Care to Nursing

[Mary9]

At present ss are looking for a nursing home for my mom to move to, as the carehome have said they can no longer look after her , at present i pay the top up fee but i am starting to struggle so this will have to stop, ss asked if i can pay the top up and i have said no,there has been no mention of an nhs continung healthcare assesment, should there be or should i ask for one?, really not looking forward to the next few months.
Thanks.

 

[Kevinl]

They can't make you pay a top up and your mum isn't allowed to pay it herself.
I assume from the fact you're paying a top up that the LA are funding her care?
If so the LA have to offer at least one home that doesn't need a top up and can meet her needs but it may well not be the one you choose. If you don't accept the offer they have fulfilled their legal obligation so pretty much that's what you get, one offer.
If the LA are funding you may as well just ask them for the names of the homes that take the LA rate, they seem reluctant to do this, I can only imagine they keep them for people absolutely not pay a top up for whatever reason so the LA want to keep the cheapest places for themselves, possibly I'm being cynical.
CHC isn't given for AZ/dementia there has to be a medical condition and they are defined as being social problems so if you apply just on that basis you have very little, if any chance of getting CHC.
If it's a nursing home then you can apply for Funded Nursing Care (FNC) which is £155.05pw (down from last year's rate of £156.25), this is paid direct to the home and is there to cover the nursing aspects of her care. Some nursing homes have 2 rates, one with and one without FNC so it's as well to ask
If the LA are funding then there is a set (local) rate they'll pay, ask them what this is then see what the shortfall is and take it from there.
K
https://www.gov.uk/government/news/nhs-funded-nursing-care-rate-for-2017-to-2018

 

[Mary9]

Thank you Kevinl,

They can't make you pay a top up and your mum isn't allowed to pay it herself.
I assume from the fact you're paying a top up that the LA are funding her care?
If so the LA have to offer at least one home that doesn't need a top up and can meet her needs but it may well not be the one you choose. If you don't accept the offer they have fulfilled their legal obligation so pretty much that's what you get, one offer.
If the LA are funding you may as well just ask them for the names of the homes that take the LA rate, they seem reluctant to do this, I can only imagine they keep them for people absolutely not pay a top up for whatever reason so the LA want to keep the cheapest places for themselves, possibly I'm being cynical.
CHC isn't given for AZ/dementia there has to be a medical condition and they are defined as being social problems so if you apply just on that basis you have very little, if any chance of getting CHC.
If it's a nursing home then you can apply for Funded Nursing Care (FNC) which is £155.05pw (down from last year's rate of £156.25), this is paid direct to the home and is there to cover the nursing aspects of her care. Some nursing homes have 2 rates, one with and one without FNC so it's as well to ask
If the LA are funding then there is a set (local) rate they'll pay, ask them what this is then see what the shortfall is and take it from there.
K
https://www.gov.uk/government/news/nhs-funded-nursing-care-rate-for-2017-to-2018

Thank you Kevinl for that info, I have followed the link and tried to take it in?, do I ask ss about this or will they just do it?, yes mom is funded by LA

 

[Kevinl]

Thank you Kevinl for that info, I have followed the link and tried to take it in?, do I ask ss about this or will they just do it?, yes mom is funded by LA

There's an explanation and a discussion on the link below.
Basically you apply for CHC, get turned down but may get awarded FNC. The shortcut route is they don't bother with the CHC assessment as they're only going to say no anyway, then a "nurse assessor", a social worker and the care home manager have a "heated discussion" the upshot of which is you get FNC.
Essentially the home manager and the social worker say why the NHS should be paying their fair share of the care bill, if my experience is anything to go by.
Nursing homes have to have a qualified nurse there 24/7 so things like; fall risk, skin integrity, insulin tests, leg ulcers or any dressings management, medicines given "as needed" basis...the list goes on.
Without a qualified nurse, the home my wife is in would have to block book a district nurse for every minute of the day and have an ambulance on standby too. A nursing home take a lot of pressure off these valuable NHS resources so it's only right the NHS should shoulder their part of the care package.
Today there were 3 qualified nurses for 28 residents (2 staff, 1 agency), that cost the home a lot more than medically unqualified staff (carers) of which there were 7 so 10 staff to 28 residents (3 empty rooms). That's why nursing homes cost more.
To get FNC she will first need to be in a nursing home unless you start the CHC process and get a pending FNC award to take with her (if that's possible), when the nursing home assess her they will know if getting FNC is a given, or they may give you 2 prices with and without FNC, but tell you that if FNC isn't given you will have to pay a top up equal to the FNC amount.
K

http://caretobedifferent.co.uk/how-is-registered-nursing-care-contribution-rncc-assessed/

 

[Pete R]

At present ss are looking for a nursing home for my mom to move to, as the carehome have said they can no longer look after her , at present i pay the top up fee but i am starting to struggle so this will have to stop, ss asked if i can pay the top up and i have said no,there has been no mention of an nhs continung healthcare assesment, should there be or should i ask for one?, really not looking forward to the next few months.
Thanks.

If SS are actually looking for a NH rather than an alternative CH that can meet your Mom's needs, then yes there has be a CHC Assessment to get any FNC. It is not your responsibility to arrange this. SS should sort this out however you may want to ask.

Wherever your Mom is moved to the new home will not be giving you 2 prices nor should they be asking you to pay any top up. All discussion on pricing will be with SS and the Local Authority.

 

[Pete R]

If so the LA have to offer at least one home that doesn't need a top up and can meet her needs............

If the LA are funding then there is a set (local) rate they'll pay, ask them what this is then see what the shortfall is and take it from there.

Don't these 2 sentences contradict each other?

The first is correct so there cannot be a set rate any more.

 

[Pete R]

The shortcut route is they don't bother with the CHC assessment as they're only going to say no anyway, then a "nurse assessor", a social worker and the care home manager have a "heated discussion" the upshot of which is you get FNC.

I have never heard of this "shortcut" route.

The link you provided states........
Instead, it’s awarded to people who have been turned down for NHS Continuing Care funding (full funding), but who still need some degree of nursing care.

In other words, there must be a proper assessment for NHS Continuing Care funding FIRST, and it’s only once the outcome of that assessment is known that a decision is made about FNC.

 

[Kevinl]

I have never heard of this "shortcut" route.
In other words, there must be a proper assessment for NHS Continuing Care funding FIRST, and it’s only once the outcome of that assessment is known that a decision is made about FNC.[/I][/B]

That's what happened to me and to some others I know, we were told "there's no point in asking for CHC we'll just go straight to FNC" (or words to that effect).
My wife and 2 others in the assessment unit all moved into care in the same home within a matter of weeks of each other, I see the relatives regularly and we have discussed the process and none had a CHC assessment but all now get FNC.
"The first is correct so there cannot be a set rate any more." The LA have a rate they will pay for care, it's regularly discussed on here, I was given a figure and told to find a care home, in budget that was impossible without a top up so I handed the matter back to the social worker. Magically they then came up with the name of a couple of homes that accepted the LA rate neither of which was on the list they gave me.
That's my experience and talking to other relatives pretty much the same thing happened to them too.
K

 

[lemonjuice]

That's what happened to me and to some others I know, we were told "there's no point in asking for CHC we'll just go straight to FNC" (or words to that effect).

I wish our assessor would be honest enough to do that.

But no. Every time she puts me through the purgatory of spending up to an hour detailing all my mother's issues and needs and then says she'll have to 'refer it to panel'. Then after referral, surprise, surprise the application is refused and awarded FNC.
I'm pretty sure 'her' recommendation swings it for refusal, so why not be upfront in the first place?

 

[Mary9]

Thanks

If SS are actually looking for a NH rather than an alternative CH that can meet your Mom's needs, then yes there has be a CHC Assessment to get any FNC. It is not your responsibility to arrange this. SS should sort this out however you may want to ask.

Wherever your Mom is moved to the new home will not be giving you 2 prices nor should they be asking you to pay any top up. All discussion on pricing will be with SS and the Local Authority.

Thanks Pete for that info, yeah they are defo looking for a NH as that is what they said Mom now needs, ok I think I will speak to SS and bring up the dredded CHC conversation, why can't they just do it, why do they make things so much harder hey ho.......

 

[Mary9]

Help

I wish our assessor would be honest enough to do that.

But no. Every time she puts me through the purgatory of spending up to an hour detailing all my mother's issues and needs and then says she'll have to 'refer it to panel'. Then after referral, surprise, surprise the application is refused and awarded FNC.
I'm pretty sure 'her' recommendation swings it for refusal, so why not be upfront in the first place?

Why do they make it so much harder than it is anyway, I feel as though no one really has any interest in the person, only about the money!!!

 

[Pete R]

That's what happened to me and to some others I know, we were told "there's no point in asking for CHC we'll just go straight to FNC" (or words to that effect).
My wife and 2 others in the assessment unit all moved into care in the same home within a matter of weeks of each other, I see the relatives regularly and we have discussed the process and none had a CHC assessment but all now get FNC.

I would not be surprised if you were told that as your Wife is Funded by Sec 117 Aftercare which cannot run in conjunction with CHC although FNC can be awarded if there is a medical need outside of the Sec 117 Aftercare which the CCG/LSSA would probably do automatically as it is a way for them to reduce their payment.

The OP is not asking about Sec 117 Aftercare situations.

The LA have a rate they will pay for care, it's regularly discussed on here, I was given a figure and told to find a care home, in budget that was impossible without a top up so I handed the matter back to the social worker. Magically they then came up with the name of a couple of homes that accepted the LA rate neither of which was on the list they gave me.

The "Set Rate" used to be talked about on here in the time of CRAG but there cannot be one anymore.
In your example the LA gave you the cheapest rate they could get for the care needed which is what they are supposed to do. If those placements had been unavailable they would have had to up their rate.