CHC funding for home care?

Marnie63

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Dec 26, 2015
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Hampshire
I read recently that you can get CHC funding for care services in your own home as well as in a care/nursing home. Has anyone here achieved this? I assume you have to be really, really bad to get it.
 

Kevinl

Registered User
Aug 24, 2013
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Salford
You can get it but be it at home or in a home the money is for Health Care not social care so you're back to the same smoke and mirrors that apply to care in a care home, what is health care and what is social care.
A friend of mine who passed away recently from a brain tumour did get CHC at home but the option was that or he stayed in hospital or a hospice and so after a very complex procedure his care was paid for in his own home and as it was defined as being "end of life" he got the CHC fast tracked to make that possible but the family did have to push and a couple of them worked for social services.
End of life care in your own home is an issue where the government say they're doing everything possible to make possible, it'll be interesting to know as it seems to be given less and less to people with AZ and if you get it you have to fight again at every review.
Definitely worth asking the question, they can only say no, but what health care would you be purchasing with the money? Carers are for social care, doctors and nurses do health care could you argue that the care needed has to be a health need and not a social need?
K
 

spbeagle

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Oct 20, 2016
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I read recently that you can get CHC funding for care services in your own home as well as in a care/nursing home. Has anyone here achieved this? I assume you have to be really, really bad to get it.
.

If you go to the blog section of the website you will be able to access personal stories - see link below-
https://blog.alzheimers.org.uk/category/personal-stories/ - you will find Peter's story, filed in Feb 2018 about how, he eventually succeeded in getting CHC to care for his wife at home.
 

Marnie63

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Dec 26, 2015
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Hampshire
Thanks, I will read that story tomorrow.

I hear what you say Kevin about 'smoke and mirrors', I've read plenty of stories on TP about people trying for, and failing to get, CHC. My argument would be that mum had a stroke last August which has left her with further issues, on top of the ones she already had (mainly cognitive before, more physical after the stroke). After further strokes and TIAs (some documented by ambulance crews and out of hours doctors) she has become a lot worse. They may class agency carer visits as 'social care', but she wouldn't need all this extra care if she hadn't had the stroke!

Right at the start of all this, in December 2015, there was a very forceful Social Worker who was looking after mum's case during the build up to her discharge from hospital. I remember her pushing the ward staff to conduct the CHC check and she emailed it to me (mum failed at the time), but unfortunately it's got lost on a broken laptop and old email account. I'm going to ask SS when they come to reassess mum for a copy of that original check. It would be interesting to see the comparison if they did one now.

My concern is that as I need more and more help with mum at home (mainly due to the incontinence - can that be classed as a 'social issue'?!), I am going to be expected to pay towards it, but I'm not sure where it will come from. Mum's remaining savings won't last long (and I will argue that some needs to be left to go towards her funeral), all of my savings are geared towards providing me with a pension one day - should I be expected to fund her care from that? This is the first time I have really had any financial worries about mum's dementia, and they are making me feel quite uncomfortable.

If SS come up with an increased level of support for mum, then my worries will ease, but I'm still going to ask them to conduct another CHC review (or ask them to ask whoever does it). I fear SS are going to try to push me to change to an agency they use, but I won't do that due to mum being familiar with our regular carers, and also a language issue.

Probably not good to go to bed with these worries, but there you go! I guess some little part of me wants to have a prod at 'the system' because of the hard time I've had since December 2015. Not that I'll get too much sympathy from the 'system' on that front!
 

Leeds

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Sep 20, 2015
165
0
Thanks, I will read that story tomorrow.

I hear what you say Kevin about 'smoke and mirrors', I've read plenty of stories on TP about people trying for, and failing to get, CHC. My argument would be that mum had a stroke last August which has left her with further issues, on top of the ones she already had (mainly cognitive before, more physical after the stroke). After further strokes and TIAs (some documented by ambulance crews and out of hours doctors) she has become a lot worse. They may class agency carer visits as 'social care', but she wouldn't need all this extra care if she hadn't had the stroke!

Right at the start of all this, in December 2015, there was a very forceful Social Worker who was looking after mum's case during the build up to her discharge from hospital. I remember her pushing the ward staff to conduct the CHC check and she emailed it to me (mum failed at the time), but unfortunately it's got lost on a broken laptop and old email account. I'm going to ask SS when they come to reassess mum for a copy of that original check. It would be interesting to see the comparison if they did one now.

My concern is that as I need more and more help with mum at home (mainly due to the incontinence - can that be classed as a 'social issue'?!), I am going to be expected to pay towards it, but I'm not sure where it will come from. Mum's remaining savings won't last long (and I will argue that some needs to be left to go towards her funeral), all of my savings are geared towards providing me with a pension one day - should I be expected to fund her care from that? This is the first time I have really had any financial worries about mum's dementia, and they are making me feel quite uncomfortable.

If SS come up with an increased level of support for mum, then my worries will ease, but I'm still going to ask them to conduct another CHC review (or ask them to ask whoever does it). I fear SS are going to try to push me to change to an agency they use, but I won't do that due to mum being familiar with our regular carers, and also a language issue.

Probably not good to go to bed with these worries, but there you go! I guess some little part of me wants to have a prod at 'the system' because of the hard time I've had since December 2015. Not that I'll get too much sympathy from the 'system' on that front!
I wish you luck, we tried to accessCHC funding for dad who is in a care home. He was placed in the home by the mental health team following a crisis at home. He had numerous long stays in various mental hospital prior to this. He developed vascular dementia following a stroke 3 years previous to diagnosis.
His other conditions include, heart failure, hypotension, diabetic, chronic arthritis and to top it all he suffered a massive pulmonary embolism. He is at late stage VD and is asleep 18 hours a day. In my experience unless the PWD is violent and unmanageable, CHC will not fund. We were told that dad could access nursing care funding, but he would have to move to a nursing home. The whole funding system is against you and the whole process is inconsistent and lacks transparency. Good luckx
 

Jezzer

Registered User
Jun 12, 2016
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Lincoln, UK
Thanks, I will read that story tomorrow.

I hear what you say Kevin about 'smoke and mirrors', I've read plenty of stories on TP about people trying for, and failing to get, CHC. My argument would be that mum had a stroke last August which has left her with further issues, on top of the ones she already had (mainly cognitive before, more physical after the stroke). After further strokes and TIAs (some documented by ambulance crews and out of hours doctors) she has become a lot worse. They may class agency carer visits as 'social care', but she wouldn't need all this extra care if she hadn't had the stroke!

Right at the start of all this, in December 2015, there was a very forceful Social Worker who was looking after mum's case during the build up to her discharge from hospital. I remember her pushing the ward staff to conduct the CHC check and she emailed it to me (mum failed at the time), but unfortunately it's got lost on a broken laptop and old email account. I'm going to ask SS when they come to reassess mum for a copy of that original check. It would be interesting to see the comparison if they did one now.

My concern is that as I need more and more help with mum at home (mainly due to the incontinence - can that be classed as a 'social issue'?!), I am going to be expected to pay towards it, but I'm not sure where it will come from. Mum's remaining savings won't last long (and I will argue that some needs to be left to go towards her funeral), all of my savings are geared towards providing me with a pension one day - should I be expected to fund her care from that? This is the first time I have really had any financial worries about mum's dementia, and they are making me feel quite uncomfortable.

If SS come up with an increased level of support for mum, then my worries will ease, but I'm still going to ask them to conduct another CHC review (or ask them to ask whoever does it). I fear SS are going to try to push me to change to an agency they use, but I won't do that due to mum being familiar with our regular carers, and also a language issue.

Probably not good to go to bed with these worries, but there you go! I guess some little part of me wants to have a prod at 'the system' because of the hard time I've had since December 2015. Not that I'll get too much sympathy from the 'system' on that front!
Hi @Marnie63 I'm a little confused (the norm Im afraid these past few years!). I believe mum is at the stage where she should be considered for CHC. As it's NHS funded, why does it appear that SS have to be approached? Who do I ask initially for an assessment to be carried out? I'm under no illusions it would be granted but I believe it is worth a try. Mum is in a CH, bed-bound and can do nothing for herself. Many Thanks x
 

Marnie63

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Dec 26, 2015
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Hampshire
I find it confusing too Jezzer - I think it's intentional so that we're all a bit in the dark about it! SS are involved in mum's care as she was assessed at the start and qualified for funding towards her home care (thank God). So, I would start by asking them, but I'm not 100% sure what the official channels are. We also have an excellent GP, so I'm sure he could advise. At the bottom of my 'wish' is that I, like most people, find it incredulous that PWDs are treated differently to people with other serious health conditions. If the brain is damaged by disease, how has that become a 'social' issue?! So part of me wants to test the system, just to see how it would apply to mum.

My other bit of confusion on my part is SS funding vs NHS funding. I know ultimately it's from the same pot, but not sure how the two work together, if at all.

Hopefully I will get more financial support from SS to be able to see this through to the end with mum at home. In that case, the CHC issue is not so important to me.

I also agree with Leeds that the systems that are supposed to help, are often against us, though have to say that I have had nothing but good support so far from GP, SS and the care agency we use.
 

nitram

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Apr 6, 2011
30,081
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Bury
Who do I ask initially for an assessment to be carried out?

You have to ask a member of an 'organisation' - professional involved in the care of your mum.

Page 5

7. The aim is to allow a variety of people, in a variety of settings, to refer individuals for a full assessment for NHS continuing healthcare. For example, the tool could form part of the discharge pathway from hospital; a GP or nurse could use it in an individual’s home; and social services workers could use it when carrying out a community care assessment. This list is not exhaustive, and in some cases it may be appropriate for more than one person to be involved. It is for each organisation to decide for itself which are the most appropriate staff to participate in the completion of a Checklist. However, it must be borne in mind that the intention is for the Checklist to be completed as part of the wider process of assessing or reviewing an individual’s needs. Therefore, it is expected that all staff in roles where they are likely to be involved in assessing or reviewing needs should have completion of Checklists identified as part of their role and receive appropriate training.
8. Individuals may request an assessment for NHS continuing healthcare. In these circumstances, the organisation receiving the request should make the appropriate arrangements for a Checklist to be completed.


https://assets.publishing.service.g..._data/file/213141/NHS-CHC-Checklist-FINAL.doc
 
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Jezzer

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Jun 12, 2016
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Lincoln, UK
I find it confusing too Jezzer - I think it's intentional so that we're all a bit in the dark about it! SS are involved in mum's care as she was assessed at the start and qualified for funding towards her home care (thank God). So, I would start by asking them, but I'm not 100% sure what the official channels are. We also have an excellent G P, so I'm sure he could advise. At the bottom of my 'wish' is that I, like most people, find it incredulous that PWDs are treated differently to people with other serious health conditions. If the brain is damaged by disease, how has that become a 'social' issue?! So part of me wants to test the system, just to see how it would apply to mum.

My other bit of confusion on my part is SS funding vs NHS funding. I know ultimately it's from the same pot, but not sure how the two work together, if at all.

Hopefully I will get more financial support from SS to be able to see this through to the end with mum at home. In that case, the CHC issue is not so important to me.

I also agree with Leeds that the systems that are supposed to help, are often against us, though have to say that I have had nothing but good support so far from GP, SS and the care agency we use.
Thanks Marnie - glad I'm not alone in my confusion(!) and also I 100% agree with your other views! We are dealing with a dreadful, dreadful illness that bit by bit takes away our loved ones. It has a profound and devastating effect on Carers and families and if this isn't bad enough, we also face a series of brick walls and, in my case anyway, a really callous professional who clearly enjoyed seeing my distress. I kid you not. I was too drained to do anything about it then but it's documented so perhaps one day ...... That said, other professionals were wonderful. I wish you luck with your application - Thank You so much xxx
Thanks also to @nitram. Mum's case was complicated but I'll go back through my folder and find who I feel is the best of those involved to contact. Thank you also for the link - it is so much appreciated. x
 

Marnie63

Registered User
Dec 26, 2015
1,637
0
Hampshire
I guess that CHC funding is more 'appropriate' to those who have to self fund care and are therefore unable to get any financial support from SS? I am extremely grateful that we get some funding from SS towards mum's home care (due to her low savings), I keep a spreadsheet of all financial transactions in relation to mum's care and the total cost since the end of 2015 is quite staggering, but of course still a lot less than if she were to be funding her own place in a care home. She has paid towards it, but thankfully that part has been affordable from her combined pension and benefits.

Can't believe you were confronted with someone who relished your distress Jezzer - what kind of people are they?! Good luck if you apply.
 

Jezzer

Registered User
Jun 12, 2016
984
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Lincoln, UK
Hi @Marnie63
When you add up costs, it's unbelievable isn't it?
As regards the person who "enjoyed" my distress, I mentioned it in passing to the then receptionist at mum's CH. She was enraged and urged me to report her. I was told she had a history of being a bully. At that time, we were trying to finalise mum's placement and, as so many of us know so well, the relentless paperwork, meetings etc can drain you completely and my focus was on mum and securing the best placement for her. I can only think she must be a very unhappy person and, if she's still in post, needs to have a career change! Fortunately, I have met some lovely people during the last few years and I think TP is a wonderful forum. Wishing you well Marnie and hoping you can get the additional support for your dear mum xx
 

Jezzer

Registered User
Jun 12, 2016
984
0
Lincoln, UK
@nitram Hi again. Could I trouble you for further advice/opinion please? I have researched on the net but have found conflicting results. This time, it concerns top up fees. I have read where they are compulsory and elsewhere where they are not. We are paying a hefty top up for mum (who is part-funded by S/S and also receives Funded Nursing Care. Mum's CH would not have been S/S choice due to high fees. The Manager of mum's CH said that mum's pension, S/S contribution, FNC and our top up just cover her fees. We have no problem contributing but what concerned us was when the Manager suggested dipping into mum's small savings to help with the top up. Surely this isn't right? We have no intention of doing this anyway. Thanks in anticipation of any advice.
 

nitram

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Apr 6, 2011
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Bury
Nobody has to pay a top up in any situation no matter what SS or care home say.

First party top up are only allowed in specific circumstances.
  • Funding is via s117
  • The person has gone into a care home on a temporary basis with a view to making a decision to remain in care permanently, then during the first 12 weeks at this temporary stay, their own property will be disregarded and they are able to pay their own top up fees.
  • A deferred payment agreement has been agreed
From what you have said the manager is suggesting your mum (or you acting on her behalf) act illegally.

The care home contract should be with the LA, you should be paying any voluntary top up to the LA not directly to the home.
 

Jezzer

Registered User
Jun 12, 2016
984
0
Lincoln, UK
Nobody has to pay a top up in any situation no matter what SS or care home say.

First party top up are only allowed in specific circumstances.
  • Funding is via s117
  • The person has gone into a care home on a temporary basis with a view to making a decision to remain in care permanently, then during the first 12 weeks at this temporary stay, their own property will be disregarded and they are able to pay their own top up fees.
  • A deferred payment agreement has been agreed
From what you have said the manager is suggesting your mum (or you acting on her behalf) act illegally.

The care home contract should be with the LA, you should be paying any voluntary top up to the LA not directly to the home.
Thank you so much for this. I recall seeing this way back. The CH manager (who has now
left) was insistent with my brother that top up was compulsory and he has been paying this to the Home - by direct debit - for 20 months. No contract/written agreement has ever been signed by either of us (we hold joint POA jointly and severally). My brother should have retired 18 months ago but has continued working to help with these fees. Our worry is that "rocking the boat" may result in mum having to move to another home but I am concerned about my brother. He isn't in great health and I worry about him. I'm not sure who we approach now but I feel this must be addressed asap. Thanks so much for your clarification.
 

nitram

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Apr 6, 2011
30,081
0
Bury
Just resist any request for an increase in top up, you, and your brother, can't afford it, you simply do not have any spare cash. If they suggest first party top up tell them it is illegal

You may be interested in this quote from 'Which'

The contract for third-party top-up payments
Whoever is paying the top-up fee will need to sign a written agreement with the local authority.

It might be the case that a care home suggests the top-up is paid to them, but the government suggests the contract rests with the council, who will invoice the third party for their contribution to the overall fee.

The written agreement with the local authority should include:

  • notification of how much the top-up payment will be
  • how often the payment will be reviewed - this should be annually
  • how the costs will be shared if the care home puts up its fees in the future
  • what might happen if the person paying the top-up fees can no longer afford the top-up.
A care home can’t ask for a third-party top-up fee. They should go first to the council. If this happens to you, ask why they are doing this and then talk to the local authority. It is the duty of the council to reassess a person’s needs and if the cost of care is going to increase, then the council should pay unless they can argue that the needs can be met elsewhere.

https://www.which.co.uk/elderly-car...ng-a-care-home/436233-third-party-top-up-fees

If needs be I'll try and dig out the corresponding legislation, problem is that invoicing via the LA is only stated to be 'best practice', hence my red in the quote.
 

Kevinl

Registered User
Aug 24, 2013
6,064
0
Salford
Thank you so much for this. I recall seeing this way back. The CH manager (who has now
left) was insistent with my brother that top up was compulsory and he has been paying this to the Home - by direct debit - for 20 months. No contract/written agreement has ever been signed by either of us (we hold joint POA jointly and severally). My brother should have retired 18 months ago but has continued working to help with these fees. Our worry is that "rocking the boat" may result in mum having to move to another home but I am concerned about my brother. He isn't in great health and I worry about him. I'm not sure who we approach now but I feel this must be addressed asap. Thanks so much for your clarification.
If the home charger more than the LA rate (and most do) then the top up is "compulsory" is so far as without it the home will ask her to leave, it isn't a question of rocking the boat the home has a rate and however much that is over the LA rate will have to come from a third party.
The suggestion you use your mum's money is totally wrong the only circumstances when you can use your mum's money are as nitram sets out in post 16.
If the top up stops then the LA will have to find at least one home that will take her at their rate but usually this is a choice of one, take it or leave it and they can place out of their area if they want. You should be offered more than one place and consideration about your mum's rights to a family should means they should consider how easy it will be for family and friends to visit but in practice this rarely seems to happen.
Before letting someone enter into a top up contract the LA are supposed to look into that person's ability to pay and continue paying the top up and his age should have been considered if your mum's only been in the home and your brother wanted to retire 18 months ago then he should not (I believe) have been allowed to agree to a top up if it mean he had to continue working unless he agreed to.
K
 

Jezzer

Registered User
Jun 12, 2016
984
0
Lincoln, UK
Thank you @nitram and @Kevinl Mum is end of life care now and I believe moving her at this stage would literally kill her.

The CH fee is certainly higher than our LA rates.

No written agreement re top up has ever been signed.

I will investigate further.