1. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    Should be attending another DST meeting within the next week. The previous meeting brought up residential care.

    2 and a half weeks after being in residential care, my Grandad ends up in hospital. Now the home won't take him back as residential but been told he's still borderline to residential and nursing.

    Nebuliser has been added to his long list of medication. His mobility is even worse and will need hoisting for when he does return. The home have subbmitted their findings for the DST meeting.

    Right now facing nursing care with no contribution. Ridiculous.

    Thoughts?
     
  2. katek

    katek Registered User

    Jan 19, 2015
    191
    Hopefully your Grandad's extra needs and the fact that the care home will be providing evidence too should help his case. If they cannot cope with him and he now needs a Nursing Home, it sounds as if he should at least get the FNC in my opinion, but you seem certain that he won't.

    Out of interest, what did he score on the DST last time, and how much higher do you think he would score now? The usual scenario is that people with, say, one 'Severe' and a number of 'Highs' are usually (and wrongly) turned down for full CHC but do at least get the nursing contribution. However, I don't know what the minimum score for this would be.
     
  3. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    I just heavily sense there's going to be a repeated battle for FNC. Not expecting continuing healthcare.

    Don't know what he scored last time. Asked for a copy but never got one. Will try and chase this up but a DST isn't done unless there's doubt...right?
     
  4. katek

    katek Registered User

    Jan 19, 2015
    191
    #4 katek, May 13, 2015
    Last edited: May 13, 2015
    The new DST will be done as a result of your grandad's recent hospital admission, and his subsequent needs upon discharge. Very few people get CHC but it seems that a high percentage of those who don't qualify for this, do at least get FNC - which is what one would expect if they passed the checklist stage in the first place. The fact that the care home are saying he needs nursing care would suggest he should be eligible, but logic such as that does not always exist in the world of DST assessments!

    Will you be going to the meeting to support his application? If so, prepare beforehand by downloading a copy of the DST and doing your own scoring based on what you can see are his needs. Together with the care home's evidence, this will put you in a better position to argue his case if the CCG try to play down his needs - as they are likely to do! Hopefully he will at least end up with the FNC to help fund his care.
     
  5. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    They are heavily dependant on evidence and I feel they'll count the care home's findings as an opinion rather than evidence.

    Yes, me and relatives will be attending the DST. Been told a doctor will be at this meeting which wasn't the case last time. It was just someone from continuing care and a social worker who thought they had a good opinion of my Grandad with a brief 5 minute chat with him!

    Yes, will be looking over the documentation beforehand.

    A nursing bed at the home is reserved and ready, feel as though matters are being made more difficult than it needs to be!
     
  6. katek

    katek Registered User

    Jan 19, 2015
    191
    Hopefully the fact that a doctor will be there will help your grandad's case. CHC teams are often a law unto themselves, acting as both judge and jury, but surely they cannot totally ignore a doctor's evidence. It's good that you and other relatives will be there too, and hopefully he will at least get FNC.

    I agree that it's wrong that this sort of help has to be so hard fought for. It's also very sad and unfair that those who have no-one to fight for them lose out.
     
  7. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    It's not certain a doctor will be there but I know they'll be someone from NHS CHC, social worker, physio, OT and a nurse from the ward. We basically got more people on "our side".

    The evidence they are so focused on basically speaks for itself this time.
     
  8. katek

    katek Registered User

    Jan 19, 2015
    191
    The nurse, OT and physio will be producing the clinical evidence for scoring on the DST, and the social worker should be on your side (especially if your grandad is not self-funding, as they too would rather the NHS paid ! ). The CHC assessor (representing the funding body (CCG)), while outnumbered, holds the power to make the recommendation either for or against CHC.

    The actual scoring is usually fairly straightforward, but the real dispute is usually over exactly how many 'Highs' etc qualify for CHC. Anything below two 'Severes' is highly unlikely BUT would very probably get FNC. If I am right, it is the FNC that you are worried you might not even get, but that is a lot easier to get than CHC (although I don't know what the actual minimum criteria are for this).

    However, if you feel your Grandad's needs are actually high enough for full CHC, you will have more of a fight on your hands. If you don't already know about the Pamela Coughlan judgement, it might be worth looking that up and reminding them of it. Their own guidelines (the National Framework) mention it, although in practice many people who don't get CHC are actually at, or even above, her level of needs.

    If CHC assessments were always fair, open and transparent, then failing to qualify would be acceptable. Unfortunately, that is not always the case.
     
  9. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    We'll see how it goes. Meeting has been organised.

    Thank you for your help katek. Much appreciated.
     
  10. katek

    katek Registered User

    Jan 19, 2015
    191
    No problem! Good luck - and I'd be very interested to know how it goes.
     
  11. wilf

    wilf Registered User

    Mar 19, 2014
    30
    Good luck but doubt you will get it. My mother at home with me. Dst completed by multi discipliniary team of social worker, chc team member, pyschiatric nurse, care agency manager. Scored 3 severe (one bordering on priority) and most other domains high. Panel refused stating lack of evidence despite my daily logs clearly proving Mum needs 24/7 care. Had 2nd dst meeting, same scores plus written evidence from GP and Head pysciatrist stating Mum needs 24/7 care and her best needs are met at home with me. Also supplied print out of times that bedside alarmed pressure mat went off (every hour or so most nights). Also supplied written evidence that last 2 occassions Mum was in respite she fell as was left unattended and when hospitalised as a result of the second fall she fell yet again as she was left unattended. Panel yet again refused chc stating Mums needs can be met in a residential home. Utter nonsense, have my M.P. on the case but not expecting any joy. Sorry to be negative but you may as well forget about chc as its a farce when it comes to providing for dementia sufferers.
     
  12. Angel Eyes

    Angel Eyes Registered User

    Mar 3, 2015
    25
    With
     
  13. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    As I've said, not after CHC as it's so difficult to get. NHS funded care is the aim.

    Getting mixed messages from hospital. He might be still residential and then he will likely get NHS funded care from somebody else.
     
  14. Black&White

    Black&White Registered User

    Dec 27, 2014
    13
    To let you all know that it went in my Grandad's favour. Outcome was funded nursing care.
     
  15. katek

    katek Registered User

    Jan 19, 2015
    191
    That's great! Without even knowing your Grandad's needs, I was pretty confident he'd get this, as it is the most common scenario i.e - pass checklist but fail to get CHC = FNC. The main difference is, in his case FNC is all you wanted (either because his needs were not particularly high, or you were just resigned to the fact that CHC is an unrealistic expectation) whereas most people who pass the checklist are hoping for CHC and see FNC as less than they deserve.

    Out of interest, what did he score on the DST?
     
  16. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,046
    Staffs
    Good news . I hope your Granddad settles back in OK.:)
     

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