No longer eligible for Continuing Health Care

[Jenn]

Hello
Does anyone have a take on this? My Mum moved care homes at Whitson, and at the time she was eligible for funding through Continuing Health Care which came to £114 a week.
We've received no notifications since she moved so I chased it up only to be told she is no longer eligible for funding because the new home is Residential not Nursing. As it happens the new care home is lovely and the care excellent, and they care for her (now severe) Alzheimers very well (better than the other place) but apparently its all down to the number of qualified nurses at the Home, even though they may not use the expertise of those nurses.
I'm annoyed because at no point did anyone point this out to me even though I had rung up discuss the move several times. And it seems crazy too - does Alzheimers does not count as a disease?
Any advice would be greatly appreciated! Is it worth going to appeal for instance?

 

[turbo]

Hello Jenn, it sounds as if your mum was receiving Funded Nursing Care. This is usually paid direct to the CH by the NHS. it is not the same as Continuing Health Care Funding but is paid when someone is receiving Nursing Care.
it's good to hear that your are happy with the care that your mum is receiving at her new Care Home.

 

[Pete R]

does Alzheimers does not count as a disease?

Mind boggling as it is but on its own no it doesn't when it comes to funding issues.

The FNC payment is £112 this year but it can only be paid direct to a care home registered to provide nursing care.

What were the circumstances of your Mum originally being granted it and what has changed in your Mum's condition, if anything, that she is now assessed as not needing it? If she was assessed as needing it who authorised the move to a home that cannot provide the care she needs?

You can appeal to the CCG but if the CH is not registered to provide nursing care I do not hold out much hope. Have you checked on the CQC website on the CH's official status?

http://www.nhs.uk/chq/Pages/what-is-nhs-funded-nursing-care.aspx

 

[Jenn]

Thank you for your replies. I thought she was receiving Continuing Health Care, not funded Nursing Care. Maybe I should discuss it with social services.
And we authorised the move - or at least my siblings did, as she is self-funding. The other home kept raising the costs, by £100+ a week, each year, and I wouldn't say the care was especially marvellous. I have to admit, I have wondered many times if it was the right thing to do, not so much the costs or anything but the upheaval of moving her.
I suppose with Alzheimers you don't need qualified nurses, just a lot of love and kindness - and unfortunately that's not rated as something worth spending any money on. When my Dad was in a care home a few years ago, the best care he received was from a cleaner, not from the nursing staff who rarely made an appearance. This is even though the cleaner was paid a pittance and certainly not paid to feed him his breakfast every morning which she did. Anyway I shouldn't rant...just bugs me that carers are thought of as lowly and unimportant.
And thank you for the website link - no I haven't checked. What an idiot!

 

[Battling though]

Continuous care appeal and continuing to pay fees whilst pending

My mum had continuous care funding for a couple of years until recently when she was re-assessed and deemed to have improved and now I have been billed for care fees.
I shall be making an appeal

I read somewhere that pending an appeal then fees do not have to be paid until the appeal process has been exhausted. I accept that if it fails then the fees will be back-dated but I fear that if I pay `upfront` then the chances of getting a refund should i win the appeal might be a problem, if not impossible.

Does anyone happen to know if it is correct that fees DO NOT have to be paid pending an appeal in these circumstances, and if it is the case where I could find the relevant supporting guidance/legislation.
Thank you in advance.

 

[Ginny Hendricks]

My mum had continuous care funding for a couple of years until recently when she was re-assessed and deemed to have improved and now I have been billed for care fees.
I shall be making an appeal

I read somewhere that pending an appeal then fees do not have to be paid until the appeal process has been exhausted. I accept that if it fails then the fees will be back-dated but I fear that if I pay `upfront` then the chances of getting a refund should i win the appeal might be a problem, if not impossible.

Does anyone happen to know if it is correct that fees DO NOT have to be paid pending an appeal in these circumstances, and if it is the case where I could find the relevant supporting guidance/legislation.
Thank you in advance.

Hello. I'm new here, as you can see, and not yet allowed to post links, but there's a website called 'Care to be different' which is all about CHC funding. I hope you find it helpful.

 

[fizzie]

Hello
Does anyone have a take on this? My Mum moved care homes at Whitson, and at the time she was eligible for funding through Continuing Health Care which came to £114 a week.
We've received no notifications since she moved so I chased it up only to be told she is no longer eligible for funding because the new home is Residential not Nursing. As it happens the new care home is lovely and the care excellent, and they care for her (now severe) Alzheimers very well (better than the other place) but apparently its all down to the number of qualified nurses at the Home, even though they may not use the expertise of those nurses.
I'm annoyed because at no point did anyone point this out to me even though I had rung up discuss the move several times. And it seems crazy too - does Alzheimers does not count as a disease?
Any advice would be greatly appreciated! Is it worth going to appeal for instance?

I would appeal on those grounds - including that noone pointed it out in discussions. I would also see if I could get something in writing from the home to say that they will give her care and nursing that she requires through to end of life from qualified nurses. It's always worth an appeal and you do have a good argument if you can get the evidence x

 

[jasmineflower]

I think your problem is that you chose to move her from a nursing home into a residential care home.

If she is being satisfactorily cared for there she doesn't require a nursing home hence she no longer qualifies for the nursing payment.

CHC and the Funded Nursing Element are all based on people's needs above and beyond what they consider as social care.

It's all very complicated!!