Reclaim Care Home Costs for Free- New MSE guide

pvsol

Good Afternoon

I put a claim in back in May for fees of £88k paid to my uncles nursing home. Finally the Health Authority have contacted me and are coming to see me on Wednesday to "fill in some of the blanks". Does anyone have any experience of one of these visits. The lady who called was a nurse I think who said that she is collating all the information ready to go in front of a panel next January. What would it be handy for me to have?

John_Pierpoint

It is always a good idea to create minutes of any meeting and email them to the participants. Complete with any attachments of copies of information that boost your case.

Beware of the investigator's "hidden" agenda and better knowledge of bureaucratic procedures.

nikinackyloo

I wonder if anyone could quickly advice, my nan was hospitalised in 2004 and went straight into an EMI home from hospital as she had dementia, my grandad was alive and they both had savings and a property so he paid for her care up until her death in May 2010 - my grandfather has now passed away, am I right in thinking we have firstly left it too late to claim and secondly cant do anything as my grandfather has since passed away?
many thanks in advance if anyone can help ?

little_acorn_2

Our situation is different to many in that my father has been fast-tracked and awarded CHC because of his rapidly deteriorating health.

My problem is that CHC commissioning team have proposed nursing homes (or care homes with nursing) that are 20 miles, and a 50 minute drive away, from where my mother lives in the country. (At 80 she still drives and has been visiting him every day in hospital for four months). I am not prepared to see/allow my mum to drive almost two hours every day through the winter so have rejected the homes for this reason.

We found another home 6 miles away that can provide the palliative nursing care he needs (they have done the pre-admission assessment) but it transpires they have reached the limit of the number of residents they are prepared to accept with CHC funding because the rate falls well short of their fees. The PCT have told us we cannot make up the difference because NHS care must free at the point of contact. They also said that if we self-fund we will be voluntarily removing ourselves from the CHC funding system. Since my dad may only have weeks to live, we are moving him to the local home anyway.

Does anyone have any advice about how I should tackle the PCT? How can I formally reject the homes they propose without prejudicing future funding? etc

Any advice, or pointers of where to go for help, would be greatfully received.

monkeyspanner

little_acorn wrote: »

Our situation is different to many in that my father has been fast-tracked and awarded CHC because of his rapidly deteriorating health.

My problem is that CHC commissioning team have proposed nursing homes (or care homes with nursing) that are 20 miles, and a 50 minute drive away, from where my mother lives in the country. (At 80 she still drives and has been visiting him every day in hospital for four months). I am not prepared to see/allow my mum to drive almost two hours every day through the winter so have rejected the homes for this reason.

We found another home 6 miles away that can provide the palliative nursing care he needs (they have done the pre-admission assessment) but it transpires they have reached the limit of the number of residents they are prepared to accept with CHC funding because the rate falls well short of their fees. The PCT have told us we cannot make up the difference because NHS care must free at the point of contact. They also said that if we self-fund we will be voluntarily removing ourselves from the CHC funding system. Since my dad may only have weeks to live, we are moving him to the local home anyway.

Does anyone have any advice about how I should tackle the PCT? How can I formally reject the homes they propose without prejudicing future funding? etc

Any advice, or pointers of where to go for help, would be greatfully received.

I am sorry to hear of your Dad's condition. I am not sure about your particular situation but if this were council social services wishing to move a resident to a cheaper home they would have to do a health and safety review. The review would take into account aspect of the patient's wellbeing like the ability to have visits from relatives. I believe the PCT are being unreasonable to expect your mother to travel 20 miles to visit and her inability to undertake the journey would be detrimental to your fathers health. You are doing the right thing concentrating on your parents. Perhaps a letter to the PCT outlining your objections to their position and requesting an independant review.

monkeyspanner

nikinackyloo wrote: »

I whttp://forums.moneysavingexpert.com/newreply.php?do=newreply&p=57937793onder if anyone could quickly advice, my nan was hospitalised in 2004 and went straight into an EMI home from hospital as she had dementia, my grandad was alive and they both had savings and a property so he paid for her care up until her death in May 2010 - my grandfather has now passed away, am I right in thinking we have firstly left it too late to claim and secondly cant do anything as my grandfather has since passed away?
many thanks in advance if anyone can help ?

I believe a claim should have been lodged with the local PCT by the 30/9/12 deadline for the period you mention This applies to England diffeerent rules apply to Wales Scotland and N.I.. This article might help explain http://www.hughjames.com/news/news_library/2012/march/care_home_fee_claims.aspx#.UM5DCawcXlY

Could I just say that it might be worth checking if your nan should have been self funding. I say this for a number of reasons.
1. If your grandfather still lived in the family home the value of the property should have been excluded from any assessment.
2. Only your nans savings should have taken into account and if these were less than the savings limit (about £22000) the council should have assisted with funding.
3. Your grandfather was not obliged to use his savings to pay for your nans care.

Hope this helps

monkeyspanner

pvsol wrote: »

Good Afternoon

I put a claim in back in May for fees of £88k paid to my uncles nursing home. Finally the Health Authority have contacted me and are coming to see me on Wednesday to "fill in some of the blanks". Does anyone have any experience of one of these visits. The lady who called was a nurse I think who said that she is collating all the information ready to go in front of a panel next January. What would it be handy for me to have?

Is this a panel to look at a retrospective claim or an independant review panel because you are challenging a previous decision to deny funding?

little_acorn_2

monkeyspanner wrote: »

I am sorry to hear of your Dad's condition. I am not sure about your particular situation but if this were council social services wishing to move a resident to a cheaper home they would have to do a health and safety review. The review would take into account aspect of the patient's wellbeing like the ability to have visits from relatives. I believe the PCT are being unreasonable to expect your mother to travel 20 miles to visit and her inability to undertake the journey would be detrimental to your fathers health. You are doing the right thing concentrating on your parents. Perhaps a letter to the PCT outlining your objections to their position and requesting an independant review.

You make a good point regarding my Mum's inability to undertake the journey being detrimental to my father's health. I will add that to the letter I'm currently composing to the PCT.

Thank you for your support.

pvsol

monkeyspanner wrote: »

Is this a panel to look at a retrospective claim or an independant review panel because you are challenging a previous decision to deny funding?

Hi,
Thanks for your reply. No this is the initial claim, my uncle was in the Nursing Home for 4 years before he died and although he did get "middle band " nursing care, his brothers had to sell the house to pay for his care and paid £88k in total from my uncles own money before he sadly passed away. They contacted the Local PCT back in May 2012 and having chased them and chased them, they finally had a lady round last month who asked lots of questions about my uncle , she had his hospital records and GP records but at that point still hadnt got the records from the Nursing Home, but she said that was the next thing that would happen.
Apparently it will then go in front of a panel which she said would hopefully be this month and they would make a decision and let my uncles executors know the outcome.
Is it normal for this to have taken from last May and has anyone had any experience of these panels ?
Many thanks.

hopeful21

I submitted a retrospective claim in January 2012 and it will go for a hearing at the review panel in March this year. I understand my county has one of the shortest waiting time and cases can take 3 years!

pvsol wrote: »

Hi,
Thanks for your reply. No this is the initial claim, my uncle was in the Nursing Home for 4 years before he died and although he did get "middle band " nursing care, his brothers had to sell the house to pay for his care and paid £88k in total from my uncles own money before he sadly passed away. They contacted the Local PCT back in May 2012 and having chased them and chased them, they finally had a lady round last month who asked lots of questions about my uncle , she had his hospital records and GP records but at that point still hadnt got the records from the Nursing Home, but she said that was the next thing that would happen.
Apparently it will then go in front of a panel which she said would hopefully be this month and they would make a decision and let my uncles executors know the outcome.
Is it normal for this to have taken from last May and has anyone had any experience of these panels ?
Many thanks.