Continuing Health Care - Preparing to fight PCT's decision

monkeyspanner

Although CHC funding is available in any setting it is more usual to be in a care home setting. I have seen what you describe about treatment of carers by agencies but that was in relation to direct payments for "at home care" but not full time care.

As far as putting the CHC funding at risk logic would say it shouldn't unless there is a change in your SIL's care needs. I do, however, fully understand your reluctance to open discussions with the PCT which could initiate a review. Normally CHC awards are reviewed on a regular basis. There does not seem to be a set period and it varies from PCT to PCT but initially it is usually 3 months and thereafter 6 months but can be longer. So it would be difficult to predict the PCT's reaction, which of course is your dilema. On the positive side if you were employing the carers directly it would probably lead to a reduction in what the PCT pay but they may prefer to deal with "fellow professionals" i.e. the agency.

You mention end of life care has your SIL been "fast tracked" or was it a standard CHC assessment?

DiggerUK

I asked for advice to help my sister with funding for her in laws just before Christmas.
It all worked out well, and she received the proper help for both Barry and Wendy.
Both have now passed on, Wendy going just after Whit weekend, Barry at Easter.

Many thanks to all the dedicated work put in by the 'Usual Suspects', I hope what goes around, comes around for you.

To all others seeking assistance; do not let them grind you down, take courage from the successes generated here.

Mr.&Mrs.D.

monkeyspanner

Sorry to hear your news but thanks for the update on your sisters success and encouragement.

realshannon

update from me - MIL now back in hospital and we are now advised she needs a nursing home - the MDT have arranged NHS Supportive Discharge Scheme funding but apart from a small leaflet we were given, cant find out much about it. anyway, still lots of letters to and fro from PCT and the merry band of people you write to who then write back and say, Not me, passed onto anon - another wait for response, to be told, Not me ... etc etc -it is a farce, I really dont know how they get away with it! The NHS does need a reform, there are too many managers and people, frankly, that dont know what they are talking about - any feedback are supportive discharge scheme would be useful please? thanks

NotSoWise

Early supported discharge scheme

Either google it or look on your hospital's website possibly under the department that is treating. I know this isn't the problem your mil has got but gives an idea:

Orthopaedic Hospital at Home Team
The Hospital at Home Team is a service for Orthopaedic patients who have undergone hip or knee replacement or other surgery at Musgrove Park Hospital.

This supported discharge scheme allows patients to leave hospital earlier than may otherwise be the case.
Experienced orthopaedic staff will support you at home with regular visits usually until you are ready to be discharged from the scheme.

We have found that patients tend to recover faster and feel better in their own home. Early discharge also helps in reducing the risk of hospital aquired infections.

At present only patients who live within a 5 mile radius of the hospital or live within the TA6 post code area are included in the scheme and we will soon be covering the area around Minehead, Watchet and Williton.

realshannon

Thanks, have Googled already but still nothing very much on it - she is actually, health wise, worse now - she was in a residential home, hence the continuing care saga, but now is going into a nursing home from hospital, which maybe tomorrow, the home tell us so but the hospital havent said anything yet. I am really trying to be positive and hope that this could be a precursor to continuing care being sorted but at least NHS are paying - I dont agree with her being discharged to be honest, she is still so poorly but maybe she will improve in a different environment, who knows, will soon find out. Have to say the MDT person who organised this was very good and supportive, actually felt like he was on our side and trying to do what was the right thing but time will tell - update to follow

pixelchick10

Hi all ... and thanks to all of you who post on here and encourage those of us currently fighting CHC battles. Presumably if the hospital have said that social services will fund care home fees while a CHC appeal is underway this is wrong? The NHS should be paying - right? I suspect the hospital are pulling a fast one. They're desperate to get my mum out and would try anything. Any thoughts greatly appreciated.

monkeyspanner

pixelchick10 wrote: »

Hi all ... and thanks to all of you who post on here and encourage those of us currently fighting CHC battles. Presumably if the hospital have said that social services will fund care home fees while a CHC appeal is underway this is wrong? The NHS should be paying - right? I suspect the hospital are pulling a fast one. They're desperate to get my mum out and would try anything. Any thoughts greatly appreciated.

I believe the only obligation for the hospital is to carry out an initial CHC cheklist this is in the CRAG guidelines. This is normally delegated to the hospital discharge team. I assume that you have had a checklist followed by a full DST based assessment, and funding has been declined.

In that event if savings were above the minimum savings limit (over £23250) the patient would be expected to be self-funding until such time as an appeal can be heard by an IRP (independant review panel). If there was a favourable outcome then fees paid would be refunded.

If savings are under the limit then the social services would assist with funding up to the standard funding for the level of care required. The patient would be expected to contribute the majority of their income including state pension, a weekly allowance of around £20 is retained by the patient for personal needs. If social services contribute then Attendance Allowance will cease 4 weeks after going into the care home. Again if the appeal result is favourable payments made will be refunded.

As you say the hospital will be keen to free up the bed space but if you can do not be rushed into a decision about care homes. It is important to get the right one and also to be clear about the funding arrangements. You may be asked to sign a 3rd party funding top-up agreement. This is commonly put to relatives as standard practice and is essentially to fill the gap between the social services standard rates and the rate the care home wishes to charge. You do not have to sign this agreement and no 3rd party is obliged to assist in care home funding. If the council cannot find a care home that is willing to take the patient at the councils standard rate the council have to make up the difference. It is also important to obtain the correct care level assessment because this will make a difference to the councils support level.

Hope this helps. For a more detailed explanation have a look at the fact sheet provided here www.counselandcare.org.uk

Trebor16

Social services always try the top up con, but tops should only be paid if a home was offered and you opted to go for a better one, or wanted a room with a view which costs more.

You have no legal obligation whatsoever to pay top ups and this is made clear in the Health and Social Care Act 2008. Section 147 repealed the section of the National Assistance Act 1948 which allowed local authorities to pursue liable relatives for any costs incurred in the care of a person.

The hospital also have to comply with the Delayed Discharge (Continuing Care) Directions 2009 and they must carry out a proper assessment before they can pass the case over to social services.

You could always take the route of refusing to pay while any appeal is pending. In my opinion the National Framework is contradictory in relation to when the NHS can stop funding care home plaements they are paying for.

realshannon

we were told by the hospital, at the most recent admission, July 2011, that the CHC checklist couldnt be done as they didnt feel she was at her optimum level - she would improve once out of hospital and then it would be the best time once she had achieved her best level of recovery. Despite raising it at every opportunity, no, it wouldnt be done. There has been no improvement, however, see my post above, when she was discharged to a nursing home, which we found and researched etc, she is now on supportive discharge team via NHS. Today, we have heard that following an assessment by the rapid intervention team, they deem she is at her optimum and a CHC checklist will be done and if positive, followed straight away by the assessment. Maybe I am winning - nothing has got better and in the big scheme of things she has deteriorated, but that is her best optimum level - crazy world - will update in a couple of weeks when hopefully this CHC will be sorted - dont give up and dont forget alot of the people who you will talk to, wont know about Data Protection and CHC and they are just fobbing you off as they are busy and dont know how to deal with your query