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CHC (Continuing Healthcare) support thread

t0ria

Registered User
Feb 22, 2015
33
0
Hi sorry if it's already been posted but there is a lot on this thread, a bit too much to read through it all, but has anyone successfully appealed a refused CHC decision?

The social worker who completed the DST marked lower than everyone else on the call on three categories. The other 4 people (Me, his CPN, the independent social worker and the manager of his care home) ranked him severe on both nutrition and mobility but the assessor marked him as high. Also she marked him as medium on continence but everyone else said high. We did agree on severe for cognition, behaviour and drug therapies. I think this should be grounds for an appeal but has anyone had a similar issue?

My dad is in Leicestershire. I'm also thinking of sending an FOI request to find out what their targets and KPIs for CHC decisions are, as he is incredibly unwell and everyone else agrees he is well beyond the threshold, so other than them having already reached their target for successful applications I have no idea what's going on. Has anyone looked into this?

He is doubly incontinent, psychotic and hallucinating, has fallen twice in a month and broken a leg, his distress and anxiety has lead to him being assaulted by another resident and being hospitalised, he's lost a stone in a month. He takes seven different meds including an anti psychotic, diazepam three times a day, sleeping pills and a strong pain medication.

The fact that complex medical decisions about a human being are made using a checklist, by a person who is not medically trained, and has not actually met him is absolutely awful. We're in a lucky position that we can afford the care he has for now, but he's medically ill and it should be paid for by the NHS.
 

MartinWL

Registered User
Jun 12, 2020
1,279
0
Hi sorry if it's already been posted but there is a lot on this thread, a bit too much to read through it all, but has anyone successfully appealed a refused CHC decision?

The social worker who completed the DST marked lower than everyone else on the call on three categories. The other 4 people (Me, his CPN, the independent social worker and the manager of his care home) ranked him severe on both nutrition and mobility but the assessor marked him as high. Also she marked him as medium on continence but everyone else said high. We did agree on severe for cognition, behaviour and drug therapies. I think this should be grounds for an appeal but has anyone had a similar issue?

My dad is in Leicestershire. I'm also thinking of sending an FOI request to find out what their targets and KPIs for CHC decisions are, as he is incredibly unwell and everyone else agrees he is well beyond the threshold, so other than them having already reached their target for successful applications I have no idea what's going on. Has anyone looked into this?

He is doubly incontinent, psychotic and hallucinating, has fallen twice in a month and broken a leg, his distress and anxiety has lead to him being assaulted by another resident and being hospitalised, he's lost a stone in a month. He takes seven different meds including an anti psychotic, diazepam three times a day, sleeping pills and a strong pain medication.

The fact that complex medical decisions about a human being are made using a checklist, by a person who is not medically trained, and has not actually met him is absolutely awful. We're in a lucky position that we can afford the care he has for now, but he's medically ill and it should be paid for by the NHS.
Potentially you might try an appeal because your social worker was out of line with the others and, you say, has not even met the person. I would be complaining in that situation. You could start by writing to the Director of Social Services asking for it to be done again.

You have to make your case under the framework of the decision support tool. If he took 100 pills a day that would count for nothing if they could be given by carers. But it sounds like you have a case so focus on the DSt criteria.

You have the option to appeal and also to complain to the local government ombudsman.
 

Paul A

Registered User
Feb 4, 2019
39
0
There are a whole load of sections to consider in a CHC assessment and your mother would have to score highly on more than one to qualify. The rule of thumb that everyone seems to use is whether the care she needs to receive has to be given by somoene medically qualified or not. In general, if she can be cared for by carers, rather than nurses, she won't get CHC. I went through the whole process but did not get it. If she needs a lot of nursing care, not carer care, then you're in with a chance. Do download the asessment tool and go through it.
I'm in the process of CHC, I have found Age UK very good for advice.
However, in the end, I went with a specialist law firm on a no win no fee. I don't know if I can post their name or not.

I found the LA and the nurse, very well scripted, they zoned in on poor documentation, and why mum was not drugged up - this was the reason for not recommending CHC.

It's more like an audit rather than mums care needs - just about money.
 

Paul A

Registered User
Feb 4, 2019
39
0
Hi sorry if it's already been posted but there is a lot on this thread, a bit too much to read through it all, but has anyone successfully appealed a refused CHC decision?

The social worker who completed the DST marked lower than everyone else on the call on three categories. The other 4 people (Me, his CPN, the independent social worker and the manager of his care home) ranked him severe on both nutrition and mobility but the assessor marked him as high. Also she marked him as medium on continence but everyone else said high. We did agree on severe for cognition, behaviour and drug therapies. I think this should be grounds for an appeal but has anyone had a similar issue?

My dad is in Leicestershire. I'm also thinking of sending an FOI request to find out what their targets and KPIs for CHC decisions are, as he is incredibly unwell and everyone else agrees he is well beyond the threshold, so other than them having already reached their target for successful applications I have no idea what's going on. Has anyone looked into this?

He is doubly incontinent, psychotic and hallucinating, has fallen twice in a month and broken a leg, his distress and anxiety has lead to him being assaulted by another resident and being hospitalised, he's lost a stone in a month. He takes seven different meds including an anti psychotic, diazepam three times a day, sleeping pills and a strong pain medication.

The fact that complex medical decisions about a human being are made using a checklist, by a person who is not medically trained, and has not actually met him is absolutely awful. We're in a lucky position that we can afford the care he has for now, but he's medically ill and it should be paid for by the NHS.
If there is any disagreement the higher score is the one that should be recorded.
 

Yorkshire gal

New member
Oct 17, 2021
5
0
Yorkshire
@Yorkshire gal , if CHC is awarded it will be reassessed after three months. If it is agreed that it continues it will then be reassessed every twelve months.
Hi Jaymor

Mum has apparently got gangrene in an ulcer now in her foot and they are saying now that the dementia is progressing rapidly.
They cannot move her to hospital to treat her as she is too ill so is on morphine for the pain. They have said it is uncurable and her respect form seems to echo this..
Is this it? She seems to be sleeping all the time now, and today has refused to eat or drink..the doctor has advised end of life as he says it will be either the gangrene or the demntia that will send her life now.. how long will I have left with her, do you know?
 

canary

Registered User
Feb 25, 2014
16,076
0
South coast
Oh @Yorkshire gal that is so hard.

Its almost impossible to tell how much time she has left, Im afraid.
If she continues to refuse food and drink this indicates that the dying process has already started. Nevertheless, they can go on with no food or fluid for a surprisingly long time. My mum went 17 days, but it is not usually that long. Sometimes it is only a couple of days.
(((((((((((((((((((((((((hugs))))))))))))))))))))))
 

Brizzle

Registered User
Mar 1, 2019
33
0
My mum who has Alzheimer’s and Vascular dementia is currently in hospital with a broken ankle and chest infection. She has been receiving 24 hour live in care for the last 2 years , to begin with self funded and later with some help from social services. She has a boot on her broken ankle but can still not put any weight on or walk. Even in good times her mobility is poor.Her oxygen levels have been low for a while now and she has a raised diaphragm on her right side, but investigations have been inconclusive. She has been taken to hospital by ambulance on a number of occasions with a chest infection during the last 6 months to receive intravenous antibiotics.

At first the doctors were considering sending mum home with extra Carers at certain times of the day provided but now I have been told that going home at present is out of the question since a few concerns have since been raised about the quality of the Carers that social services have provided. Mum will have to go into a specialist nursing home to be reassessed by social services in a few weeks time.

Mum has also deteriorated in recent months in other ways, now being totally incontinent and with numerous skin conditions . She needs help with everything and has put on some considerable weight making mobility even more difficult. At the hospital today she does not seem to understand anything that the nurses have been asking her. She is flat out being uncooperative and refusing to make any effort with the physiotherapists. Before mum is discharged from hospital is this a good time to be raising the CHC question. Due to the NHS making decisions on my mums behalf would they perhaps consider her initial care be funded by the NHS under CHC to be reviewed in 3 months time depending on how well she has recovered?

My gut feeling is that while mum is in hospital that now is as good a time as any to raise the CHC question. Should I raise this with the NHS or Social services or both?

Thank you.
 

Eogz

Registered User
Sep 9, 2021
36
0
Hi,
If your mum is being discharged to a nursing home, it is likely to be discharge to assess, this means that it will likely kick off the CHC assessment process.
You may find that it starts anyway.
 

Paul A

Registered User
Feb 4, 2019
39
0
In my experience I would seek help from this forum or legal professionals - it's a very complicated process and unfortunately the system is set up to say no.