary CEO, CASCAIDr – our donation button, if you’d like to support our aims

Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

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