Not sure if I originally found the link on TP, but I've just watched the following, very informative talk: Social Care Law Lecture Series - NHS Continuing Health Care & Law by Professor Luke Clements.
Gx
I wonder if this link will help youHi can i ask..my mum gets chc social worker advised us not to pay top fee...but home are saying we need to as its 3rd party top fee!@
CHC has to pay what it takes to pay for care without a top up, if they can find somewhere that can do that then that's the rate they will pay. If you want somewhere over and above that then you'll have to pay a top up same as people who are LA funded.Hi can i ask..my mum gets chc social worker advised us not to pay top fee...but home are saying we need to as its 3rd party top fee!@
KCHC has to pay what it takes to pay for care without a top up, if they can find somewhere that can do that then that's the rate they will pay. If you want somewhere over and above that then you'll have to pay a top up same as people who are LA funded.
If a home won't accept the CHC rate then either you have to pay a top up or move to somewhere that will accept the CHC or LA rates, if the home takes someone CHC or LA funded at a lower than normal rate then we're back to the old argument about self funders subsidising "government funded" residents whether it be CHC or LA they're paying less and let's not drift into that well worn old argument on yet another thread.
The home should be saying "if you want to stay here, we won't take the CHC/LA rate of funding so pay a top up or move out" because that's what it amounts to in essence.
Neither LA nor CHC funding is a blank cheque to stay in the poshest homes and let you stay there when the LA/CHC start to fund care, so if the home won't take the money the LA?CHC are offering then it's top up or ship out.
The social worker may well be right in telling you not to pay a top up as it's an open ended commitment to pay whatever the care home fees go up by and the differential between the care homes price rise and the LA/CHC annual rise, which can be considerable.
The home are wrong when they say you "need to as it's a 3rd party top up fee" they should tell you that first party top us aren't allowed (other than section 117 funding) and so the only way to get back the difference between their set rate and the LA/CHC rate is to ask you to pay a top up to make up the difference.
A lot of homes won't take LA funded people these days and it's only a matter of time before CHC funding goes the same way, homes will only take self funders or people who can be topped up, then the government will have a problem on their hands as demand is already outstripping supply and it's only going to get worse with an aging population and the LA's won't be able to find homes that will accept their rate so they'll have hospitals full of "bed blockers" at massively more cost to the NHS which is another branch of...government.
There's currently no joined up thinking, the NHS want people out of beds they don't need to be in, the LA wants to pay the least possible so it's cheaper for them to leave people in an NHS bed and the CHC people just don't want to pay anything to anyone if they can avoid it.
A couple of nights in an NHS bed cost as much as a week in a care home but the LA don't have to pay the NHS so they want to keep you off their books for as long as possible (although there is a theoretical mechanism by which the NHS can charge the LA but it's never used) and CHC could be used to keep people out of the NHS but they don't like giving money away it's easier for them to wait until you qualify for hospice (mainly charity based) care and leave you as an NHS problem, doesn't cost the CHC anything.
The NHS has become the dumping ground to keep other government department spending down irrespective of the fact it's the most expensive alternative and until someone does some joined up thinking it isn't going to change.
K
CHC has to pay what it takes to pay for care without a top up, if they can find somewhere that can do that then that's the rate they will pay. If you want somewhere over and above that then you'll have to pay a top up same as people who are LA funded.
If a home won't accept the CHC rate then either you have to pay a top up or move to somewhere that will accept the CHC or LA rates, if the home takes someone CHC or LA funded at a lower than normal rate then we're back to the old argument about self funders subsidising "government funded" residents whether it be CHC or LA they're paying less and let's not drift into that well worn old argument on yet another thread.
The home should be saying "if you want to stay here, we won't take the CHC/LA rate of funding so pay a top up or move out" because that's what it amounts to in essence.
Neither LA nor CHC funding is a blank cheque to stay in the poshest homes and let you stay there when the LA/CHC start to fund care, so if the home won't take the money the LA?CHC are offering then it's top up or ship out.
The social worker may well be right in telling you not to pay a top up as it's an open ended commitment to pay whatever the care home fees go up by and the differential between the care homes price rise and the LA/CHC annual rise, which can be considerable.
The home are wrong when they say you "need to as it's a 3rd party top up fee" they should tell you that first party top us aren't allowed (other than section 117 funding) and so the only way to get back the difference between their set rate and the LA/CHC rate is to ask you to pay a top up to make up the difference.
A lot of homes won't take LA funded people these days and it's only a matter of time before CHC funding goes the same way, homes will only take self funders or people who can be topped up, then the government will have a problem on their hands as demand is already outstripping supply and it's only going to get worse with an aging population and the LA's won't be able to find homes that will accept their rate so they'll have hospitals full of "bed blockers" at massively more cost to the NHS which is another branch of...government.
There's currently no joined up thinking, the NHS want people out of beds they don't need to be in, the LA wants to pay the least possible so it's cheaper for them to leave people in an NHS bed and the CHC people just don't want to pay anything to anyone if they can avoid it.
A couple of nights in an NHS bed cost as much as a week in a care home but the LA don't have to pay the NHS so they want to keep you off their books for as long as possible (although there is a theoretical mechanism by which the NHS can charge the LA but it's never used) and CHC could be used to keep people out of the NHS but they don't like giving money away it's easier for them to wait until you qualify for hospice (mainly charity based) care and leave you as an NHS problem, doesn't cost the CHC anything.
The NHS has become the dumping ground to keep other government department spending down irrespective of the fact it's the most expensive alternative and until someone does some joined up thinking it isn't going to change.
K
CHC has to pay what it takes to pay for care without a top up, if they can find somewhere that can do that then that's the rate they will pay. If you want somewhere over and above that then you'll have to pay a top up same as people who are LA funded.
If a home won't accept the CHC rate then either you have to pay a top up or move to somewhere that will accept the CHC or LA rates, if the home takes someone CHC or LA funded at a lower than normal rate then we're back to the old argument about self funders subsidising "government funded" residents whether it be CHC or LA they're paying less and let's not drift into that well worn old argument on yet another thread.
The home should be saying "if you want to stay here, we won't take the CHC/LA rate of funding so pay a top up or move out" because that's what it amounts to in essence.
Neither LA nor CHC funding is a blank cheque to stay in the poshest homes and let you stay there when the LA/CHC start to fund care, so if the home won't take the money the LA?CHC are offering then it's top up or ship out.
The social worker may well be right in telling you not to pay a top up as it's an open ended commitment to pay whatever the care home fees go up by and the differential between the care homes price rise and the LA/CHC annual rise, which can be considerable.
The home are wrong when they say you "need to as it's a 3rd party top up fee" they should tell you that first party top us aren't allowed (other than section 117 funding) and so the only way to get back the difference between their set rate and the LA/CHC rate is to ask you to pay a top up to make up the difference.
A lot of homes won't take LA funded people these days and it's only a matter of time before CHC funding goes the same way, homes will only take self funders or people who can be topped up, then the government will have a problem on their hands as demand is already outstripping supply and it's only going to get worse with an aging population and the LA's won't be able to find homes that will accept their rate so they'll have hospitals full of "bed blockers" at massively more cost to the NHS which is another branch of...government.
There's currently no joined up thinking, the NHS want people out of beds they don't need to be in, the LA wants to pay the least possible so it's cheaper for them to leave people in an NHS bed and the CHC people just don't want to pay anything to anyone if they can avoid it.
A couple of nights in an NHS bed cost as much as a week in a care home but the LA don't have to pay the NHS so they want to keep you off their books for as long as possible (although there is a theoretical mechanism by which the NHS can charge the LA but it's never used) and CHC could be used to keep people out of the NHS but they don't like giving money away it's easier for them to wait until you qualify for hospice (mainly charity based) care and leave you as an NHS problem, doesn't cost the CHC anything.
The NHS has become the dumping ground to keep other government department spending down irrespective of the fact it's the most expensive alternative and until someone does some joined up thinking it isn't going to change.
K
Hi k,
I am fighting for chc now. You seem to know the system well. Qualifying for chc is a matter of law and not NHS policy. Getting chc funding is a nightmare. To try and stick to the point, does not a patients well being come into play, you just can't move someone from their home. Article 8 of human rights. This can seriously effect a person with dementia and the NHS has a duty of care. And an authority can't say we will not pay. Is this not called fettering of a discretion? I was under the impression that you are not obligated to provide top ups for a relative.
More people are claiming chc as they become aware of the secretary of states fraud and it is this. In 1948 the promise from government was free health care to everyone irrespective of income from cradle to the grave. Hence the creation of the two major statutes NHS and social services statutes. Chc is supposed to cover 100% of all care costs by the NHS. The law has not changed in essence since then. Ref LUKE CLEMENTS LECTURE SERIES on chc and social care on YOUTUBE. I cannot stress how informative this man is. Also the government can afford it as the figures suggest that chc costs 0.5% of the national budget. The difference between chc funding from the NHS and social services funding is that SS funding is means tested chc is free at point of delivery.
For a lot of information on CHC go to ************ her you will find the founding campaigner who set the precedences in law for CHC care. Her name is PAMELA COUGHLAN who had a long campaign against the local Devon authorities in the court of appeal and wone.
CHC has to pay what it takes to pay for care without a top up, if they can find somewhere that can do that then that's the rate they will pay. If you want somewhere over and above that then you'll have to pay a top up same as people who are LA funded.
If a home won't accept the CHC rate then either you have to pay a top up or move to somewhere that will accept the CHC or LA rates, if the home takes someone CHC or LA funded at a lower than normal rate then we're back to the old argument about self funders subsidising "government funded" residents whether it be CHC or LA they're paying less and let's not drift into that well worn old argument on yet another thread.
Hi @Kevinl,
My understanding is that CHC funding does not allow for topups.
From Age UK Factsheet 20: ....... if you funded your care home before being eligible for NHS CHC or a relative paid a ‘top up’ to meet your preferred home’s costs which were higher than your local authority would normally pay. ‘Top ups’ are allowed for social care, but not under NHS legislation, so unless it is possible to separately identify and deliver the NHS-funded elements of a service, it is not usually permissible for you to pay for higher-cost services and accommodation.
HiGood morning everyone. Sorry in advance for the long post.
I had a CHC meeting for my father yesterday. Felt really nervous about it beforehand, like I had been swatting up for a test or a job interview. I thought about posting here beforehand to get some advice on what makes for a successful case but, on reading this entire forum from the beginning (I didn't quite get through all 37 pages, I'm afraid), I realised that there is no set answer. Some people with similar stories seem to have been successful, whilst others with loved ones who seem to be worse off than my father have been unsuccessful.
But, I had to try. And so I did lots of research beforehand, watching the Prof Clements video, reading up on past similar cases, and trying to match the wording in my father's case to the supposed buzzwords (complexity, unpredictability, etc) and statutes/guidance.
Well, I came out of the process feeling disappointed. I forgot to mention every point I had written down and I have been told to wait for up to 28 days for a decision in the post.
This might seem premature to be considering an appeal, but I'd like some advice from others on this, if possible.
Firstly, would anyone recommend going down the route of employing an advocate? My way of looking at it is that if it saves money in the long run, then it would be worth it if we were successful in gaining the funding. Or is this route best to take before an appeal (in which case I will have to wait another year)?
Secondly, I'm wondering if I can appeal against how the procedure went. The nurse at the NH where my father is resident is on my side, but she was totally distracted throughout the meeting as yesterday she was juggling 3 roles as chief nurse, manager and receptionist rolled into one! She kept answering the telephone throughout the meeting and buzzing people in...
Then, there was the social worker. She was the very first person to speak in the meeting. The first thing she asked me how much my father had in savings! She actually waited with pen poised for me to answer. I did not. CHC funding is not supposed to be means tested and I was fuming that this should set the tone for the rest of the meeting. It was again the last thing she asked me about before she left.
I'm also surprised by the CHC nurse. My father, who is in the later stages of Alzheimer's, had a CHC funding assessment carried out a little over a year ago. In the "Cognition" category he scored Severe, and rightly so, as he is a risk to himself and others and completely dependent on carers. But, yesterday, the nurse wanted to score him as High! It's the only category I am confident he is Severe in. Fortunately, even the SW disagreed with her and she reluctantly settled on Severe. I did wonder if she appreciated my father's needs at that point. I wondered again in the "Medication" category when she tried to downgrade him to Low as his medication needs are currently well managed. Again, fortunately, the rest of us disagreed and she changed it to Moderate.
On top of all of this, I was a little disappointed that the SW and CHC nurse did not meet my father until after the meeting and, even then, it was literally for less than a minute to say "hi". That's all they said, then left. I had to wonder if the decision had already been made before even seeing him.
Personally, I am feeling like a bit of a failure. I'll wait and see what the outcome is, but I'll fall off my seat if we have been successful!