Aspiration + Continuing Health Care

[Triplecarer]

Hi all,

My mum is in hospital at present but is in the throws of being discharged. We are having all kinds of problems with getting the right kind of care for mum and working out who pays for such care. Mum has only been diagnosed with aspiration for about 6 weeks, approximately 2 weeks prior to being admitted to hospital after a fall. Whilst in hospital she was diagnosed with a community acquired 5th chest infection which is what has kept her in hospital. Prior to hospital admission mum was being swapped social services teams with a view to assessing her for Continuing Health Care. Whilst in hospital this has become a real bone of contention. With both the hospital and community social services team arguing who should provide this assessment.

During the discharge meeting mum was pre assessed for continuing health care and we were told she didn't qualify even though they admitted the aspiration needs were primarily a health care need. I did fight mum's corner yet again and pointed out that when she went into the community she was likely to be assessed due to the previously voiced wishes of the community social services team. I have since been told that the hospital social services team cannot commission a care agency to thicken mum's drinks or supervise her meals. Without this care there is a very strong possibility that mum could choke and worst case scenario die. They wanted a family member to go in daily and thicken all drinks for mum, both hot and cold which is totally impractical.

Yesterday, I was told that an agreement had been reached and the NHS would pay for the care agency to thicken mums drinks and supervise her meals because it was primarily a health care need but this is not 'Continuing Health Care' as she still didn't qualify!

My question is what scheme is it that the NHS is paying for nursing care needs if it is not continuing health care and what safeguards do we have that the NHS won't pull out if the going gets tough where finances are concerned? I am very confused. To help we live in Wales.

Thanks in advance and sorry for long first post.
Sylvia

 

[jaymor]

Hi and welcome to Talking Point.

The NHS pay FNC, funded nursing care which is totally different to CHC.

It is a fixed weekly amount that is paid to a nursing home to cover the nursing care of a resident. It could be that there is also a fund that covers for the type of care your Mum requires at the moment.

if your Mum requires thickener then she should have it. My husband's was on repeat prescription and we never had a problem with the hospital thickening his drinks on his admissions to hospital. Contact your Mum's doctor and see if he will prescribe it.

 

[Triplecarer]

Thank you Jay. I will look up FNC as I have never heard of this before.

The thickener is prescribed by our GP with no problems.

Mum will be going back to her own home and this is where the funding and commissioning problems have arisen. They have also suggested looking for residential care homes as they say mum does not need nursing care. They are obviously contradicting themselves constantly here.

Thanks again.
Sylvia

 

[nitram]

FNC can only be paid to a nursing home, it is a contribution to the home for the availability of a nurse 24/7. It cannot be paid for care at home.

If a persons nursing needs become too unpredictable or complex for the community nursing service the person has to be transferred to hospital or a nursing home.

From what you have said they are not contradicting themselves, giving thickened drinks does not require a nurse, it does however require an experienced person.

 

[Triplecarer]

FNC can only be paid to a nursing home, it is a contribution to the home for the availability of a nurse 24/7. It cannot be paid for care at home.

If a persons nursing needs become too unpredictable or complex for the community nursing service the person has to be transferred to hospital or a nursing home.

From what you have said they are not contradicting themselves, giving thickened drinks does not require a nurse, it does however require an experienced person.

If the FNC can only be paid to a nursing home this cannot be the pt from which the NHS Trust are taking the money as mum is returning to her own home for at least the forseeable future.

Again the hospital are telling me to look for residential care homes not nursing homes. I really am getting very confused sorry.

I understand what you are saying because prior to mum going into hospital the carers were thickening her fluids with few problems. (That's yet another horror story!) It is only since she has been in hospital that both the nurses and hospital social worker are saying they cannot commission care workers to thicken mum's fluids. This is where the query over CHC and then them saying family members would have to do this on a daily basis, which is not practicable or possible.

I will look up the FNC now to see what it says.
thanks for all your help.
Sylvia

 

[nitram]

"I will look up the FNC now to see what it says."

I've done it for you:

Who is eligible for NHS-funded nursing care?

You may be eligible for NHS-funded nursing care if:
you are not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse
you live in a care home registered to provide nursing care

http://www.nhs.uk/chq/Pages/what-is-nhs-funded-nursing-care.aspx

I think you are getting into deciding whether all 'carers' are allowed to mix and give thickened drinks. I think that it is reasonable that carers in a residential home will be trained/supervised to do this, whether home carers from an agency understand what is required is another matter.