Reclaim Care Home Costs for Free- New MSE guide

spacebun

How do you start a claim if a person has died? I have tried to find out but am having trouble finding the correct information. I have all the documentation required to fill in relevant forms, but no idea where to start. Any information will be gratefully received. Thanks.

Bellyman

Can someone advise me please. My mother was assessed and went into a care home in November 2010, but sadly passed away in June 2012. Because she didn't have much in the way of savings, she didn't have to pay care home fees, although her attendance allowance and pension (all but a small amount of pocket money) was taken away from her as a contribution towards costs. I paid an additional top-up fee of £560 per month in order that she was able to go into a care home of a slightly higher standard. Do you think I could claim back this top-up fee for the time that she spent in the care home? She suffered from dementia and heart problems and suffered falls.

monkeyspanner

spacebun wrote: »

How do you start a claim if a person has died? I have tried to find out but am having trouble finding the correct information. I have all the documentation required to fill in relevant forms, but no idea where to start. Any information will be gratefully received. Thanks.

You will need the contact the CHC department of the PCT and ask for a retrospective review. See previous posts about this process.

monkeyspanner

Bellyman wrote: »

Can someone advise me please. My mother was assessed and went into a care home in November 2010, but sadly passed away in June 2012. Because she didn't have much in the way of savings, she didn't have to pay care home fees, although her attendance allowance and pension (all but a small amount of pocket money) was taken away from her as a contribution towards costs. I paid an additional top-up fee of £560 per month in order that she was able to go into a care home of a slightly higher standard. Do you think I could claim back this top-up fee for the time that she spent in the care home? She suffered from dementia and heart problems and suffered falls.

Regarding the 3rd party top-up payments. These are normally viewed as voluntary agreements and it may be argued that the additional expense was not necessary. But I cannot say with any certainty if you are likely to recover these top-ups if successful with CHC funding.

There may, however, be other issues of process involved here.
As your mother was assisted by the council in her fees up to their standard support levels did they find the care home and say they wanted a top-up from you? If they did they could be in breach of process. The councils are not permitted to request a top-up if they are unable to find an alternative care home in the locality which will accept the patient at the council's standard fees support levels.
If the care home choice is at the initiative of the patient or their family then the council can request a 3rd party top-up payment if the fees are in excess of the council standard support levels.

The other issue that can affect what you pay in top-ups is what the level of care was assessed. I believe the councils normally have 4 levels of care each associated with a different level of financial support.

tinkerbellkirst

I am going to discuss this with my Mum regarding my grandad.

He is in a care home and has been since around Sept 2009. My grandma is currently funding all of his care as they have savings but this is slowly decreasing. His health when first placed may not have been bad enough to qualify but through looking at the checklist I now think it is.

He has Parkinsons and Dementia, he is doubly incontinent and unable to communicate effectively most of the time, he is also disorientated and lives in his own little bubble, bless his heart.

He is only in a care home not nursing however he probably should be nursing care. He has entered hospital a few times due to infections but im not sure if this assessment was completed any time, how do i find this out? And find out his score for this?

Hope someone can help

Thankyou x

megansden

Hi!

It appears from my investigations so far that my mother was only granted CHC funding for the last 5 days of her life, although she had medical needs for at least 2 years prior to he death, do you think that I still have a case with the charges that she had to pay?

Former_MSE_Dan

Hi folks,

Thanks for all the posts, and especially to those of you who have been providing help to others asking questions.

For individuals after guidance on the process, reading the guide in full will be an important start. Then, if you need to speak to someone, the Alzheimer's Society has a helpline staffed by volunteers who have been through the reclaim process. This number was originally in the guide but Alzheimer's became overwhelmed by demand, so please read the guide before calling them as it may answer your question

Details are in here: http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=398

Dan

monkeyspanner

tinkerbellkirst wrote: »

I am going to discuss this with my Mum regarding my grandad.

He is in a care home and has been since around Sept 2009. My grandma is currently funding all of his care as they have savings but this is slowly decreasing. His health when first placed may not have been bad enough to qualify but through looking at the checklist I now think it is.

He has Parkinsons and Dementia, he is doubly incontinent and unable to communicate effectively most of the time, he is also disorientated and lives in his own little bubble, bless his heart.

He is only in a care home not nursing however he probably should be nursing care. He has entered hospital a few times due to infections but im not sure if this assessment was completed any time, how do i find this out? And find out his score for this?

Hope someone can help

Thankyou x

I was a little concerned that you mention your grandmother is funding your granfather from presumeably joint savings. Only your grandfathers savings should be used for funding his care. Your grandmother is not under any obligation to fund his care from her savings. So if their saving were say £60,000 in joint accounts £30,000 of that is your grandmothers leaving £30000 to be assessed. The first £23,250 is the lower savings limit leaving £6,750 for use against the care home fees. Once your grandfathers savings reach the lower savings limit the council must assist with his fees. This means that a means test is made of your grandfathers income including state and other pensions and any other capital. The means test should take account of your grandmothers needs and property should be excluded from the assessment if your grandmothers is still living there. The situation could get more complicated if the savings were in an account in your grandfathers name only.

The hospital records should show if any CHC checklists have been carried out. This is a requirement on disccharge from hospital and the results should be communicated by the discharge team to the patient or their representative.

If you believe that your grandfathers needs are now primarily health related then a CHC assessment should be requested asap.

monkeyspanner

megansden wrote: »

Hi!

It appears from my investigations so far that my mother was only granted CHC funding for the last 5 days of her life, although she had medical needs for at least 2 years prior to he death, do you think that I still have a case with the charges that she had to pay?

Quite possibly you could approach the PCT for a retrospective review please see above posts where this is discussed.

megansden

monkeyspanner wrote: »

Your mother should only have been self-funding in the care home if her assets were higher than the lower savings limit. (currently around £23500). You mention fees outstanding will her estate cover these fees?
Yes it is the PCT you should approach if you think her primary needs were medical rather than social.

Since contacting the PCT it appears that my mother was only on CHC for 1 week which seems bizzaar as she has ongoing clinical problems for at least 2 years (dementia, incontinence and constantly falling over) I am wondering if there is a case for compensation given the circumstances:mad: