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  • FIRST POST
    • shammygirl
    • By shammygirl 16th Apr 18, 9:26 AM
    • 7Posts
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    shammygirl
    Continuing Healthcare Question
    • #1
    • 16th Apr 18, 9:26 AM
    Continuing Healthcare Question 16th Apr 18 at 9:26 AM
    Hi

    I'm hoping there may be a number of people who have gone through this who may be able to advise.

    background:
    Until December my 97 year old Gran has been in her own home with 4 care visits per day to help with general washing, feeding, and such. In December she had a fall(onset of dementia, she forgot she couldn't walk) and ended up in hospital. From Hospital she ended up in a respite place while the relevant authorities decided what was best. it was decided she would need to go into a care home, relevant one found, and she has been there since the beginning of march.

    She had the Continuing healthcare assessment completed and unsurprisingly she didn't meet the criteria, she was only entitled to the care element 155.05 per week. We are going to appeal this as her assessment stated she had 6/7 elements that covered Major, High & moderate levels(but no complexity as shes quite a nice old lady, so no continuing healthcare funding). My mother never wanted to broach the subject of transferring her house in case of such an event so her home remains in her name.

    The piece i'm looking for advice on is at the meeting to discuss the assessment the question was asked can she go back to her own home if she only needs the care element and the resounding answer was "No absolutely not".

    my question is: is it legal for them to force her into a care home and have her pay for it herself? i can't get my head around being forced into a care home and being made to pay for it herself. Being in the care home is the right decision for her well being but in the end she has had no choice in the matter. maybe its my naivety but it just feels like legalised theft.

    Any advice/perspective greatly accepted

    thanks
Page 1
    • pmlindyloo
    • By pmlindyloo 16th Apr 18, 9:57 AM
    • 12,063 Posts
    • 13,901 Thanks
    pmlindyloo
    • #2
    • 16th Apr 18, 9:57 AM
    • #2
    • 16th Apr 18, 9:57 AM
    it may help to know the criteria for Continuing Health Acre

    The team's assessment will consider your needs under the following headings:
    behaviour
    cognition (understanding)
    communication
    psychological/emotional needs
    mobility
    nutrition (food and drink)
    continence
    skin (including wounds and ulcers)
    breathing
    symptom control through drug therapies and medication
    altered states of consciousness
    other significant needs
    These needs are given a weighting marked "priority", "severe", "high", "moderate", "low" or "no needs".
    If you have at least one priority need, or severe needs in at least two areas, you should be eligible for NHS continuing healthcare. You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.
    In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS continuing healthcare should be provided.

    When you say the care element are you talking about payment towards access to a registered nurse? So your gran is currently in a nursing home rather than a residential home?

    As to your question is it legal to force her into home? The answer is 'no' but is this what happened?

    Does anyone have power of attorney for her? Did she agree to move to the nursing home?

    With all due respect, why do you appear to have a problem with her being in a nursing home? Is it not suitable? Do you believe she could manage at home?

    If you could give answers of your concerns then someone might be able to suggest things.
    • shammygirl
    • By shammygirl 16th Apr 18, 10:46 AM
    • 7 Posts
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    shammygirl
    • #3
    • 16th Apr 18, 10:46 AM
    • #3
    • 16th Apr 18, 10:46 AM
    Thanks for the reply

    i know the criteria for the CHC assessment, my Gran was given 1 severe, 3 High, 3 Moderate and i believe some low's. Sorry i don't have the assessment to hand as my sister has all of the documentation.

    When you say the care element are you talking about payment towards access to a registered nurse? So your gran is currently in a nursing home rather than a residential home?
    My gran is in a Nursing home

    As mentioned my gran was in hospital, on exiting hospital it was deemed necessary to move to a nursing home. At this point the CHC assessment would be completed although i believe one was completed when she was in hospital too.

    Does anyone have power of attorney for her? Did she agree to move to the nursing home?
    My mother, sister and I all have enduring power of attorney. My gran is in no position to make decisions for herself. She was being assessed in her own home before her fall with regards to dementia which has escalated fairly quickly.

    As to your question is it legal to force her into home? The answer is 'no' but is this what happened?
    with regards to forcing her into a home, as she/we have been told there is no alternative then in my mind yes she has been forced as she/we have been told she can not return home

    With all due respect, why do you appear to have a problem with her being in a nursing home? Is it not suitable? Do you believe she could manage at home?
    we do not have a problem with her being in a nursing home. the problem i have is that she/we have been told she can not return to her own home but must pay the 710 p/w(less 155 NHS funding). She doesn't have enough issues to warrant full funding but has too many issues to be able to be cared for in her own home and must pay for the nursing home herself.

    If we have to pay for her nursing home by selling her house then we will, it just feels almost like she is being held to ransom because she/we have been given no alternative
    • pmlindyloo
    • By pmlindyloo 16th Apr 18, 11:06 AM
    • 12,063 Posts
    • 13,901 Thanks
    pmlindyloo
    • #4
    • 16th Apr 18, 11:06 AM
    • #4
    • 16th Apr 18, 11:06 AM
    Do make sure that she is receiving Attendance Allowance as this can be paid whilst self funding.

    I do not believe there is anything else we can help with. You are going to appeal for NHS continuing health care which is your right.

    Otherwise, if you do not believe that she can be cared for in her own home then a nursing home would seem appropriate.

    As regards funding then that is entirely a different matter and probably one for the discussion forum. (I believe there is already a discussion going on there) As it stands those are the regulations. If she has income/savings/property then she will have to self fund.

    AgeUK has some good information about paying for care.

    Is it possible to rent the house out? Would this cover the fees with any savings/pension without having to sell the property?
    Last edited by pmlindyloo; 16-04-2018 at 11:09 AM.
    • marliepanda
    • By marliepanda 16th Apr 18, 12:18 PM
    • 6,896 Posts
    • 15,037 Thanks
    marliepanda
    • #5
    • 16th Apr 18, 12:18 PM
    • #5
    • 16th Apr 18, 12:18 PM
    From your OP you seem to agree the home is the best place for her, so why are you talking about ;forcing; and ;legalised theft; and ;not given an option;

    If its the best place for her, its the best place for her. Why does it matter if she has to pay for that best place?
    Last edited by marliepanda; 16-04-2018 at 12:19 PM. Reason: Subbing apostrophes
    • sheramber
    • By sheramber 17th Apr 18, 5:54 PM
    • 5,579 Posts
    • 4,241 Thanks
    sheramber
    • #6
    • 17th Apr 18, 5:54 PM
    • #6
    • 17th Apr 18, 5:54 PM
    The local authority will have a limit as to how much they pay. They can provide the care she needs cheaper in a care home setting than individually at home.

    Alternatives?
    Could the family fund the care she needs to allow her to come home?

    Could family move in with her to look after her 24/7 to allow her to come home?
    • xylophone
    • By xylophone 17th Apr 18, 7:04 PM
    • 27,650 Posts
    • 16,612 Thanks
    xylophone
    • #7
    • 17th Apr 18, 7:04 PM
    • #7
    • 17th Apr 18, 7:04 PM
    Being in the care home is the right decision for her well being but in the end she has had no choice in the matter.
    She has a choice if she is in a position to fund ( or the local authority will fund) 24 hour care at home?

    If the nursing home is the best place for her then really that's it and all about it?


    If she does not qualify for CHC and has assets above the threshold, then she will be required to use those assets to support herself.

    Presumably she is already receiving Attendance Allowance - if this is not at the higher rate and she now needs night as well as day care she should apply for higher rate.


    https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs10_paying_for_permanent_residential_care_fcs.pdf

    https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs46_paying_for_care_and_support_at_home_fcs.pdf
    • lisyloo
    • By lisyloo 18th Apr 18, 9:35 AM
    • 22,848 Posts
    • 11,405 Thanks
    lisyloo
    • #8
    • 18th Apr 18, 9:35 AM
    • #8
    • 18th Apr 18, 9:35 AM
    was asked can she go back to her own home if she only needs the care element and the resounding answer was "No absolutely not".
    Sounds like a misunderestanding here.
    They are saying they will pay for the medical element of her care (paid by the NHS). The personal care is still absolutely required but from a financial point of view is means tested.
    She certainly can go home if she wants to fund 24/7 care (and has the room for both carers and equipment like hoists) but that will be far more expensive both in terms of the care costs and the equipment needed e.g. cot style bed with moveable sides.

    is it legal for them to force her into a care home and have her pay for it herself?
    Is there a power of attorney in place?
    If no the hospital/authorities have legal authority.
    If yes the power of attornies have the authority but the only 2 options are nursing home or care at home. She clearly cannot be safely left alone.

    i can't get my head around being forced into a care home and being made to pay for it herself.
    We are all liable for our own personal care (medical care is free and in her case is being covered by the 155).

    but in the end she has had no choice in the matter. maybe its my naivety but it just feels like legalised theft.
    None of us have any choice.
    Who do you think should pay?
    Do you think young working people should pay whilst she has any empty house.
    I'm in the same posistion (my MIL is in a nursing home with dimensia) and my view is that she should pay rather than other tax payers if she has the means.
    Regardless of my opinion or your opinion the law is that if she can pay for personal care then she should.

    It's your right to appeal but personally I don't think you will succeed because many of her needs (help with standing, walking, going to the toilet safely, eating, dressing, washing) are personal needs and not medical and whether you agree with it or not, those are the criteria.

    Does she have a will? who is executor (have they died?)
    Is there power of attorney.
    If not your might want to consider seeking deputyship under the court of protection as you will ultimately need this to sell her house as she is not capable of agreeing to the sale.
    This process takes a whilst so you might want to start it now.

    We are in the position where FIL has just died and we need to apply to the courts to sell the home that belongs to my MIL who is in the same position.

    She should be able to get attendance allowance.
    She might also be able to get pension credit (house disregarded for 12 months).
    Her home should also be disregarded for 12 weeks for care fees.
    If she has other savings e.g. cash or investments I'm don't think those are disregarded.

    If you can say what other savings (cash/investments) she has I can tell you how that affects care fees and pension credit.
    Threshold for getting free LA care is <14,250.
    Pension credit threshold is 10,000 after which savings affect the amount you get at 1 for each 500 or part of.
    Last edited by lisyloo; 18-04-2018 at 10:26 AM.
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