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  • FIRST POST
    • SVFM
    • By SVFM 16th Dec 16, 9:49 PM
    • 28Posts
    • 76Thanks
    SVFM
    Nhs continuing healthcare
    • #1
    • 16th Dec 16, 9:49 PM
    Nhs continuing healthcare 16th Dec 16 at 9:49 PM
    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.
Page 1
  • archived user
    • #2
    • 17th Dec 16, 2:02 PM
    • #2
    • 17th Dec 16, 2:02 PM
    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.
    • elsien
    • By elsien 17th Dec 16, 2:07 PM
    • 19,247 Posts
    • 48,861 Thanks
    elsien
    • #3
    • 17th Dec 16, 2:07 PM
    • #3
    • 17th Dec 16, 2:07 PM
    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.
    • SVFM
    • By SVFM 17th Dec 16, 5:01 PM
    • 28 Posts
    • 76 Thanks
    SVFM
    • #4
    • 17th Dec 16, 5:01 PM
    • #4
    • 17th Dec 16, 5:01 PM
    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
    • elsien
    • By elsien 17th Dec 16, 8:56 PM
    • 19,247 Posts
    • 48,861 Thanks
    elsien
    • #5
    • 17th Dec 16, 8:56 PM
    • #5
    • 17th Dec 16, 8:56 PM
    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.
    Last edited by elsien; 17-12-2016 at 8:58 PM.
    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.
    • Pollycat
    • By Pollycat 18th Dec 16, 7:15 AM
    • 22,663 Posts
    • 61,276 Thanks
    Pollycat
    • #6
    • 18th Dec 16, 7:15 AM
    • #6
    • 18th Dec 16, 7:15 AM
    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
    • Biggles
    • By Biggles 18th Dec 16, 8:19 AM
    • 7,611 Posts
    • 5,016 Thanks
    Biggles
    • #7
    • 18th Dec 16, 8:19 AM
    • #7
    • 18th Dec 16, 8:19 AM
    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
    Originally posted by Pollycat
    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.
    • SVFM
    • By SVFM 3rd Jan 17, 9:57 PM
    • 28 Posts
    • 76 Thanks
    SVFM
    • #8
    • 3rd Jan 17, 9:57 PM
    • #8
    • 3rd Jan 17, 9:57 PM
    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.
  • archived user
    • #9
    • 9th Jan 17, 9:13 AM
    • #9
    • 9th Jan 17, 9:13 AM
    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.
    • FluffyVal
    • By FluffyVal 15th Jan 17, 3:59 PM
    • 12 Posts
    • 14 Thanks
    FluffyVal
    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.
    Always carry a sturdy hairgrip!
    • SVFM
    • By SVFM 15th Jan 17, 7:06 PM
    • 28 Posts
    • 76 Thanks
    SVFM
    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.
  • archived user
    SVFM - that's wonderful news. Well done for persevering! Be aware that there will likely be a three-month review. Stand your ground - and make sure you're involved and invited. Funding should stay firmly in place. The only reason it should ever be removed is if care needs reduce BUT only if they reduce to below the level of eligibility.
  • archived user
    Fluffy Val - thanks for your very kind words. Appreciated.
    • ThemeOne
    • By ThemeOne 17th Jan 17, 8:00 AM
    • 1,261 Posts
    • 1,035 Thanks
    ThemeOne
    You must be so relieved SVFM and congratulations on persevering with this.

    In my case I had managed to get my father into a hospice, and he then transferred to a nursing home. He got CHC, and I never had to do anything - was just told he'd be getting it and no nursing home fees would be payable.

    Perhaps this was a case where the system worked as it should, or maybe if someone's already in a hospice, CHC is pretty much automatic if they transfer somewhere else?
    • FluffyVal
    • By FluffyVal 17th Jan 17, 10:17 AM
    • 12 Posts
    • 14 Thanks
    FluffyVal
    Well done SVFM!
    IMHO once Continuing Healthcare has been awarded then the case is made that continuing care and support for illness is established. It should then be very difficult to take it away. In theory at least lol
    Always carry a sturdy hairgrip!
    • Pennylane
    • By Pennylane 27th Nov 17, 7:38 PM
    • 2,091 Posts
    • 6,004 Thanks
    Pennylane
    Wow! I so wish I had seen this thread earlier. My mum was in hospital very poorly and I heard about CHC and asked them to assess her. I made sure I was there and the nurse and I went right through and she got several As and Bs, mainly because I upped what the nurse said but we were in agreement.

    A few days later she appeared with the document and said she had given it more thought and altered it as she felt Mum was now more able. It was therefore downgraded and she said much as she would like to, Mum wasn't eligible.

    I wish I had had the confidence to argue or stand my ground.
    • AdzWSM2019
    • By AdzWSM2019 3rd Mar 19, 7:37 PM
    • 1 Posts
    • 0 Thanks
    AdzWSM2019
    Can anyone help me?? My grandmother is having a NHS continuing care assessment in a couple of weeks.

    She is in the nursing home receiving palliative care after leaving hospital from a stroke. She cannot eat or drink solids, she cannot walk, she is also using a catheter.....

    She has no funds from savings and I am wondering if the continuing healthcare will be granted as she is a home owner?

    Some advice no matter how big or small or what to expect will be much appreciated


    Adz X
    • elsien
    • By elsien 3rd Mar 19, 7:42 PM
    • 19,247 Posts
    • 48,861 Thanks
    elsien
    Finances/assets have no effect on CHC funding.
    If she's palliative, I would expect them to use the fast track process.

    Simple breakdown of the process:
    https://www.mariecurie.org.uk/help/support/terminal-illness/care-needs/continuing-healthcare-assessment
    Last edited by elsien; 03-03-2019 at 7:48 PM.
    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.
    • Keep pedalling
    • By Keep pedalling 4th Mar 19, 7:40 AM
    • 6,568 Posts
    • 7,644 Thanks
    Keep pedalling
    Does anyone hold power of attorney for her?
    • balooney2000
    • By balooney2000 6th Mar 19, 3:59 PM
    • 70 Posts
    • 4 Thanks
    balooney2000
    I have/had 2 relatives in a nursing home (one has now passed away). At the end of 2017 I asked why neither had ever been assessed for CHC. Each was awarded free nursing care when they became resident in a nursing home, but has never been assessed since, despite continuing decling health.

    Social services agreed and conducted the assessment for each relative. Despite scoring the top level on many of the categories, it was not awarded

    I was told it was because they didn't score in enough categories at the highest level. Some categories were not applicable to them and so they could never score in these categories, thus downgrading what the overall score.

    I then involved a solicitor to launch an appeal for both relatives. We have just had a Local resolution meeting with the local health authority, and are awaiting the outcome. However, we were warned that if a person has predictable decline in their health e,g through dementia, that is not considered complex and therefore they won't qualify. I did say to them "How ill does a person have to be?"!!

    This has been going on for over a year and in that time one relative has passed away. I'm not holding my breath, since it seems to be very difficult to obtain this funding. Health authorities will use every excuse not to have to pay out, even when there are primary health needs.
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