Reclaim Care Home Costs for Free- New MSE guide

in_need_of_help_2

monkeyspanner wrote: »

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.

Thank you, i will use this information i know she had the assessment done as i saw it, didnt realise its importance at the time, now need to get a copy, will try my contact with the stoke hub team, and if no go the pct. Many Thanks

SocialCare

grandmabirch wrote: »

My Grandma was cared for in her own home (she had severe Parkinsons). My Grandparents were told that because they had savings, they would have to pay for the entire costs themselves. Can these costs of a live in carer be reclaimed?
Many thanks.

Hi. The original wording of this and similar articles probably isn't the best. It's not simply reclaiming all money for everyone (MoneySpanner made some helful observations in another post comparing it to PPI reclaiming).

That said though, some people who have a primary health needs (which is the benchmark for health funding in the form of CHC funding) have been paying for their care or paying a contribution whilst social services pay the remainder.

The type of care is irrelevant. It may be a liv-in carer, a care home, nursing home, etc. The setting doesn't matter. If care fees have been paid and there is a primary health need you should make attempts to have the care fees refunded.

The fact that your Grandmother paid for all her own care is a different matter. It's either because they had over the capital limit or refused social service involvement to help with funding. Social service funding is means tested CHC funding is not. If someone is eligible for CHC funding then their complete care costs are covered. It sounds crazy I know but it's to do with the NHS being free.

speacock36

in 2003/2004 my mother-in-law was sectioned under the mental health act, placed in hospital and assessed this took around 5/6 months, she was then allowed home with free homecare morning till night until she totally deteriorated. She was then placed back into hospital for 3 months and i was told to find a suitable home for her needs (Alzheimers) by the hospital and social services, we had many meetings. She was incontinent, did not recognise people and could not hold conversations. Social Services told me they would pay some of the fees until i sold her house this was Sept 2005. In 2006 i heard about Continuing Care and applied, the process took 4 to 6 months and she was granted the funding in July 2006, i asked if it could be backdated to the date of claim but was told no. After it was awarded i received a bill for the social services payments. An assessment is supposed to be carried out each year and the next one occurred last year (hows that for consistency?) They tried to take it away from my mother-in-law but the head of the care home argued every inch of the way (she was excellent), she can no longer feed herself, completely incontinent, does not move any of her body parts and weighs the same a small child. Why assess after the first one, THEY ARE NOT GOING TO GET BETTER! People on DLA get better but do not get re- assessed that quickly! I am now going to try and claim the 11 months of fees back, I feel my mother-in-law was wrong done by in the first place, she had no savings and still had 30k mortgage from 23 years ago, i sold the house for a lot less than what they assessed. If you have good reason to think you have a case you must apply. Good luck to all!

monkeyspanner

speacock36 wrote: »

in 2003/2004 my mother-in-law was sectioned under the mental health act, placed in hospital and assessed this took around 5/6 months, she was then allowed home with free homecare morning till night until she totally deteriorated. She was then placed back into hospital for 3 months and i was told to find a suitable home for her needs (Alzheimers) by the hospital and social services, we had many meetings. She was incontinent, did not recognise people and could not hold conversations. Social Services told me they would pay some of the fees until i sold her house this was Sept 2005. In 2006 i heard about Continuing Care and applied, the process took 4 to 6 months and she was granted the funding in July 2006, i asked if it could be backdated to the date of claim but was told no. After it was awarded i received a bill for the social services payments. An assessment is supposed to be carried out each year and the next one occurred last year (hows that for consistency?) They tried to take it away from my mother-in-law but the head of the care home argued every inch of the way (she was excellent), she can no longer feed herself, completely incontinent, does not move any of her body parts and weighs the same a small child. Why assess after the first one, THEY ARE NOT GOING TO GET BETTER! People on DLA get better but do not get re- assessed that quickly! I am now going to try and claim the 11 months of fees back, I feel my mother-in-law was wrong done by in the first place, she had no savings and still had 30k mortgage from 23 years ago, i sold the house for a lot less than what they assessed. If you have good reason to think you have a case you must apply. Good luck to all!

You raise an interesting point. Many PCTs reassess only 2-3 months after CHC was granted. This is justified on the basis that patients improve after hospital discharge. This is actually the case but as day to day NHS hospital care for the elderly is so poor the care home environment provides a more normal environment and patients conditions are better managed and stabilise as a result.

There is a key point here. The CHC National Framework highlights that it is the patients underlying condition that should be assessed not its current manifestation. So if an condition is well managed this does not detract from its complexity and it must still be assessed. "A well managed need is still a need" This is often not well understood by assessors and they will try to downgrade the seriousness of a condition if symptoms have disappeared or are under control.

A typical example of this is dementia symptoms which with proper medication and careful management can be improved.(assuming the PCT in your area is prepared to pay for these drugs).

John_Pierpoint

Slightly off topic:
When the inevitable happens and the person dies, try to make sure the correct cause of death is given for the death certificate. Don't be fobbed off with pneumonia, if that is the result of getting a cold, when "do not resuscitate" is on the notes.

Never mind the health authority fudging the figures, and thus getting less funding for chronic long term disease, there just might be an In-Heritance Tax (IHT) consequence if the deceased has been involved in "active service" for their country in times of conflict.
Be aware that such people as well as getting the high level of attendance allowance, should be able to claim some support from
http://www.veterans-uk.info/pensionscompensation.htm

collins_sus

I have been trying to get CHC for my mother who has Alzheimers for nearly 4 years and I am still fighting. She has been in care in two different PCT areas and so I in effect have 2 claims going. On of the PCT's are so awkward and difficult and have done nothing but drag their heels with my mothers case. When they did the DST they said she only needed social care despite the fact she had overdosed on medication whilst still at home on several occasions, she wandered out in the early hours of the morning, couldnt remember to eat or drink or do any of the daily tasks we do as a matter of course. Her time in this particular PCT area has for some reason been split into 2. The first period of review was the first 3 months she was in this area and this decision of social care only has been appealed 3 times and they still say she only needs social care. All of this has taken 2 years alone! Now I am told that I cannot appeal again. I am still trying to get the rest of the time she has been in care reviewed. They have just done the DST for this time and still say social care only. My mother is now incontinent, does not know who I am and is totally dependant on the care home. How can they still say this? I have been to the Parliamentary and Healthcare Ombudsman and they say that the PCT/SHA have done nothing wrong in the way they have handled my mothers case but I have paperwork that shows inefficiency and maladministration all the way round. It is all so frustrating and time consuming but I will not give up

2274

Hi after a bit advice please.
I have just applied to the pct for a retrospective claim for my late grandmother.Even before there has been public knowledge about reclaiming care home fees being advertised everywhere I thought I had been unfairly treated by the authorities.My grandmother went into hospital and got transfered to a nursing home.against her wishes.She inially was in the hospital part of the home.Cut a very long story short it was such a traumatic experience it was quite unbelievable.the social services, the care home and the council it is all a big fix,they were all in together.the place should have been closed down for neglect anf employee exploitation.They just took over and never explained anything to me even though I had power of attourney.Didnt even mention CHC.However they did explain how much money they wanted with the charge they put on my grandmothers property.They took her full pension and placed a charge on the property.i was living there at the time and it had to be sold because when they took my grandmothers pension we could not afford the morgage so it had to be sold.If it is the law and you have to pay thats fair! In the case of my grandmother she was in there for health care not social she could not stand because of fluid on her legs.there was a district nurse coming in to treat her.She was in a wheel chair.The weight loss was unreal.she had toilet issues and didnt even know where she was.she thought she was living in some posh appartment that she had bought (had serious dementia issues.) just wanting to know what the procedure is for reclaim.its all like a different language for me.I cant be bothered with any stress from it all. any help would be appreciated.thanx

megansden

monkeyspanner wrote: »

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.

My mother was in a the same position with council social services making a deferred arrangement, whilst in the assisted care home the property became unfit to live in and after lots of break-ins it was decided to demolish it. Mother still had to pay fees to the home from her attendance allowance since she has died the land was sold to pay for bills etc but not the care home fees and indeed I still have some outstanding fees to pay at the moment, she suffered the same as this the above have. I think I shall start a claim (but who with?) is it the PCT? Alittle help to start would be great by the way I had POA on her estate

Thanks in advance

Gold_Star

Hello..

My father (74yrs) had a stroke in Feb 2011 and was in hospital until July 2011 where he was admitted straight to a nursing care home for approximately one month. He had has a left sided weakness, speech difficulties, poor mobility co-ordination and diabetes. He required help with bathing, dressing, walking, sometimes feeding and administering his medication and insulin. He came home in September 2011 and tended to by carers through the Council to whom my mother (74yrs) the main carer is paying. The invoice costs vary from £1000.00 - £3000.00 at irregular periods from the time he came home in September. He has been assessed by a social worker at Leeds City Council at home. What position are we in to make a claim?

MSE_Martin

Thank you for all the feedback above. We are working through it.

I wanted to get this article on the site, as it is an important issue that's not covered, and not enough people know about their rights under Continuing Health needs with the NHS.

The team and I have worked hard to get this out quickly, and in a way people understand (which I think is one of the difficulties with this issue) but we make no bones about the fact it is a new subject for us and a learning experience.

To those of you who have been through this process (or are going through it) do let us know your feedback and suggestions for improvement on the guide - we're more than happy to have them.

I've already made a few tweaks after checking up things mentioned here.

Thanks

Martin