Cathy's chc journey

[try again]

Mum (Cathy) was moved from her care home to a nursing home before Xmas. The nursing home apply for the FNC part of their fees. Today I received a phone call and then the standard letter and we have a full assessment at the end of the month.

I'm not pushing or fighting for CHC and as she has no other health issues do not expect to be granted other than FNC (funded nursing care)
Mum is self funding after her house sale and has enough to fund about 3 years care. The family is sad that her assets are needed to pay for her care but realistically at this stage she is not going to spend it on anything else.

I'm posting this just to chronicle our experience to add to the wealth of knowledge to be found in this forum .

Anyway, the letter reads

"The NHS Continuing Healthcare Department has received an application for consideration of eligibility for NHS Continuing Health Care. This application is called an NHS Continuing Healthcare Checklist and was received from The Nursing Home on 29th December 2023.
The Checklist is a screening tool used to assess an individual’s healthcare needs. The information determines whether a full assessment of an individual’s eligibility for NHS Continuing Healthcare is required. This process is in accordance with the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care July 2022 (Revised).
The received NHS Continuing Healthcare Checklist indicates that full consideration for NHS Continuing Healthcare eligibility is required, and a Multi-disciplinary Team (MDT) meeting has therefore been arranged."

Will update at end of month.

 

[Dave63]

The nursing home apply for the FNC part of their fees.

Have you checked whether the fees your mum is currently paying are inclusive or exclusive of any FNC? If inclusive then if she is awarded FNC then the £940pm (£11'400pa) should be deducted from her fees. If exclusive then she continues paying the current amount and the nursing home will keep the FNC amount. Bit unfair if a person is already paying for the nursing care, but that's just my view.

I'm not pushing or fighting for CHC and as she has no other health issues do not expect to be granted other than FNC (funded nursing care)

How your mums needs impact on the four key indicators of Nature, Complexity, Predictability, and Intensity will determine whether there is a primary health need. These will be recorded and scored using the Decision Support Tool during the MDT. Download a copy and see how you think your mum would score based on her current needs. The evidence the nursing home present during the MDT will be vital to proving the levels of need. I wouldn't be surprised if some homes downplay the levels of need as CHC being awarded is not financially beneficial to them, where as FNC, if it is exclusive of their fees, most definitely is.

https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare-decision-support-tool-guidance-2022.pdf

 

[try again]

Thank @Dave63 Yes the fees are 950 or so excluding nursing so if she doesn't qualify for FNC they will go up. The thought is as the care home requested she move she will qualify for FNC.

The email includes all the relevant lists . I have looked at them months ago when I first saw chc mentioned and will review.

 

[Rayreadynow]

Mum (Cathy) was moved from her care home to a nursing home before Xmas. The nursing home apply for the FNC part of their fees. Today I received a phone call and then the standard letter and we have a full assessment at the end of the month.

I'm not pushing or fighting for CHC and as she has no other health issues do not expect to be granted other than FNC (funded nursing care)
Mum is self funding after her house sale and has enough to fund about 3 years care. The family is sad that her assets are needed to pay for her care but realistically at this stage she is not going to spend it on anything else.

I'm posting this just to chronicle our experience to add to the wealth of knowledge to be found in this forum .

Anyway, the letter reads

"The NHS Continuing Healthcare Department has received an application for consideration of eligibility for NHS Continuing Health Care. This application is called an NHS Continuing Healthcare Checklist and was received from The Nursing Home on 29th December 2023.
The Checklist is a screening tool used to assess an individual’s healthcare needs. The information determines whether a full assessment of an individual’s eligibility for NHS Continuing Healthcare is required. This process is in accordance with the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care July 2022 (Revised).
The received NHS Continuing Healthcare Checklist indicates that full consideration for NHS Continuing Healthcare eligibility is required, and a Multi-disciplinary Team (MDT) meeting has therefore been arranged."

Government website : I read that CHC has to be turned down before FNC can be applied for. I also read that you should get all relevant care records, daily care records because the assessments are largely done by the ICB's using written records, and its in the Care Homes interest to down play a persons needs or not record them on a persons worse days.

 

[try again]

Government website : I read that CHC has to be turned down before FNC can be applied for. I also read that you should get all relevant care records, daily care records because the assessments are largely done by the ICB's using written records, and its in the Care Homes interest to down play a persons needs or not record them on a persons worse days.

I don't see why the nursing home would play down a persons needs, what would motivate this?

 

[nitram]

I don't see why the nursing home would play down a persons needs, what would motivate this?

If resident is self funding the home may receive less if CHC is granted.

 

[try again]

If resident is self funding the home may receive less if CHC is granted.

I just assumed a top up would apply from mums finances else it means if you qualify for CHC your choice of home has been taken from you?

 

[Dave63]

I just assumed a top up would apply from mums finances else it means if you qualify for CHC your choice of home has been taken from you

Top up's are not allowed for CHC funded residents.

 

[nitram]

I just assumed a top up would apply from mums finances else it means if you qualify for CHC your choice of home has been taken from you?

CHC cannot be topped up.
Additional provided services not assessed as needed can be paid for privately.

Cue arguments about bars and cinemas.

 

[Rayreadynow]

CHC cannot be topped up.
Additional provided services not assessed as needed can be paid for privately.

Cue arguments about bars and cinemas.

Cue the reason why a Care Home would play down a persons needs. Its an interesting conundrum that the care homes are only too aware of.

 

[maisiecat]

My husband's dementia home applied for CHC for him although he had already been awarded FNC. He has Parkinson's disease late stage,epilepsy,2 types of dementia,vascular disease and is at serious risk of fracture. His frailty score is off the wall, he was deemed not to have a primary health need. It was one of the things that really made me laugh as it is so obviously ludicrous. I hadn't expected to get it and felt it was unlikely to benefit either of us

 

[Rayreadynow]

My husband's dementia home applied for CHC for him although he had already been awarded FNC. He has Parkinson's disease late stage,epilepsy,2 types of dementia,vascular disease and is at serious risk of fracture. His frailty score is off the wall, he was deemed not to have a primary health need. It was one of the things that really made me laugh as it is so obviously ludicrous. I hadn't expected to get it and felt it was unlikely to benefit either of us

That's utterly unfair. All I would say is I was urged not to ask the Care Home to apply for CHC because it would been they would probably get less per week from the NHS for care, the care home records may underplay a persons needs.

 

[maisiecat]

That's utterly unfair. All I would say is I was urged not to ask the Care Home to apply for CHC because it would been they would probably get less per week from the NHS for care, the care home records may underplay a persons needs.

Oddly I hadn't asked them to apply and knew the FNC had been agreed virtually as a lifetime award as all his conditions are progressive. The LA pay most of his care taking his pensions following assessment. I managed to keep half his private pensions and I also top up from a legacy i had. I didn't expect to get it as in the Parkinsons community it is an open secret that its rarely awarded and if he had got a percentage I thought the LA would reduce their commitment so I put it in my p*** off file.

 

[Rayreadynow]

Oddly I hadn't asked them to apply and knew the FNC had been agreed virtually as a lifetime award as all his conditions are progressive. The LA pay most of his care taking his pensions following assessment. I managed to keep half his private pensions and I also top up from a legacy i had. I didn't expect to get it as in the Parkinsons community it is an open secret that its rarely awarded and if he had got a percentage I thought the LA would reduce their commitment so I put it in my p*** off file.

I wish everyone could have a p*** off file. There is something about this whole system of who pays for what that I find really distasteful. The LA expect you to Top-Up here Top-Up there. Then people start comparing Dementia with Parkinsons or Parkinsons with alzheimers, it is quite life sapping.

 

[Kevinl]

Never pay a top up, there's no legal liability for a 3rd party adult in this country, note 3rd party.
In effect a top up is a voluntary contribution for an "upgrade" in terms of choice of; location, particular care home you want as opposed to the cheapest option.
The rate the LA pay the homes is often a lot less than the self funding rate as they're "bulk purchases" bigger buy, better value, a bit like the food packaging bigger pack better value.
In effect the self funders are subsiding the LA funded.
K

 

[Rayreadynow]

Never pay a top up, there's no legal liability for a 3rd party adult in this country, note 3rd party.
In effect a top up is a voluntary contribution for an "upgrade" in terms of choice of; location, particular care home you want as opposed to the cheapest option.
The rate the LA pay the homes is often a lot less than the self funding rate as they're "bulk purchases" bigger buy, better value, a bit like the food packaging bigger pack better value.
In effect the self funders are subsiding the LA funded.
K

If a person has POA or deputyship for someone then I don't think they can top-up on behalf of the donor/client either.

 

[try again]

A Google search showed me back to this forum with some old threads from 2011 and 2014. @kevini name came up in discussions as did some other recognisable names debating chc and 'lifestyle' choices being requested by some care homes. Round and round we go my friends 😁

 

[Rayreadynow]

A Google search showed me back to this forum with some old threads from 2011 and 2014. @kevini name came up in discussions as did some other recognisable names debating chc and 'lifestyle' choices being requested by some care homes. Round and round we go my friends 😁

Don't worry, Boris has sorted out Social Care, he said so.

 

[try again]

Don't worry, Boris has sorted out Social Care, he said so.

Don't get me started 😡

 

[nitram]

If a person has POA or deputyship for someone then I don't think they can top-up on behalf of the donor/client either.

They can't top up using donor/client funds, they can top up using their own funds.