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Chc is it worth trying

wonderwoman

Registered User
Sep 12, 2012
22
I do not know whether i will be able to keep dad at home until end. Is it worth trying for CHC, I have been told that he is EMI residential but when he went in for rest bite they said they could not meet his needs. i asked for him to be reassessed cpn stated he is still EMI, and would not be eligible very confused and upset that i will not be able to have rest bite. she is trying to get me to put him in full time why? if they cannot meet his needs says not all care homes the same? Anybody shed any light?:confused:
 

Cloverland

Registered User
Jun 9, 2014
244
Im in the process of applying for chc funding for dad, first hurdle have been told by SW's manager he won't meet criteria. I'm going to ask for assessment anyway as SW is local authority and chc is NHS, so not sure how they know he won't meet criteria, I want the proper channels to tell me.

I have read that chc funding is available for dementia patients whether at home or in care, so here goes nothing to lose.
 

wonderwoman

Registered User
Sep 12, 2012
22
Well Done

I agree, I have had similar experience when i asked for a assessment the cpn stated that i have had a assessment done but this was with local authority not nhs and she works for nhs does not make any sense it seems to me they are trained to block u out she talk to me as if i was stupid. can you tell me how i apply, i have received no assessment from nhs only local authority. What does the nhs do?

Can you let me know how you get on. Thanks very much, and best of luck.



Im in the process of applying for chc funding for dad, first hurdle have been told by SW's manager he won't meet criteria. I'm going to ask for assessment anyway as SW is local authority and chc is NHS, so not sure how they know he won't meet criteria, I want the proper channels to tell me.

I have read that chc funding is available for dementia patients whether at home or in care, so here goes nothing to lose.
 

Saffie

Registered User
Mar 26, 2011
22,507
Near Southampton
Social workers do have some idea of what criteria need to be reached to qualify for CHC funding, simply from their experience. It is actually in the SS/LA's interest for the fundingto be allocated to a person because it saves them money. However it doesn't mean to say that they are always right.

Dementia alone will not qualify though - unless the resident is very aggresive. The whole point of the CHC/NHS funding is that it is for medical needs rather than social.

It does no harm to try though but it is far from a walk in the park going through it.
 

wonderwoman

Registered User
Sep 12, 2012
22
Make no sense is not your brain a medical part of the body a very vital part as nothing else works without it. Is it just me or has world gone crazy, they just accept what they want to.


Social workers do have some idea of what criteria need to be reached to qualify for CHC funding, simply from their experience. It is actually in the SS/LA's interest for the fundingto be allocated to a person because it saves them money. However it doesn't mean to say that they are always right.

Dementia alone will not qualify though - unless the resident is very aggresive. The whole point of the CHC/NHS funding is that it is for medical needs rather than social.

It does no harm to try though but it is far from a walk in the park going through it.
 

Saffie

Registered User
Mar 26, 2011
22,507
Near Southampton
Make no sense is not your brain a medical part of the body a very vital part as nothing else works without it. Is it just me or has world gone crazy, they just accept what they want to.
Sorry, I was just trying to answer your query as to whether it was worth trying for the funding.

CHC funding is based on need. A lot of sufferers of dementia have other serious health problems as well and it is mainly for these that the CHC is intended and it is hard to obtain even for them.

You mention wanting your respite time but I haven't ever heard of the funding being granted for respite.
It is meant for nursing needs over and above that which is covered by general nursing.


PS. There are a number of threads about CHC. If you 'search' the word, you will find a lot of information about other TPers experience with it.
 
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Onlyme

Registered User
Apr 5, 2010
4,995
UK
Mum can't feed or drink by herself, is immobile, can only move her head slightly and lift one hand, has bad eye sight, very deaf, osteoarthritis, had had bed sore, double incontinent, heart failure, hallucinates due to dementia. CHC says she doesn't have any medical needs, only social.
 
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Cornishman

Registered User
May 27, 2013
379
In my experience, if you amend Saffie's post above to read "CHC should be based on need" (instead of: "is based on need"), you're getting closer to the problem many on here encounter.

It is not unknown for CCGs to start with the outcome that an individual is not eligible, and work backwards up the framework document process, and the DST scoring in particular, to "evidence" that position.

There also appear to be significant differences in the various CCGs' approach to all this.

I would definitely encourage anyone to ask for the CHC assessment process to start where eligibility looks possible based on the criteria and the person's current and likely needs in the foreseeable future, but bear in mind that as most of the process is "evidence based", to keep that aspect in mind and be watchful of evidence being omitted, downplayed or deemed irrelevant.

Onlyme's summary of mum's needs have many similarities with my own mum's situation, and in my mum's case to be told she was in the CH for "accomodation" and not primarily for health is frankly ridiculous.

Good luck and very best wishes
 
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Lainey 127

Registered User
Nov 25, 2012
216
Liverpool UK
Yes! Please keep trying for CHC. Mum very elderly and has mixed dementia - 2 years now. It took me six months of form filling and GP's letters, even Mums consultant stated that he didn't think Mum would qualify, but she did! First time!
I had to provide medical reports from Mums GP and give examples of her behaviour and state of health etc...I downloaded the CHC check list from the internet and went through it carefully with the district nurse and social worker to give examples of each criteria. Mum ticked 7 out of the 11.
Good luck!
 

Cloverland

Registered User
Jun 9, 2014
244
I will keep you informed. As I said to the SW when she said 'NO' that I want the checklist assessment and then full assessment and if Chc funding is refused, I will be appealing. They already know I don't take no for an answer as proven with his medication for his lack of inhibition. Without this medication no home would take him for day centre, respite or permanently so to me his dementia is about primary health.

From reading posts on here re chc funding it really seems that it's a lottery and despite guidelines no-one really has a clue as to who qualifies and who doesn't and that the 'professionals' wing it and see who appeals. Win some lose some springs to mind.

But I will be applying for everything at each step, as nothing to lose by trying. Waiting for LA re funding too. Pension credit and savers part if LA funding successful as they assume you already receive it whether you are or not. So by applying for everything hopefuly playing them at their own game, they can't have it both ways. If he doesn't qualify for pension credits I will be expecting them to increase their funding on this but I'm jumping a bit far ahead.

Hope that makes sense, I've been reading a lot of information packs either government or society's re funding criteria and thresholds.
 

wonderwoman

Registered User
Sep 12, 2012
22
Mum can't feed or drink by herself, is immobile, can only move her head slightly and lift one hand, has bad eye sight, very deaf, osteoarthritis, had had bed sore, double incontinent, heart failure, hallucinates due to dementia. CHC says she doesn't have any medical needs, only social.
That is unbelievable.
 

wonderwoman

Registered User
Sep 12, 2012
22
I will keep you informed. As I said to the SW when she said 'NO' that I want the checklist assessment and then full assessment and if Chc funding is refused, I will be appealing. They already know I don't take no for an answer as proven with his medication for his lack of inhibition. Without this medication no home would take him for day centre, respite or permanently so to me his dementia is about primary health.

From reading posts on here re chc funding it really seems that it's a lottery and despite guidelines no-one really has a clue as to who qualifies and who doesn't and that the 'professionals' wing it and see who appeals. Win some lose some springs to mind.

But I will be applying for everything at each step, as nothing to lose by trying. Waiting for LA re funding too. Pension credit and savers part if LA funding successful as they assume you already receive it whether you are or not. So by applying for everything hopefuly playing them at their own game, they can't have it both ways. If he doesn't qualify for pension credits I will be expecting them to increase their funding on this but I'm jumping a bit far ahead.

Hope that makes sense, I've been reading a lot of information packs either government or society's re funding criteria and thresholds.

Your right we have nothing to lose, thanks for reply
 

Cornishman

Registered User
May 27, 2013
379
Well it isn't really. It means a person needs help, it doesn't mean they need to be fully funded from NHS.
True - in theory - but as is often the case, it's all about the context.

If you re-read Onlyme's post where the extent of her mum's condition and therefore her nursing needs are summarised, and then consider that by refusing CHC, the CCG and Social Services are jointly asserting that all this is within the scope of the level of care the Local Authority (as opposed to NHS) can and should provide, it just doesn't seem credible, and is possibly unlawful, because the LA is almost certainly exceeding the level of need it can legally provide (even allowing for a possible FNC provision). There is no lower limit to level of need the NHS can lawfully provide, but the upper limit for what the LA can lawfully provide is reasonably well defined, but often ignored, as appears to be the case here.
 
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WILLIAMR

Account Closed
Apr 12, 2014
1,078
Your right we have nothing to lose, thanks for reply
Hi Wonderwoman

I will not go in to detail but my step mother was in hospital bed blocking and the social worker wanted me to pay for my step mother's care by selling a bungalow I owned but she was occupying in accordance with the terms of my father's will.
I and her son just walked out of the meeting and said we would involve a solicitor.
About 2 hours later we had a call asking us to return to the hospital.
We were then told the matter had been reconsidered and 3 months CHC funding had
been awarded.
Even after that the Social Worker kept on coming back saying that saying that it was not right that the taxpayer should pay for her care when the bungalow could be sold.
The Social Worker paid no attention to the fact it was my bungalow.
When my step mother left hospital the doctor said he would be surprised if my step mother would be alive in 6 months and the nurse in the care home said the same.
Sadly she passed away a week after going in to care but it was due to a blocked intestine.
Obviously the medics could have not foreseen this.

William
 

flower1

Registered User
Apr 12, 2013
124
Mum can't feed or drink by herself, is immobile, can only move her head slightly and lift one hand, has bad eye sight, very deaf, osteoarthritis, had had bed sore, double incontinent, heart failure, hallucinates due to dementia. CHC says she doesn't have any medical needs, only social.
I have just read your response and think that is's disgraceful that your Mum does not qualify for CHC. My mum was awarded it in for first year in nursing home than had it taken away once she managed to put on a few pounds in weight. Four years later and in last stage of vascular dementia (severe stage) I am still fighting for it after 3 years, they are very crafty with the domains covered and questions to be answered at these meetings. Because my Mum is too poorly to be aggressive now, totally immobile, not aware of her surroundings, has to be spoon fed by the nurse, extra thickened drinks etc etc it totally goes against her, so the more you decline the more it goes against you - so so wrong is the system and all that people have worked for in their lives!! - Good luck and never give up fighting because I wont x
 

catbells

Registered User
Jun 14, 2010
384
Cambridgeshire
Just gone through CHC and I knew Mum didn`t qualify. I didn`t request it , but local ASC pick up on it. Mum in latter stages of cardoi vascular (very baby like now) but the key thing was SHE DOESNT NEED "NURSING" She has to be fed, isn`t mobile, sleeps more than is awake, just makes noises etc, but no nursing required yet. The care she receives is excellent, so so far no bed sores etc. Beware this is an emotionally grueling assessment for relatives as the emphasis is on - what they can`t do,(negative) rather than what they can do. I wish you luck. The assessor did explain that although it wasn`t likely she would quality, but it was a necessry process to make sure no one falls through the net which is a good thing.
Take care
Be brave xx Heather :):)
 

jaymor

Volunteer Moderator
Jul 14, 2006
12,899
England
My husband entered his nursing home CHC funded. He was fully mobile, could eat his meals normally, could hold a conversation and was not incontinent.

He is now spoon fed pulverised food, drinks thickened fluids from a beaker, is immobile, incontinent and silent most of the time and unintelligible when he does speak. All these problems are dealt with by his carers, his health only qualified him for CHC not the care he needs.
 

catbells

Registered User
Jun 14, 2010
384
Cambridgeshire
So confused. Yes I didn`t mention my Mum has been on pureed food for 12 months now, thicken drinks, double incontinent for the past 3 years, no longer mobile, has a happy demeanor, affectionate, loving, cuddly - but it was explained to me that NURSING was the key thing. She is helpless need assistance with everything, Residential care home meeting her needs. The other thing that was mentioned that if she did qualify, she may have to be moved to a Nursing Home at which I was horrified, it was traumatic enough moving to her to a residential secure dementia unit, We`ve been there 3 years now, have total confidence with the carers. I pray I don`t need to make this decision.
I was sent this linkvia TP
www.gov.uk/government/upload..._easy_read.pdf

I had a look at the link which only confused me more which will be self explanatory. I may persue in the new year.
Keep in touch
Heather x
 

Cornishman

Registered User
May 27, 2013
379
The problem we've encountered with my mum is the absolute determination on the part of the CCG to avoid CHC wherever possible because of funding problems.

So for example having recently passed a checklist with 3 A's and 4 B's, they then wrote to say they wouldn't be taking this forward to a full CHC assessment because they claimed there was "no material change" in mum's condition in over 2 years since they assessed her last and took her CHC eligibility away. Absolute rubbish of course, but they know that you're pretty powerless to do much except go through an appeals process. We've just finished appealing the August 2012 decision! They knew she was CHC eligible, but simply refused to assess her based on a lie.

We've fought the withdrawal of CHC with all our ability and sheer hard work, but for example the Ombudsman has said there was no lack of process in taking a year from assessment to decision (the framework explicitly says 28 days), and even went on to say my mother was "favoured" (their word) by this delay because she was still being funded. So never mind the complete lack of process, we're supposed to feel lucky. Utter nonsense and actually quite insulting.

The IRP said that although my mum's nursing needs were "increasing" (their actual word), she didn't qualify because having dementia didn't make a person CHC eligible. But hang on - we were there because her CHC had been withdrawn, so if her needs were "increasing", wouldn't she be even more eligible for CHC? But let's not allow logic and evidence to get in the way. The IRP was clearly going to support the CCG who weren't criticised in the slightest, even over things like going to see my mother behind the family's back despite us writing to say they were to stop doing it. And then having found my mother very different from how they reported her in August 2012 in that much later visit over a year on, omitting to mention subsequently they had been to the CH to see her because the evidence didn't suit their purpose - until I found out by chance. I wouldn't have believed this sort of behaviour was possible by healthcare professionals unless I'd seen it for myself. Total bullies.

There is clear evidence from openly available government statistics that our CCG has one of the lowest CHC eligibility rates per capita in the whole of NHS England, so there is a degree of postcode lottery and the pressures that some CHC assessors and their managers are under to be outcome driven also must have an impact.

In short, it's far from a level playing field, and if other public servants in other professions (police etc) breached very clear guidelines and rules so blatantly, I suspect they could be in serious trouble. And the appeals process at all levels, including the PHSO, is far from independent and leans towards supporting the NHS, however compelling the evidence. Sadly, I can't see the situation getting any better, but it needs to be gripped soon as right now it's a complete shambles.

I would never dissuade anyone from looking to obtain CHC, but my advice would be to be prepared for an uphill struggle. Hopefully CCGs will do the right thing though (as they did with mum in 2009, until the funding pressures emerged).
 
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