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CHC (Continuing Healthcare) support thread

Brizzle

Registered User
Mar 1, 2019
72
0
Thank you jaymor for sharing your experience, I am pleased the CHC team did the right thing in relation to your husbands care.

However since I am told that less than 1 in 3 people that pass the checklist stage are actually given ongoing CHC I think it is extremely important that I get records from Mum’s GP concerning mum’s history with relevant health problems and hospital visits.

On my talk with the CCG they were unaware of a number of problems that mum is facing with her general health. Due to confidentiality restrictions they are unable to get mum’s full records and to date have only consulted with 2 nurses at the hospital about mum’s general state of health as those nurses interpret it right now rather than the bigger picture of the ongoing and unpredictable health issues entailing amongst other things a number of paramedic advised ambulance hospital visits over the last year or so.

They also tell me that they will put a general invite out to social services concerning the CHC assessment but cannot guarantee that they will be present. If they decline for any reason then the meeting will go ahead without them. From my readings on preferred practice I have also read that it is highly desirable that someone from social services is present as well as NHS health care workers particularly where people with dementia are concerned. It is social services I believe that should be obtaining information from their 24 hour appointed live in carers about mum’s immediate challenges prior to her admission to hospital.

Everything seems a bit rushed to be honest for what I think is a very important decision. I have now been told that due to the backlog of assessments caused by an increasing queue for discharge to assess care and nursing home beds they are doing the assessments while people are still in hospital even though previously and until quite recently best practice was do to it in a care home setting.

On a good note they have at least given me another 2 weeks to hopefully get mum’s medical records and decide whether I wish to get one of her most recent carers or others to give feedback about the health and dementia challenges that mum has had to face prior to her admission to hospital . If things still seem too rushed I might well enlist the help of someone like Beacon CHC legal services to ensure that nothing is overlooked at the full assessment.

Has anyone else used Beacon. I see that the NHS funds them to give a free 90 minute advice line so I guess they must be as reputable as anyone if one chooses to use their paid services ?
 

Cazil

New member
Feb 16, 2022
7
0
Hi Ive had same experience Had meeting in hospital to discuss dad and then at end told by consultant this was a meeting to see if he met chc criteria and he doesnt but does need nursing home not residential home
 

Cazil

New member
Feb 16, 2022
7
0
NO idea they were doing that ! Ive not seen any documentation records at all . Hes been in hospital for several months there has now been 3 meetings cancelled and the 4th was changed at from 2pm to 10am giving me 15 mins notice .. so i was unable to get there. Told i could take part in the meeting over the phone as i did not have internet. However they phoned me and said they had had the meeting and had made a decision but i could make a comment...What for
they had already made decision without me
 

Natureboy

New member
Apr 4, 2020
3
0
Hi, sorry to add a Q - I can’t find answer in post. Should I be paying £850 or £1037.60
What I know…
* Our Care Home Charges…
* £650 Pw for residential
* £850 pw for nursing. (NOTE £200 cost for nursing)
* We need nursing.
* NHS / Age UK etc says get CHC - ”CHC/FNC helps towards your nursing costs”
* We got assessed for CHC and got FNC £187.60pw.
* Care home says, great you got FNC - your cost is now £850 + £187.60 = £1037.60.
* So CHC/FNC doesn’t help towards costs it seems.
 

nitram

Registered User
Apr 6, 2011
25,157
0
North Manchester
The FNC is paid directly to the nursing home as a contribution towards provision of nursing , some homes say the reduction is included in their nursing fee, others reduce fee charged by FNC

No way should you be being charged the FNC.
Do they have a nurse available 24/7?
If not they are not classed as a nursing home and can't receive the FNC and may think you can receive it and pass it on to them.
 

Natureboy

New member
Apr 4, 2020
3
0
The FNC is paid directly to the nursing home as a contribution towards provision of nursing , some homes say the reduction is included in their nursing fee, others reduce fee charged by FNC

No way should you be being charged the FNC.
Do they have a nurse available 24/7?
If not they are not classed as a nursing home and can't receive the FNC and may think you can receive it and pass it on to them.
Thank you nitram. I will query with the home on Monday.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Would anybody like to hazard a guess regarding the level of needs in CHC DST in the mobility field.

Under High needs is : - Completely unable to weight bear and is unable to assist and cooperate with transfers and/or repositioning.

And under Severe needs is :- completely immobile and/or clinical condition such that , in either case, on movement or transfer there is a high risk of serious physical harm and where the positioning is critical.

Mum imo is completely immobile , she needs a hoist requiring 2 nurses present to get her out of bed safely , she has not walked on her broken ankle in more than 3 months and the outlook is not thought to be good. While visiting her in hospital during this time and more recently in a nursing home I have not witnessed her moving one inch from the variety of positions she has been left on the bed by her nursing staff. Added to this she has very challenging behaviour shouting ,spitting and hitting out a carers and nurses every time they need to move her or provide care. When receiving care at home prior to her hospital visit this had led her to deliberately fall/slip to the floor on a number of occasions. Although we will never know for sure it is quite likely this may have been the cause of her ankle fracture.

To be honest I would have thought that being “completely unable to weight bear and unable to assist and cooperate with transfers and/ or repositioning was as close to being completely immobile under the severe field as one could get.

Seems to be a very fine line between ratings on some of the fields.
 

nitram

Registered User
Apr 6, 2011
25,157
0
North Manchester
Severe additionally includes "on movement or transfer there is a high risk of serious physical harm and where the positioning is critical."
 

Brizzle

Registered User
Mar 1, 2019
72
0
Yes I noted that , due to mum’s behavioral issues if she fights while being moved to /from or within the shower /bathroom there could be a serious harm issue but other than possible future events due to being completely immobile such as infections from bedsores I guess the “positioning is critical “ bit will put mum out of the severe needs category at the present time.

Being totally immobile is not good for anyone, particularly the elderly with complex dementia, it is a medical fact that numerous health issues will invariably arise in the days and months ahead due to long term or remainder of life immobility.

I hope that the National framework ensures that the MDT take this amongst other things into consideration in the overall picture when reaching any final decision .
 

Brizzle

Registered User
Mar 1, 2019
72
0
One minute before my mum’s “ MS teams” full assessment for CHC meeting today I got a phone call from CCG saying it wasn’t happening. They had previously insisted due to backlog that the CHC checklist and consequently full assessment was carried out at short notice in hospital setting ( my mum was there 3 months). She passed the checklist and was referred to a full assessment with nurses/ others from the hospital and LA taking part. However this was called off in the last minute of the eleventh hour due to my mum moving to a nursing home in the last few days which they say the hospital had not informed them of. The whole process has been so stressful with it seemingly being rushed through at lightening speed with scant detail one moment to it being drawn out the next . Now waiting for everything to be rescheduled.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Had the full assessment today thinking professional nurses from mums new nursing home would be part of the MDT but it turned out that the input only came from a care worker who was not part of the MDT contributing to the DST ratings. Only the CCG appointed nurse (who has never met mum and has doubled up as the coordinator) and a social services representative who met mum just once in her home way back in 2020 at her initial assessment for local authority support were part of the MDT. On a meeting that lasted over 2 hours the social worker must have contributed for approximately 2 brief minutes with insignificant comments. They did not come with any notes about mums condition as it was in the preceding month and immediately before she was admitted to hospital... I had to provide those details since they were basically clueless about everything and anything that could contribute to the meeting.

So I have a MDT consisting of two local Government workers who have met mum just once between them since August 2O20 deciding on her fate concerning CHC. I have to say things looked rather cosy between them so I am not too hopeful.

Until today I had no idea who the MDT team would be , apart from the CCG nurse assessor, who has been very vague about everything in the run up to the full DST assessment. I also learnt today that in recent days without any contact to myself social services had sent someone to the nursing home to “interview “ my bed ridden mum who is in a Complex Dementia and nursing wing with very challenging behaviour and zero cognition . Go figure !

The assessor did not mark any areas of the DST today ,said she needed to investigate matters further, so I was unable to comment on whether I agreed or disagreed. She did however try to get my opinions about where mum should be marked. I respectfully reminded her it was her job to mark mum along with the silent social worker and I would tell them my position regarding their judgements at the next remote meeting.

Reading between the lines everything sounded a bit negative with FNC ( the get out of jail free card option) on the CHC monopoly board being mentioned despite the fact that the assessment was for CHC.

I feel absolutely drained, up late in the early hours due to stress, need to try and sleep now... lots more to report besides from the meeting..but that’s for another day.
 
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MartinWL

Registered User
Jun 12, 2020
2,029
0
65
London
I would certainly complain and demand that the meeting be held again. It is unacceptable for descisions to be made by a group who have no understanding of the patient's condition. This would also be reaso to appeal a decision. At these meetings you can and should say where the person is on the DST, and argue your case firmly.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Thanks MartinWL . I was contacted today by the CHC nurse who advised that she and the social worker ,who had contributed virtually zero to the CHC assessment meeting, together had had a meeting behind closed doors to mark the domains of the DST to which I was not privy. It seems pretty obvious that this was completed immediately following me and the nursing home representative leaving the teams meeting. I left the meeting yesterday given the clear impression that the 3 of us would be getting together again under another teams meeting at a near future point so my opinion although not overriding as to the marking could at least be taken into consideration and possibly cause a rethink should I put forward a strong case for a higher mark in a number of domains. Well as you can see that never happened.

I was told my mum’s marks today and asked where I thought she should be placed but everything I said fell on deaf ears since the CHC assessor had already completed the DST....anotherwords I was being asked to contribute my opinion after the horse had well and truly bolted and left the stable . I was told abruptly at the end of our conversation and all of my input that my opinion would be recorded on the DST for the CCG to see but her recommendation was that my mum did not meet the threshold required to receive CHC.


There have been so many serious questions from start to finish over the validity of this CHC process and whether National Framework guidelines were being correctly adhered to that I immediately told the assessor that I rejected the CHC assessment and would ask for it ,based on the evidence I have accumulated , to be declared null and void. If this was rejected I would be appealing the decision anyway since I felt it was seriously flawed and I had strong evidence over recent weeks and particularly in the last 2 days to strongly support my case for which I would employ (and I will) a professional CHC legal team who know this “business” inside out and who no doubt would be listened to and shown greater respect than I have received over the last 2 days.

Anyway to make quite a long story a little longer I received a call back later today which may and I stipulate “may” suggest that perhaps the CHC have actually started to listen to some of what I have had to say and also possibly offered an “olive branch” going forward regarding how things may progress from here.
 
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Brizzle

Registered User
Mar 1, 2019
72
0
Thanks for your positive words Banjomansmate. The fight will most certainly go on . When under very sad circumstances you are on the right side of wrong you really have no viable alternative but to pursue your case. For the official representative of the NHS to even insinuate that my poor mother has more “social care needs” than Health care needs is an insult beyond what I can reasonably comprehend given her current situation.

I cannot devulge too much right now but I am fully on the case and will meet
” those that be “every step of the way in regard to their blatantly flawed and possibly biased decisions based on their available financial budget for CHC .
 
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Brizzle

Registered User
Mar 1, 2019
72
0
Thank you so much for your support and encouraging words Elle 3 . It’s probably going to be a long journey to get justice but already I have accumulated so much evidence that correct procedure is not being followed coupled with the fact that there have been some serious “creative “ assessment decisions going on in an under representative and (IMO) biased MDT panel taking place.

I never thought that “ creative accounting” might also be prevalent in a health care context within such a beloved institution as the NHS but I do now. Such a shame that when we are least expecting it life continues to shock and catch so many people off guard from the very people we trust the most to do the right thing for our loved ones.

The MDT only consisted of a CCG nurse who doubled up as coordinator and had never seen or met mum and a historical social services representative who had met mum just once in 2020. Although they called on the professional nurses of the nursing home to give up to date evidence for some reason they denied them the right to mark the DST which was conducted behind closed doors after the meeting. That I am sure would have been one cosy and smug meeting with the parties conveniently agreeing with each other over the marking so as neither the NHS or local government would have to support mum due to the fact she would be self funding as a result of their biased decision.

Never mind, it’s early days and based on audio and other strong evidence I have obtained I’m quietly optimist that with the right professional expertise on my side justice will prevail.
 
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Brizzle

Registered User
Mar 1, 2019
72
0
Can I ask anybody who has been through the DST process how many people were on the MDT panel that contributed to the marking of the DST. Other than the CCG nurse assessor what other professionals contributed and what capacity did they hold. Also was the coordinator at your meeting independent or as in my case assumed by the CCG nurse who doubled up her role ?

Thank you
 

Andy54

Registered User
Sep 24, 2020
162
0
Can I ask anybody who has been through the DST process how many people were on the MDT panel that contributed to the marking of the DST. Other than the CCG nurse assessor what other professionals contributed and what capacity did they hold. Also was the coordinator at your meeting independent or as in my case assumed by the CCG nurse who doubled up her role ?

Thank you
When my wife's assessment took place in addition to the nurse assessor from CCG there were: Social Worker, Community mental health nurse (both had previous dealings with my wife and were fully aware of her needs), and the care home manager all of who had a considerable input. The CCG nurse did act as coordinator.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Thank you Andy54. Although each of these individuals had considerable input to the live meeting do you know whether they were all asked to mark the 12 domains of the DST as to the level of needs from low to priority that they considered your wife had ?

If so did you see how each of theses professionals along with the CCG assessor marked the checklist and consequently how the MDT as a whole came up with their final decision of the level of needs in each of the domains ?

Thanks again, very much appeciated.