CHC (Continuing Healthcare) support thread

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

  1. artyfarty

    artyfarty Registered User

    Oct 30, 2009
    267
    London
    Thank you - I've not heard of Beacon - I will go and have a look straight away. Amazing these things exist but you have to search so hard for them. The problem that we have really is that mum has had dementia now for 10 years and so is very severely effected. Her communication is non-existent but they keep insisting that this is moderate. She has zero awareness of her behaviour so comes into conflict with other residents - she was attacked and did nothing to defend herself as she didn't understand what was going on. Yet, this wasn't mentioned at all in the assessment. In that domain, I was told that Severe only applies to people in a coma! I asked how you could possibly put systems in place to help someone in a coma to communicate but not surprisingly didn't receive an adequate explanation. Likewise, things like Psychological/Emotional Health and were just put down as moderate as mum doesn't participate in activities - she has no language left and is not able to understand instructions or answer questions so this seems impossible to assess. This weekend I tried asking her all sorts of questions - are you a man? are you a woman? do you prefer meat or fish for dinner? are you hot? are you cold? are you in pain? are you happy? She couldn't answer a single question but still this is moderate. In the assessment, myself, the care home manager and the social worker all said that this should be Severe but in the assessment it was put down as Moderate but noted that we didn't agree. She is in a very good (bloody expensive) home and they do manage her care very well. I think this is why they feel able to downgrade her needs despite the fact that this is specifically mentioned as something you shouldn't do.
     
  2. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    7,935
    Yorkshire
  3. nitram

    nitram Registered User

    Apr 6, 2011
    18,929
    Male
    North Manchester
    This is not in accord with the guidelines:

    "If, after considering all the relevant evidence, it proves difficult to decide or agree on the level, the MDT should choose the higher of the levels under consideration and record the evidence in relation to both the decision and any significant differences of opinion. "

    Page 8
    https://www.beaconchc.co.uk/wp-cont...ision_support_tool_-_October_2018_revised.odt
     
  4. artyfarty

    artyfarty Registered User

    Oct 30, 2009
    267
    London

    Yes, I agree. It's one of the reasons we are considering appealing. Mum's lack of any awareness affects so many of the domains and I really feel that they are deliberately downplaying this in itself but also as some sort of support for their other opinions. Knew this wouldn't be easy and we haven't even really got started (if we do go this route). All my siblings want to proceed but I'm not sure I've got the stomach for the fight.
     
  5. artyfarty

    artyfarty Registered User

    Oct 30, 2009
    267
    London
  6. padmag

    padmag Registered User

    May 8, 2012
    245
    nottingham
    We are using a no win no fee solicitor for Mum's appeal. We are now in the process of organising a date for the appeal. I know the charges are high, but I feel that as they are taking on Mum's case in the knowledge of the DST results (which were downgraded after the meeting), then they must think she has a chance of succeeding. Obviously nothing to pay if the appeal fails. We (my sister and I) gathered all the information for the DST and were fully prepared, but going forward we needed professional help to ensure the legal side was adhered to by CCG at the appeal meeting, as neither of us are as familiar with the law.. Also I am a full time carer for my partner with dementia (10 years now) so am not fully able to give the appeal as much support as I wish. I would hesitate before paying any monies up front in these circumstances.
     
  7. Platinum

    Platinum Registered User

    Nov 7, 2017
    66
    Female
    South east
    #787 Platinum, Jul 23, 2019
    Last edited by a moderator: Jul 23, 2019
    My OH underwent DST CHC assessment in March 19 instigated by his NHS unit and scored
    1 severe
    1 high
    5 moderate
    2 low
    2 no needs
    I represented my OH at the meeting which was properly convened. My strategy was to complete the DST myself and use my typed domain assessments to argue the case. I took a long time to research/prepare and found the process very hard; being focussed/negative about OH in such detail was depressing. We were refused CHC and granted FNC. We disagreed on 3 domains, one of which they scored high I had scored severe. I gave them a copy of my domain assessments at the end of the meeting. I agree interpretation makes the whole process difficult along with the fact that barely 20% of applications are successful depending where you live.
    I have posted our history before and am always pondering how on earth we got here. Briefly in September 18 he was taken to hospital by paramedics after he dialled 999. He subsequently had 2 failed residential placements, admission to another hospital and following a mental health assessment was admitted to an NHS mental health unit in January 19. Prior to this I looked after him with carers (18 hours including 1 waking night) and it was not easy and I pondered respite but overall I never thought what happened would happen. He is labelled now and despite being assessed by several NHs only one is likely to take him and he is top of their waiting list. Ironically they take a high proportion of LA residents which is why there is a W/l for self pay.
    I have had free advice who felt I should appeal. My reason for applying for CHC was the high probability of needing 1:1 24 hr care for some time after admission. I have been quoted £3500 pw in the past. I had always expected to pay for care fees if the need arose but I now worry we could run out of money. We are not married but have been together for a long time.
    I did not expect him to be in his NHS unit after 6 months and currently as we do not pay fees I don’t feel like going through a review as life is hard enough. I have two months to decide under the 6 month review period. I visit OH every day and it does not get any easier as he always wants to come with me when I leave. I can’t say I feel better with him being away, something which is mentioned a lot here.
    Has anyone reapplied for CHC having let the review period lapse?
    Thank you for any advice offered. Sorry this is a little convoluted.
     
  8. LocalResident

    LocalResident Registered User

    Jul 21, 2013
    11
    #788 LocalResident, Jul 23, 2019
    Last edited by a moderator: Jul 23, 2019
    ++++++++
    Has anyone reapplied for CHC having let the review period lapse?
    +++++++
    I'm not sure about this, however, I've been told that if an appeal is in progress [and that appeal may continue], and patient's condition/circumstances change, you can ask for another DST to be done. Then you consider the result. How this kind of situation is handled might depend on the particular NHS Trust /NHS Clinical Commissioning Group. If two appeals are going on at the same time - I would expect them to be 'combined'.
    [However also bear in mind, when a DST is retrospective then the process/procedures are most likely to be different. I've been told that retrospective cases are called 'reviews' and non-retrospective cases are 'appeals'.]

    So, if they you should appeal - follow it up - enquire how much they will need to start your appeal etc. etc. Good luck and prayers.
     
  9. Jackie1962

    Jackie1962 New member

    Aug 10, 2019
    2
    Apologies if I’m not posting in the correct place
    My mum has been receiving CHC for almost 4 years. Yesterday I was told that this will discontinue and she will be moved from her NH to a a CH and receive partial nhs funding.
    The only thing that’s changed for mum is a broken leg which happened earlier in the year. Because she is in late stage Alzheimer’s she’s been left with it in a pot as she can’t understand physio etc. So now she is unable to walk etc.
    They said her hallucinations are happy ones so that’s nice for her..!

    I’m fuming! Because she is drugged to the eyeballs and is now immobile she’s better!

    I just don’t know how I’m going to cope with an appeal as I’m about to undergo major surgery which will mean I’m non weight baring for months.
    Will her funding stop immediately? It’s immoral to move her at such a late stage..oh my head is cabbaged with the injustice of it all..

    Sorry for the rant!
    Jackie
     
  10. Moose1966

    Moose1966 Registered User

    Feb 10, 2017
    96
    Female
    Staffordshire
    Hi just been through this , briefly mum was part funding in CH for two years , totally bedridden not able to feed , move , dress etc took a down turn deemed EOL so was fast tracked CHC and I was told to find NH within the week !i didn’t want to move her but they gave me no choice . Found one thankfully very pricey but they authorised it and she moved . Three months down the line CHC review and they withdraw funding despite being scored 1 severe 3 highs 3 moderate etc borderline I believe . The review was 3rd July funding stopped on 6th August . It was then transferred to LA for them to pick up funding as she is below threshold , they dithered and it seem as she had survived !!!! she was obviously stable enough to move to cheaper NH . Thankfully I had an amazing social worker who said no way was mum fit enough to move she’d only just settled from last forced move . After a stressful week we got the result she can stay where she is , it’s an amazing home and they manage her needs very well . Remember a managed need is still a need !! . You must stand your corner .
     
  11. Jackie1962

    Jackie1962 New member

    Aug 10, 2019
    2
    Thank you for responding so quickly.
    May I ask did you have to do a formal appeal? Unfortunately I wasn’t at the multidisciplinary meeting so only told over the phone.
    Jackie
     
  12. Moose1966

    Moose1966 Registered User

    Feb 10, 2017
    96
    Female
    Staffordshire
    We didn’t appeal for the CHC funding as the lady who did the review was adamant that funding was to be withdrawn. Mum now has Funded Nursing Care which is a weekly contribution from the NHS and then Local Authority pick up shortfall after mums contribution .
     
  13. Moose1966

    Moose1966 Registered User

    Feb 10, 2017
    96
    Female
    Staffordshire
    It was left by CHC team that if mums needs changed they’re to be notified and will come and review again with a view to reinstating CHC funding . I’m not happy about that it just means they keep assessing mum which is distressing for us and they can withdraw it again if she rallies again . The sad part is mum is no better it is just that this NH are brilliant at managing her lack of mobility and skin breakdowns .
     
  14. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    7,935
    Yorkshire
  15. LocalResident

    LocalResident Registered User

    Jul 21, 2013
    11
     
  16. LocalResident

    LocalResident Registered User

    Jul 21, 2013
    11
    Hi,
    Also contact Beacon CHC. They provide 90 minutes free telephone advice.
    You'll have to make an appointment for Beacon to call you back.
    Be prepared, and be concise, when you speak to one of their professional officers.
    The 90 minutes does not need to be used all in one call.

    And IF the NHS Trust/NHS CCG has failed to follow the correct procedures [whatever they are in your type of case] you can also make a COMPLETELY separate complaint about the Trust/CCG not doing things correctly. Remember if you do this, ensure that you make it clear you're complaining about their failures etc. etc. and not for example about a DST/appeal etc.
     

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