'My aunt fell through cracks in the system'

A midwife who devoted 40 years of her life to the NHS has been let down by the long-term care system.

June Birch now is in advanced stages of Alzheimer's disease, living in a nursing home in Lancashire. She may finally be receiving the care she needs, but it has been a costly four-year battle to get there.

In summer 2007, June started to develop signs of dementia and, after a series of distressing incidents, was admitted to Southport Hospital. Discharged in November that year, the local authority told June's family that she could not return to her flat but, instead, required round-the-clock care from an EMI (elderly mentally infirm) home. Daren Birch, June's nephew, began researching local care homes, and placed her in the care of what he was told was a suitable residence.

Over the course of the following year, June became increasingly confused and, as a result, aggressive, frequently lashing out at other residents and staff. Daren noticed the deterioration in her condition and questioned the type of care that she was receiving.

"She lost a considerable amount of weight and it was not very long before she no longer recognised us. She was doubly incontinent and her general health became significantly worse," he said.

During this time, Daren applied to the Court of Protection to gain control of June's estate, while the care-home fees mounted to the tune of 40,000.

June's worsening condition and daunting debts prompted Daren to contact Paladin Advocates, legal specialists in continuing health care. Continuing care patients receive full funding and 24-hour nursing care.

"I had never even heard of continuing care," said Daren. "But once it was explained it became clear that June was eligible."

It was only when Paladin became involved that June underwent an assessment, and it was found that she was not in a care home that met her needs.

"We had stated from the beginning that we wanted an EMI care home – as the hospital had told us to request," said Daren.

"The place we had been told was an EMI establishment was only a residential care home, and did not provide the level of care June required. Luckily, our request was on record so once the mistake was brought to our attention June was moved straight away."

Unfortunately, although June was recommended by the nurses who assessed her as eligible for continuing care, the primary care trust refused to accept the recommendation. Anne Reed of Paladin appealed against the decision on behalf of the Birches and took it to review – twice.

The assessment was finally accepted in August this year, but Ms Reed's plea was reassessed last month. The primary care trust has yet to reach a decision on whether it will accept the recommendation.

Ms Reed is now fighting to have the total cost of June's care repaid, arguing that she should never have had to pay for her care.

"I cannot believe that no one ever thought initially to give June a care assessment. She was clearly eligible for continuing care from November 2007, when she was first discharged from the hospital, yet her first assessment was not until February 2010 – prompted by us," said Ms Reed.

Daren said the emotional costs had been far greater than the financial ones. "I can't understand how she fell through the cracks in the system," he said.

"I can't help thinking that if she had received the correct level of care from the beginning her condition would not have deteriorated so quickly."