Reclaim Care Home Costs for Free- New MSE guide

noelphobic

monkeyspanner wrote: »

Because of the deadline there are a number of companies advertising heavily for this kind of business. I may be wrong but my advice would be not to take any of these offerings too seriously. I believe they represent the same style of business which calls me repeatedly saying I should reclaim PPI which I have never had. When you look at these web sites if you cannot see a contact telephone number and a real postal address and look like actual solicitors I would not consider them. Many are merely call centres whipping up enquiries which they then will farm out to willing solicitors who may or may not have a track record in this area.

It would seem contrary but look for solicitors who are not advertising who have been successful in this area previously. One such company has been mentioned several times in this thread they have won 5 and 6 figure cases in the past.



Not sure about the 6 years but the 2001 Care Home Regulations require that records are kept for a minimum of 3 years.

Records17.—(1) The registered person shall—
(a)maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user;
(b)ensure that the record referred to in sub-paragraph (a) is kept securely in the care home.
(2) The registered person shall maintain in the care home the records specified in Schedule 4.
(3) The registered person shall ensure that the records referred to in paragraphs (1) and (2)—
(a)are kept up to date; and
(b)are at all times available for inspection in the care home by any person authorised by the Commission to enter and inspect the care home.
(4) The records referred to in paragraphs (1) and (2) shall be retained for not less than three years from the date of the last entry.

Here is a link to the regulations. http://www.legislation.gov.uk/uksi/2001/3965/regulation/17/made

Many thanks for this extremely useful information. Regarding the solicitors I have filled in an online form for Hugh James and will see what they say when they get in touch. I will also look at other solicitors.

Regarding the care home records, that is probably the regulation that was quoted to us by the owner. I had googled it previously but was unable to find this regulation with the information I had been provided with. However, the way it was quoted to us implied that the records HAD to be destroyed after 3 years, which I knew couldn't be true.

We did put a formal complaint in about an incident that happened when my mother was in this home so I think they destroyed the records at the earliest opportunity in case we ever took any further action!

noelphobic

akfxxx wrote: »

After reading the article two weeks ago, we contacted our PCT who were very helpfull and sent the forms within three days, We needed copys of will,power of atterny etc, after contacting our mums solicitor he gave us all for FREE, we contacted the care home where mum resided up to dying and they have given us all other details,records for FREE, so we have sent them into the PCT and they have replied within days advising they have statred looking into this for us, only downfall they have said at the moment cases are taking a year to complete, but hey thats ok we never thought we had a chance, THANK YOU for all your help Martin.:j:rotfl::money:

Did the PCT ask you to send the records in? I telephoned our PCT and advised that we wished to claim (my mother was already dead at that time). That was followed up by me sending a letter. We have obtained records from social services/hospital/GP/care homes without any problems. We have not given these records to the PCT as it is their responsibility to obtain whatever records they require themselves. They have told me that when it is time to consider the appeal they will show us all the records they have.

We were told 2 years ago that it would be about 18 months before our case was considered. I recently received a letter stating that they had to deal with more recent cases first (which is obviously ridiculous) and that our case would be dealt with by April 2013.

I am now investigating the possibility of appointing solicitors to deal with this case as I feel that dealing with it myself would be detrimental to my health.

Wisdom123

Could you still potentially claim back even if relative resided in a residential only care home? Thanks

monkeyspanner

Wisdom123 wrote: »

Could you still potentially claim back even if relative resided in a residential only care home? Thanks

Yes CHC funding is available for any setting including patients own home and the care does not have to be provided by medical staff.

jenhugs

Ok so my nan has been in a residentaial emi unit since around 2000. She had to sell her house and and her life savings have now all gone. She has pics disease. Now the money has run out the social are contributing so much but now my mum has to cover the shirt fall. Mum tried to look after my nan at first but it was horrendous, eating from the cat bowl, pooing on the floor. To the point where I had to call social services and advice my mum could not cope any longer. I know that sounds terrible, but mum was not able to get her up and down the stairs, in and out the bath and just deal with NANS every day needs.
Mum has recently been in touch with a solicitor regarding my nans case.
Now for the questions.
Firstly: we are in Wales, can we still claim? This solicitors is saying they can.
Secondly: they want 200 pounds up front for nans medical records is this the norm?

Thanks for reading and thanks for any input.

monkeyspanner

Hi Willowgill
Sorry to hear you your loss.
So if I have understood.
-From around July 2009 to June 2010 your mum was in a care home and funding assisted by a joint funding arrangement by council services and NHS but contributed the bulk of her pension. The family home was disregarded as your dad still lived at home.

-Around June 2010 your dad fell ill and also went to live in the care home fully funded by NHS CHC. This triggered the assessment of the value of the family home against your mum's care home fees.

-From June 2010 to September 2011 part of your mum's fees were accrued against the value of the property under a deferred payment arrangement.

-Your mum had assessments in July 2009, September 2010 and September 2011. The last assessment granted full funding.

-Your concern is the period July 2010 and September 2011 and the failure of the September 2011 assessment to allow CHC funding. You mentioned that you insisted this was incorrect. Did you make a formal request for a review of the decision? Would there be a record at the PCT that you made your disquiet known? It may still be worth contacting the PCT and say that you want a retrospective review of the September 2010 decision and the period you are concerned about. It may also be worth considering the period prior to your dad going into the care home as you may be able to recover your mum's contribution from her pension.

I have to say I am unsure how joint funding arrangements are decided.

monkeyspanner

jenhugs wrote: »

Ok so my nan has been in a residentaial emi unit since around 2000. She had to sell her house and and her life savings have now all gone. She has pics disease. Now the money has run out the social are contributing so much but now my mum has to cover the shirt fall. Mum tried to look after my nan at first but it was horrendous, eating from the cat bowl, pooing on the floor. To the point where I had to call social services and advice my mum could not cope any longer. I know that sounds terrible, but mum was not able to get her up and down the stairs, in and out the bath and just deal with NANS every day needs.
Mum has recently been in touch with a solicitor regarding my nans case.
Now for the questions.
Firstly: we are in Wales, can we still claim? This solicitors is saying they can.
Secondly: they want 200 pounds up front for nans medical records is this the norm?

Thanks for reading and thanks for any input.

Wales has a CHC funding system originating from the same legal cases as England. Wales has introduced a similar DST based assessment system and National Framework but this was introduced later than England.

I am unsure about making retrospective claims in Wales and as far as I am aware the NHS in Wales have not set deadlines for making claims but I may be wrong.

There are no PCT's in Wales so the CHC assessment system is administered by the Local Health Boards in Wales.

What fee arrangements has your mum made with the solicitor? Have the solicitors agreed a no-win no-fee arrangement sometimes called a conditional fee arrangement? If they haven't this could get very expensive for your mum. It is normal for hospitals etc. to charge a fee for providing records and in the past I have paid £50 for each request. However if the solicitors have already agreed a no-win no-fee arrangement it would be more normal for them to pay all expenses. Perhaps they need the records to make a decision whether they will take the case but it would be better to be absolutely clear what kind of client/solicitor agreement is in place.

jenhugs

Thanks money spanner. It is a no win no fee, on the basis of 25% to them. I just don't understand the 200 pounds up front has anyone else been asked to pay for medical records up front?
By the way my nan has never been assesed!

monkeyspanner

jenhugs wrote: »

Thanks money spanner. It is a no win no fee, on the basis of 25% to them. I just don't understand the 200 pounds up front has anyone else been asked to pay for medical records up front?
By the way my nan has never been assesed!

Interesting that you say your nan has never been assessed. You might want to draw the social services attention to the following clauses in the Welsh CHC National Framework document of 2010.

3.4 Each local authority is under a duty to assess fully any person who appears to it to be in need of community care services2. Community care services can include residential accommodation for persons who by reason of age, illness or disability are in need of care and attention which is not otherwise available to them3 as well as domiciliary and community-based services enabling people to continue to live in the community.
3.5 The local authority, 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 local authority must also notify the relevant LHB if, in carrying out the assessment, it becomes apparent that the person has needs which may fall under the National Health Service (Wales) Act 2006, and invite them to assist in the making of the assessment (see National Health Service and Community Care Act 1990 section 47(3)).

John_Pierpoint

jenhugs wrote: »

Secondly: they want 200 pounds up front for nans medical records is this the norm?
.

This is like getting a solicitor to get the probate when someone dies.
I needed to get the records for a dead relative.
The doctor's records had gone to a local "cottage" hospital and the district hospital still had its own records.
I agreed to collect them in person (so I could get some explanation of the medical terms).
The cottage hospital kept me waiting for a few weeks.
The district hospital kept me waiting nearly 6 months. "We don't cash the cheque immediately because that just encourages people to telephone and ask if the records are ready yet".
In both cases I was faced with a pile of documentation several inches thick to which the 80:20 rule applied [actually more like 99:1].
As an individual I could afford to spend hours going through the mountain of bumph and it turned out to be a profitable exercise - especially when I discovered a mis-diagnosis . (The doctor was right the hospital was wrong).
So if you employ a "professional" to evaluate your claim, £200 seems cheap.