I am very confused regarding CHC assessment and the possibilities for reducing the huge financial worry which is stressful ant a time when all you want is to do the best for your loved one. Does anyone know anything thing about the companies who can help with the assessment and fight your corner ( at a cost ) . Be grateful for any advice .
CHC (Continuing Healthcare) support thread
- Thread starter stanleypj
- Start date
We are using a company called Compass. They are based In Barnstaple. We have not long instructed them, but they are gathering information to support mums case. I know plenty of people do it all themselves, but I’m not in a position to take it all on right now.
Hi,
There's a group of Solicitors who are members of "Solicitors for the Elderly". The members of this association have experience in dealing with "the elderly" and often have experience of older clients with problems of sight or hearing impairment and dementia, and often cases of mental capacity/incapacity etc. They not only deal with Wills, LPAs, Deputyships, etc, but some of them will have experience in CHC claims.
If you google sfe.legal you should find the society, who have a "find a solicitor" search on their website. If there is one or more in your area, you can easily speak with the appropriate firm to see if they do deal with CHC claims, and what their charge rates are.
This may help.
There's a group of Solicitors who are members of "Solicitors for the Elderly". The members of this association have experience in dealing with "the elderly" and often have experience of older clients with problems of sight or hearing impairment and dementia, and often cases of mental capacity/incapacity etc. They not only deal with Wills, LPAs, Deputyships, etc, but some of them will have experience in CHC claims.
If you google sfe.legal you should find the society, who have a "find a solicitor" search on their website. If there is one or more in your area, you can easily speak with the appropriate firm to see if they do deal with CHC claims, and what their charge rates are.
This may help.
Thought I'd share this video with Prof Luke Clements which gives good background insight into CHC funding -worth watching to get a basic understanding
Really useful and historically interesting also - thank you Palerider. Decision support tool being guidance and not decision making and how its use is not necessarily correct - worth thinking about. e.g. I am fascinated about how assessments about behaviour are measured for example, with dementia the behaviour will change with time, as the disease progresses and of course the setting affects it too.
MiL currently in a nursing home on a trial basis as recommended by social worker. We filled in the financial assessment as we have LPA on finances, we don't have it on health and welfare. We have had two letters, the first was how much she would pay with carers visiting her at home, but by then she was in a nursing home, the second explains they are taking £296 a week backdated to when she entered the home on what they call a short term case basis - this leaves her with about £32 a week, which just covers her council tax, added to this is contents insurance, insurance on her boiler etc. the cost of her furniture which is still in storage because we had to clear space for hospital bed, Sara steady, commode and hospital chair, which means we now have to transfer £600 from her savings which are under the £23,000 threshold just to pay her bills on the flat. We will do this but the next stage is that if Social Services agrees that she is better kept in the nursing home, (and this seems most likely) there will be another financial assessment and we should have the 3 month disregard during that period?
I have posted before about the confusion over shared ownership of a leasehold flat and what value it would have under the 'willing buyer' rule. We have yet to find a RICS professional view in writing on that issue, I do have an email from an estate agent saying she would not be able to sell half a flat and would struggle to sell the flat because the lease is getting near to the 82 year cut off for mortgages. I am only partially ready for a battle should it occur, if the local authority 'over value' the flat by simply splitting it 50% based on some sort of Zoopla tool.
Since being in this nursing home MiL has developed another health problem and spent another night in A&E, a GP is going to assess this week and she may be referred to a consultant colorectal specialist. Sadly having been taken from bed by a hoist and into a wheelchair and eating in the dining room for a week or two, she is bed bound again. So looking at continuing healthcare may now be something we need to think about depending on GP view etc over the coming weeks.
We haven't applied for any sort of allowances yet, I ticked the box on financial assessment for my local authority to look into this, but noone has been in touch so I am now wading my way through the form for attendance allowance and another application to not pay council tax as the property is empty. I am unclear whether social services will apply for the nursing care allowance and whether this is instead of attendance allowance or in addition to?
In essence as well as dementia causing confusion, inability to read anymore, can't read the time on her favourite clock that we have put up in her nursing home room, usually doesn't know what day it is or time or day, sleeps more than being awake, MiL has hearing loss, lost mobility due to a mix of her broken ankle and due to dementia and loss of strength she is not expected to gain any more mobility and will likely loose it as muscle wasting continues, she cannot carry out any personal hygiene, cooking etc. she has kidney disease and a heart condition (on apixoban), she is incontinent since all her hospital stays and lack of mobility combined with dementia, and has just suffered rectal prolapse, that may become a recurring problem and this has led to her being bed bound whilst an opinion is sort from an OT and GP. She was sent home by a local hospital 8 weeks ago because they said she had capacity, but the social worker agreed within 10 minutes of meeting her that she did not have capacity. Previous to that the discharge person at that hospital has said she was looking for a nursing home, but a different OT took charge and determined that MiL wanted to go home, The OT likely believed home was a house with relatives living in it as this is what MiL believed herself at that time, it was a flat with no relatives nearby to act as carers. The care visits were poor (didn't do the 45 minutes they were tasked with, sometimes only one instead of two, leaving mouldy food in the fridge, dirty linen on the kitchen floor, didn't attempt commode daily etc.). combined with the fact that what the carers are paid to do compared with what was needed, caused issues too. I have said before at what point does anyone ask who is doing the food shopping, putting the bins out, washing soiled bedlinen, picking up post, ..... there just seems to be an assumption that someone will magically appear and do these things. In this case mostly me, it was just lucky I had resigned from my part time job and had time whilst looking at what to do next.
So we are weeks away from knowing long term plans and long term costs as well as whether this additional health problem will be sorted without the need for another hospital visit.
There will be many others up and down the country going through the same of course, but always useful to touch base here and receive views and support.
MiL currently in a nursing home on a trial basis as recommended by social worker. We filled in the financial assessment as we have LPA on finances, we don't have it on health and welfare. We have had two letters, the first was how much she would pay with carers visiting her at home, but by then she was in a nursing home, the second explains they are taking £296 a week backdated to when she entered the home on what they call a short term case basis - this leaves her with about £32 a week, which just covers her council tax, added to this is contents insurance, insurance on her boiler etc. the cost of her furniture which is still in storage because we had to clear space for hospital bed, Sara steady, commode and hospital chair, which means we now have to transfer £600 from her savings which are under the £23,000 threshold just to pay her bills on the flat. We will do this but the next stage is that if Social Services agrees that she is better kept in the nursing home, (and this seems most likely) there will be another financial assessment and we should have the 3 month disregard during that period?
I have posted before about the confusion over shared ownership of a leasehold flat and what value it would have under the 'willing buyer' rule. We have yet to find a RICS professional view in writing on that issue, I do have an email from an estate agent saying she would not be able to sell half a flat and would struggle to sell the flat because the lease is getting near to the 82 year cut off for mortgages. I am only partially ready for a battle should it occur, if the local authority 'over value' the flat by simply splitting it 50% based on some sort of Zoopla tool.
Since being in this nursing home MiL has developed another health problem and spent another night in A&E, a GP is going to assess this week and she may be referred to a consultant colorectal specialist. Sadly having been taken from bed by a hoist and into a wheelchair and eating in the dining room for a week or two, she is bed bound again. So looking at continuing healthcare may now be something we need to think about depending on GP view etc over the coming weeks.
We haven't applied for any sort of allowances yet, I ticked the box on financial assessment for my local authority to look into this, but noone has been in touch so I am now wading my way through the form for attendance allowance and another application to not pay council tax as the property is empty. I am unclear whether social services will apply for the nursing care allowance and whether this is instead of attendance allowance or in addition to?
In essence as well as dementia causing confusion, inability to read anymore, can't read the time on her favourite clock that we have put up in her nursing home room, usually doesn't know what day it is or time or day, sleeps more than being awake, MiL has hearing loss, lost mobility due to a mix of her broken ankle and due to dementia and loss of strength she is not expected to gain any more mobility and will likely loose it as muscle wasting continues, she cannot carry out any personal hygiene, cooking etc. she has kidney disease and a heart condition (on apixoban), she is incontinent since all her hospital stays and lack of mobility combined with dementia, and has just suffered rectal prolapse, that may become a recurring problem and this has led to her being bed bound whilst an opinion is sort from an OT and GP. She was sent home by a local hospital 8 weeks ago because they said she had capacity, but the social worker agreed within 10 minutes of meeting her that she did not have capacity. Previous to that the discharge person at that hospital has said she was looking for a nursing home, but a different OT took charge and determined that MiL wanted to go home, The OT likely believed home was a house with relatives living in it as this is what MiL believed herself at that time, it was a flat with no relatives nearby to act as carers. The care visits were poor (didn't do the 45 minutes they were tasked with, sometimes only one instead of two, leaving mouldy food in the fridge, dirty linen on the kitchen floor, didn't attempt commode daily etc.). combined with the fact that what the carers are paid to do compared with what was needed, caused issues too. I have said before at what point does anyone ask who is doing the food shopping, putting the bins out, washing soiled bedlinen, picking up post, ..... there just seems to be an assumption that someone will magically appear and do these things. In this case mostly me, it was just lucky I had resigned from my part time job and had time whilst looking at what to do next.
So we are weeks away from knowing long term plans and long term costs as well as whether this additional health problem will be sorted without the need for another hospital visit.
There will be many others up and down the country going through the same of course, but always useful to touch base here and receive views and support.
whoknkows - a very detailed post and I can't help with most of it tbh especially regarding the finances, but the best advice I can give is regarding your point of thinking about CHC funding. You absolutely must do this, based on what you have said your MiL should be assessed for this. First of all there is a checklist which may well lead on to the DST assessment. You are entitled to ask for a checklist to be done as an initial step if it hasn't already been carried out.
This will help with the finance side if accepted and funding is given, but be aware there can be a lot of work and stress involved. I feel it is worth pursuing but the entire system is a mess, is massively complicated (being cynical I think this is intentionally so) and need a total overhaul. I visited my MP last week to discuss this with him.
I tried to post a link with info about the checklist but wasn't able to, so just search online for CHC checklist or similar.
This will help with the finance side if accepted and funding is given, but be aware there can be a lot of work and stress involved. I feel it is worth pursuing but the entire system is a mess, is massively complicated (being cynical I think this is intentionally so) and need a total overhaul. I visited my MP last week to discuss this with him.
I tried to post a link with info about the checklist but wasn't able to, so just search online for CHC checklist or similar.
So I have a question.. does CHC pay care homes less than a self funding patient would?
the manager at mum’s home casually dropped into the conversation that mum had got very suspicious of him one evening ( he is also a nurse) and wouldn’t let him do her injection. Apparently he said he handed it to her and she did it herself! There’s no way mum can remember how to do that… I even asked one of the nurses to let mum do it herself when she first arrived ( to try and retain a bit of control for her, as she’s been looking after herself and my sisters Diabetes for over 50 years) she went to grab it needle first, so it’s obvious she’s lost that ability.
I got the feeling he was planting this right before mum’s assessment this Friday.
the manager at mum’s home casually dropped into the conversation that mum had got very suspicious of him one evening ( he is also a nurse) and wouldn’t let him do her injection. Apparently he said he handed it to her and she did it herself! There’s no way mum can remember how to do that… I even asked one of the nurses to let mum do it herself when she first arrived ( to try and retain a bit of control for her, as she’s been looking after herself and my sisters Diabetes for over 50 years) she went to grab it needle first, so it’s obvious she’s lost that ability.
I got the feeling he was planting this right before mum’s assessment this Friday.
DJC33 thank you for your response. Other relatives visited MiL at the nursing home yesterday - the senior nurse had a long chat with them and has recommended a reassessment of MiL dementia status - she says her decline has been noticeable even in 6 weeks. She has tissue issues exacerbated by her drugs and yesterday had been refusing meds and asking for a gun 
. whether this is due to her UTI and other infection we can't be sure, it is not the first time sadly - but the first time since being in the nursing home. DH will ring the nursing home and speak to the senior nurse, we are a bit confused about who can organise the reassessment, the relative was suggesting DH has to organise all this, but I explained that we don't have PoA on health and well being. I think the home is confused too, but everyone seems to think it is our decision, and neither her stay in the home nor taking control of medical issues, is for us to decide - and in a way that is best, because we would rather the experts decide and not have family dynamics and arguments get in the way. So should it be MiL's GP, who hasn't seen for months, or the nursing home via their visiting GP or the SW? Of course we agree she does need a reassessment and I wonder if the home are thinking about CHC too.
In the meantime, MiL hasn't been charged yet for her care fees, even though we have the invoice and a letter confirming the costs, nowhere does it say what dates the DD will be taken - it is very frustrating! I noted the invoicing is from an outsourced company 300 miles away... I have had luck with some refunds for MiL and cancelling things she no longer needs, getting there slowly - I feel responsible for not wasting her income. The cost of the temporary care takes 95% of her income, so savings will be needed to pay her insurances, and temporary furniture storage for a another month perhaps. My list isn't shrinking yet
. whether this is due to her UTI and other infection we can't be sure, it is not the first time sadly - but the first time since being in the nursing home. DH will ring the nursing home and speak to the senior nurse, we are a bit confused about who can organise the reassessment, the relative was suggesting DH has to organise all this, but I explained that we don't have PoA on health and well being. I think the home is confused too, but everyone seems to think it is our decision, and neither her stay in the home nor taking control of medical issues, is for us to decide - and in a way that is best, because we would rather the experts decide and not have family dynamics and arguments get in the way. So should it be MiL's GP, who hasn't seen for months, or the nursing home via their visiting GP or the SW? Of course we agree she does need a reassessment and I wonder if the home are thinking about CHC too. In the meantime, MiL hasn't been charged yet for her care fees, even though we have the invoice and a letter confirming the costs, nowhere does it say what dates the DD will be taken - it is very frustrating! I noted the invoicing is from an outsourced company 300 miles away... I have had luck with some refunds for MiL and cancelling things she no longer needs, getting there slowly - I feel responsible for not wasting her income. The cost of the temporary care takes 95% of her income, so savings will be needed to pay her insurances, and temporary furniture storage for a another month perhaps. My list isn't shrinking yet
DH spoke to nursing home, relative getting things wrong and passing on instructions that just caused confusion and upset, nursing home are organising reassessment, they have registered MiL with their GP which is what we agreed, but not what relative told us. Still no news from SW about long term plans, this was temporary trial basis, which is financially assessed (but payments still not taken). Relatives mean well but have a habit of thinking they know better, I am a little concerned that the relative gave MiL her meds - the nursing home had said MiL had refused in the morning but it is their role and they have records to keep - so relative deciding to take over and give them instead is not something I would have encouraged..... I don't blame the nursing home staff, and they can't really tell family off 🤭. Going to ring the bank today and see if DD is about to go through....
Age UK publish a paper on how to get free NHS continuing Healthcare funding for your relatives with mental and physical incapacity and dementia. The law is flouted by some staff. So be persistent in trying to get free care and try and be present for the healthcare assessment in a care home and hospital
Just to say, that with the help of Compass solicitors mum has been awarded CHC. The decision came only a week after the multi agency meeting. I’m so happy and relieved For her.
Well done @Suzysheep01 - that's great news.
Don't forget that she will be entitled to a refund of all fee's paid since the 28th day after the initial checklist assessment was received by the ICB.
The outcome letter should state the start date of any reimbursement period. Check to make sure it corresponds with the date of the initial checklist. Our ICB stated it was from the date of the MDT instead of the checklist, which equates to an awful lot of money for our mum as there was a significant delay in getting from checklist to MDT. We're still jumping through hoops to get this sorted.
Retrospective claims for CHC Funding - Claim back monies paid
Retrospective claims for CHC Funding - NHS Continuing Healthcare Funding (CHC) is free funded care paid by the NHS for individuals...
caretobedifferent.co.uk
Thanks. They have back dated it to the 18 July which is when the first MTD was ( had to have 2 because the nurse from the home couldn’t make the meeting at the last minute) I’ll have a look.Well done @Suzysheep01 - that's great news.
Don't forget that she will be entitled to a refund of all fee's paid since the 28th day after the initial checklist assessment was received by the ICB.
The outcome letter should state the start date of any reimbursement period. Check to make sure it corresponds with the date of the initial checklist. Our ICB stated it was from the date of the MDT instead of the checklist, which equates to an awful lot of money for our mum as there was a significant delay in getting from checklist to MDT. We're still jumping through hoops to get this sorted.
Retrospective claims for CHC Funding - Claim back monies paid
Retrospective claims for CHC Funding - NHS Continuing Healthcare Funding (CHC) is free funded care paid by the NHS for individuals...
Seems to be par for the course!
It's definitely 28 days from receipt of the checklist. It's part of the guidance set out in the National Framework, have a word with Compass as they'll be aware of this.
Yes, they are aware. It’s more money to pay for them to do it!
can you tell me, what is the 3 month review like? Would you say I need compass on board for that?
No idea I'm afraid as mum is yet to have hers. However, there does appear to be a pattern with reviews being used to withdraw funding due to the person suddenly becoming miraculously better in an originally higher scored domain. The guidance is very clear in that the review should only be used to ensure the care package in place is still sufficient and that a new MDT should not be requested unless there is a significant change in that persons needs. As with everything CHC the guidance is often ignored in favour of an individual ICB's 'policies'.
Guidance for the 3 and 12 month review is set out the National Framework from para 201 onwards.
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