CHC Funding and Attendance Allowance

[mrsapple]

Would be grateful for any advice : Having been self funding for almost five years mum has just been awarded CHC funding - she is in a residential care home (not a nursing home). I've been told that the CHC funding will meet all the care home costs but that her Attendance Allowance will be stopped.

However, I've found a NHS CHC FAQ website which says that if care is not provided by "qualified nursing or medical staff" she can't be described as being like a patient in a medical institution and therefore AA could continue.

Has anyone experience of this?

 

[Witzend]

I was under the impression that if all care homes costs are being met by someone else (whether NHS or LA) then AA is stopped. I thought only self-funders were entitled to it, which would seem fair and sensible enough, since self-funders are still having to pay for all their 'attendance' costs themselves.

 

[NewKid]

Residential CH says my Mum's 'too dependent' for them - can I get CHC funding now?

Interesting post, as I too am hoping to finally secure some CHC having been footing care bills now for five years... Input very welcome and in regards to the original post, I had assumed that CHC would be quite a lot more than Attendance Allowance anyway so maybe the loss of AA won't be such an issue? I may be wrong…?

My own problem is that Mum's residential home has just sent me a letter saying they have been found to be non compliant on staff-resident ratios - so she, who is deemed to have 'high dependency', is going to have to go. As you can imagine, I'm gutted: Mum has been there over four years and only recently I had difficult but reassuring 'end of life' conversations which included her not being admitted to hospital but kept at 'home' with them.

Where are these 'high dependency' residents (the audacity of it) supposed to move to?!

Mum has just been accepted on a 6-week trial at another residential (not nursing) home with a better staff-resident ratio and they have been told about her needs (I hope realistically). It is in London, near me (whereas until now mum has been miles away near her old home town) which means the fees are £200 pw higher. Another home - which is 'nursing' - told me if she is being ousted out of her current CH because of her 'high dependency' then surely we must be eligible for CHC ? But does anyone know? Would she have to be in 'nursing' home?

Also, I am really keen on this new home, but again it's residential. I would be reliant on them calling in district nurses however they are renowned for good 'end of life' care and understanding of dementia. Has anyone views on whether a residential home like this copes well enough as their relatives decline?

My Mum no longer communicates well, can walk sometimes but with assistance, is incontinent and needs help with all personal care, with her main physical issue so far being need of a very rigorous skin care regime or she gets acute excema.

I'm sorry my post is so long but it's been a very difficult and upsetting week and I know from experience that sharing here will help. Thanks so much and to mrsapple I hope you soon get help too.

 

[Saffie]

However, I've found a NHS CHC FAQ website which says that if care is not provided by "qualified nursing or medical staff" she can't be described as being like a patient in a medical institution and therefore AA could continue.

I am mystified that someone can recieve CHC funding, which is for a primary health care need, can receive CHC funding without any input from any medical person. Yet people who obviously have a primary health care need which does require qualified medical care, are refused it.

If the fees for care are not being paid by the person concerned, why would they need the AA payments? Surely,all the fees are being covered by the CHC. As newkid has suggested, the AA payments are a mere drop in the ocean where CHC funding is concerned.

 

[NewKid]

Quick question what IS Attendance Allowance covering?

Just wondered what Attendance Allowance is actually for? Is it to cover costs of visiting/ supporting when your relative is cared for in another setting?

I have just had a phone call from Social Services who will assess my Mum and see if she is eligible for CHC funding - I hope I get some help, as my costs for her residential care are about to rise dramatically.

Does anyone know if you have to be in a 'nursing' setting to qualify?

 

[Saffie]

Does anyone know if you have to be in a 'nursing' setting to qualify?

Going by the OP's post, then the answer is no. Many of us with relatives in nursing homes and with definite health care needs other than dementia, have been refused it though, so it's not easily come by but a lot depends on which Health authority you come under, so you can never tell.

As I understand it, AA is for someone to 'attend' the sufferer and help them.

 

[Witzend]

Just wondered what Attendance Allowance is actually for? Is it to cover costs of visiting/ supporting when your relative is cared for in another setting?

?

As I have always understood it, it is to help to pay for assistance for, or supervision of the person. E.g they need help with washing/dressing/meals, or need someone there most/all of the time because they are not safe to be left alone.

I don't think it is intended to cover costs of visiting someone in a care home. If someone is self funded in a care home it will usually go towards the much greater cost of that 24/7 care.

As I said before, for fairly obvious reasons I don't think anyone who is not self funded is entitled to AA

However if someone has power of attorney for finances, I gather they are allowed to claim reasonable costs for necessary visiting. I know a BIL of mine (as straight as they come) who had p of a for an aunt and lived a very long drive away, would repay his own costs for petrol and the odd overnight stay.

 

[Saffie]

I don't think it is intended to cover costs of visiting someone in a care home. If someone is self funded in a care home it will usually go towards the much greater cost of that 24/7 care.

I'm pretty certain it is intended as you say Witzend. I hope my comment about attending and helping a sufferer didn't imply otherwise.

 

[NewKid]

Thanks - I did gather that getting CHC is random and hard

Yes that all makes sense - well it doesn't, in the fact that the assessment for eligibility for CHC seems as usual random and nonsensical. I use the AA to help fund mum's care and in reality I'm not anticipating success in my CHC application, but guess it's worth a go.

It will be for physical needs, as if having dementia wasn't enough of a physical illness… Today the manager at the CH I've applied to listed their concerns about accepting mum rather coldly as: 'doubly incontinent' 'mobility problems' and 'needs feeding' - I felt like saying, I know it doesn't sound pretty, but that's dementia for you.. He made it sound like a favour that he would consider her case.

Jeez! Just needed to get that off my chest.

 

[NewKid]

Apparently self funders can have both Attendance Allowance and CHC funding

Just to add, a social worker who is about to assess my Mum's 'nursing needs' tells me that the weekly allowance for a nursing element is around £109 pw and that self-funders that qualify for CHC are also entitled to the Attendance Allowance. They are separate and unconnected, she says, as MrsApple was also told. I still don't have high hopes of getting any CHC .. as I hear you Saffie and know it's not always easy or seemingly fair how it's allocated.

 

[garnuft]

This is what I found by browsing the internet.

Does NHS continuing healthcare have any effect on benefits?

Most benefits aren’t affected by NHS continuing healthcare, but if the person you look after gets this in a care home, they will stop being eligible for some disability benefits.

If the person you care for gets Attendance Allowance (AA) or Disability Living Allowance (DLA), and they are awarded NHS continuing healthcare in a care home, their benefits may be affected. If the care home provides care from medically trained staff or qualified nurses, and the resident can be described as receiving medical treatment like an inpatient in a hospital or similar institution, then their benefit will stop on the 29th day after the NHS begins to fund their care, or sooner if they have recently been in hospital.

If their care isn’t provided by qualified nursing or medical staff and they can't be described as being like an inpatient in a hospital or similar institution then their DLA should not automatically stop.

However, if they are getting DLA and have a Motability agreement, the higher rate of their DLA mobility component will continue to be paid to Motability’s service providers.

If the person you care for gets AA or DLA, and also gets a means-tested benefit such as Income Support or Pension Credit, their means-tested benefit may include an extra amount called a disability premium, or severe disability premium. If their AA or DLA stops, they’ll no longer get any disability-related premiums. This could mean they’ll get less means-tested benefit, or that they no longer qualify for any.

People getting AA or DLA who go into a care home or hospital that is funded by NHS continuing healthcare must notify the Attendance Allowance Unit or Disability Living Allowance Unit by calling 08457 123456.

If the person you care for gets NHS continuing healthcare in their own home, they will still be able to claim AA or DLA as long as they meet the eligibility criteria for these benefits.

http://www.nhs.uk/CarersDirect/guide/practicalsupport/Pages/continuing-care-faq.aspx

http://www.nobilis.co.uk/dealing-wi...ects/48-am-i-entitled-to-attendance-allowance

 

[jenniferpa]

If you receive the nursing care allowance and are self-funding otherwise you can definitely still receive AA. However if you are getting full CHC funding you do not. This is because getting CHC funding is akin to being in hospital and if you are in hospital, AA stops after 28 days.

 

[NewKid]

Thanks for clarifications

Thanks for clarifying. The CHC allowance I quoted is still be a drop in the ocean of overall costs for a self-funder after all.

 

[scared daughter]

CHC allowance?! I thought CHC funded the whole cost of care - my mum hasn't been granted AA allowance as shes not paying the full amount of care ie nursing element funded - so I'm really confused now!

 

[nitram]

"...my mum hasn't been granted AA allowance as shes not paying the full amount of care ie nursing element funded..."


If she is self funding apart from the receipt of FNC she should still receive AA as she is deemed to be meeting the 'whole cost'.

Meaning of “whole cost”
61755 A person meets the whole costs of all the qualifying services (see DMG 61735) where the fees charged by the home, excluding the cost of nursing care paid for by the HA, or provided by (or the provision of which is secured by) the LA, are paid in full. Grant or other subsidies made by LAs or HAs to the home do not affect payment of benefit and should not be taken into account1.
1 HL: CAO & Secretary of State v. Steane


>>>DECISION MAKERS' GUIDE AA & DLA<<<

 

[scared daughter]

This

 

[nitram]

For attendance allowance when in receipt of FNC just refer them to:-

DMG Vol 10 Ch 61: Attendance Allowance and Disability Living Allowance : 61755

I included the text in my last post.

 

[jenniferpa]

Nitram's quite right. My mother got was then called the RNCC (now FNC) plus AA as a self-funder.

 

[scared daughter]

n

 

[Ppod]

Why does it have to be so hard?

I'm afraid I can't really offer any knowledge as I am still fighting but really, why on earth at a time which is stressful and difficult would anyone think its ok for the money stuff to be anything but simple. I was recently told that CHC was granted when people would have to be in hospital (at the expense of the state) if not in their current care establishment. Truthfully I don't understand any of it - so good luck to all that have to go through the process