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CHC (Continuing Healthcare) support thread

stanleypj

Registered User
Dec 8, 2011
10,708
North West
It would be helpful if anyone who has experience/knowledge of the the 'fast-track' CHC could post about the possible reasons why someone whose partner has been told he is approaching the end of life stage has been refused fast-track.
 

LYN T

Registered User
Aug 30, 2012
6,960
Brixham Devon
It would be helpful if anyone who has experience/knowledge of the the 'fast-track' CHC could post about the possible reasons why someone whose partner has been told he is approaching the end of life stage has been refused fast-track.
Stanley, that was the strange thing about Pete being awarded CHC within the hour. That was DEC 2013 and I wasn't told that Pete was approaching the end of life stage until May 18th 2014.:confused: I've no idea why it didn't go to the panel stage and end of life wasn't mentioned in the notes I was sent.

I'm very confused at times when I read that EOL stage has been reached and CHC is refused.
Love

Lyn T XX
 

nitram

Registered User
Apr 6, 2011
20,275
North Manchester
"It would be helpful if anyone who has experience/knowledge of the the 'fast-track' CHC could post about the possible reasons why someone whose partner has been told he is approaching the end of life stage has been refused fast-track."

Together with my two daughters I sat in a room with a consultant, registrar, and nurse.

The consultant said 'I'm very sorry Mr nitram but your wife has very little life left '
I asked about fast track and the registrar said it would be approved.

That conversation was on Friday evening, on Saturday they were keen to discharge her back to the nursing home as they had two wards closed because of the Noro virus. I refused unless they gave me the anticipatory pack, which had been dispensed, to take with her, they agreed on the Sunday and she was transferred. I again queried the fast track and got the answer that it would be approved on Wednesday at the weekly meeting.

I did not query the CHC for a fortnight as I had other things on my mind. When I started asking I was met with evasion, I therefore downloaded the form and got the GP to sign. It was faxed to the PCT ( CCG forerunner) and an approval received by return fax. I then sent an email to the PCT asking why a patient discharged with an anticipatory pack did not meet

The individual fulfils the following criterion:
He or she has a rapidly deteriorating condition and the condition may be entering a terminal phase. For the purposes of Fast Track eligibility this constitutes a primary health need. No other test is required.


The CHC was back dated by a fortnight.
My wife actually survived for three months.

As for reasons for the stalling I can only assume that the cost impacts more on the PCT than the GP.
 

AlsoConfused

Registered User
Sep 17, 2010
1,953
The "snapshot in time" argument came up at our CHC meeting which the assessor interpreted as restricting the area of interest to Mum's few weeks in the nursing home. I'm trying the following argument:-
it’s only possible to show the true significance and interactions of X’s ongoing long-term medical / nursing needs, state and behaviour when these are considered over enough time and within the very different environments of family home, hospital and nursing home. NH are able to “well-manage” X’s needs in ways that are not possible outside a good nursing home ... It’s much easier for the DST Panel to realise the true level of X's needs - and the skill shown by NH in managing them - when they have the comparative data to hand showing how X fared in environments not specifically designed to support patients with her range of health conditions.
I don't know whether the argument will "work" ... though it SHOULD. Anyone who wants to adapt it for their own purposes is welcome to do so!
 

geum123

Registered User
May 20, 2009
4,604
Couldn't this thread be made into a sticky??????

Lots of people have contributed their experience over the years, and it seems such a shame that all the info is now lost.
In fact the Alzheimers Society used to operate an advocate scheme at one time.
 

2jays

Registered User
Jun 4, 2010
11,598
West Midlands
Thank goodness for this thread.

I now in a position of needing to know more about CHC. Mums care home suggested today that we should apply, in fact they have already put the wheels in motion.....

For them to say mums needs CHC has been a bit of a shock, to say the least. I've thought about claiming, in the future, so it never occurred to me mum was at that stage yet.....



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LYN T

Registered User
Aug 30, 2012
6,960
Brixham Devon
Thank goodness for this thread.

I now in a position of needing to know more about CHC. Mums care home suggested today that we should apply, in fact they have already put the wheels in motion.....

For them to say mums needs CHC has been a bit of a shock, to say the least. I've thought about claiming, in the future, so it never occurred to me mum was at that stage yet.....



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I'm sorry that your Mum is being considered for CHC 2jays. I know that statement may seem a bit odd to many who apply and don't get the funding, but I must say that when Pete was given CHC Funding I felt really, really sad because it was almost like we had reached the point of no return. A stupid feeling really because there isn't ever any come back from dementia. The most we can hope for is that CHC opens up the possibility of more care on a personal level for our loved ones-and that can't be bad.

Love,

Lyn T XX
 

2jays

Registered User
Jun 4, 2010
11,598
West Midlands
Thank you Lyn. I must admit my first thought was good, no more paying out silly money for a while.... Then the words registered for what they meant :(

I was assured that the care home would do everything possible so that mum didn't need to move into full nursing care, but it's now a very strong possibility that mum may have to move care home as her needs have, and keep, changing dramatically. Almost daily without any "bounce back", just a fast continual down turn.




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2jays

Registered User
Jun 4, 2010
11,598
West Midlands
Thanks both. I've gone into head in sand mode for the moment. Not thinking about it until after initial assessment. Will report back once I have any news, or more likely requests for advice.


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LYN T

Registered User
Aug 30, 2012
6,960
Brixham Devon
Thank you Lyn. I must admit my first thought was good, no more paying out silly money for a while.... Then the words registered for what they meant :(

I was assured that the care home would do everything possible so that mum didn't need to move into full nursing care, but it's now a very strong possibility that mum may have to move care home as her needs have, and keep, changing dramatically. Almost daily without any "bounce back", just a fast continual down turn.




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2jays, don't get me wrong I was relieved that Pete no longer had to pay -he had been self funding but was about to go to LA funding. However, the really big benefit of CHC Funding was that Pete could stay at his lovely CH. The Manager hadn't said anything BUT I could see they were all struggling with Pete-even though the ratio of 1 Carer to 3 residents was really good. CHC paid for 1 to 1 care and it took the pressure off the CH staff as well as benefiting Pete. Do you think your Mum would be able to stay where she is if she gets CHC and something like 1 to 1 is available?

Love

Lyn T XX
 

2jays

Registered User
Jun 4, 2010
11,598
West Midlands
Do you think your Mum would be able to stay where she is if she gets CHC and something like 1 to 1 is available?

Love

Lyn T XX
That's the impression I got from the manager yesterday. If mum gets CHC she could definitely stay.

Nothing was said as a threat, it was discussed sensibly, looking for different ways to enhance mums care. It all boils down to finance.

My thinking is, at the moment mum is "comfortably off" financially, so when she fails to get CHC I am thinking she could afford to pay for one to one care.... For maybe a year or two. I say a year or two, because I'm guessing her fees could be up to double what they are now. Then the thought is, if I do that, I guess that would be considered deprecation of assets :rolleyes: as another care home could be a cheaper option.

Head in sand until initial meeting has been done mode....


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stanleypj

Registered User
Dec 8, 2011
10,708
North West
Then the thought is, if I do that, I guess that would be considered deprecation of assets :rolleyes: as another care home could be a cheaper option.
I can't believe that a self-funder being in the care home of their choice and paying for the nursing that they need could be thought to be deliberately deprivating their assets 2Jays.
 
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2jays

Registered User
Jun 4, 2010
11,598
West Midlands
I can't believe that a self-funder being in the care home of their choice and paying for the nursing that they need could be thought to be deliberately deprivating their assets 2Jays.
Nor do I really, but once the money runs out, who knows what the LA will say at that time :rolleyes:

I'm also a person who dilly dallies, then over thinks a situation, and you could also call me a procrastinator on occasions, who is hot headed when challenged :)

not good traits when decisions, calm or otherwise, have to be made :D




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geum123

Registered User
May 20, 2009
4,604
Nor do I really, but once the money runs out, who knows what the LA will say at that time :rolleyes:
Hi 2jays,
I think you could argue that your Mum should remain in familiar surroundings with staff who know how to interpret her needs. Everything should be geared in your Mums best interests.
That's the argument I used to keep my Dad in his nursing home once he got NHS Continuing Health Care, and the mental health team and the nursing home backed me up.
Of course the nursing home had to be able to meet his needs.

I'm very sorry to hear your Mum has got to this stage though.:( xxxxxxxxxxxx
 

notsogooddtr

Registered User
Jul 2, 2011
922
This is going to be rather a long post.Background:my Dad has deteriorated dramatically over past 3/4 months,agitated,hallucinating,shouting,impossible to engage him.I asked that checklist be completed and said I wanted to be there.Checklist completed without informing me,Dad's score didn't trigger full assessment.I asked NH home manager to ask assessor to ring me as I wanted to discuss it.2 weeks later he rang and rather reluctantly agreed to meet me to explain the results.We met yesterday,he kept me waiting for over an hour which wasn't a great start.Then told me Dad wouldn't get CHC,plenty of people much worse than him.I asked him to talk me through the assessment,Dad hadn't scored higher than 'B'in any domain:eg in cognition,although he has no cognition he is not at risk of harm or neglect because he is in a NH.Is this a case of a 'managed need'stiil being a need.Communication;a moderate score states the patient 'sometimes'unable to reliably communicate.I asked for an example of when my Dad CAN communicate reliably,he couldn't tell me because he doesn't know him well enough.Anyway we finally agreed 2 A scores for communication,C for skin,breathing and consciousness and B for everything else.He still doesn't want to put forward for assessment because he knows it won't be successful,he has to fill in a 60 page form,he has 280 patients on his list and his professional integrity is at stake.The checklist is a subjective document and not a cut and dried exercise.He will discuss with colleagues and get back to me.I feel completely defeated.On reflection I think that keeping me waiting was a deliberate tactic to put me in my place and let me know that he had many more important things to deal with.
 

AlsoConfused

Registered User
Sep 17, 2010
1,953
You have every right to make a formal complaint to his superiors about the incompetent and unprofessional behaviour of this assessor. In your shoes I'd do so. I'd also be asking for the assessment to be done again by someone else.

You've said your Dad has now been awarded 2 "A"s? That's enough on its own - even disregarding the number of B ratings - for him to go through to full assessment (the DST stage of the process).

although he has no cognition he is not at risk of harm or neglect because he is in a NH.Is this a case of a 'managed need' still being a need?
Yes. If his cognition is so poor that an A rating is appropriate that's what your Dad should have got.