CHC (Continuing Healthcare) support thread

Discussion in 'Legal and financial issues' started by stanleypj, Sep 22, 2015.

  1. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,774
    Salford
    My wife's in an EMI nursing home, some of the residents in there are, like my wife; immobile, incontinent, unable to feed themselves and have effectively zero comprehension, some are worse and are bed bound and on oxygen and need regular medical care.
    I asked about getting CHC and the manager told me they don't even bother to apply anymore.
    I asked "not even for resident X" who I'd never ever seen other than as a lump under a duvet when the staff entered and left her room, "no, not even her" was the reply.
    I also understand it is reviewed after the first 6 months and if you haven't had the decency to die in that time they'll routinely withdraw it as you've obviously got better.
    K
     
  2. nitram

    nitram Registered User

    Apr 6, 2011
    19,530
    Male
    North Manchester
    #662 nitram, Mar 28, 2018
    Last edited: Mar 28, 2018
    There is no specified time on a fast track CHC award.
    A 'relevant clinician' has to sign:

    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.

    In my wife's case the A&E registrar made a mess of the application, after 20 days of getting nowhere I went proactive, got the GP to sign and submit by fax complete with my complaint about the 'system', result awarded back dated by return fax.

    A&E was for AKI, my wife lasted 3 months.
     
  3. Heathersperry

    Heathersperry New member

    Mar 29, 2018
    3
    Hi everyone sorry to be in here. Mum' been in a home for 6 years funded by CHC. New assessment done in March and they have stopped funding and only awarded FNC.

    2 weeks ago mum collapsed BP went down for 4 mins and when she came around it was 60/60. Subsequently she is now on palliative end of life care. She is just 5 stone with bed sores. She is on thickened fluids as she is aspirating everything and she is allowing weight. Doctor has given and of life drugs and also said it could be weeks now. She is also blind, doubly incontinent, completely dependable and non capacity. She can't talk, walk etc.

    Basically we need to get end of life CHC funding in place But I don't know where to start and I wonder if some one can help.me with advice how I ask for immediate reassessment due to her decline in health plus Fast Trak. Any help would be good. I have called the original assessment people and as always it' we will call you back. Thank you
     
  4. nitram

    nitram Registered User

    Apr 6, 2011
    19,530
    Male
    North Manchester

    You ask the GP to consider filling in a fast track application.

    https://www.gov.uk/government/uploa...143/NHS-CHC-Fast-Track-Pathway-tool-FINAL.doc
     
  5. Heathersperry

    Heathersperry New member

    Mar 29, 2018
    3
    This is the Nursing Home GP ? Obviously her GP she hasn't used for years.
     
  6. nitram

    nitram Registered User

    Apr 6, 2011
    19,530
    Male
    North Manchester
    #666 nitram, Mar 29, 2018
    Last edited: Mar 29, 2018
    Her current GP will have access to all her health records and should be able to make a judgement.

    EDIT

    Try this doctor whether hospital or GP
     
  7. 1mindy

    1mindy Registered User

    Jul 21, 2015
    539
    Female
    Shropshire
    Well. It's now 2 years 6 months since my husband got fnc but refused CHC . Appeal took place on the 29th January 2018. The period in question was April to September 2016. . He got CHC funding for the first month , refused the other 5 . (He must have got better but I missed it )Just doing the paper work to get the money . Next job , paper work to appeal to NHS England .
    I cannot even begin to tell you how tiresome this all is , maybe the one month money was a sop to make me very grateful . So back to my desk to sort out this paperwork which the NHS says is clear and transparent .
     
  8. crybaby

    crybaby Registered User

    Jan 8, 2017
    42
    This is interesting, Orac60, because we had our CHE assessment yesterday.

    My husband cannot stand, walk or even sit up, or speak properly, and has difficulty swallowing, and his Social Worker, and 2 nursing types spent 3 hours with us, trying to talk to him, but mainly asking me a million questions.

    They were all lovely ladies, and very friendly and understanding (our social worker really had been pushing for this because she has seen his rapid decline) but at the end of the afternoon, they said that my husband would not qualify because his condition is not that bad, mainly because I look after him so well!!!!!

    Why do we even bother?

    Tomorrow is another day, everyone - love and hugs to you all
     
  9. Baz22

    Baz22 Registered User

    Dec 30, 2017
    46
    Male
    South West
    The CHC people are a disgrace in the way they try and avoid paying for healthcare. Re your post "mainly because I look after him so well!!!!!" it states in their own framework that "A need should not be discounted just because it is being successfully managed - a well managed need is still a need" (DST Key Principles Para 28).

    My Mother has mixed dementia and is at Stage 6 Alzheimers and yet in a recent re-assessment they concluded she was improving; she is not and will not. I am a bit of a novice as I have only been fighting them for 7 months. They ignore their own timescales and did not even reply to a Data Protection Act request within the statutory limit. They think they are a law unto themselves. As if dealing with the dementia was not bad enough you then get the stress of NHS arrogance at its worst.
     
  10. lemonjuice

    lemonjuice Registered User

    Jun 15, 2016
    1,535
    England
    My mother had CHC assessments for more than 6 years, Each time she was refused. Even at stage 7d, incapacitated and unable to move her body voluntarily, unable to swallow without prompting, unable to communicate in any way and being on 'palliative care' after a large number of emergencies, after which I requested a fast Track Application the assessor refused to even start filling in the form as no one could say with certainty that she would die within a short time-frame. She died about 6 weeks later:(
     
  11. Baz22

    Baz22 Registered User

    Dec 30, 2017
    46
    Male
    South West
    So sorry to hear you had to go through that. Sadly I was not surprised. My Mother's first CHC assessment was 4 years ago, but I was somewhat naïve back then and still trusted what the NHS said. Current appeal only 7 months old but they have now done a re-assessment whilst the appeal is still in process and hence will probably have two appeals going at the same time. Quite bizarre, all smoke and mirrors.
     
  12. Deboratom

    Deboratom New member

    May 19, 2018
    6
     
  13. Elle3

    Elle3 Registered User

    Jun 30, 2016
    632
    Hi, I just wanted to add a good news story to this thread, I have just heard today that my dad has been awarded CHC funding.

    My dad has advanced Dementia and is living currently in a Dementia+ unit within a care home. We did the initial CHC review with the SW on the 13th June and he scored enough A's and B's to be referred to the NHS Assessment team, this was mainly for his Behaviour, Cognition and Communication. The Assessment team contacted me and arranged to carry out their assessment on the 26th June.

    At this meeting was 2 nurses from the Assessment team, the nurse from the care home, myself and my dad. Going through the 12 areas, Dad was found to be Severe for Behaviour due to his unpredictable challenging behaviour and High for Cognition and Communication as he his unable to understand or express his needs whilst still being very fit and mobile, he his also on medication for his behaviour that has to dispensed by the nurse. The Assessment team agreed that dad was eligible for funding and referred him to Panel.

    The Panel met on Monday this week and they agreed with the assessment team and dad has been awarded funding as from the 26th June.

    I have read so many stories on here of people applying for CHC funding and it being turned down, so I was fully expecting my dad to also be turned down it was only down to the SW and the Care home staff urging me to apply that we did and we are so pleased to have got a positive outcome. The SW has been very supportive and the care home have been brilliant and have been recording every incident with dad within the home against ABC charts and they had gathered lots of evidence to support our claim, which seemed to be key. So I just wanted to say if you are considering applying for funding for the PWD please do not be put off, there is certainly no harm in trying.

    Elle x
     
  14. lemonjuice

    lemonjuice Registered User

    Jun 15, 2016
    1,535
    England
    Certainly not. especially as you say
    This is the only reason I've heard of here anybody ahs been successful. My mother always scored Severe for Cognition & Communication and yet was always refused at panel.
     
  15. Elle3

    Elle3 Registered User

    Jun 30, 2016
    632
    Yes I read your comments above and it is so sad what you had to go through with your mother.

    To be honest the Assessment team seemed more concerned with dads lack of ability to communicate and understand his needs and said this was key to his unpredictable challenging behaviour, if it had just been his behaviour I don't think he would have been awarded it. Also they said due to the fact he has no other illness and he is very mobile he required more 121 care than normal, so his needs can be predicted and his challenging behaviour managed.
     
  16. Jezzer

    Jezzer Registered User

    Jun 12, 2016
    984
    Female
    Lincoln, UK
    This is so very WRONG @lemonjuice. I honestly think my mum qualifies for CHC but it is almost unheard of for anyone in this area to be awarded. She didnt qualify when she went into care - which I understood - but things are very different now. I dont know if I can set us up to fail. The initial battle broke me (mum started with mixed dementia shortly after losing her sister to vascular dementia and since her daughter didnt want to know, I took things on). I didnt realise what a toll it had taken on me until mum got ill and off we went again. Much harder this time as I am so close to my darling mum. Not sure I can go through applying for CHC again.
     
  17. Jezzer

    Jezzer Registered User

    Jun 12, 2016
    984
    Female
    Lincoln, UK
    They concluded your mother "was improving"???? They know full well nobody improves with this illness. They know it is terminal. This is disgraceful. These "professionals" are not fit for purpose. I am so sorry. Why should families have to fight and fight and fight? And for what? Another slap in the face.
     
  18. Elle3

    Elle3 Registered User

    Jun 30, 2016
    632
    It is disgraceful and I feel very sad for everyone who hasn't been able to get it, especially those that have gone through numerous appeals.

    We must have been very lucky to get a very understanding Assessment team, they even said to me, due to the nature of Dementia and the fact dads Communication and Cognitive skills will never improve but get worse, it is very unlikely that funding would be removed. I am sure though at some point this may change so I'm never going to assume it won't.
     
  19. Elle3

    Elle3 Registered User

    Jun 30, 2016
    632
    Can anyone help me please regarding CHC funding?

    As I posted above my dad has just been awarded CHC funding, however I received a phone call yesterday from the CHC team questioning why dad was not in a Residential care home. As stated in the Assessment I explained that he was in a Residential home but had to be moved due to being too challenging for them to cope with and we had to pay for 121 agency care until we could find a more suitable care home. I was advised by SS to look for a Dementia+ unit as they have a smaller staff to resident ratio and are better equipped to deal with challenging residents.

    The CHC are now saying their funding can only meet some of the cost and that dad may have to move to a different care home or we could pay a third party top up of approx £450 per week to keep him in his current care home. I told them I couldn't afford to pay that. They said they are reluctant to move dad as he is so settled so the lady has gone away to talk to her Manager.

    I have since spoken to the lady at dads care home who deals with the finances and CHC funding and she has told me that it isn't classed as a third party to up fee, the extra cost can still be funded by dad. She said what happens is that the CHC pay for one part of his care and we have a separate contract (like self funding) for the additional care element.

    I'm not sure that this is right and to be honest I will wait for the CHC team to come back to me. But just in case it is, can anyone tell me what would happen when dads funds get to the LA limit of £24,250 is this still applicable with the CHC funding or is this something totally different? Would dad have to continue paying for the additional care element until his funds get down to zero and then what happens? Dad currently get AA and I'm aware this will stop, what happens to his state pension, does this stop also or does it continue?

    Sorry I'm probably thinking too deeply about this. I just assumed that the CHC would be funding the total amount of dads care, now it seems that it's not much different than if the LA was funding it.

    Thanks.
    Elle x
     
  20. nitram

    nitram Registered User

    Apr 6, 2011
    19,530
    Male
    North Manchester
    Top up fees are not allowed for CHC funding.

    As there is an ever decreasing number of homes that will accept the CHC rate fudges are being made to enable residents to privately purchase 'extras' even if sometimes these 'extras' appear to be an essential element of the necessary care package.

    Financial assessment is not done for CHC funding

    You are effectively self funding for the 'extras', if funds run down to the upper limit and you ask for LA assistance they will say you should have moved your dad to a cheaper home which accepted the CHC rate and allow you to run the funds to zero.

    Your only argument is that moving your dad to a different home would not be in his best interests.
     

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