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Nhs continuing healthcare

edited 30 November -1 at 12:00AM in Over 50s Money Saving
41 replies 14.7K views
SVFMSVFM Forumite
28 posts
edited 30 November -1 at 12:00AM in Over 50s Money Saving
Wondered if anyone is obtaining the above for a relative and how difficult it is to get?
Relative has been in care home for 4 years and is self funding. Initially it was residential, then dementia residential and now care home want assessment carried out for nursing care (not continuing healthcare). We have looked at the decision making sheet they will use and feel that the relative meets the criteria for NHS continuing healthcare, particularly as they are in hospital at present following injuries obtained after altercation with another resident (the suggestion of nursing care was discussed prior to this occurring). We need to obtain as much information as we can in order to decide the best option for the relative when/if they leave hospital., as we are considering all options for their future care, including bringing them home to live. Thanks for any replies.
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  • SystemSystem
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    Hi SVFM

    An assessment for NHS Continuing Healthcare (CHC) should take place before anyone pays a penny in care fees - and before any health or social care professional asks about a person's financial situation. Your relative should be assessed for CHC before being discharged from hospital. This is set out in the Care Act, and yet many people working in health and social care don't have proper training and don't understand the law. Insist that a "Checklist assessment for NHS Continuing Healthcare" is done before the discharge team clear your relative for discharge. If they do say he/she is being discharged, remind them of their legal responsibilities under the Care Act to do the CHC assessment before this happens. Makes sure you're present when the assessment is done.

    There is a very important distinction between local authority (social) care and NHS care – the former is means tested, the latter isn’t. And that distinction does NOT depend on how much money your relative has; it depends only on their care needs. Remember also that CHC is available in residential care homes, nursing care homes and also in a person's own home. The location doesn't matter - nor do the qualifications of the person/people delivering the care, nor does the diagnosis a person may; what matters are their day-to-day care needs only, regardless of the cause.

    There are different stages to the assessment process. Don’t be put off by people within health and social care who may tell you it’s ‘not worth it’ or that your relative ‘won’t qualify’ or that a person has to be at ‘end of life’ or some such other nonsense. No one can say whether or not your relative should receive the CHC funding until care needs have been properly measured against the CHC eligibility criteria. Those care needs must also be viewed in the light of the legal limit beyond which a local authority cannot provide care – and beyond which any means test or financial assessment would be illegal. (Google the 'Coughlan case'.)

    The fundamental point in all of this and the deciding factor in ALL NHS Continuing Healthcare assessments is whether a person’s care needs are primarily social care needs or primarily healthcare/nursing care needs. If the latter, the person should be fully funded via CHC. This means no means testing, no financial assessments and no top up fees to pay.

    Read up on the assessment process as much as you can before the assessment (there are two main stages); the more the assessors realise a family knows what should and shouldn't happen, the more likely the assessors are to do things properly.

    Hope that helps. I have been through this process for my own family more than once - successfully - and have helped many others secure CHC funding too.
  • elsienelsien Forumite
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    As an aside, was a safeguarding alert made with regards to the altercation and injuries?
    All shall be well, and all shall be well, and all manner of things shall be well.

    Pedant alert - it's could have, not could of.
  • SVFMSVFM Forumite
    28 posts
    Thankyou Care to Be for your very informative reply.
    Good to hear that you were successful.
    I am trying to gain all the information I can myself as different 'professionals' are giving different interpretations so I will ensure that I am well prepared and will ensure that the hospital carry out the assessment before my relative leaves and I will be there.
    A safeguarding was already in place and yes the safeguarding team have been informed.
    Thanks again
  • edited 17 December 2016 at 9:58PM
    elsienelsien Forumite
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    edited 17 December 2016 at 9:58PM
    In my area, if someone in hospital is assessed to be fully funded by CHC then 3 homes (if available) are identified and relatives have 48 hours to choose one otherwise the choice is made for them.
    I can't comment on home care because the people I see don't have families, but just wanted to warn you that due to fines for delayed discharge things can happen very quickly.
    It's not as fast for someone who is only partly CHC funded because the social work required are better at following the best interests process.
    All shall be well, and all shall be well, and all manner of things shall be well.

    Pedant alert - it's could have, not could of.
  • PollycatPollycat Forumite
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    This is a very old thread so may not be relevant but this poster had the devil of a job getting CHC for her MIL:

    http://forums.moneysavingexpert.com/showthread.php?t=800521
  • Important update! We have recently reviewed and updated our Forum Rules and FAQs. Please take the time to familiarise yourself with the latest version.
  • BigglesBiggles Forumite
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    Pollycat wrote: »
    This is a very old thread so may not be relevant but this poster had the devil of a job getting CHC for her MIL:

    http://forums.moneysavingexpert.com/showthread.php?t=800521
    IIRC, the OP (monkeyspanner) became quite an expert on NHSCHC. He doesn't seem to post regularly now, but you might get his attention with a PM.
  • SVFMSVFM Forumite
    28 posts
    Thought I'd post an update on the above.
    After constantly being told by hospital staff and care home staff that we don't need to have a continuing healthcare checklist carried out in hospital we have stood our ground and insisted. We also did a report stating what we felt made them eligible for CHC stating the documented evidence to support this. Finally we have had the checklist carried out and the relative got 5A's 3 B's and 3C's. This has now been sent off to the CCG to trigger a DST to be carried. The relative is still in hospital, does anyone know how long it would normally take for the DST to be carried out. We know that if the checklist had been carried out in the care home then the CCG would have had 28 days to carry out the DST. The hospital are ready to discharge the relative however we are still stating that we want the DST carrying out before this happens. Thankyou for any responses.
  • SystemSystem
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    SVFM - well done for standing your ground a the hospital and getting the Checklist done. The whole process - from the Checklist to the actual funding decision (post DST) - is supposed to take 28 days. This rarely seems to happen. If your relative is discharged from hospital before the Multidisciplinary Team (MDT) meeting (where the DST is completed), don't pay a penny in care fees until the actual funding decision is made. The NHS has a legal duty to cover all care costs until this process is complete, regardless of whether or not your relative is in hospital.
  • FluffyValFluffyVal Forumite
    12 posts
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    care to be different helped me get my husband Contining Healthcare. I followed the advice on their website and persevered, that is a must. the recent care act mandates that assessment for continuing care must be made prior to local authority doing any financial testing. especially in hospital be firm that this happens.
  • SVFMSVFM Forumite
    28 posts
    Thanks for your advice Care to be. We had the meeting in the hospital within 7 days of the checklist being carried out and our relative has been awarded Continuing Healthcare as from the date of the meeting. Thanks for your advice which gave me the confidence to pursue this.
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