NHS Continuing Healthcare funding cap?

monkeyspanner

A friend's husband has been admitted to a care home under a guardianship order. He has advanced alzheimer's requiring 24 hour care and has multiple care need due to his condition. Our friend has been informed that most of his care home fees will be funded but £400 a month will come from his pension. Apparently this figure has been "agreed" between the council and NHS at a meeting our friend did not attend. This contribution will mean our friend will have to claim pension credit.

Our friend believes her husband is being funded by NHS continuing healthcare. However it was my understanding that a CHC award meant that all care home fees would be met by the NHS.

Has anyone had a CHC award "capped" or any knowledge that this capping is possible?

margf

Hi

My friend is in the same position with her father and is having to top up the shortfall (hers is in the region of £160/ month) she was given a maximum amount per month they would fund but very few homes were charging this and with one home she looked at the shortfall was £85 per week.
I just had a quick search and found this taken from a Bromley Council document The standard rates for 2013/2014 are: Residential care £ 530.00
Residential care for people with dementia (Sometimes called Elderly Mentally Infirm care) £556.00
Care homes with nursing up to £720
It would appear that any charges over the tariff have to be paid

Marg

converted

If your friend is being asked to pay towards care, it means that he did not qualify for NHSCC and is being funded by the Council as such his income with a sum deducted for a residential allowance pays towards the cost of his care. She should have had a letter from the NHS explaining that he did not meet the criteria for NHSCC.

monkeyspanner

converted wrote: »

If your friend is being asked to pay towards care, it means that he did not qualify for NHSCC and is being funded by the Council as such his income with a sum deducted for a residential allowance pays towards the cost of his care. She should have had a letter from the NHS explaining that he did not meet the criteria for NHSCC.

That was the conclusion I reached but could not reconcile the published council support rates with or without the NHS nursing supplement with the support figures our friend had been given.

She has not been given the result of any CHC award assessment or decision. In addition she believes her husband has savings over the savings limit and therefore would not be council supported.

converted

I can see why she is confused - if savings are over the threshold then he would not attract council funding! The support rates from the council would entirely depend on his income. Normally you are not asked to pay towards care if health are paying (unless the home selected is too expensive and they have put a cap on what they will pay). She should contact the discharge planning team at the hospital and ask to speak to the nurse who completed the DST (decision support tool - completed at the meeting your friend did not attend) they will be able to advise if he has been put forward for NHSCC

monkeyspanner

converted wrote: »

I can see why she is confused - if savings are over the threshold then he would not attract council funding! The support rates from the council would entirely depend on his income. Normally you are not asked to pay towards care if health are paying (unless the home selected is too expensive and they have put a cap on what they will pay). She should contact the discharge planning team at the hospital and ask to speak to the nurse who completed the DST (decision support tool - completed at the meeting your friend did not attend) they will be able to advise if he has been put forward for NHSCC

Thanks. Her husband was taken straight from the family home under a guardianship order when his GP felt she could no longer manage his condition. This was not at her instigation and the care home was not selected by her.

This unusual situation means that as far as I am aware a discharge team was not involved. I will try to feed her some questions to ask in order for her to obtain a clearer picture.

I wonder under these circumstances how any sane person could say his needs are not primarily medical.

DiggerUK

Me and Mrs D have inherited the responsibility for an uncle with dementia/downs.
We are surprised to find he does not get CHCF, instead he is under the care of Social Services.
He has been placed in a new home and we are going through procedures to get him referred and assessed for CHCF. I came here to look at the old threads, only to find them gone.

We have also found that the rules have changed since we were last involved with the procedures. Any help welcome.

Savvy_Sue

Is this the thread you're looking for?

inholms

NHS funding; Be Warned! Don't take it lying down Fight Back!

Last week I participated in a meeting with an NHS assessment nurse and my father, who is in a nursing home in Gillingham, Kent to see if the NHS would contribute to my 92 year old fathers nursing fees. She produced pages of a tick box score system which apparently goes to a local panel of 'professionals' for them to decide if they would provide funding.

My father is currently bed ridden, doubly incontinent, unable to feed himself and can hardly move. Yet I get a phone call today to say that 'the panel had met and deliberated my fathers case, and had decided that he was not entitled to any funding because he does not meet the criterion'

One has to question just how ill do you have to be to meet the 'criterion'?

it was quite clear from the start that the scoring method was crudely weighted to ensure the NHS gets away with paying nothing. For example; my father, double incontinent and bed ridden On that page the score was 'MODERATE' as it was for most other pages as there is a higher level of illness with the classification of 'SEVERE' In this case, to qualify you have to have a daily surgical procedure for your incontinence!

How can a government department get away with such cynical trickery and treating people as idiots? The meeting was a charade, a waste of everyones time and I wonder how so called 'professionals' can bring themselves to participate in such a dishonest sham.

I now realise that this is going on across the country and most of it is illegal. This needs to be challenged, maybe through a 'Class Action'. In an Election Year this could have very serious ramifications and well deserved payouts to all those who have been shafted!

pmlindyloo

This might be useful as regards the assessment:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213138/NHS-CHC-Checklist-FINAL.pdf

pineapple123

Inholms , CHC funding is based on health needs not nursing needs. A person such as your father has many nursing needs but does he require specialist nurse care for example an individual may need help with feeding, anyone can feed someone (nursing need) but has that person also been assessed as have difficulty swallowing, risk of choking maybe need thickend fluids etc (this is now a health need) and should mean in a care setting only someone who is trained not necessary a qualified nurse should be feeding that person. Can you see the difference. CHC is complex difficult to obtain depends on having several health needs and can be taken away even after its been awarded.