DST Assessment

KEZH

Registered User
Feb 6, 2014
24
0
London
Hi everyone

I have just heard from the NHS that my mother will be having the DST Assessment for NHS Continuing Care on 4th December (not a lot of time to prepare!).

She has resided in a care home for 3 years now and this is her current status:

Alzheimer’s and Vascular dementia
Doubly incontinent
Incoherent eg. she speaks but we cannot understand her.
Refuses food (will eat a banana and drinks orange juice most days)
Needs help with food but can drink out of a glass.
Refuses medication (apart from insulin which is injected)
BMI – 17
Has been violent towards staff and other residents
Anxiety issues
Has on occasion been found unconscious on the floor and been admitted to A&E (mostly due to low sugar levels) but has also had a pacemaker fitted this year.
Unable to dress or wash herself.
Doesn't recognise her family.
Sleeps most of the time.
Is able to walk
Chronic kidney disease (stage 4 but is manageable)
She is on a low dosage of Risperidone


Has anyone else had the DST assessment and looking at the above what do you think our chances are?

Thank you.
 

kindred

Registered User
Apr 8, 2018
2,937
0
Hi everyone

I have just heard from the NHS that my mother will be having the DST Assessment for NHS Continuing Care on 4th December (not a lot of time to prepare!).

She has resided in a care home for 3 years now and this is her current status:

Alzheimer’s and Vascular dementia
Doubly incontinent
Incoherent eg. she speaks but we cannot understand her.
Refuses food (will eat a banana and drinks orange juice most days)
Needs help with food but can drink out of a glass.
Refuses medication (apart from insulin which is injected)
BMI – 17
Has been violent towards staff and other residents
Anxiety issues
Has on occasion been found unconscious on the floor and been admitted to A&E (mostly due to low sugar levels) but has also had a pacemaker fitted this year.
Unable to dress or wash herself.
Doesn't recognise her family.
Sleeps most of the time.
Is able to walk
Chronic kidney disease (stage 4 but is manageable)
She is on a low dosage of Risperidone

Has anyone else had the DST assessment and looking at the above what do you think our chances are?
Thank you.

She would score highly on a lot of these issues. Mobility, being able to walk would bring the score down. Her unpredictability and aggression would bring the score up! She cannot communicate her needs.
List the number of times a nurse would be needed - and the A and E.
I think you are in with a marginal chance. warmest, Kindred.
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
They are very thorough so prepare as well as you can . Mum was granted CHC in April this year we breathed a sigh of relief and then at her 3 month review because she hadn’t got better ( never going to happen ) or worse ( ie not died ) they withdrew funding . She’s borderline and they are very sweet and say if there is any change re apply !!!! Sarcasm in my post I hope you pick up on . If I reapply it’s too stressful for all to be in limbo again . This disease causes enough stress without red tape aswell , good luck and hope it goes well .
 

Lellyhelly

Registered User
Jul 27, 2019
39
0
I was told a few days ago that I have to attend a CHC review on Wednesday on behalf of my mother. I had no idea that I had to do this, and really don't know what to expect either
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
I was told a few days ago that I have to attend a CHC review on Wednesday on behalf of my mother. I had no idea that I had to do this, and really don't know what to expect either
Hi the review will be lengthy and thorough, I was total four hours . They go through care plan and if your mum is care/nursing home all the notes on care , medication etc are gone through . They then review each criteria and score it from low to severe . Whilst I didn’t agree with mums score they explained that we could appeal but the appeals process is even tougher than there scoring . Mums social worker was present and fought our corner but we still had it withdrawn. I do think it’s pot luck on your review panel apparently our county had just had a recruitment drive and new employees, possibly eager to come in a be seen to be saving money . Have they given you any indication on how long they intend to be it may be worth asking .
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
I was told a few days ago that I have to attend a CHC review on Wednesday on behalf of my mother. I had no idea that I had to do this, and really don't know what to expect either
I should add mums CHC was initially given via fast track as palliative care nurse in CH decided mum had days /weeks to live and needed a Nursing Home , I’m not sure on your situation. Good luck.
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
I should add mums CHC was initially given via fast track as palliative care nurse in CH decided mum had days /weeks to live and needed a Nursing Home , I’m not sure on your situation. Good luck.
Agree with kindred on her scoring certain factors will take her to low but others will take her high . It’s so complex but cleverly done so that sometimes a positive cancels out the negatives and goes against you ,
 

KEZH

Registered User
Feb 6, 2014
24
0
London
Thank you for all your replies. I feel very ill equipped, only a few weeks to prepare. Ive been chasing up the checklist for months only to discover it had been done in September and the date ready set for the DST in the home on 4th December. Im now thinking if I hadn't chased they would have gone ahead without me. If I lose I will appeal through a lawyer.
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
Thank you for all your replies. I feel very ill equipped, only a few weeks to prepare. Ive been chasing up the checklist for months only to discover it had been done in September and the date ready set for the DST in the home on 4th December. Im now thinking if I hadn't chased they would have gone ahead without me. If I lose I will appeal through a lawyer.
How long has CHC been in place .
 

KEZH

Registered User
Feb 6, 2014
24
0
London
How long has CHC been in place .
The home apparently applied for the CHC months ago. After chasing again and again I received an email from the Health Authority to say the checklist had been completed and the DST was taking place on 4th December. I have a copy of the DST and a copy of the National Framework Agreement
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
The home apparently applied for the CHC months ago. After chasing again and again I received an email from the Health Authority to say the checklist had been completed and the DST was taking place on 4th December. I have a copy of the DST and a copy of the National Framework Agreement
Read up as much as possible , definitely see if you can get some idea of how long it is likely to take. Do you need time off work .
 

KEZH

Registered User
Feb 6, 2014
24
0
London
Read up as much as possible , definitely see if you can get some idea of how long it is likely to take. Do you need time off work .
Yes...I'll have to take the day off and looks like I'll be doing a lot of prepping. I'll need lots of evidence from the home.
 

Lellyhelly

Registered User
Jul 27, 2019
39
0
Thanks for your reply, mum was moved from a care home to a nursing home at the request of the original home. She was also fast tracked. Is it worth obtaining mum's medical record from her GP?
 

Moose1966

Registered User
Feb 10, 2017
147
0
Staffordshire
That's a good idea.
Yes get as much info together at you can . Also I read a great quote on here that is powerful “ a well managed need is still a need “ . It’s hard to define medical need and need that would be medical if not monitored correctly. Mum is well managed but I think it’s unfair to withdraw funding because we’ve been lucky enough to find excellent NH
 

KEZH

Registered User
Feb 6, 2014
24
0
London
That is moreorless stated in the Framework Agreement...
Yes get as much info together at you can . Also I read a great quote on here that is powerful “ a well managed need is still a need “ . It’s hard to define medical need and need that would be medical if not monitored correctly. Mum is well managed but I think it’s unfair to withdraw funding because we’ve been lucky enough to find excellent NH
Yes... I've seen exactly that from Clause 65 of the Framework Agreement...

“in summary, the reasons given for a decision on eligibility should not be based on the:

Individual’s diagnosis
Setting of care
Ability of the care provider to manage care
Use (or not) of NHS employed staff to provide care
Need for/presence of ‘specialist staff’ in care delivery
The fact that a need is well managed
The existence of NHS funded care or;
Any other input-related (rather than needs-related) rationale.”
 

Lellyhelly

Registered User
Jul 27, 2019
39
0
Hi everyone, we had the assessment meeting for CHC. The NHS lady was lovely, social worker sometimes disagreed with her markings, wanting to make it lower. We did get awarded the £165 a week and the meeting was well managed. I was able to put my points of view and they were well received. Good luck to those having to go through this procedure soon , it wasn't scary really.
.