Hello Paul, sorry to read of your troubles. Long and perhaps boring post follows, but it's beginning to depress me to see how so many people have to struggle with misleading information coming their way. So, my apologies, Paul for hogging your thread!
The response of Social workers and assessment coordinators,who do not appear independent, has been very negative to the family.
That is the norm, I’m afraid – the majority are negative about CHC and do their very best to give out misleading information about the whole process. Usually the reason for this is that they have not undertaken the appropriate training to understand it, and they should not be in a position to influence the thinking of others. There is a continuing healthcare postcode lottery still at work in England.
In order to qualify your needs have to be such that they can only be met in a hospital type situation. By this they mean that your mum's care would only be able to be carried out by qualified medical personnel. The NHS can however discharge their responsibility for the care to a nursing care home in order to free up beds in the hospital by paying for the full cost of that care.
As part of the assessment, they will examine every aspect of your mum's needs and will decide whether each one requires medically qualified staff to carry it out or if it can be done by non-medically qualified carers in the home. There is a big difference between someone needing the majority of their care provided by medical staff than just needing the services of a medically qualified person to be there "just in case" the need arises.
Fifimo, I have to disagree with much of your post, I’m afraid, but in particular the above quote from it. To qualify for CHC you have to have a ‘primary health need’. There is nowhere that I’ve read that says that those needs have to be such that they can only be met in a hospital type situation, or that the care could only be able to be carried out by qualified medical personnel.
It appears to me that the recommendation is based on the need for NURSES to to carry out multiple tasks, so if the condition gets worst and the tasks are based around someone that is bedridden, those tasks are mainly carried out by CARERS, so NHS funding is not given.
Scraggedbloke, There is no need for NURSES to carry out the caring.
The confusion is often caused by the use of the word ‘
nursing’ care. That does not mean care carried out by Registered Nurses, or by care workers.
Here is the
Royal College of Nursing’s definition of ‘nursing’:
http://www.rcn.org.uk/__data/assets/pdf_file/0008/78569/001998.pdf
The use of clinical judgement in the provision of care to enable people to improve,
maintain, or recover health, to cope with health problems, and to achieve the best
possible quality of life, whatever their disease or disability, until death.
Not all nursing is undertaken by qualified nurses, any more than all teaching is undertaken by qualified teachers. Other people who ‘nurse’ include relatives, other informal carers, and a variety of care assistants and support workers. Their contribution to care is invaluable, but it is different from that of the professional nurse.
The distinction between professional nursing and the nursing undertaken by other people does not lie in the type of task performed, nor in the level of skill that is required to perform a particular task.”
The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care 2009 (revised):
NB. NHS CHC and NHS FNC are not one and the same thing – they are vastly different. An assessment for NHS CHC should be completed
before any assessment for NHS funded Nursing Care.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103161.pdf
I'm posting only a selection of those that apply to some comments on TP (only? Thank goodness for that I hear you cry!
).
Paragraph 8 of the NF on page 4:
Eligibility for NHS continuing healthcare places no limits on the settings in which the package of support can be offered or on the type of service delivery.
Para 24:
Eligibility for NHS continuing healthcare must always be considered prior to any consideration of eligibility for NHS-funded nursing care.
Para 25:
Where a person’s primary need is a health need, they are eligible for NHS continuing healthcare. Deciding whether this is the case involves looking at the totality of the relevant needs. Where an individual has a primary health need and is therefore eligible for NHS continuing healthcare, the NHS is responsible for providing all of that individual’s assessed needs – including accommodation, if that is part of the overall need.
NB: “.... including accommodation, if that is part of the overall need” indicates that those living in their own homes can still qualify for NHS CHC.
Para 28:
...... Instead, a practical approach to eligibility is required – one that will apply to a range of different circumstances, including situations in which the ‘incidental or ancillary’ test is not applicable because, for example, the person is to be cared for in their own home.
Para 46:
Eligibility for NHS continuing healthcare is based on an individual’s assessed health needs. The diagnosis of a particular disease or condition is not in itself a determinant of eligibility for NHS continuing healthcare.
Para 47:
NHS continuing healthcare may be provided by PCTs in any setting (including, but not limited to, a care home, hospice or the person’s own home). Eligibility for NHS continuing healthcare is, therefore, not determined or influenced either by the setting where the care is provided or by the characteristics of the person who delivers the care.
Para 56:
It should always be borne in mind that assessment of eligibility that takes place in an acute hospital may not always reflect an individual’s capacity to maximise their potential. This could be because, with appropriate support, that individual has the potential to recover further in the near future.
(As far as I know, there has only been one person ever known to recover from dementia.)
Para 63:
Whoever applies the checklist should be familiar with, and have regard to, the content and principles of this guidance and the Decision Support Tool (see paragraphs 67–78).
Para 69:
The Decision Support Tool should be used following a comprehensive multidisciplinary assessment of an individual’s health and social care needs and their desired outcomes. If a multidisciplinary assessment has recently already been completed, this may be used; but care should be taken to ensure that it provides an accurate reflection of current need.
Please read the full National Framework here:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103161.pdf
Also read the Coughlan and Grogan references at the end of the above link.
