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  • arhodes
    • #2
    • 29th Aug 12, 12:03 AM
    • #2
    • 29th Aug 12, 12:03 AM
    my mother entered a privately paid for care home in 2002 and died there in 2010. She suffered from Dementia from the start which gradually got worse and she paid for care out her own pocket for the whole time. One month before she died she went into hospital and was formally assessed as qualifying for free care due to her condition.
    I am wondering if I can make a claim as she had been in that qualifying condition for some time (maybe a year or more) prior to being assessed but she wasn't formally assessed as I didn't know you could be.
    I had POA but this ceased on her death. Will I be able to claim any money back for her estate?
    Any help appreciated.
  • stargrazer10
    • #3
    • 29th Aug 12, 6:26 AM
    refund of nusing home fees
    • #3
    • 29th Aug 12, 6:26 AM
    Hi
    My father had parkinsons and dementia and paid in full his nursing home fees until he died in 2005. I recently saw an advert on tv re the reclaiming of nursing home fees. I contacted the company and they were very helpful and they sent me a claim pack. The claim pack had a tick list of all the health problems that my father may have had. I realised that I could claim the possible refund myself, and used the tick sheet to help compose a letter to the primary care trust. I also phoned the relevent pct and spoke to a nurse ( they seem to have allocated a specialist nurse to deal with such claims) After discussing my fathers' case with her she was not at all discouraging in the possibility of a claim. I suggest you contact the pct concerned, and if you need help composing a letter ask for an info pack from one of the many companies dealing with refund claims - you dont have to use them, and their info packs are very useful!! ( I have had only one reminder email from the company since getting their pack in June)
  • arhodes
    • #4
    • 29th Aug 12, 7:27 AM
    reclaiming fees.
    • #4
    • 29th Aug 12, 7:27 AM
    Stargazer10,

    Thanks for the reply. My only problem is that my mum was in a rest home not a nursing home and therefore I'm not clear if she would have a case. It was only at the end of her illness that she deteriorated to the point where she was assessed as needing nursing care and I may be wrong but I thought that until she needed nursing care she had to pay. When exactly she crossed that line would be hard to say as she is no longer alive.
    I will investigate though. thanks for the help.
    • Spent Up
    • By Spent Up 29th Aug 12, 8:20 AM
    • 3 Posts
    • 1 Thanks
    Spent Up
    • #5
    • 29th Aug 12, 8:20 AM
    • #5
    • 29th Aug 12, 8:20 AM
    Hello

    My Mum has been in a care home for 8 years. She suffers from Alzheimers and is also incontinent. In April 2011 she was hospitalised and had a pacemaker fitted. She receives no financial help other than receipt of Attendance allowance. She has been assessed but we were told that she would only receive the difference between care home fees and nursing home fees and her attendance allowance would be stopped. Also that if we applied for the nursing home fees then the authority would require her to be placed in a nursing home. We do not want her to be moved, she is happy where she is, the staff know her and understand her moods and is feels this is her home. Can we claim or will this result in her being moved? We have had to sell her home to fund her care.
    • auntiepam
    • By auntiepam 29th Aug 12, 8:40 AM
    • 60 Posts
    • 82 Thanks
    auntiepam
    • #6
    • 29th Aug 12, 8:40 AM
    Found the process difficult and stressful
    • #6
    • 29th Aug 12, 8:40 AM
    I guess this is a partial success story, I was successful in getting costs paid under continuing health care for my mother when she went into a dementia care home due to needing terminal care because of brain cancer. However, my father went into the same home at the same time as he has alzheimers, ( my mother was his carer) and currently I am not going to attempt to reclaim as I know, despite being told by a GP that he must not be left on his own, he is no where near being as bad as he needs to be to qualify.
    I think my mother was fast tracked as she was terminally ill, and it all happened quite fast so I did not have time to familiarise myself with all the criteria, but the meeting where the decision was made was horrid - I disagree with martins article, I think you do need to read the decision support tool - just to see how poorly someone needs to be - otherwise you could do a lot of work when the criteria might not be meet - they are looking at the nature,
    intensity, complexity or unpredictability of the individual’s needs. I found myself having to argue each point that she was worse than than the health professionals said she was -because that is what I thought and in the knowledge that if she was not deemed that bad, ie did not score highly enough, she would meet the criteria. This was all happening as the hospital wanted her out of the bed because they were not treating her and so she was a blocker.
    At some point I may think again about my father - but it was stressful especially as you are having to do it for someone who you care about, so will not do it until I am pretty sure of succeeding.
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 8:43 AM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    • #7
    • 29th Aug 12, 8:43 AM
    • #7
    • 29th Aug 12, 8:43 AM
    Hello

    My Mum has been in a care home for 8 years. She suffers from Alzheimers and is also incontinent. In April 2011 she was hospitalised and had a pacemaker fitted. She receives no financial help other than receipt of Attendance allowance. She has been assessed but we were told that she would only receive the difference between care home fees and nursing home fees and her attendance allowance would be stopped. Also that if we applied for the nursing home fees then the authority would require her to be placed in a nursing home. We do not want her to be moved, she is happy where she is, the staff know her and understand her moods and is feels this is her home. Can we claim or will this result in her being moved? We have had to sell her home to fund her care.
    Originally posted by Spent Up
    Continuing healthcare funding is available in any setting including own home. I am not sure about the nursing supplement but the threat to move her sounds like a way to make you back off in your claim.
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 8:50 AM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    • #8
    • 29th Aug 12, 8:50 AM
    • #8
    • 29th Aug 12, 8:50 AM
    I guess this is a partial success story, I was successful in getting costs paid under continuing health care for my mother when she went into a dementia care home due to needing terminal care because of brain cancer. However, my father went into the same home at the same time as he has alzheimers, ( my mother was his carer) and currently I am not going to attempt to reclaim as I know, despite being told by a GP that he must not be left on his own, he is no where near being as bad as he needs to be to qualify.
    I think my mother was fast tracked as she was terminally ill, and it all happened quite fast so I did not have time to familiarise myself with all the criteria, but the meeting where the decision was made was horrid - I disagree with martins article, I think you do need to read the decision support tool - just to see how poorly someone needs to be - otherwise you could do a lot of work when the criteria might not be meet - they are looking at the nature,
    intensity, complexity or unpredictability of the individual’s needs. I found myself having to argue each point that she was worse than than the health professionals said she was -because that is what I thought and in the knowledge that if she was not deemed that bad, ie did not score highly enough, she would meet the criteria. This was all happening as the hospital wanted her out of the bed because they were not treating her and so she was a blocker.
    At some point I may think again about my father - but it was stressful especially as you are having to do it for someone who you care about, so will not do it until I am pretty sure of succeeding.
    Originally posted by auntiepam
    I agree with this completely. Read the DST and be prepared to argue each criteria or the assessment will downplay the seriousness of your relatives condition. Also read the National Framework document to see if the PCT is following proceedure. You will have to fight each step of the process and it is not a simple process even down to having to argue the meaning of individual words on the DST.

    For more personal experience see this MSE thread which has been running for some years. http://forums.moneysavingexpert.com/showthread.php?t=800521&highlight=chc
    • auntiepam
    • By auntiepam 29th Aug 12, 8:53 AM
    • 60 Posts
    • 82 Thanks
    auntiepam
    • #9
    • 29th Aug 12, 8:53 AM
    • #9
    • 29th Aug 12, 8:53 AM
    Hello

    My Mum has been in a care home for 8 years. She suffers from Alzheimers and is also incontinent. In April 2011 she was hospitalised and had a pacemaker fitted. She receives no financial help other than receipt of Attendance allowance. She has been assessed but we were told that she would only receive the difference between care home fees and nursing home fees and her attendance allowance would be stopped. Also that if we applied for the nursing home fees then the authority would require her to be placed in a nursing home. We do not want her to be moved, she is happy where she is, the staff know her and understand her moods and is feels this is her home. Can we claim or will this result in her being moved? We have had to sell her home to fund her care.
    Originally posted by Spent Up
    I would suggest you go through this check-list first http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103328.pdf. to see if she meets the requirements for a full assessment.
  • DaisyHawkins
    [QUOTE=monkeyspanner;55458423]I agree with this completely. Read the DST and be prepared to argue each criteria or the assessment will downplay the seriousness of your relatives condition. Also read the National Framework document to see if the PCT is following proceedure. You will have to fight each step of the process and it is not a simple process even down to having to argue the meaning of individual words on the DST.

    For more personal experience see this MSE thread which has been running for some years.


    Thanks for this link which I will read with interest. Our experience is one of failure.
    My mother-in-law has MS. She is incontinent, immobile, bedbound and nearly blind. Her hands are badly deformed to the extent that she can only feed herself with finger food and needs to be assisted with her meals. She frequently suffers from urinary tract infections which make her delirious and at worst comatose. She has been paying for her own care at home for a number of years and was admitted to hospital when her bedsores became infected. On discharge she went into a nursing home andher care was being paid for by continuing health care. This year she was reassessed and the funding has been terminated because her bedsores have cleared up and there is no longer a medical need for her care. We appealed but to no avail. She is currently paying for her care which approx. £800/week and we are in the process of selling her house.
    Last edited by DaisyHawkins; 29-08-2012 at 9:44 AM. Reason: spaces
  • in need of help
    Care costs for free
    I saw the link today on the weekly email, well done to all of you who have put this together and to those who have been sucessfull.
    My mum has had a bad stroke and after the main hospital was discharged to a community hospital where she could stay for only 6 weeks, we manage 7 weeks and 3days! She was given the assessemnt for care by the staff nurse, they went over this with me but i do not have a copy of it, but it was to assist with transfering her to an interim care home, to prove she needed assistance. She was transferred, and now needs to undergo a Financial Assmt which by all accounts will mean she is to pay for her care. This interim care home is inorder for use to convert our gargage to accomodation and wet room for mum to move in with us as they have said she cannot live independently, perhaps i can claim back the costs for this too....
    However after reading todays link, i believe she has a need for continuing health care something the NHS keep close so we the general public do not know about it!!
    So any ideas on how i should tackle this, do i argue now with the nhs, pct or ......
    Thanks in advance for your help.
    p.s. will have power of att in the next 2 weeks.
  • ladybrady
    Grandma's Nursing Home Fee's??
    I don't know the full in's and out's but my Grandma suffered from Dementia and Alzheimer 's which got worse over the years. She was admitted to Hospital and then discharged straight into a Nursing Home as she could no longer care for herself. She was ringing the Police as she was convinced there were boy's and girls in her house taunting her. Her condition deteriorated quite quickly and I think she was in nursing home that specialised in Dementia patients for approx 18 months. My mum became POA and looked after her affairs. My mum was told as my Grandmother had money she had to pay for her own nursing home fee's which were i think around £800 p\w which then increased considerably as her condition deteriorated.

    My Grandmother died in 2008 and i have mentioned this post to my mum but am wondering if anyone has an opinion on whether we would be eligible for a claim as my Grandmother has passed away and we no longer have any paperwork for the nursing home fee's/bank statements.

    Many thanks
    • mwddrwg
    • By mwddrwg 29th Aug 12, 10:36 AM
    • 478 Posts
    • 252 Thanks
    mwddrwg
    People in Wales can also claim back money through the Welsh Government scheme although not sure if the deadline has passed. In my line of work I've seen many people get refunds.
    • Gmod
    • By Gmod 29th Aug 12, 11:24 AM
    • 3 Posts
    • 0 Thanks
    Gmod
    On a similar note, I read somewhere that the care home/PCT cannot force you to sell your home immediately. For example, if my father was in a care home we could wait until after his death to "settle the bill"?

    Does anyone know if this is true?
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 11:51 AM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    On a similar note, I read somewhere that the care home/PCT cannot force you to sell your home immediately. For example, if my father was in a care home we could wait until after his death to "settle the bill"?

    Does anyone know if this is true?
    Originally posted by Gmod
    If you have an asset like a property it would be the council social services assessing how much contribution you have to pay towards your care fees. The care home are not involved in this directly other than setting the fees they are prepared to accept. This can vary for the same services between what is paid by a self-funder and what the council may pay. The PCT are involved if the resident is due CHC funding or the nursing supplement which are both funded from the NHS.

    The council assess both income, including state pension, and capital. Property is included in capital assets. Whilst the council cannot force a sale if assessed as self-funding the resident may be put in the position that the property has to be sold to fund care. There are certain exemptions which mean the property will be excluded from the assessment e.g. if the spouse of the resident still lives in the property. Or if any person normally resident in the property is over 60.

    The resident can apply for a deferred fee arrangement with the council. If this is agreed there will be a financial charge put on the property (similar to a mortgage but the amount own gets larger as more fees are paid) and fees will accrue against this charge. When the property is sold the council get repaid from the proceeds of the sale. It should be noted that there are no interest charges on the deferred fee arrangement until the resident dies.

    There are obviously other arrangements the resident could make to pay fees e.g. by renting out the property. Making their own loan arrangements against the property value etc..

    I hope this helps clarify what you have heard.
  • redsquirrelsuk
    I am just commencing a claim. My mother died in July after a stroke. It was only whilst she was in hospital that we first heard the term "continuing care". She had been in a nursing home since 2008 after a number of falls. Social Services said that they would no longer be willing to allow her to stay in her own home. Since she had been in the home her condition had deteriorated (through no fault of theirs) so that she was unable to walk. She was also beginning to suffer with dementia. We did ask about her attending a memory clinic but nothing happened with that. Once she was in the nursing home the NHS/Social Services seem to have lost interest in her. We had to sell the home that my Dad (an ex-soldier) worked hard to buy. There is no doubt in my mind that her needs were health related.
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 12:01 PM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    I saw the link today on the weekly email, well done to all of you who have put this together and to those who have been sucessfull.
    My mum has had a bad stroke and after the main hospital was discharged to a community hospital where she could stay for only 6 weeks, we manage 7 weeks and 3days! She was given the assessemnt for care by the staff nurse, they went over this with me but i do not have a copy of it, but it was to assist with transfering her to an interim care home, to prove she needed assistance. She was transferred, and now needs to undergo a Financial Assmt which by all accounts will mean she is to pay for her care. This interim care home is inorder for use to convert our gargage to accomodation and wet room for mum to move in with us as they have said she cannot live independently, perhaps i can claim back the costs for this too....
    However after reading todays link, i believe she has a need for continuing health care something the NHS keep close so we the general public do not know about it!!
    So any ideas on how i should tackle this, do i argue now with the nhs, pct or ......
    Thanks in advance for your help.
    p.s. will have power of att in the next 2 weeks.
    Originally posted by in need of help
    Couple of things to bear in mind.
    If your Mum is in england she should have had an initial CHC checklist performed prior to discharge to see if she should have a full DST based CHC funding assessment performed. The patient and/or carer should be informed of the result of this checklist. If this was not done the PCT have failed to follow the gudelines of the CHC National Framework document.

    CHC funding is available in any setting including your own home.

    My advice would be to follow this up as soon as you can as making retrospective claims are more difficult.
  • redsquirrelsuk
    Go For It
    my mother entered a privately paid for care home in 2002 and died there in 2010. She suffered from Dementia from the start which gradually got worse and she paid for care out her own pocket for the whole time. One month before she died she went into hospital and was formally assessed as qualifying for free care due to her condition.
    I am wondering if I can make a claim as she had been in that qualifying condition for some time (maybe a year or more) prior to being assessed but she wasn't formally assessed as I didn't know you could be.
    I had POA but this ceased on her death. Will I be able to claim any money back for her estate?
    Any help appreciated.
    Originally posted by arhodes
    Go for it, what have you got to lose? Ring your local PCT and ask them to make a retrospective assessment, they will then send you a form to fill in. They asked me to send in a letter stating that I wished to make a claim so that this would be in before the deadline.
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 12:03 PM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    [QUOTE=DaisyHawkins;55459467]
    I agree with this completely. Read the DST and be prepared to argue each criteria or the assessment will downplay the seriousness of your relatives condition. Also read the National Framework document to see if the PCT is following proceedure. You will have to fight each step of the process and it is not a simple process even down to having to argue the meaning of individual words on the DST.

    For more personal experience see this MSE thread which has been running for some years.


    Thanks for this link which I will read with interest. Our experience is one of failure.
    My mother-in-law has MS. She is incontinent, immobile, bedbound and nearly blind. Her hands are badly deformed to the extent that she can only feed herself with finger food and needs to be assisted with her meals. She frequently suffers from urinary tract infections which make her delirious and at worst comatose. She has been paying for her own care at home for a number of years and was admitted to hospital when her bedsores became infected. On discharge she went into a nursing home andher care was being paid for by continuing health care. This year she was reassessed and the funding has been terminated because her bedsores have cleared up and there is no longer a medical need for her care. We appealed but to no avail. She is currently paying for her care which approx. £800/week and we are in the process of selling her house.
    Originally posted by monkeyspanner
    Did you get an Independant review panel when you appealed?
    • monkeyspanner
    • By monkeyspanner 29th Aug 12, 12:05 PM
    • 2,118 Posts
    • 1,933 Thanks
    monkeyspanner
    I am just commencing a claim. My mother died in July after a stroke. It was only whilst she was in hospital that we first heard the term "continuing care". She had been in a nursing home since 2008 after a number of falls. Social Services said that they would no longer be willing to allow her to stay in her own home. Since she had been in the home her condition had deteriorated (through no fault of theirs) so that she was unable to walk. She was also beginning to suffer with dementia. We did ask about her attending a memory clinic but nothing happened with that. Once she was in the nursing home the NHS/Social Services seem to have lost interest in her. We had to sell the home that my Dad (an ex-soldier) worked hard to buy. There is no doubt in my mind that her needs were health related.
    Originally posted by redsquirrelsuk
    Your experience of not being informed is not uncommon. Good luck with your claim.
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