Continuing Health Care - Preparing to fight PCT's decision

greenflamingo_2

Thanks everyone - re. Attendance Allowance - we have been waiting quite a few months for the POA - I think the average time is around 4 months waiting! Can I apply for Attendance Allowance before POA is granted or should I wait? I do have a letter from the POA people to say it will be granted week commencing 13th October - would this suffice for the application or should I wait until I get the actual papers?

So I am quite within my rights to withdraw my fathers savings and not declare them on the form (so we have renovate his property)? Obviously I dont want to start getting the builders in if the health authority then demands the money back. I dont see why they would be interested in his money anyway if they can put a deferred charge on his house?

JuneBow

Greenflamingo, although I said that awaiting the registration of the POA was "just cause" for the delay in claiming the AA, you do not want the "argument" or appeal. I would therefore apply for the AA. You can do this on his behalf. He does not need to know that you have made the claim.
State on the form, that you are signing the form on behalf of him, and also state that you are awaiting the registration of the POA docs from the court of protection.
I personally would not mention that you have had the work done. Not because I was trying to hide anything, but because it adds another complicaton. You have to remember that the first person to open the claim is a low paid clerk, who, although will know the general rules for claiming, will have to refer anything unusual to his/her supervisor. This adds to a delay, and a possible "argument".
If you are asked however, you will have to make a full disclosure. I would never, never, advocate lying on the forms.
Mostly, I would say mention everything you can, but in this case I would only mention this when/if asked.

margaretclare wrote: »

But it's surprising how many people we've met since this present crisis started who have asked me in detail about his diabetes and have expected me to know, assuming I was his 'carer'. In fact, we're 'carers' for each other, if the term means anything at all.

Totally irrelevant for the purposes for AA.

Also irrelevant is the fact that you woke up in the night to phone the ambulance. (I am assuming you did)
My mother woke up to find that my father had had a heart attack. He would not have survived if not for her. Did that make him eligible for AA? No.

You cannot bend your leg. Does that mean you cannot feed yourself? No. Cannot get into bed, dress yourself, bath yourself? Possibly, however, not necessarily. It depends on the person. But it does not mean that you need help for a substantial part (ie more than 5 hours) of the day.

So just because you cannot bend your leg, and you were slipping into a hypoglaemic coma, does not mean that you are eligible for AA and can legally claim. Those are the rules. It does not matter a jot whether you agree with them or not.

Sorry for mentioning pension credit. Do not discount it however. I just thought, with your husband being so poorly, you are worrying about money.

HTH

Ambre_Solaire

Moneyspanner

Good news ! We attended a meeting with my Mums GP, PCT representative, District Nurse, Psyciatric Nurse, Social Services representative amongst others regarding my Mums care package. The "heated discussion" last about 1 1/2 hours. At one stage I was accused of being "unfair" when I challenged the DN. The valuable information you gave me put me in strong postion and "they" seemed taken aback when I started speaking about the DST and questioning them as if I knew it all !

Here we are 3 weeks later and we have just found out today that the PCT Panel have agreed that they will continue to pay for my Mums care at home

To say I feel like a huge weight has been lifted off my shoulders is an understatement ! All we want to do is keep Mum in her home as long as possible ensuring that she is healthy and safe.

Keep up the good work !

Kind regards

Ambre

weanie

Hi
I seem to have missed something of your story - sorry. anyway - it seems to be excellent news and once again 'Monkeyspanner' seems to have provided very useful information.
It seems as if PCT are funding your Mum's care in her own home? I am facing a situation where Mum is officially in hr own home but very very often wiht me. Eventually we are aware she will go to a home. Currently some element of cost [carers] is picked up by Social Services and Mum contibutes to this from her pension. I didn't realise that PCT could also be asked to provide care or is this an alternative to S Services funding?
I am running around from one idea to another to try to get the best help for our situation.

greenflamingo_2

Well the latest situation with us is that we are now awaiting the outcome of the AA application.

The PCT informed us they were undertaking a review of my father in law (apparently this is done as routine every so often). What they havent done which they promised to do 6 weeks ago is to arrange a psychiatric and dietary assessment - so basically the review is toothless and a waste of time. We have instructed a solicitor who has written to the PCT but as yet not received any response (the review is supposed to be on Tuesday).
My FIL was admitted to hospital last Friday over the weekend with an ongoing chest infection and was weighed infront of us (he couldnt move without two nurses getting him out from bed) - he weighed 6 stone. Basically he has lost 50% of his body weight in 12 months yet the PCT report states "no special dietary requirements" !! Personally I cannot understand how the PCT thinks this is acceptable in a frail gentleman of 78. He was then discharged on Monday back to the nursing home. I just hope that the PCT are not stupid enough to carry out the assessment without these reports and us not being in attendance.

malid

greenflamingo wrote: »

Well the latest situation with us is that we are now awaiting the outcome of the AA application.

The PCT informed us they were undertaking a review of my father in law (apparently this is done as routine every so often). What they havent done which they promised to do 6 weeks ago is to arrange a psychiatric and dietary assessment - so basically the review is toothless and a waste of time. We have instructed a solicitor who has written to the PCT but as yet not received any response (the review is supposed to be on Tuesday).
My FIL was admitted to hospital last Friday over the weekend with an ongoing chest infection and was weighed infront of us (he couldnt move without two nurses getting him out from bed) - he weighed 6 stone. Basically he has lost 50% of his body weight in 12 months yet the PCT report states "no special dietary requirements" !! Personally I cannot understand how the PCT thinks this is acceptable in a frail gentleman of 78. He was then discharged on Monday back to the nursing home. I just hope that the PCT are not stupid enough to carry out the assessment without these reports and us not being in attendance.

When my uncle was admitted to hospital from the nursing home, I was told that if it was determined that there was nothing they could actually do in terms of treatment, he would be discharged back to the nursing home (which in Wales would mean he came under the jurisdiction of the LHB - similar to PTC in England). It was at this point I vigorously pursued the CHC insisting that I wanted it carried out before any such discharge. The nursing staff instigated a review which meant he was not discharged until this took place. As you will have seen from my previous posts, my uncle passed away a few hours before the review took place.

Since then, my aunt has received a bill from the nursing home (where he was for 11 days only) for 'chiropody treatment and personal grooming products'. I have sent a response on a very stiff piece of cardboard and no payment.

monkeyspanner

Ambre Solaire
So pleased you have had a successful outcome.

Weanie
The normal arrangements for home care are that this is part funding by social services, the level of funding varies from council to council and is normally means tested. The care was traditionally provided by council employed teams but in many councils this has been contracted out to third party private providers. Some councils also provide direct payments as a form of alternate funding where the 'client' has to contract their own service provider funded partly by council funds.

NHS continuing healthcare funding is provided in cases where the patient has a primary healthcare need. i.e. they have medical needs which outweigh their domestic needs. See my other posts for how this assessments is made. Care which is CHC funded can be provided in any setting including the patient's own home. It used to be stipulated that all CHC funded care had to be provided by medically qualified staff e.g. registered nurse, doctor etc but this has been viewed as too proscriptive and I believe quidance has been changed.

Green Flamingo
This kind of dramatic weight loss should certainly be viewed as a serious need. When my MIL had a retrospective review for CHC funding her weight loss in hospital which was much less significant was taken into account in her CHC funding assessment.

greenflamingo_2

Monkeyspanner and everyone- we have now found out that my fil lost two stone between September and November. The dietician is supposed to be visiting him today at the nursing home where I suspect he will come out with the usual and say there is nothing wrong with him; hopefully she will see through this and notice he is all bones and no fat! Because he has breathing issues I am thinking he is using more calories as he struggles to breathe at times - hence the weight loss.

We are supposed to fill in the form giving details of my fil savings (which will be £0K if we take out his savings to renovate his property for rental) or it says on the form that he will have to self fund all the nursing home costs. I am still not sure whether I should remove the savings and then send off an up to date statement to Adult Care showing no savings. If I keep the savings in the account they may try and insist that the nursing home fees are paid out of them until they are all gone and then we cannot renovate the property for a rental income. Also even though he was awarded the higher nursing element payment I do not know where this has gone as we have never seen any such payments - once awarded does this money go straight to Adult Services or to the nursing home without even hitting my fil's current or post office account? Once awarded was there something else we needed to have done to get the money - I am very confused about all this.

It says on the financial form that if you dont fill it in then you are liable to pay the full nursing home costs - but does this mean £500 per week less the nursing element?He is currently paying the home £100 per week out of his own money so where does the nursing element part go to? We want to go down the route of putting a charge of his property (which is an option offered) so therefore do we have to fill in this form giving details of Post Office/Current Account or can I just refuse to fill
the form and ask for a charge to be put on property instead?

I was hoping that the reassessment would have been done by now but unfortunately we are still waiting for GP records and dietician reports.

I have managed to put off the financing issue for a month until end November, and am wondering if I can try again to put off for another month?

Should I be enquiring about where the nursing element is ? Also I am wondering if it would be a good idea to have an independent medical assessment of my fil. Our solicitor has suggested an independent nursing assessment, but at £2K it seems very expensive ! Lots of things to think about and I dont have a clue!

margaretclare

DH was in hospital for 4 weeks fighting a severe infection - an abscess in a replaced knee-joint which spread to a generalised septicaemia - and in that time he has lost quite a bit of weight. Not that it matters in his case, but it obviously would in a person who is thin to start with. Struggling to breathe, fighting an infection, all those kind of things use up more calories.

Since DH has been home - 10 days - I would challenge JuneBow's assertion above that he does not need 'care'. He needs help with all the things that AA is meant to be about. He can't get into the shower so he needs me to wash him. He needs help with dressing. He can just hobble about indoors on crutches, but that's about all. Because of this infection his diabetes control is all over the place, and I have sometimes had to give him jam and bread at midnight. He couldn't get up to get it for himself. The powerful antibiotics given to combat the infection have resulted in a beautiful case of thrush all around his unmentionables, which wasn't even noticed before he was discharged from hospital, and which needs treating very tenderly with Canesten cream.

It is practically a full-time job, never mind 5 hours a day.

fredsnail

greenflamingo wrote: »

We are supposed to fill in the form giving details of my fil savings (which will be £0K if we take out his savings to renovate his property for rental) or it says on the form that he will have to self fund all the nursing home costs. I am still not sure whether I should remove the savings and then send off an up to date statement to Adult Care showing no savings. If I keep the savings in the account they may try and insist that the nursing home fees are paid out of them until they are all gone and then we cannot renovate the property for a rental income.

When we were given a financial assessment form we were asked to supply 12 months worth of statements etc to support the balances entered on the form. You may need to tread carefully on taking out the savings if you have a jobsworth - even though what you're planning makes far more sense.