NHS funded care homes

tallyhoh

Please move if not on the right board- thanks-

We have recently realised that FIL in a care home is probably ill enough to qualify for- I think they call it- ongoing healthcare, something like that. In other words he would not pay for his care.

Anyway after being advised to ring various people after 2 days we have found out that the assessment for this had already been started without our knowledge or imput:mad: . While we are quite cross about this, it made me think further.

FIL's wife suffered with extreme dementia for years and for about the last year of her life was fed through her stomach and was unconcious for weeks on end. Yet her husband still paid for her care, albeit at a reduced rate because she had no savings. She died in 2001, is it worth taking this up?

Thank You In advance.

Biggles

tallyhoh wrote: »

Anyway after being advised to ring various people after 2 days we have found out that the assessment for this had already been started without our knowledge or input

I think the time to be annoyed would be if they hadn't responded to any changes in health condition. In fact, I understand that these assessments are normally automatic and ongoing, which should mean that the resident might well be assessed for Continuing NHS Care without waiting - maybe for months or years - until his relatives realise the family may be paying for something they were entitled to for free.

tallyhoh

Hi Biggles,

I appreciate what you are saying, very much so.

We understand there are several appeals to go through if he is not considered for free nursing care. That being the case do you think that we should be informed that rthe assessment is taking place so that we can have our say along with the people who care for him

As you say it is an "ongoing" assessment I am surprised that his wife did not qualify. Or is it a new thing?

Thank You for replying.

Biggles

I really don't know the mechanics of it, Tallyhoh, just that I was advised that, if my mother's condition deteriorated to the point where she would qualify for NHS continuing care, I wouldn't have to apply for it or demand an assessment as they would assess her automatically. I imagine it's triggered by feedback from nurses, routine visits, medical records etc.

A great deal changed after a court case a few years ago (the Coughlan case, I believe) where it was held that a resident should have been give free care but had not been, so at the time when your mother-in-law may have qualified this would not have happened. I don't know the answer to your other question, whether it's not worth pursuing that case.

tallyhoh

Thank you Biggles. Makes more sense now.

rolo1952

tallyhoh,
Within a residential care or nursing home setting clients are continually assessed in relation to their changing needs.
This will need to be recorded within the clients care plan.
In addition there is a system in place whereby a review takes place (usually six monthly). This would normally involve the client, care manager, family and staff fromthe home. This review meeting should be recorded and kept within the care plan file.
This review would consider the clients need to determine if there was any change. Have you been involved in this process ?. Have you seen a record of this ?.
It is good the the home has noticed the change in you FL.
did they contact you and inform you what was happening .
Crucial at these times is very clear and effective communication between all partys to help alleviate anxiety for the client and family members.

If you have not been involved up to this point could I suggest the you contact the home and care manager a request the you are kept notified of any change or development in the care of your father in law.

Good Luck.

beetplek

T. I realise that you must care dearly for you FIL, but unless he is not able to make dessicions on his own they will not ask you, its all part of cenfidentiality.

frannyann

As you mention severe dementia, I would assume they should have involved next of kin in any assessment. As with another thread I would suggest you check he is being assessed for Continuing Care (which pays all fees) rather than higher rate RNCC which will only pay for what the PCT will have agreed with home it nursing element of care which will be around £100 per week.

monkeyspanner

Guidelines on continuing care and the nursing element of care payments change on 1 October. Nursing element changes from 3 levels to a single level of £101/week.

sarah_h_4

Hi Tallyhoh,

Are you aware that even if someone has died you can still ask for their case to be looked at for full health funding. It is called a retrospective assessment and can lead to refund of care fee's which were paid when the person should have been funded by your local PCT. Money spanner mentions the change in the Nursing element fee's This is not a replacement for full funding it is the stage below full funding for anyone in a nursing home who is not elegable for full funding. You may benifit from visiting the department of health web site which has all the guide lines for the old critieria which your mother in law would be looked at against and also the criteria which comes into place on the 1st October this year.

Yes you should be informed the assessment is happening and also you should be kept informed as to how the claim is going on and at the end of the day you should be given the outcome. If you are not happy with the outcome then you have a right of appeal which the PCT has to guide you through.

Hope all this helps you make a successful claim.

EdInvestor

Update on the state of play here:

http://www.parliament.the-stationery-office.co.uk/pa/cm200405/cmselect/cmhealth/399/399i.pdf