Reclaim Care Home Costs for Free- New MSE guide

theboylard

Hi there,

wow!
There is a lot of useful information here, thank you to all for being so candid.
A lot of people have either not been told the truth, or were allowed to continue believing what they thought were the rules when that wasn't the case.

Looking at the comments and the article, I believe we are now in a position to make a claim for my late Father in Law.
A brief outline is below, but bits are left out for brevity (honestly!)

Like many, we were very honest about my FiL's assets when discussing his ongoing care with the hospital and social services after he was admitted in April 2010 - our erroneous assumption that because he had assets over c.£24,000 that whatever care he needed we would be paying for out of his estate.

The sticky point that we have is that he lived in Doncaster, but we live 100 miles away and we wanted him in a home near us.
Being brutal, with the now diagnosed vascular dementia, and other existing multiple ailments, he wouldn't know where he was living (and as time went on he thought we were in Singapore, India, Spain, Ilfracombe, Hillingdon, Swansea....) but if he was in a home in Doncaster, then logistically it would have been difficult for us to see him regularly.

My wife found a local home that she felt could offer the kind of environment that Ellis could settle in to and enabled us to visit him daily and take him out regularly.
We discussed funding with Doncaster Social Services (DSS), and as Ellis did not have a living will/power of attorney, we had to go through the Court of Protection - not fun.
DSS agreed that they would pay Ellis' fees and we would repay once we had authority. But they would only pay up to £370 per week, and we would have to pay the home the balance directly.
This continued until my wife was appointed Deputy to CoP (should have been 4 months, took 10, and you get 3 sides of A4 paper), when we then settled the outstanding money with DSS, and we continued to repay them on a monthly basis, until he passed last November.
At no time did we interact with our local PCT (Northants).

So, my question is - thanks for listening by the way - is our claim solely with Doncaster, with Doncaster and Northants, or just Northants? Is it based on location or who you were dealing with?

Thanks again to all,

mjk_2

Hi,

My Mum died of Alzheimer's 2 years ago. During the last year of her life she was assessed for NHS Continuing Care and rejected. Is there any point in me trying again?

A bit of background: Alzheimer's was her only health problem when she entered a Nursing/Residential Home approx 2.5 yrs before her death. During her time there she became incontinent, suffered delusions, extreme confusion/distress/anxiety, towards the end she couldn't communicate or feed herself and became completely immobile after breaking her hip.

Any advice gratefully received.

Kefte

If you're part of East Yorkshire and you're unsure how to get the ball rolling on this matter. eroy-pct.ContinuingCare@nhs.net Will be your first point of call.

monkeyspanner

mjk wrote: »

Hi,

My Mum died of Alzheimer's 2 years ago. During the last year of her life she was assessed for NHS Continuing Care and rejected. Is there any point in me trying again?

A bit of background: Alzheimer's was her only health problem when she entered a Nursing/Residential Home approx 2.5 yrs before her death. During her time there she became incontinent, suffered delusions, extreme confusion/distress/anxiety, towards the end she couldn't communicate or feed herself and became completely immobile after breaking her hip.

Any advice gratefully received.

I think it would depend largely on whether you made an appeal against the original decision and if you exhausted the appeal process.

monkeyspanner

theboylard wrote: »

Hi there,

wow!
There is a lot of useful information here, thank you to all for being so candid.
A lot of people have either not been told the truth, or were allowed to continue believing what they thought were the rules when that wasn't the case.

Looking at the comments and the article, I believe we are now in a position to make a claim for my late Father in Law.
A brief outline is below, but bits are left out for brevity (honestly!)

Like many, we were very honest about my FiL's assets when discussing his ongoing care with the hospital and social services after he was admitted in April 2010 - our erroneous assumption that because he had assets over c.£24,000 that whatever care he needed we would be paying for out of his estate.

The sticky point that we have is that he lived in Doncaster, but we live 100 miles away and we wanted him in a home near us.
Being brutal, with the now diagnosed vascular dementia, and other existing multiple ailments, he wouldn't know where he was living (and as time went on he thought we were in Singapore, India, Spain, Ilfracombe, Hillingdon, Swansea....) but if he was in a home in Doncaster, then logistically it would have been difficult for us to see him regularly.

My wife found a local home that she felt could offer the kind of environment that Ellis could settle in to and enabled us to visit him daily and take him out regularly.
We discussed funding with Doncaster Social Services (DSS), and as Ellis did not have a living will/power of attorney, we had to go through the Court of Protection - not fun.
DSS agreed that they would pay Ellis' fees and we would repay once we had authority. But they would only pay up to £370 per week, and we would have to pay the home the balance directly.
This continued until my wife was appointed Deputy to CoP (should have been 4 months, took 10, and you get 3 sides of A4 paper), when we then settled the outstanding money with DSS, and we continued to repay them on a monthly basis, until he passed last November.
At no time did we interact with our local PCT (Northants).

So, my question is - thanks for listening by the way - is our claim solely with Doncaster, with Doncaster and Northants, or just Northants? Is it based on location or who you were dealing with?

Thanks again to all,

If your FIL was discharged from a hospital in Northants then you should approach the PCT in that area and ask for a retrospective review. Your FIL should have had, as a minimum, a CHC checklist performed prior to discharge or if a period of recouperation was involved at the end of that period. The results of that checklist should have been communicated to you so that you had a chance to comment. However it is not uncommon for results not to be communicated, so you may find that a checklist was performed.
The council is not under an obligation to suggest or carry out a CHC checklist and are often complicit in keeping quiet about CHC funding. However they are required to involve the PCT if they believe a patients needs may fall under the NHS Act 2006. The relevant National Framework clause is as below.

16. Each LA is under a duty to assess any person who appears to it to be in need of community care services (section 47 of the National Health Service and Community Care Act 1990). Community care services may include residential accommodation for persons who, by reason of age, illness or disability, are in need of care and attention that is not otherwise available to them (section 21 of the National Assistance Act 1948), as well as domiciliary and community-based services to enable people to continue to live in the community. The LA, having regard to the result of that assessment, must then decide whether the person’s needs call for the provision of community care services. The LA must also notify the relevant PCT if, in carrying out the assessment, it becomes apparent to the authority that the person has needs which may fall under the National Health Service Act 2006, and invite the PCT to assist in making the assessment (see section 47(3)(a) of the National Health Service and Community Care Act 1990).

margaretclare

mjk wrote: »

Hi,

My Mum died of Alzheimer's 2 years ago. During the last year of her life she was assessed for NHS Continuing Care and rejected. Is there any point in me trying again?

A bit of background: Alzheimer's was her only health problem when she entered a Nursing/Residential Home approx 2.5 yrs before her death. During her time there she became incontinent, suffered delusions, extreme confusion/distress/anxiety, towards the end she couldn't communicate or feed herself and became completely immobile after breaking her hip.

Any advice gratefully received.

Alzheimer's was her only health problem? But Alzheimer's is progressive, it doesn't stay the same, it gets worse - and it did, in the last 2 1/2 years of her life. In addition to that, she suffered a broken hip. This is an extremely common thing to happen in the older age-groups and it is known that they just do not recover from a major fracture (of any bone!) in the same way that a younger person can.

I am sorry for your loss. But she was suffering, and now is free of all suffering. May she rest in peace.

monkeyspanner

alicebean wrote: »

Hoping someone can advise. My nan has been in a residential home for 10 years. My concern is that if I start this process and she turns out to be eligible for CHC will that trigger or give evidence to the home to ask for to be moved to a nursing place. As this is not an option - when she stopped be privately funded and the local authority had to step in we had a big fight to keep her where she was.

I presume the fight was due to her fees being higher than the council standard support rates. I understand your concern. CHC funding is available in any setting including residential care homes without nursing facilities. In my MIL's case she was not in a nursing facility and continued in the same home after funding was agreed.

hollyhocks123

theboylard wrote: »

Hi there,

wow!
There is a lot of useful information here, thank you to all for being so candid.
A lot of people have either not been told the truth, or were allowed to continue believing what they thought were the rules when that wasn't the case.

Looking at the comments and the article, I believe we are now in a position to make a claim for my late Father in Law.
A brief outline is below, but bits are left out for brevity (honestly!)

Like many, we were very honest about my FiL's assets when discussing his ongoing care with the hospital and social services after he was admitted in April 2010 - our erroneous assumption that because he had assets over c.£24,000 that whatever care he needed we would be paying for out of his estate.

The sticky point that we have is that he lived in Doncaster, but we live 100 miles away and we wanted him in a home near us.
Being brutal, with the now diagnosed vascular dementia, and other existing multiple ailments, he wouldn't know where he was living (and as time went on he thought we were in Singapore, India, Spain, Ilfracombe, Hillingdon, Swansea....) but if he was in a home in Doncaster, then logistically it would have been difficult for us to see him regularly.

My wife found a local home that she felt could offer the kind of environment that Ellis could settle in to and enabled us to visit him daily and take him out regularly.
We discussed funding with Doncaster Social Services (DSS), and as Ellis did not have a living will/power of attorney, we had to go through the Court of Protection - not fun.
DSS agreed that they would pay Ellis' fees and we would repay once we had authority. But they would only pay up to £370 per week, and we would have to pay the home the balance directly.
This continued until my wife was appointed Deputy to CoP (should have been 4 months, took 10, and you get 3 sides of A4 paper), when we then settled the outstanding money with DSS, and we continued to repay them on a monthly basis, until he passed last November.
At no time did we interact with our local PCT (Northants).

So, my question is - thanks for listening by the way - is our claim solely with Doncaster, with Doncaster and Northants, or just Northants? Is it based on location or who you were dealing with?

Thanks again to all,

Hi, it'll be about the GP, but you should start with the original GP, so if that was Doncaster that'll be who you need to contact first. don't forget it's about health eligibility though, not finance:) So if you write to the PCT talk about the hospital discharge into a home (if they said it has to be a nursing home they should have done a DST, if a residential home then not necessarily but there may have been a checklist, may not.) and where you think there are health needs i.e. where a nurse in the home needed to give care / be involved.

hollyhocks123

mjk wrote: »

Hi,

My Mum died of Alzheimer's 2 years ago. During the last year of her life she was assessed for NHS Continuing Care and rejected. Is there any point in me trying again?

A bit of background: Alzheimer's was her only health problem when she entered a Nursing/Residential Home approx 2.5 yrs before her death. During her time there she became incontinent, suffered delusions, extreme confusion/distress/anxiety, towards the end she couldn't communicate or feed herself and became completely immobile after breaking her hip.

Any advice gratefully received.

Ask for a copy of the DST, if totality of need was considered there is no grounds for a retrospective (look to see if the 4 key indicators were used, is usually a good sign the totality was considered) if not then you should apply for a retro.
Just my opinion, but from what you've written there's nothing there to indicate CHC to me, so sounds like DST may have been right, however without seeing the whole DST it's obviously not definative, just a view also worth noting how close that DST was done towards the end, if not done close but there was a rapid deterioration (i.e. went downhill very fast - 4 weeksish) then may have been eligible for fast track funding.

alicebean

monkeyspanner wrote: »

I presume the fight was due to her fees being higher than the council standard support rates. I understand your concern. CHC funding is available in any setting including residential care homes without nursing facilities. In my MIL's case she was not in a nursing facility and continued in the same home after funding was agreed.

Thank you monkey spanner. It was about the funding difference and when the home thought they were going to lose money they suddenly found my nan difficult to deal with. This was almost 4 yrs ago. So if we apply, they find that my nan did and does have health needs would that then give the residential home grounds to say they can no longer accommodate her needs. She's 99 and a move would probably kill her. I am assuming that the point behind all this is that there are many people out there who in fact have health as well as social needs and therefore CHC should be footing part of the bill?