Continuing Health Care - Preparing to fight PCT's decision

monkeyspanner

I would call Counsel and Care 0845 300 7585 or one of the other charities for advice on this specific issue. They gave us some very good advice regarding funding.

As fredsnail says I think it is unlikely you will be able to avoid declaring the savings.

Once you have the independant advice I would try to talk directly to the relavant finance department in your council. We actually found the finance department much more approachable than the social worker. They should be able to advise how to approach the issue of renovating and renting out the house. You will also need to discuss with them defering payments until you manage to get the income flowing.

JuneBow

Greenflamingo, as monkeyspanner has said, Counsel and Care are are good source of advice.
As far as I can see, you should qualify for NHS continuing care. You should not be therefore having to answer questions about savings etc, as this is totally irrelevant. It seems however, because of the questions about resources, your PCT is not going to come easily.
From a means testing point of view, essential repairs on a home is not deprivation of assets, and therefore if you spent the money on this, you should not face too much difficulty. I can understand why you are nervous about doing this, as you appear to be fighting on so many fronts at the moment. If you are awarded CHC, then any monies you have paid should be refunded.
However, personally, I would spend the money on the house. That is easy for me to say, because I know the system.
Sorry if I have not been as much help as monkeyspanner, but I hope your AA claim is sorted out quickly.

margaretclare wrote: »

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.

If you read my post properly, I said that because you cannot bend your knee, and have diabetes, this does not, in itself qualify you for AA. Some people with these conditions can cope quite easily. I am not sure why you have removed your original posts?

You will also note from the AA qualifying conditions that you must have needed help for more than 6 months. From what you are describing, it is the effects of the septicemia which render him incapable of looking after himself. This should clear up well within 6 months.

I can understand that you are finding things tough at the moment, are are clearly desparate for this benefit, but if you look on the disabilities thread there is a chap who is a decision maker in the AA unit, who has quite kindly offered to help.

I do think however, you should be careful. You have been found to have been less then honest in the past with your own claim. Even to the point of encouraging others to lie on their own claim form. http://forums.moneysavingexpert.com/showthread.html?p=15792319#post15792319
I am not going to reply to this again, as I think you should debate your entitlement on a separate thread. You are not adding any useful information on this rather important, and informative thread, and it really is unfair on those who genuinely require help on this topic.

margaretclare

What rubbish. I am not 'desperate for this benefit'.

The post to which you took such exception, which - as you have such a good memory - you can put your finger straight on to, was when I quoted what I had been told by a Benefits Adviser at CAB, about how best to complete the AA/DLA application forms.

I do not know whether my husband's present problems will clear up within 6 months, or whether they will last longer or will leave him with permanent problems. I do know that a few weeks ago there were two 'worst-case scenarios' facing his medical/surgical team. One was that he might not survive, the other was to amputate his affected leg above the knee in order to remove the site of infection once and for all. That threat has receded somewhat but it hasn't gone away entirely.

You know little of the Gram-positive organisms which have caused this infection, their means of attack and the antibiotics - vancomycin and teicoplanin - which are used to combat them, if you can write so blithely about 'clearing up well within 6 months'. Killing these very aggressive bugs is a long slow process, and only when the infection is finally under control can his surgeon contemplate reconstituting his knee joint. And even that is not guaranteed to be successful - that will be the 4th attempt at a replacement of that knee. 6 months? We're nearly at the end of 2 months, already. He has lost weight, he has lost muscle mass and muscle strength, he has nothing like the strength and energy that he once had. This episode has put 10 years on to him.

You accuse me of fraud. In the thread you refer back to there was someone talking of giving gifts to grandchildren: " If the money is given to the grandchildren would it show up for means testing. i.e. will the state help to pay for nursing home?"

I would have thought that this was fraud that was being contemplated, yet you have chosen to attack me rather than the OP in that thread? Although I do agree that anyone should be able to give anything to anybody, in principle.

You are not going to reply to this again. Great. You appear to have some kind of a 'witch hunt' against me personally. At the present moment, with DH readmitted to hospital and not knowing just what is going on, I can do without your comments.

Snowbird

Monkeyspanner and JuneBow, there is some very useful information here.
JuneBow, I agree about hijacking the thread, and I hope that this question does not steer the thread off topic too.
It is really to Monkeyspanner.
My mum has complex disabilities. She is very intellegent and young for her age. Because of her disabilies, most people would be entitled to attendance allowance, but she does not claim it because she has been able to manage her illnesses herself.
She is in hospital now, but she is climbing the wall.
I was thinking about trying to get 24/7 nursing care so that I can bring her home. Does that come into the category of continuing health care, and how does one go about getting it?
I had thought about paying for the nurses myself, but am now running two homes as we have moved near mum (something we were considering for some time) We have not sold our other house as the children may want to use it to visit friends etc and also, it is not a good time to sell.
We could therefore do without having to fund this ourselves.
If I can get her home even if I have to pay, I will do it, but with things as they are.....
Someone told me, I think, that you can have continuing health care in your own home. Is that right?
Also, JuneBow, does the fact that mum copes so well impact on any claim for attendance allowance. Its just that she lives on her own. She travels on her own. I know others of a more delicate disposition would not be able to cope, but it just seems unfair.
Hope I have not taken this off topic because this is such a fantastic and useful thread, I do not want to deviate from it and not allow others to benfit.
TIA

weanie

My mother has vascular dementia [among other medical problems] and the doctor suggested we conact social services to seeif there could be an input into her home care. To cut a very long story short, it is social services - the council who fund somehting called direct paymenst. These are ring fenced funds which i manage to pay two carers who cal in for two separate half hours each day. naturally we top up her care enormously ourselves. Mum was assessed by the council and she has to make a contribution weekly towards the money paid into this pot. Social Services advise me that this money could also be paid if she were ever to come to live with me. direct payments cann never fund care homes - the purpose is to allow people to 'remain in the community'. Funding from the PCT is another issue which we will have to investigate in the future.
good luck

Errata

Snowbird - does your mum absolutely need 24/7 nursing care ? If not, but needs a substantial amount of care, something called Direct Payments may be worth looking at here http://www.direct.gov.uk/en/DisabledPeople/FinancialSupport/Introductiontofinancialsupport/DG_10016128

monkeyspanner

Snowbird
As with all threads this one is developing over time. I am not too concerned about where it goes as long as stays around the topic of care/assistance for the elderly and/or infirm. I would like particularly to publicise the existence of NHS Continuing Healthcare funding because it is so difficult to access and is not properly promoted by the NHS.

It sounds like your Mum is independantly minded and like many elderly people does not want to claim benefits. I am not an expert on any of these topics and can only really speak from personal experience and knowledge picked up by reading around the topics. There is no reason why your Mum should not claim AA the advantage of it being that it is not means tested. A helpful Social Worker (dying breed I'm afraid) helped my MIL with her application. She explained that the applicant should include on the form what they could manage on their worst days. e.g. My MIL could get upstairs without assistance but only by either crawling up on all fours or shuffling up one stair at a time whilst sitting down, so she could validly say she would need assistance to walk upstairs. Having said that the more your Mum is still able to do the less likely she is to obtain AA.

Could I suggest you have a look at my previous post no: 17 in this thread for links to the relevant CHC documents. A CHC funding assessment can be requested when the hospital say your Mum is coming up for discharge. This will initially take the form of a checklist. Your Mum should be informed of the result of this and she can request a full assessment based on the new DST (decision support tool) even if the hospital say the checklist does not indicate a need. Alternatively contact the CHC department of your mum's local PCT.

The DST assesses a number of areas of need and your mum would need to score a high or severe need in several categories to be assessed as qualifying for CHC funding. Essentially the care need has to be primarily medical rather than domestic. It is a bit like arguing about how many social workers can dance on the head of a pin.

CHC funding is available in any setting including own home but the decision regarding the level of care required is not the patient's or family's although you may be able to have an input. So if you wanted 24/7 nursing for your mum but the NHS decided this was not necessary they wouldn't fund it.

I hope this helps.

JuneBow

Snowbird, you are correct about your mum and AA I am afraid. It is perhaps because she is so youthful that she is able to cope. AA is indeed awarded on need rather than diagnosis.
Ecellent illustration of this by a decision maker in the AA unit.http://forums.moneysavingexpert.com/showthread.html?t=1250001&page=3 I would personally try to claim however. You are entitled to the benefit if you need help rather than are getting help already. It may be that she actually does need help, but is not getting it as she is so independantly minded.
Even if she does not get it, take comfort from the fact that mum can actually cope. You would hate it if she couldn't.
Not much other advice I can give you I am afraid.

Snowbird

Errata, she does need 24 care at the moment. That is why the hospital are not discharging her, but she is hating it, so was thinking about getting some nurses in to look after her.
I don't think she will actually qualify for any funding, because she is getting it at the moment really, as she is hospital.
The is making good progress, and they are talking about sending her home at the weekend. I am hoping so.
I am exhausted at the moment. Lots of travelling, organising moving etc.
When she is not in hospital, I suppose she does not really need any "care" as she copes herself.(she would not lie, or exaggerate her condition)
She is looking much better, so fingers crossed all this may be totally irrelevent.
Can I ask something errata? Is the direct payments means tested?
She did have some savings, and then spent most of them. She has only about £30k now in savings (she does not own her own house) I don't like her savings to get below this, so I pay for any extras she needs eg holidays, car, furniture.
Would this level of savings disqualify her from direct payments?

weanie

Hi Snowbird
Yes - direct Payments are means tested. The social worker compiles a report, it gets written up, goes to 'panel' on the apropriate day and they decide on the need level. After this, the finance team sort out how the payments can be used and monitor the use of the money. After this - they get round to making an assessment upon the person's income and a level of contribution [or not] is decided and this has to come out of the person's account to go to D Payments. It might be like robbing Peter to pay Paul and possibly not worth it in your mum's case.
good luck