CHC (Continuing Healthcare) support thread

[Kevinl]

From today's DM.
http://www.dailymail.co.uk/money/news/article-4729936/NHS-care-fund-don-t-tell-about.html
Why they don't tell you about CHC

To be fair the whole article is about CHC I counted 6 references to it.
They do say "These so-called Continuing Healthcare rules apply to both nursing home residents and those who receive home help for physical or mental needs" But why they call it "so-called" I don't know, it is called Continuing Healthcare, but the phrase "Continuing Healthcare" is used 6 times in the article.
I found this a bit misleading "Currently, you have to finance your own care bills if you have assets of more than £23,250. This includes your home" as it doesn't mention mandatory disregards and could scare some people who have a partner with AZ.
K

 

[Louise7]

My Mum is in hospital after a fall (the first one she has had) and I got a call from the discharge team yesterday to say that she won't be able to go home as she is at high risk of falls. CHC was mentioned and also possible joint funding with the LA and they said that they would look for a bed in a nursing home. I was asked various questions which, having had a quick look on-line, are similar to those on the CHC 'check list'. I've been asked to meet with someone from the discharge team tomorrow to sign some papers. I'll try to do a bit more research before then and read through all of this thread but wondered if anyone has some advice about what I need to do/say tomorrow? What papers would I be signing? It all seems a bit quick but Mum is fit to be discharged and they need the bed.

 

[Kevinl]

I've been asked to meet with someone from the discharge team tomorrow to sign some papers. I'll try to do a bit more research before then and read through all of this thread but wondered if anyone has some advice about what I need to do/say tomorrow? What papers would I be signing? It all seems a bit quick but Mum is fit to be discharged and they need the bed.

Why would you need to sign any papers? If they return her property: clothing, money, jewellery or something then I can see why they might want you to sign for that but just watch out what they're asking you to sign.
I was asked to sign to agree to paying top up "just in case they were needed"
Needless to say I didn't.
Before you sign anything you should read it, if you don't understand then ask to take the papers away so you can ask your solicitor to look at them and see what their reaction is. It may all be very innocent but my mother and my wife were discharged from hospital several time and I was never asked to sign anything (other than for property) other than when my wife went from hospital into care, that was when the social worker on the team asked me to sign the top up forms.
K

 

[stanleypj]

There's nothing to stop you from looking around to see if there are any nursing homes with vacancies that you like Louise. Even if they choose a home, you should try and ensure that you are able to view it first. I know it's stressful when 'they need the bed' but it's very important that you do all you can to ensure that the placement will be appropriate for your Mum.

I have no experience or knowledge of the jpint funding but on the face of it I suppose it might mean that any top-up they ask you to pay could be less.

 

[Louise7]

Before you sign anything you should read it, if you don't understand then ask to take the papers away so you can ask your solicitor to look at them and see what their reaction is.

I always read before I sign Mum doesn't have any property to sign for so I thought it might be to do with the CHC process.

 

[Louise7]

There's nothing to stop you from looking around to see if there are any nursing homes with vacancies that you like Louise. Even if they choose a home, you should try and ensure that you are able to view it first.

I have no experience or knowledge of the jpint funding but on the face of it I suppose it might mean that any top-up they ask you to pay could be less.

They are going to find out where a bed is available and said that I can view to make sure that it's suitable.

I've been doing a few searches on Google and from what I can tell, if the funding is 'joint' the NHS pay a contribution- which is not means tested- and the LA pay a contribution which is. I'm not sure what the process is for paying the fees if they move Mum to a nursing home before the CHC decision has been made though? Hopefully all be a bit clearer after my meeting this morning. Mum is currently not a self-funder but has a house, which up to now has been disregarded because she was living in it.

Social services know that Mum is in hospital because they are investigating neglect against Mum's care agency. They contacted me to let me know that they were holding a safeguarding meeting (10 days ago) but I haven't heard a peep out of them since.

 

[nitram]

"I've been doing a few searches on Google and from what I can tell, if the funding is 'joint' the NHS pay a contribution- which is not means tested- and the LA pay a contribution which is."

If the outcome is CHC (Continuing Health Care) all care is free. The costs may be shared between the NHS and the LA.
The person can be cared for in a home or at home.

If the outcome is FNC (Funded Nursing Care) the NHS pays for the nursing, other costs are paid by the person using the normal financial assessment to determine if the LA should assist.
FNC can only be paid to a person in a nursing home.

Before your Mum is discharged there should be an ongoing care plan, this implies that the decision on CHC, FNC, or no NHS financial assistance, will have been made.

 

[Louise7]

Thanks Nitram, that's really useful. From my conversation with the hospital discharge team they say that Mum can not go home due to her risk of falls and needs a nursing home. It was implied that Mum has got through the 'check list' stage so will need a full CHC assessment. From what you're saying Mum won't be discharged until the decision on funding has been agreed. Hopefully this will be soon as the hospital is not the best place for Mum to be in now she is able to be discharged. She is on a general ward and is restless and keeps trying to get out of bed.

 

[nitram]

Risk of falls does not necessarily mean a nursing home, it could be a care home.

You could ask the ward manager or local PALS http://www.nhs.uk/Service-Search/Patient advice and liaison services (PALS)/LocationSearch/363 for a copy of the hospitals discharge policy.

What should happen and what does happen are not always the same.

 

[Louise7]

The meeting was this morning and the document I needed to sign was to agree to the CHC process going ahead and also give permission for Mum's medical info to be shared during the process.

From what was said after going through the CHC checklist FNC is going to be recommended and I'll know next week if the 'panel' have agreed this. Once the decision is known social services will get in touch regarding a financial assessment. In the meantime Mum will stay in the hospital until a suitable nursing home place is found.

 

[Lillie]

CHC being withdrawn

Hello,

I was wondering if anybody could please help or offer me any advice. In a nutshell my mum has been diagnosed with early onset dementia (Alzheimers) for 11 years (she is now 72) and currently is in receipt of CHC funding a live in carer and daily care package following the unexpected death of my father last year (who up to the point of his death had cared for mum at home). The review meeting for funding was recently held and I attended, having previously been advised by a number of professionals (including the GP and the previous CHC nurse assessor) that it was unlikely the funding would be withdrawn as they would have to demonstrate an improvement in order to rescind it. At the previous assessment mum was able to walk with assistance and was more aware. She is now sadly fully bed bound and has become much more withdrawn. She was only moved 'down' in one of the domains (Behaviour - now deemed compliant as does not resist any attempts by the carers to assist her) and she stayed the same or was moved 'up' in the rest of the domains. As such I was hopeful that the funding would continue as to me she has deteriorated significantly since the last assessment. However I have had contact from the Social Worker who has advised me the nurse assessor is recommending full withdrawal of mum's funding as it is her opinion mum no longer fits the criteria for CHC. When I asked why this would be when she has clearly got worse he said it is because mum's needs are now more predictable and as she is bed bound her risk of falls etc has reduced so although she may have scored higher in some areas her overall complexity has reduced and therefore she apparently no longer mets the criteria for funding.
I'm sorry if this has been asked elsewhere on the thread but as it is a long thread and time is short I was wondering if someone can please offer some guidance as to whether we have a leg to stand on regarding an appeal? It has not been to panel yet but based on what the SW said I feel it is a done deal and I'm expecting the worst. We have all been through so much as a family recently that I do not want to waste our energy fighting something that is futile but I also do not just want to back down without a fight if people's opinion is that we may have a chance. I feel at a complete loss and now feel very naive for trusting 'the process' and for not being more prepared. Can anyone shed any light at all on the situation and how best to proceed?

Thank you in advance

 

[nitram]

"When I asked why this would be when she has clearly got worse he said it is because mum's needs are now more predictable and as she is bed bound her risk of falls etc has reduced so although she may have scored higher in some areas her overall complexity has reduced and therefore she apparently no longer mets the criteria for funding."2

What were the domain grades in both assessments?

Moving up does not help unless the move is to an A or B.

 

[Nessie21]

Don't give up the fight!

My mum had Alzheimer's and was totally uncontrollable and violent and went through a period of being sectioned and ended up spending over 3 yrs in a very expensive care home with 1 staff to 4 patients. We stupidly thought she would qualify for CHC as her needs were so bad, but we were put off when she was initially turned down for CHC, by her care home manager who told us the health authority we are in are the worst in our area to agree CHC and that no one in her care home under that authority had funding. There were lots of people worse than my mum in that care home so it made us accept their judgement and not expect it. We attended all the meetings and reviews and put up a good case but never really questioned their rulings. My mum's condition suddenly deteriorated and the last 8 months of my Mum's life she could do nothing except breath, she had to be hand fed, carried, lifted, dressed, everything she made no attempt to lift anything or weight bear with her legs and spent most of that time in bed or in a chair. At that point we thought they must pay now and tried to get them to visit to review her situation . It took them 9 months to respond to our many requests to review her condition and by then she was dead so they had to do a retrospective review. But during the time we were waiting for them and seeing how bad she was it seemed ridiculous that they wouldn't fund her so it made me investigate funding a bit more and I saw an advert for a seminar at a local solicitors about not paying care home fees so I went and discovered that we probably did have a good case against the local authority, we instructed a no win no fee solicitor to fight on our behalf. It was a hugely slow process and has taken lots of form filling and copies of documents and solicitor visits but after 4 years today I received notification they have agreed that she was eligible for full CHC Funding. It will probably take us another 4 years to get the money that is owed, we have yet more forms to fill out etc but we have finally won!

My message to you all out there in a similar position who have had CHC funding turned down, don't ever give up and keep fighting and if you need to don't be frightened of instructing a solicitor to help. Whilst it all came far too late to help my mum, I know she would have hated the fact that all her savings over £140,000 was spent on care home fees.

 

[Louise7]

Quick query. Mum has been sent a letter about funding which states that the Panel considered the recommendations made by the multi-disciplinary team (MDT). Am I right in thinking that Mum (or a representative) should have been invited to the MDT meeting?

 

[SnowWhite]

My mum had Alzheimer's and was totally uncontrollable and violent and went through a period of being sectioned and ended up spending over 3 yrs in a very expensive care home with 1 staff to 4 patients. We stupidly thought she would qualify for CHC as her needs were so bad, but we were put off when she was initially turned down for CHC, by her care home manager who told us the health authority we are in are the worst in our area to agree CHC and that no one in her care home under that authority had funding. There were lots of people worse than my mum in that care home so it made us accept their judgement and not expect it. We attended all the meetings and reviews and put up a good case but never really questioned their rulings. My mum's condition suddenly deteriorated and the last 8 months of my Mum's life she could do nothing except breath, she had to be hand fed, carried, lifted, dressed, everything she made no attempt to lift anything or weight bear with her legs and spent most of that time in bed or in a chair. At that point we thought they must pay now and tried to get them to visit to review her situation . It took them 9 months to respond to our many requests to review her condition and by then she was dead so they had to do a retrospective review. But during the time we were waiting for them and seeing how bad she was it seemed ridiculous that they wouldn't fund her so it made me investigate funding a bit more and I saw an advert for a seminar at a local solicitors about not paying care home fees so I went and discovered that we probably did have a good case against the local authority, we instructed a no win no fee solicitor to fight on our behalf. It was a hugely slow process and has taken lots of form filling and copies of documents and solicitor visits but after 4 years today I received notification they have agreed that she was eligible for full CHC Funding. It will probably take us another 4 years to get the money that is owed, we have yet more forms to fill out etc but we have finally won!

My message to you all out there in a similar position who have had CHC funding turned down, don't ever give up and keep fighting and if you need to don't be frightened of instructing a solicitor to help. Whilst it all came far too late to help my mum, I know she would have hated the fact that all her savings over £140,000 was spent on care home fees.

Well done you for persevering Nessie! My Mum feels the same. She never had any money when we were small and we all lived in cousins cast offs and jumble sales. She was really, really sad when we explained we had to sell her house to fund her care as it was her home for about 60 years and if it hadn't been their ex LA house which they bought at a huge discount many years ago they never could have owned a house.

 

[SnowWhite]

Well, we've started filling in the CHC form. Mum is in hospital (4+ weeks now) so I asked them to do it. A nurse and I filled it in together. We have left two sections to do later on. It was about 20 pages and not at all how I imagined.

I naively thought there might be sections to list all Mums ailments and problems but there wasn't. Some of the parts were similar I thought. The nurse kept wanting to write down C but I disagreed and we got lots of As and quite a lot of Bs. I kept telling her that the lady she sees now is not the lady she was a few weeks ago and I doubt whether she will ever toilet herself again or walk with a frame but she says we should wait and see what the Physio says so they were the parts we will complete later. I think we may fall down because Mum is not aggressive or unpredictable so she put C for that.

Another thing she kept saying was "well care assistants could deal with that, it wouldn't require a nurse."

Any advice welcome.

 

[Molly6]

Well, we've started filling in the CHC form. Mum is in hospital (4+ weeks now) so I asked them to do it. A nurse and I filled it in together. We have left two sections to do later on. It was about 20 pages and not at all how I imagined.

I naively thought there might be sections to list all Mums ailments and problems but there wasn't. Some of the parts were similar I thought. The nurse kept wanting to write down C but I disagreed and we got lots of As and quite a lot of Bs. I kept telling her that the lady she sees now is not the lady she was a few weeks ago and I doubt whether she will ever toilet herself again or walk with a frame but she says we should wait and see what the Physio says so they were the parts we will complete later. I think we may fall down because Mum is not aggressive or unpredictable so she put C for that.

Another thing she kept saying was "well care assistants could deal with that, it wouldn't require a nurse."

Any advice welcome.

Hello
We asked for this to be done for dad he's 94 and been in hospital since May, he is in a poor way and we were not there when they did the assessment. When we received it , it was the most fictional Read ever , apparently he could walk to the toilet , sort out his own finances , could make good decisions etc etc we were amazed and thought they must have assessed another man . After phoning the assessment team I realise that their first line is to turn down claims much like an insurance company. Then it was on tv inside out which said NHS employ a company to oversee the assessments to refuse two thirds of them . Sadly dad has deteriorated since and we haven't the energy to argue
Hope you can press for another assessment, good luck x

 

[nitram]

Well, we've started filling in the CHC form.

Do you mean a >>>CHECKLIST<<<?

Some of the parts were similar I thought.

Each section is scored separately, enter everything relevant in each section

Another thing she kept saying was "well care assistants could deal with that, it wouldn't require a nurse."

The level of competence of any necessary clinician is not mentioned in the checklist which just attempts to assess the medical needs

Any advice welcome.

 

[SnowWhite]

YEs, thanks Nitram, that's the one!

 

[Mrnkar]

Hi, wonder if someone can please tell me, what actually gets sent to the CCG for the final decision on CHC. It's just the hospital have sent me one filled out at the meeting, which i attended, although some levels have been changed and also my name has been signed by someone else, in the assessors box.
I'm just trying to find out, if i have the one completed at the meeting, then what do they send to the CCG as I thought it would be that.
Sorry if this has already been asked, New to all this and slowly gong through this very helpful thread.
The hospital said my father didn't score enough to get CHC but would get FNC. He will be going to a Nursing Home for 24hr care when discharged from hospital and I am building a case for appeal.
Thank you for any help received.