Help needed with Continuing Care funding application

Norman-B · 12 December 2007 at 7:23PM

I popped up to see my dad earlier today and was handed a form by the ward sister to complete. It's a form asking for the Patients views and the Carer's views on his future care.
Now, I have not got a clue where to start or what to include.
My dad entered into a Care home in August 2005, suffering from severe Dementia. He was very mobile, liked the home and got on well with other residents and staff. He weighed 11 stone in July of this year.
In August 2007, he suffered a stroke and was admitted to hospital. Shortly after, he contracted C-Diff. He has been in isolation ever since. 5 weeks ago, he got MRSA. He now weighs 6 stone.

I was informed that on his discharge, he would be placed in a Nursing home. I contacted his Care Home and they are very happy to accept him back into the Nursing section of the home. The weekly cost is £800 PW.
The panel meet on Friday to discuss his funding package. So, I need to complete this form giving mine and my sisters views on his future care.
What do I include?
Have we got a say in what Nursing home he will go to?
If he obtains CC funding, can we top it up by paying more to get him into a home of our choice?

I really hope someone can assist us with advice.
Thanks for reading so far!

Savvy_Sue · 12 December 2007 at 10:20PM

You might do well to see if you can get some help from a specialist adviser: don't know if Help the Aged or Age Concern can help, or a Welfare Rights person or CAB.

I think - and I'm no expert, just picked up from reading other threads on this board - that to get nursing - as opposed to personal - care paid for your dad has to meet clear criteria. so it's worth knowing what those are, to make sure your form sets out why your dad meets those criteria (or not). It may be one of those times when you need to concentrate on what he can't do for himself rather than what he can do for himself, even though that can be very depressing.

If this is the local council's panel, then the care home may be able to advise you.

monkeyspanner · 13 December 2007 at 12:06AM

Sorry to hear your Dad is so unwell. The little I know about continuing care is that your Dad's primary need must be medical rather than domestic. He must need the supervision/care of registered nursing staff. So I guess the you should stress the medical care that he needs. The following is taken straight from the NHS leaflet so forgive me if you already have it.

There are 4 key indicators:
Nature- The type of condition or treatment required and its quality and quantity.
Complexity- symptoms that interact, making them difficult to manage or control.
Intensity-one or more needs which are so severe that they require regular interventions.
Unpredictability-unexpected changes in condition that are difficult to manage and present a risk to the patient or to others.

If your Dad is assessed as needing continuing care his total care costs will be picked up by the NHS and he will not be expected to make a contribution from his income or savings. I'm sorry I can't give you an answer on whether you will have a choice of home but I think you could argue that he stands a better chance of some sort of recovery in an environment he knows.

If he is not assessed as requiring continuing care (from what you have told us I cannot see that he doesn't, but cc is notoriously difficult to obtain), then he should be able to get an NHS nursing supplement of £101 per week to help towards his care home with nursing fees this would be on top of the council support you may have previously received.

Could I suggest you have a look at this charity website www.counselandcare.org.uk which has lots of very detailed fact sheets and also runs a telephone helpline they should be able to help you. They can also put you in touch with specialist legal advisors who could help if you wished to appeal if the CC assesssment is unsuccessful.

Norman-B · 13 December 2007 at 9:17AM

Thank you to both the above writers for the help and advice. I will visit the sites mentioned after work today.

monkeyspanner · 13 December 2007 at 10:35AM

Here is the link to counsel and cares fact sheet on continuing care. http://www.counselandcare.org.uk/assets/library/documents/27_Continuing_Care_-_Should_the_NHS_be_Paying_for_your_Care.pdf
It appears that your views as to location of provision of care should be taken into account.

As regards the £101 nursing care payment I made an error in my last post. Apparently this reduces the council contribution to care by the same amount. So it is just a budgetary adjustment to the source of funds.

Norman-B · 13 December 2007 at 10:17PM

An update.

I was asked to attend a meeting this afternoon re CC funding. Present were, Dad's Doctor, discharge nurse, ward sister and social worker and myself. Dad needs were judged as Severe on two points, High on 3 points and Moderate and Low the remaining 6 points. The meeting agreed that he should be granted CC funding and that finding would be put to the funding panel due to meet Tues 18th Dec or Tues 15th Jan.
I was asked to start looking for a Nursing home for him asap, as he is likely to be discharged as soon as a place can be found for him. Here we go again! I did all this 28 months ago when he needed a care home place. Looks like the wall papering in the spare bedroom will have to wait.
I was informed by the SW that we should not assume that Dad will get funding, as there is a battle between the PCT and social Services as to who should pay.
My worry is that if Dad does not get funding, what happens when his savings runs out? Will he have to move to a cheaper home? I had one quote late this evening of £900 per week.

We will just have to keep our fingers crossed.

Savvy_Sue · 14 December 2007 at 12:21AM

The first thing to remember is that once your Dad's savings fall below the upper limit, then he starts to get some help towards his care home fees, and once they fall below a lower limit then he gets maximum help.

The worry is that there can be a gap between what local authorities are prepared to pay, and what care homes need in order to break even. But as long as your dad has savings he can make his own choices, or you can make them for him.

Speaking personally I'd go into 'hang the expense' mode and get whatever care I thought best now. If the money runs out, his needs may have changed to mean he gets more funding.

What about the nursing home part of where he was before - is that an option? You do at least have some idea what you're getting there, and if you were happy with it until now that's a good start.

monkeyspanner · 14 December 2007 at 1:04AM

This sounds like the typical mess. How can they be pushing you to find a care home with the ability to nurse your Dad when they haven't agreed to provide the funding for CC. It was my understanding that if Continuing Care was approved funding became the responsibility of the NHS normally via the PCT which is in charge of the area in which your Dad's GP works. Why is the SW saying there is an argument between the PCT and social services?

I have heard of the PCT saying they don't have the funds to pay CC. I think I would try to slow the process down until they stump up the funds.

Best of luck.

Norman-B · 14 December 2007 at 9:45AM

Savvy_Sue wrote: »

The first thing to remember is that once your Dad's savings fall below the upper limit, then he starts to get some help towards his care home fees, and once they fall below a lower limit then he gets maximum help.

The worry is that there can be a gap between what local authorities are prepared to pay, and what care homes need in order to break even. But as long as your dad has savings he can make his own choices, or you can make them for him.

Speaking personally I'd go into 'hang the expense' mode and get whatever care I thought best now. If the money runs out, his needs may have changed to mean he gets more funding.

What about the nursing home part of where he was before - is that an option? You do at least have some idea what you're getting there, and if you were happy with it until now that's a good start.

Sue, that's where we would like him to live. He was happy there and well liked. The worry I have is, he was paying £400 per week for care and the home are now asking for a large increase for Nursing care. Should I just say, "To hell with it!. I will spend what he has now and worry later, if or when his funds run out"
At that point, leave it to Social Services to sort out?

Norman-B · 14 December 2007 at 9:48AM

monkeyspanner wrote: »

This sounds like the typical mess. How can they be pushing you to find a care home with the ability to nurse your Dad when they haven't agreed to provide the funding for CC. It was my understanding that if Continuing Care was approved funding became the responsibility of the NHS normally via the PCT which is in charge of the area in which your Dad's GP works. Why is the SW saying there is an argument between the PCT and social services?

I have heard of the PCT saying they don't have the funds to pay CC. I think I would try to slow the process down until they stump up the funds.

Best of luck.

That is exactly what my sister wants to do! Hold on until the funding panel meet and then move him out of hospital.
As fantastic as the staff at the hospital are, I do sense they need to discharge Dad as soon as possible, to free up a bed.

Norman-B · 14 December 2007 at 1:12PM

margaretclare wrote: »

Personally, I think that's what I would do.

I've recently had a stay in hospital myself, for acute surgery. I was admitted on Thursday morning, went home Thursday for the night, back 7 am Friday morning for the surgery, home Sunday morning.

I wouldn't stay one night in hospital longer than I had to, and that was in an acute surgical women's ward which was very clean.

If it was me, I'd want to get Dad back to where, as you say, he was happy and well-liked. What's the point of staying in hospital when nothing else is being done, nothing that can improve his prospects, where people are doing nothing but haggle over costs as if it was some kind of cattle-market?

Well, that's what I think anyway.

Margaret

Sums up my feelings exactly! Thanks for the imput.

Thanks to the other posters for writing.

Help needed with Continuing Care funding application

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