Man fights for continued care for elderly mother
A Tyrone man has said he will fight to keep his mother in an NHS residential care home, in spite of being told the local trust is restricting admissions.
Last week, the health board said that was not the case, but admitted figures were being managed in some areas.
However, confidential documents reveal "restricting admissions" was among the northern trust's options to make some homes "unsustainable".
The BBC understands the model would have been approved by the health board.
The model has also been adopted by some other trusts.
The confidential briefing paper on residential care for older people, was written by trust staff before the controversy in April that saw the health minister stepping in to halt how trusts were handling the potential closure of homes.
Howard Menary, whose 94-year-old mother is in a County Tyrone home, said he had been told to find her alternative accommodation due to the trust restricting permanent admissions.
Eileen Menary is being cared for in Westlands residential care home in Cookstown.
Mrs Menary was admitted as a patient 10 weeks ago for respite. After being assessed, her family were told she could no longer live independently at home.
However, when the family inquired about her stay becoming permanent they were told the home can no longer admit permanent residents.
Mr Menary said moving his mother at this stage would kill her.
"My mother is elderly and frail. While originally she was only there for respite, there is a genuine need for her now to stay.
"She's so much better, she's eating, among friends and is happier. I will fight for her to remain in that home."
Mr Menary was told about the move in a letter signed by the health trust's senior director, Paul Cummings.
The letter, viewed by the BBC, said: "The northern trust's position in relation to Westlands residential home is that we are restricting permanent admissions to the unit, but continue to admit people who require respite.
"This is in keeping with the regional position which states: 'There is no regional ban on the permanent admission of older people to statutory residential accommodation however some Trusts have been restricting permanent admissions.'"
Figures revealed by the BBC show there are now 331 elderly people living in NHS residential care across Northern Ireland.
In response to those figures the health union, Unison, said that a non-admissions policy in place for several years had reduced the figures significantly.
The chief executive of the health and social care board, John Compton, told the BBC that while some areas were being managed a non-admissions policy was not in place.
"Well of course if you are in a situation where you see a drop in people wanting residential care of 8-10% per annum, you either lead a situation where you get into chaos or you try to manage it," he said.
"And I think it's quite appropriate that we control some admissions, in some areas not all."
However, confidential documents seen by the BBC reveal that actively reducing occupancy in some homes was among several options discussed by the trusts.
Last year, a briefing paper for the northern trust stated that among the options available would be to reduce numbers and create an "unsustainable environment".
Two of the four options suggested this practice: "Establish a level of occupancy at which the social environment for residents is unsustainable and which would indicate a timescale for closure."
Another advised: "Establish a level of occupancy at which the environment for residents and the cost of provision are unsustainable and which would indicate a timescale for closure."
The other two options discuss setting a definite date for closure of specific homes and actively working to transfer residents by that date.
Mr Menary said he was angry that there appeared to have been a deliberate move to restrict numbers, when clearly there was a need for NHS care.
"For several years I paid for my mother to get 24-hour help at home. Social services told me they can't provide that level of care - so therefore she needs to stay where she is. Why are they telling her to leave?"
While these documents are dated December 2012, sources have told the BBC that the non-admissions practice dates back to before 2009.
According to Unison, the policy is an attempt to run down residential care homes.
Stephanie Greenwood is branch secretary for the northern trust.
"Our advice to residents is to stay put. They don't have to leave," she said.
"We are concerned about this so-called consultation or non-consultation. Residents should have a representative with them when completing questionnaires, these must not be done on a one-to-one basis."
In May, Health Minister Edwin Poots ordered trusts to suspend consultation plans.
The move followed a public outcry, with families and residents angry about how the matter was being handled.
Last week, the health board announced there would be two consultations in the next six months about the way forward.
When asked about the contents of the papers leaked to the BBC, the health board said: "The Health and Social Care Board last week published a document setting out the way forward for engaging, consulting and implementing changes to the provision of statutory residential care homes across Northern Ireland.
"No final decisions have been made at this stage and we are firmly committed to a full and open discussion on the future of residential care for older people.
"The desire to improve services for older people and to minimise any anxiety and concern is the single most important reason for wanting to have these discussions.
"The board made it clear last week, and in the document published on the way forward, that where trusts have made decisions to manage admissions they will be kept under review as the process develops.
"When a service is in transition it is essential that each trust plans ahead for any potential change and continues to assess and provide the necessary care required in their areas, while at the same time minimising any potential future disruption to residents that may be caused by any change process.
"For example, the board is aware that the Northern Trust put in place thorough and considered plans to ensure a smooth transition of residents from Greenisland to other residential homes in order to start building a new supported living facility which will enhance the quality of life for older people and lead to greater independence."
While both the health board and the trusts might argue that these confidential papers were prior to the minister's U-turn on policy in May, it still provides the public with an in-depth view of their thinking.
It also confirms accusations that some of the trusts were operating a restricted admissions policy; something that was denied by health officials at the time.