chc assessment yesterday

[sunnybank]

went to chc assessment yesterday at mum in laws care home. I was given no evidence before the meeting by the nurse organiser from health authority . at the meeting we generally didn't agree on ratings but he said he put one in on the first 3 and made a note the family didn't agree. then he said he was in between ratings ,so I said if your in between the rating has to go to the higher level ,he disagreed and said no it doesn't and refused to do any more ratings as he wasn't sure. It was a friendly meeting and the care home staff were lovely. the social worker had not seen Mum and knew nothing about the case other than what came up at the meeting ,which was what I said and the care reports from the home. this was despite me emailing him twice and asking for reports and where we might get them from. I thought I was quite clued up on the process but when he said he wasn't rating until he had a chance to think about it ,I was completely floored.I phoned him this morning after checking notes and he just denied that he could decide between 2levels and he just needed to think about it.Is he allowed to decide this after meeting

 

[jackie ja]

Am I being cynical?
I have recently been through this process, still waiting for the paperwork, though based on the meeting am struggling to work out what grounds there are for appeal, in fact it would seem the better someone is being cared for the less likely you are to get funding, ie if someone is at risk of falling but has not, or if there skin is weak but no sores due to good management or not wanting food and drink or medication but responding to gentle prompting.

Surely this should be about actual need rather than evidenced based on weight charts, fall records, Number of UTI's etc, but it clearly is not.

 

[susiesue]

I was told that a need is still a need whether it is managed or not!

I appealed when my husband was declined CHC funding. Admittedly I went through a firm of solicitors specialising in such claims and two and a half years later I was refunded all the fees that I had paid! so yes I defininitely think it is worth appealing.

Good luck.

 

[crazyfish]

went to chc assessment yesterday at mum in laws care home. I was given no evidence before the meeting by the nurse organiser from health authority . at the meeting we generally didn't agree on ratings but he said he put one in on the first 3 and made a note the family didn't agree. then he said he was in between ratings ,so I said if your in between the rating has to go to the higher level ,he disagreed and said no it doesn't and refused to do any more ratings as he wasn't sure. It was a friendly meeting and the care home staff were lovely. the social worker had not seen Mum and knew nothing about the case other than what came up at the meeting ,which was what I said and the care reports from the home. this was despite me emailing him twice and asking for reports and where we might get them from. I thought I was quite clued up on the process but when he said he wasn't rating until he had a chance to think about it ,I was completely floored.I phoned him this morning after checking notes and he just denied that he could decide between 2levels and he just needed to think about it.Is he allowed to decide this after meeting

Hi sunny bank,
Was this the checklist or a full MDT assessment?
If it was a full MDT assessment who else was present?
Have you been given any paper work by the NHS to explain the CHC assessment process?
You say in his scoring he put one in the first three can you explain was this a domain score?
Have you also downloaded the national framework for CHC and read it through.
If not you must.
These are the rules and procedures the NHS must abide by when considering CHC applications.
If you could expand your thread there are people here who can advise.
Mick

 

[Johnsonj]

Hi Sunny bank, Have been through some of this process, considering appeal, and think this does not seem quite right, while I feel the process is unfair, to date i have felt included, mum is unable to understand anything so i act as her advocate, there has been checklist meeting, home nurse, me and nhs chc rep. Social worker visit to see muM, me present, dst meeting with nhs chc rep, social worker, home nurse and me. All friendly but to the point. They are duty bound to use the process correctly. They should agree on levels, and record your comments /objections clearly. I was certainly told their exact assessment, which is subject to ratification at the end of the meetings, (not in the least impressed by the outcome, though). What i did learn is that they have taken on more staff to cope with the work load, perhaps lack of training here.

 

[Johnsonj]

I was told that a need is still a need whether it is managed or not!

I appealed when my husband was declined CHC funding. Admittedly I went through a firm of solicitors specialising in such claims and two and a half years later I was refunded all the fees that I had paid! so yes I defininitely think it is worth appealing.

Good luck.

susiesue, have heard this said about a need, but have you any idea where this comes from please.

 

[crazyfish]

susiesue, have heard this said about a need, but have you any idea where this comes from please.

Hi Johnson,
I think what susiesue meant was,
A well managed need is still a need!!!
If you removed the care what would happen?
Mick

 

[nitram]

"...susiesue, have heard this said about a need, but have you any idea where this comes from please...."

28. Needs should not be marginalised because they are successfully managed. Well-managed needs are still needs. Only where the successful management of a healthcare need has permanently reduced or removed an ongoing need will this have a bearing on NHS continuing healthcare eligibility. However, there are different ways of reflecting this principle when completing the DST. For example, where psychological or similar interventions are successfully addressing behavioural issues, consideration should be given as to the present-day need if that support were withdrawn or no longer available and this should be reflected in the Behaviour domain.

>>DST SUPPORT TOOL<<

 

[Johnsonj]

Hi, sorry was no clear, understand what susie sue is saying but was trying to track down if this came from something official as i also feel if needs are well managed, they tend to be ignored/ downgraded in assessments

 

[Johnsonj]

"...susiesue, have heard this said about a need, but have you any idea where this comes from please...."

28. Needs should not be marginalised because they are successfully managed. Well-managed needs are still needs. Only where the successful management of a healthcare need has permanently reduced or removed an ongoing need will this have a bearing on NHS continuing healthcare eligibility. However, there are different ways of reflecting this principle when completing the DST. For example, where psychological or similar interventions are successfully addressing behavioural issues, consideration should be given as to the present-day need if that support were withdrawn or no longer available and this should be reflected in the Behaviour

Yes thanks, this is sort of thing i was thinking about

 

[crazyfish]

susiesue, have heard this said about a need, but have you any idea where this comes from please.

Hi Johnson,
I think what susiesue meant was,
A well managed need is still a need!!!
If someone is being well cared for in a ch then it doesn't mean that still don't have a need .
The basis of this quote comes from the national framework and practice guidance sec11.3 .
Mick

 

[BeckyJan]

It may be worth you googling Decision Support Tool for NHS Continuing Healthcare, November 2012 (Revised). This is an extract from Page 13:

after considering all the relevant evidence, it proves difficult to decide or agree on the level, the MDT should choose the higher of the levels under consideration and record the evidence in relation to both the decision and any significant differences of opinion. Please do not record an individual as having needs between levels. It is important that differences of opinion on the appropriate level are based on the evidence available and not on presuppositions about a person’s need or generalised assumptions about the effects of a particular condition

I had much advice and support for an Appeal from the voluntary support group:
http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=398

 

[susiesue]

I can't remember who told me - possibly the solicitors who acted for me - but it seems Johnsonj has clarified this.