Turned down for NHS Continuing Healthcare

[Corriefan]

Hi,
My elderly dad recently had a very serious accident and currently in hospital. I am his unofficial carer and live with him. Prior to this he has had problems with his bowels and waterworks resulting in accidents around the house. He has difficulty walking, severe osteoporosis and curvature of the spine and stomach problems. His eyesight is also bad and since the accident seems to have deteriorated to the point where he can't see to read or even as far as the end of his bed even with glasses on. He is also seeing things and appears to be developing dementia. The accident left him with a broken leg and pelvis and severe leg wounds that almost needed skin grafts. He is in his eighties.
I just got told that dad has been turned down for NHS Continuing Healthcare. I would have thought he was eligible even if on a temporary basis. Can anyone tell me if I can appeal and if so how do I do this. I also asked about nursing care. They are talking about him coming home even though he can only walk with the aid of two nurses and a zimmer frame and only take a few steps even then. I am worried about how I am going to cope. He also has challenging behaviour and I am not sure I can face going through it all again when he comes home. He owns half the house I live in also. I am so so worried and can't see a way forward.

 

[Cat27]

Have you seen this thread? http://forum.alzheimers.org.uk/showthread.php?86059-CHC-(Continuing-Healthcare)-support-thread

It's got lots of information.

 

[Corriefan]

Have you seen this thread? http://forum.alzheimers.org.uk/showthread.php?86059-CHC-(Continuing-Healthcare)-support-thread

It's got lots of information.

Thank you for this Cat27.

 

[Dothedealnow]

There is s CHC thread elsewhere on the site. With a wealth of good advice.
You can appeal, but do it within 14 days.
My mother is just about to be turned down with severe dementia, doubly incontinent, diabetes, partially blind and deaf plus much more. She can however walk a few feet and ask if you want a coffee 39 times an hour. We will appeal as well but hold little hope. Apparently she needs to be far worse.
Good luck and someone with more detailed advice will be along soon.

 

[Corriefan]

Thank you for the advice. It's unbelievable that people in this condition should be turned down. How much worse do they want them to be?

 

[Dothedealnow]

How much worse

After an unofficial chat with my mums consultant:
Bed bound
Incoherent
Unable to eat or drink without help
And so forth.

My mum will be going into a self funded care home shortly. First her savings will go then house to fund it.

You may want to look into care at home ot a car home as well as I suspect you will struggle at home.

 

[Shedrech]

Hi Corriefan
I agree with your concerns about having your dad back home

They are talking about him coming home even though he can only walk with the aid of two nurses and a zimmer frame and only take a few steps even then. I am worried about how I am going to cope. He also has challenging behaviour and I am not sure I can face going through it all again when he comes home. He owns half the house I live in also. I am so so worried and can't see a way forward.

Please forcefully express your concerns, and even refuse to have him back home - warn them that you are fearful that you will not be able to cope even with a care package, and then he will end up back in hospital as a failed discharge (they don't want this) - as he is a 'vulnerable adult' SS have a duty of care - and you are worried that you will have a carer breakdown, putting you both at risk
I appreciate that this will mean a care home placement for your dad. maybe though, with the situation as you describe, moving him into a home will be 'in his best interests' - he will be supported all day, every day; and you will be able to visit without the strain and stress of the full time carer role
If you are concerned about the financial side of things, maybe have a chat with CAB - if you jointly own the house, I don't think it is included as part of a financial assessment, but other members will know about that
best wishes

 

[Corriefan]

Thanks Shedrech. It is the house I am worried about more than anything. He jointly owns it with my mum who has NHS Continuing Healthcare. But it is my home and I don't want to lose it. I have a little dog and he is happy here and they don't usually accept pets in rented accommodation. I have been under unbearable stress for the last five years. I have felt close to a breakdown several times. Recently had to give up my job as they wouldn't give me more than a couple of days compassionate leave.

 

[Dothedealnow]

Discharge Manager

Am sorry to hear of your issues. This may come across as harsh, but concentrate on your father, not yourself and the house.

I would book a meeting, if you've not already had one with the Consultant and Ward Sister. Please calmly and succintly express that you will be needing substantial help to manage care at home and in fact you believe that this would not be possible as the above poster.
Secondly, before your father is discharged there will be a meeting between the hospital SS, the discharge manager and yourself. You must attend these meetings and put your point across that you are absolutely unable to manage your father's care as the poster above and that readmission is almost a certainty.
I would not discuss that you motive seems to be to remain at home or that you want CHC funding. Your primary goal is that you want the best care for your father.


I believe that you should have been involved in the CHC decision. Ask to see the how they scored your father in each domain. Where you disagree, say so and record it. Then ask them for the appeal procedure.

As stated, my primary goal is to get the best care for my mother as possible. The fact that will be losing out on c300K is a little annoying I must say but not a key consideration for the NHS, me, nor are the childrens pets. CHCs only considerations are the "scores" the consultant possibly and one other gives your Father. Quite frankly it all seems focussed on not granting CHC and again let me stress that its how you father scores in these domains that's important, not you or the dog etc. So in my case, we are losing any inheritance, the house will fund the carecand the dog is being adopted BUT mum will he getting the best care possible.

A little harsh I know, but you must focus on the well being and safety of your father. If it came to it you could rent a flat and give the pet away........I doubt that this will be the case but if both home owners go into care then the house may be considered. Please verify this though.

I trust that you are under the care of a GP, on suitable meds and have asked for a helpline, support groups and other tools to cope with the pressure that you are under? If not then I would book an appointment with your GP today.

 

[Shedrech]

Hi Corriefan
It seems to me that
your dad clearly is your main concern and that you are most worried that he will be sent home without an adequate care package, that you will not be able to support him properly, and so you are looking to make the move to a care home so that he can receive the appropriate care - however it seems to you that they are looking to send him back home
your next worry is that the care will have to be funded and how to go about doing this given that your mum is already living in a care home and that your parents jointly own the house
your other worry is for where you will live, given that you have been caring for both your parents, living in the house with them, and you will need to make some preparations, maybe even find a way to continue living in the house - quite an understandable concern (I read no indication that you are after safeguarding an inheritance - I do see that all this is pretty overwhelming).

For your dad - as you have in some ways been through all this with your mum, I'm sure you are in contact with the discharge team etc and will make your voice heard
as to the funding - I really think you need to contact the LA and get a financial assessment going, so that you have some facts to work on - see what help CAB can be - maybe contact the DWP to get their take on this - it may well be worth having a chat on the AS Helpline
https://www.alzheimers.org.uk/site/scripts/documents.php?categoryID=200365&_ga=1.60346734.213745934.1462100281
and for your future - might you be able to rent your parents' house (at a fair market rate)? worth looking into (even if the house has to be sold, that will take a fair amount of time and give you a chance to look into your options)

there's a lot for you to see your way through - there is time, though, so work out a plan of 'attack'

and keep posting

 

[Pickles53]

Annex B, section 34 -36 of the Care Act Statutory Guidance describes when a property must or may be disregarded for the purposes of a financial assessment. You can find this document in the gov.uk website if you search for 'care act book'. Usually the link can be directly posted but it seems that the relevant part of the website is undergoing maintenance.

Have a look at this, it may set your mind at rest because you would be covered by the 'mandatory disregard'. If it's a discretionary disregard issue it may be harder but st least you are armed with the correct information. My main point us, don't assume your home will be at risk, it may be OK.

 

[Dothedealnow]

I thought property was only disregarded if the relative living there was incapacitated or over 60 (either or both of which may be the case).

I suggest you get professional advive ASAP.

 

[Pickles53]

I thought property was only disregarded if the relative living there was incapacitated or over 60?

There are some other possibilities in the guidance. I don't know whether any of them would apply to the OP, but I would always recommend that people look at the statutory guidance just to make sure.

 

[Dothedealnow]

Indeed and as I mentioned get professional advice.

 

[dottyd]

Also watch the Luke clements video. Is easy to watch.
Clear concise advice.

It's terrible he's turned down for CHC .

 

[LYN T]

There is s CHC thread elsewhere on the site. With a wealth of good advice.
You can appeal, but do it within 14 days.
My mother is just about to be turned down with severe dementia, doubly incontinent, diabetes, partially blind and deaf plus much more. She can however walk a few feet and ask if you want a coffee 39 times an hour. We will appeal as well but hold little hope. Apparently she needs to be far worse.
Good luck and someone with more detailed advice will be along soon.

You can appeal within 6 months. I did and was successful.
http://https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=399