Does Continuing Healthcare Funding mean no choice with care home???

[MissBB]

Hi - my question is can I refuse to accept a care home if I'm not happy with it?

The hospital are insisting on discharging my mum - she has been awarded NHS Continuing Care funding - but they are only giving us the choice of two care homes.

We're in a catch 22. NHS continuing healthcare sounds like a good thing - BUT the discharge nurse at the hospital (mums been sectioned twice) says that only two homes
a) have an NHS CHC contract and
b) can cater for mums complex needs.

One of the homes is too far away for my dad to visit (and had a bad CQC report), and we have been told by someone who worked in the other one that it's really bad.

I have found another home I like (the only one out of 14 that I've looked at) and, although they don't have an NHS contract, the manager has said that they have in some circumstances done a 'spot contract' for an NHS resident. They are aware of mums needs and are prepared to do an assessment IF and only IF the CCG (the NHS CHC awarding body) would agree to an arrangement where they pay for the nursing care and we top up with the 'lifestyle' extra.

We want to do this - we were thinking we'd have to pay for it all anyway. I just want my mum in the best place - if the funding means that can't happen that seems so wrong - as we are prepared to pay the difference!

My dad is 82 and due for major heart surgery - there is no way he can travel to the homes they are suggesting, and I don't feel happy about either of them in terms of mums care anyway (one had a bad CQC report and the other we've had the bad reference).

I'm horrified that this very unsympathetic discharge nurse is saying they will choose if we don't! I said to her that my mum getting as many visits as possible at this stage in her illness is really important - friends and family are visiting and they wont if she's 40 miles away, never mind my dad.

Ive told her I'm going to dig deeper as to whether the CCG can do a 'spot contract' for us for the home we like.

But like so much about this NIGHTMARE system we all have to struggle through - I just wondered if anybody had been in this position??

Many thanks

 

[jaymor]

Hi Kkoo,

My husband receives CHC and is looked after in a nursing home specialising in challenging behaviour. We only found two such homes, one miles and miles away and one 10 minutes drive away from home. He was assessed and found to need 1:1 care. I am sure that every one of the 26 residents are on CHC because of their complex needs and nursing needs.

This purpose built small nursing home belonging to a large care company was the one we chose. It covered my husband's needs and has proved to be a really exceptional home that has delivered to a very high standard.


I can see no reason why any home cannot accept someone receiving CHC. They receive self funding and LA funding so why not CHC which in fact the NHS paying. The contract would be between the NHS and the home.

I pay no extra at all other than chiropodist, toiletries and clothes.

Jay

 

[Lily2789]

My dear late Dad decided to go into a NH for his last 10 months, he was self funding and received FNC funding. He had a property to sell so received 12 weeks disregard funding from His LA. The NH he moved to was was near to me and in a different authority. His authority didn't have a contract with the home, but for the time he received the payments from his authority and if he continued to receive funding that authority made a contract with the Home, this would continue until the house sold and Dad was self funding and then the authority in the NH area would take on his case if required when his monies were less than £23,000.
This may be of some help


Sent from my iPad using Talking Point mobile app

 

[Saffie]

CHC funding is not given lightly and to be honest, being given allowances of any kind will usually involve compromise somewhere along the line. The NHS will obviously want to select homes that can accomodate the extra needs of the resident. There will obviously be a certain cost effectiveness as well though not to the same level as the LA involvement because top-ups are not permitted with CHC funding.

Lily, FNC is different as it is only a nursing supplement that is paid, so input from the resident is still necessary whereas CHC is the full funding.

I'm afraid I have never heard of a 'spot contract' so know nothing about it but someone else here may do.
I do believe you have some choice as to the home chosen under CHC but within certain boundaries. Good luck with it.

 

[nitram]

"...I have never heard of a 'spot contract' so know nothing about it but someone else here may do..."

In this context I would regard it as meaning agreeing a fee where there is no previously arranged contracted fee.

 

[MissBB]

Thanks everybody for your helpful replies.

My mum has got CHC because of challenging behaviour and I fully appreciate that this limits our choice in care homes.

But the home we like is willing to assess, they do have the specialist dementia nursing criteria, and they say they have taken people in similar circs in the past - under a 'spot contract'.

My gut feeling is that the hospital / CCG don't want to go through the procedure to draw up a contract because they want my mum out of hospital asap. Whilst I appreciate this - I don't think its fair that we get told something is impossible when it MIGHT be possible.

I'll keep making enquiries and if I get straight answers - I'll post outcome here.

Thanks again
KKoo

 

[nitram]

Before the financial aspect of any contract can be sensibly discussed the CCG should ensure that a care plan has been drawn up detailing your Mum's specific care requirements.

Is such a plan in existence?

 

[SengoSon]

Hold Firm

But the home we like is willing to assess, they do have the specialist dementia nursing criteria, and they say they have taken people in similar circs in the past - under a 'spot contract'.

My gut feeling is that the hospital / CCG don't want to go through the procedure to draw up a contract because they want my mum out of hospital asap. Whilst I appreciate this - I don't think its fair that we get told something is impossible when it MIGHT be possible.

May I suggest that as your Mother is in a NHS Hospital and they have a duty of care to her and they need to get approval from you as your mother 'champion' before they can transfer her. Just hold firm (I know it can be hard) and re-iterate your concerns about the distance and that a Care Home locally would access and take your mother.

Perhaps also suggesting that in the medium to longer term it will benefit the NHS Hospital to have more options for transferring future patients, especially as Alzheimer's and Dementia are going to get more common with an ever ageing population.

Good Luck and a fair wind.

 

[MissBB]

I spoke to the CHC nurse who assessed my mum and awarded the CHC funding - and told her I'm not happy about the two care homes that have been suggested by the discharge nurse due to a) distance and b) CQC reports.

I told her that the care home I like have said that, although they don't have an NHS contract, they have taken CHC residents in the past - with the family topping up the 'lifestyle' payment on top of the funding. The CHC nurse said 'that's against the rules' (terms and conditions of CHC). So how have they done it - is there a loophole?

The CHC nurse said she would ask the CCG to speak to my preferred care home to see if they can meet my mums needs at the allocated rate, and if they can, then they can do an assessment to see if the can accommodate her clinical needs. So the CHC nurse is at least willing to explore the option.

But I think the amount awarded is around £600 pw and the home is £900 pw. So I'm not raising my hopes because they seem to insist we can't pay the difference.

Many thanks again - I'm so grateful there is somebody out there who understands this.
Kkoo

 

[MissBB]

Before the financial aspect of any contract can be sensibly discussed the CCG should ensure that a care plan has been drawn up detailing your Mum's specific care requirements.

Is such a plan in existence?

I believe it is - and we have a meeting on 4th July with consultants, nurses etc to go over it. I will say at this meeting that my dad won't be able to visit her at the homes they have suggested due to his ill health / age - and that I would like them to try and suggest places nearer.

Thanks for your reply.

 

[Monkey1980]

Any outcome?

I believe it is - and we have a meeting on 4th July with consultants, nurses etc to go over it. I will say at this meeting that my dad won't be able to visit her at the homes they have suggested due to his ill health / age - and that I would like them to try and suggest places nearer.

Thanks for your reply.

Hi Kkoo
Curious what the outcome was for you- we're just going through the CHC process and want mum to be nearer us but have heard the health board won't pay the rates. Did you reach a compromise in the end? Did they also allow you to top up the lifestyle element?
Thanks
Cerys

 

[99purdy]

Hi Monkey, My step dad was awarded CHC for challenging behaviour. We needed a EMI unit and unfortunately in the whole of our region only 4 units had a bed vacancy. I went round to them all with the assessor. They were all very different. The two units which were my preferred choice were so different. One was near to my home, looked like a 5* hotel, but the staff were not too friendly. The second choice was not 'posh' but to be honest I liked the staff, they served me tea and biscuits!!! They knew all about their patients. The staff had all worked there for a long period of time, some 17 years! Anyway, against my better judgement I chose the 5* hotel. Well guess what when they came to assess him they turned him down saying his behaviour was too challenging. So he was admitted to my second choice. He has been there 18 months, my goodness has he been challenging. The staff at this home are fantastic, the food is excellent they deal with his challenging behaviour and he is happy. I am so pleased he is there. He had to go into hospital and this was a nightmare his behaviour deteriorated. When he went back to the NH I felt a big weight had been lifted. I know they will care for him. The point I suppose I am trying to make is don't think if you pay more and the home is better decorated then you will get better care. Ask the carers how long they worked there, see if the other residents look happy, ask other visitors how they find the care etc. I can only wish you the best of luck and hopefully you will find a really good home that will provide the best care for your relative. X