Case management
care consultancy
Not everyone has a family to help them piece together what they need in later life which is where our case management service comes in. Whether it’s arranging, chasing up and attending health appointments, dealing with household admin, or managing the maintenance of a property, there is always something which needs attention.
Knowing about and being able to assist with the details of someone’s life needs a lot more involvement and coordination than just a daily care call. It needs time, but primarily it needs the input of a trusted companion who knows the ins and outs of their client.
Home & Company offers a case management package providing a care consultancy and case management service for clients in and around Brighton t to include coordination and management of all aspects of mental health and home.
We provide cost effective, options and services where case management is a collaborative process that’s carefully organised and agreed upon between us and our clients.
Case study – a step by step approach to introducing holistic support
Mrs T was adamant she didn’t need any support and had done a good job of ensuring that friends and family couldn’t look too closely. It was only after she’d had a fall and her GP raised a concern that a social worker got involved. Mrs T was widowed with no children, but had a good, albeit hands-off, relationship with her nephews who lived some distance away.
The social worker brought together Mrs T, a nephew, a neighbour and Home & Company for an initial case management meeting. The social worker was keen that Mrs T had a daily care call for help with shopping, meal preparation and household chores. After a difficult meeting, Mrs T agreed to two care calls per week. The social worker was concerned it was too little but felt it was a start.
On the first visit, Mrs T was unconvinced about the need but was allowed access and was chatty. She did a tour of the large house and it became apparent that the bed linen had not been changed for months, possibly years, and that Mrs T had been in the same clothes for some time.
Mrs T wasn’t sure when the washing machine had broken. Or the cooker. Or the taps in the kitchen. Or the boiler. We assisted Mrs T with purchasing a new washing machine that morning and had coffee and a chat.
It felt like a successful visit, although it was clear that there was a mountain to climb.
Over the next few weeks, we were able to organise getting the other things fixed. Mrs T’s neighbours had been doing her shopping and as they were also elderly and in poor health they were desperate for us to pick up the reins.
Carrying out the shopping gave our visits a focus as Mrs T was adamant that the house didn’t need cleaning initially. But over the course of the next few weeks, Mrs T built up a good rapport with the members of our team and slowly we began to start tackling the household jobs.
The team worked out that if they ran a bath for Mrs T she would happily get in and while she was in the bath her clothes were put in the wash and some cleaning could be done, two birds with one stone! We were also able to take Mrs T to various medical appointments – she really responded to having support with these. Within a few months, Mrs T was amenable to having someone Monday to Friday and became very used to having people in her house and assisting with chores.
We either left Mrs T with lunch or we had lunch together. Mrs T’s GP was delighted as her weight, which had been plummeting in recent years, started to go back up.
We had two members of the team working with Mrs T across the week and between them, they liaised about what jobs needed to be done in the house, what shopping was needed, and managed all the various appointments for hairdressing, eye, hearing, feet and other medical matters, as well as the larger house maintenance issues.
As a team, we liaised regularly with the nephew and the social worker over a two-year period. Ultimately were able to work together to smoothly identify and introduce live-in carers when Mrs T’s dementia deteriorated to the point where she was no longer able to live safely alone.
Case study – moving home in your eighties when you don’t have a family to help
We were introduced to Mrs D by a local befriending agency. Mrs D had been living in a care home for 18 months following a fall at home but was now desperate to leave and was writing letters to the befriending agency asking for their help. They felt it wasn’t within their remit and asked for our involvement. On meeting Mrs D we could see that although she was fairly frail she was very with it and determined.
Mrs D had an appointed POA but she found that he wasn’t listening to her and she felt she had no voice. Furthermore, we realised that her house had stood empty and untouched for 18 months. We helped Mrs D to appoint a professional POA who could be more responsive and support her.
Over the course of a number of weeks of getting to know Mrs D we felt less sure about her moving back home. She was a type 1 diabetic and in her late 80s. We talked to her about other care homes and supported living environments and took Mrs D to visit a variety of options.
Although Mrs D was sad about the idea of not getting back to her home, she understood that she wasn’t getting any younger and that a supported living environment would future-proof her whilst giving back her independence. We wanted to be sure that this was the best option for Mrs D and so liaised with the local authorities’ adult health and social care team to arrange for an assessment.
The social worker was very supportive of the plan but obtained Mrs D’s agreement that she would have regular daily care calls at least for an initial month, as the move from a residential care home back to independent living was bound to be an adjustment.
With the go-ahead from the social work team we helped Mrs D to put her property on the market and to appoint a conveyancer who would manage her purchase and sale. We supported Mrs D with all of the paperwork. We also arranged for Mrs D’s property to be packed up and the remaining items to be disposed of by house clearance.
Meanwhile, the flat that Mrs D was purchasing needed renovations before she could move in, in particular, the bathroom needed adapting so that there was a walk-in shower. We liaised with the supported living organisation to arrange for the work. Once the work was completed we agreed with Mrs D that we would arrange the removals and get the flat ready for her arrival.
We made a list with Mrs D of new items which she would need, in particular, kitchen items and made sure they were purchased and in the flat ready for her arrival. We made sure that everything was put where Mrs D had asked for it to be as unpacked as much as we could so that the bed could be made.
We also did a food shop so that Mrs D was fully stocked. Mrs D agreed that she would have the daily lunch provided by the supported living accommodation.
In the weeks leading up to the move, we liaised with a number of care agencies that were on the council’s preferred supplier list. Only one company was responsive and able to meet Mrs D’s needs. They assessed Mrs D and agreed to start supporting her from her move date. Eighteen months on we are delighted that Mrs D is still happy and settled in her flat.
Only once we’d embarked on this journey did we realise what a mountain it is to climb if you don’t have family members helping you.
