Post Operative domestic help

NOTE:  This event is included on this Blog, as it can be fairly assumed that the unnecessary, unwarranted distress and anxiety  caused by the unauthorised disclosure of his HIV+  status, exacerbated  F’s general health, as referred to in Dr Walsh’s letter, dated  5th February 2014

Update 22nd May 2019:  Ms Cheng, RBKC’s Reablement Team Manager  wrote to F, trying to justify the difference between the “Reablement” and “domestic help” part of the recovery process.  It is clear that she is confused and poorly advised  what F’s “Post-Operation_help” is all about.  She keeps repeating that F was due “Reablement” sessions.  This is not so.    He should have been offered  the “domestic help”, as the Reablement, is provided by the NHS, at its cost and takes place at the Porchester Leisure Centre.  This was thoroughly explained to Ms Cheng in F’s reply.   In the same reply, F sent the requested invoices from the Care Agency, as RBKC has agreed, as gesture of “good will” to reimburse him for these costs.  This will be challenged later on.

During their “Pre-Operation Assessment”, “Pre-Op”, those who are to undergo a  Heart Surgery, are given  the Guy’s and St Thomas leaflet  “Going Home after Your Heart Surgery“. 

Page 19 recommends  that in order to achieve speedy healing of the breastbone,  which was cut apart during his operation and a speedy recovery from the operation as  a whole, the patient should  NOT participate in even mildly strenuous activity.

Although the patient is asked, during the “Pre-Op” assessment,  whether he will have domestic help available for this short period of time, it appears that  the “Pre-Op” department does NOT make any arrangements, should this not be the case, to ensure smooth transfer home after the operation.  It is left to the patient to make the necessary arrangement. 

The patient  has to apply for this temporary service  to his Council’s social services, in what is called a “self-referral”.   This in itself may be quite a hard thing to do, particularly if he is elderly, disabled, or whatever, where he finds this to be a daunting task.  

Therefore, this service, if needed,  should be agreed BEFORE the operation.

Before F went  for his Open Heart operation on 11th November 2018,  he asked RBKC about the current temporary domestic care arrangements for Borough Residents, who  had an ‘Open Heart‘ operation. 

When on 21st November 2018, F did not receive any news from neither the Hospital, nor RBKC’s Social Services, about the status of his request for this help, he sent a  status  enquiry to PALS  at the Hammersmith Hospital.

On 22nd November 2018, Ms Justina, assuming to be a Social Worker at the Hammersmith Hospital, called F and told him to call RBKC Social Services and ‘self-refer’ himself, as it was a private matter.  We do not agree with this statement.

 Later on 22nd November 2018,  RBKC  phoned F and carried out a short assessment.  It became clear that the person who spoke to F had NO idea about this specific unique one-of situation.

He was asked  about ‘information sharing’ and whether he had any ‘other existing medical conditions.’  F refused to give any details, as they were irrelevant to the application. 

At the end of the short assessment,  by whomever, F was informed that RBKC would NOT provide merelydomestic help‘ as F did NOT have any PERSONAL care needs. 

When asked, RBKC refused to confirm this in writing, why this would be so, This is reflected in their reply, when on 22nd November 2018,  RBKC only  sent him a list of  agencies. 

This letter, as it is incomplete, is at odds with a precedent set by the Appeal ruling in Savva v RBKC, which states that letter  should be self-contained,  fully explaining the matter, without referring to anything else.

The mere fact that F had  undergone the Pre-Op assessment and is waiting for his operation, should be adequate justification  to entitlement to this specific service.   

F  found that his temporary post-operative domestic care should have been provided by RBKC, if asked for,  irrespective whether he received PERSONAL CARE OR NOT

In order to ensure that the patients  receive the recommended DOMESTIC CARE, the  “Pre-Op” team  should  record on patient’s file that a  reliable help to assist him with his every day chores, for about six weeks, will be available.

For those living alone, or unable to arrange for this short term service,  the “Pre-op” team  should issue instructions   to  the patient’s Council social services to arrange, in principle,  for this short term service.  Dates and scope of the service to be decided later.

This would remove the possible difficulty that may emerge on the discharge date, when it may become  clear that the necessary help is NOT in place.  The individual may have to remain in hospital for undefined time,  BLOCKING the much needed BED.  This should be of a specific concern, if the individual is elderly, frail, or just appears unable to cope.

It is of paramount importance that a satisfactory  outcome of  what is a major surgery, in F’s case costing about £30,000,  is achieved.  Otherwise,  it could be seriously  compromised  by Council’s  refusal to provide the temporary help, in F’s case costing about £ 400.00

On 28th March 2019, he wrote to Ms Jordan Griffith-Brown of RBKC’s Social Services, on the matter. Let’s see what the NHS London and the Department of Health and Social Care have to say in this matter.

It is sad that such a confusion exists at RBKC over such an important short-term social services facility.   This becomes even more serious, when  it is considered that those who undergo this kind of an operation, are  often elderly and by the nature of the conditions, quite frail.  Individuals may end up in undesirable, even dangerous situation, relating to  their post-operative care.

The Bottom line:  We feel that the “Pre-Operation Assessment” process should ensure that the temporary domestic help of about six weeks is  clearly arranged at this stage, rather than leaving it until the operation time.  

The patient’s local authority  should be instructed of this service, so that arrangements  could be put in place;  and if needed, the necessary funding arrangements made.  

The patient’s file should clearly reflect the fact that he DOES or DOES NOT require this short term service.  It  is much easier to cancel the provision, rather than run around on the day of discharge, trying to make these arrangements, when it may become evident that care agencies may NOT have spare manpower to arrange this at short notice.

This will ensure that arrangements are in hand and will “kick in” when the patient is discharged from hospital.  Thus, preventing any possible “bed blocking”, resulting from the failure to arrange the home help.

 

 

 

 

 

 

 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.