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CHC second stage assessment- how to prepare

Discussion in 'Legal and financial issues' started by missmarple, Jan 7, 2015.

  1. missmarple

    missmarple Registered User

    Jan 14, 2013
    Hello everyone I am hoping for some more advice after the excellent replies I have received previoulsy.Just to recap Dad is at home, lives with my brother (who has mental health problems) and requires all day carers 7 days/ week for his own safety. Diagnosis is AD, and he has challenging behaviour which meant one attempt to settle him in a care home failed. He is self funding. I requested a CHC assessment, 1st step was I believe the checklist about 3 weeks ago and now I have had a call from the CCG to say a meeting will take place in his home next week with CCG present.
    I have been told by a friend who is a nurse I should request to see the Health Needs Assessment? Does this sound about right? Is there anything else I should do to prepare? Obviously I plan to attend. Many thanks for any advice.
  2. Benrese

    Benrese Registered User

    Apr 12, 2014
    I am sure others will be along with their inputs, but I would suggest recording it. My husband and his sister attended an assessment and asked if they could record to help them go over the finer details which can be forgotten after such meetings. They were agreeable to this.

  3. missmarple

    missmarple Registered User

    Jan 14, 2013
    Thanks Benrese. Looking around on the net, i wonder whether the health needs assessment is something that only applies if you are in hospital.
    Any advice to me at this stage to prepare for the assessment next week would be most welcome. I am reading the govt DST document, is there anything else i should be aware of? Thank you.
  4. Cornishman

    Cornishman Registered User

    May 27, 2013
    Here's a straight cut and paste of a reply to a similar situation I posted a few weeks ago - may not fit your particular circumstance precisely but the thrust of the message is the same:

    "My recommendation based on previous experience is to get ahead of the game, and complete your own version of the DST as objectively as possible. This will give you a feel towards the outcome that would be the most appropriate in your dad's particular case. Alternatively, you could just complete the checklist itself, but the DST is more comprehensive.

    There are some things to watch out for - don't fall into the trap of believing condition or illness (even if formally diagnosed) is the basis or justification for CHC - it's all about NEED. Secondly, having established a need, it's evidence, evidence, evidence.

    Something that isn't scored in the DST, in the manner that the other domains are, are the terms "complexity, unpredictability, intensity and nature" of someone's condition and need. Because they are not scored, and are fairly loosely defined, a common trick, even where the DST markings otherwise suggest eligibility, is to say the person's needs are not of a "complexity, unpredictability, intensity or nature" to warrant CHC. That's what they did with my mum when they took her CHC away.

    And just in case you didn't see it first time: Evidence, evidence, evidence. "

    Hope this helps a bit.

    Best wishes and good luck.
  5. missmarple

    missmarple Registered User

    Jan 14, 2013
    Thanks so much Cornishman I really appreciate you taking the time to advise me, especially when you have had disappoinitng news recently. I will read the government's DST document and have a go at completing it in advance of the meeting.
    I am fully anticipating they will not award CHC funding, but will appeal if I think there is any hope of getting it eventually.
    Will post again when I know more.
  6. missmarple

    missmarple Registered User

    Jan 14, 2013
    Well we had the assessment on Wednesday and Dad scored 1 severe 2 highs 1 moderate, according to the CCG and I was told it was borderline and they are going to consult with a senior team member and get back to me. Dad was scored high for behaviour and I feel it should be severe. Grounds for this include the fact that he is highly mobile, requires all day carers to manage his behaviour when he is out of the home, and prior to full time carers starting in March 2014 there were numerous incidents of aggression involving police.In the last three weeks he has: attempted to enters people's homes and cars, gone out naked below the waist and boarded a school bus which came to his street to pick up a neighbour's disabled child (this was because he went out 1/2 an hour before carers started), helped himself to a lady's bag in the pub etc. Each time these behaviours require a skilled carer or myself to manage. If a skilled/ responsible person had not been in attendance the repercussions can only be imagined. I am expecting a no when they ring me on Monday, and will then join the club of persons appealing.

    WILLIAMR Account Closed

    Apr 12, 2014
    I must say I don't really know how they scored my step mother.
    I was advised she would not qualify for CHC funding but and the bungalow she was living in would have to be sold to pay the fees in spite of the fact I was the owner.
    I was also told if I did not pay she could be let out and she could seriously hurt a child.
    I just walked out of the meeting and said I would get a solicitor involved and I invited the LA to take me to court if they thought I was liable for the fees.
    2 hours later we had a phone call and we were asked to return to the hospital and by some miracle she was granted CHC funding but I was asked to sign that I would pay if her CHC funding was withdrawn.
    I just refused knowing she was bed blocking and the hospital wanted her out.
    It took a few more days for a home to be found and I was approached by the social worker and she said the cost was way above what the NHS would pay and a special meeting would have to take place which could not happen for 2 weeks and the room could be lost in the meantime. She could however go if I paid.
    I stood firm and somehow she was transferred to the home 3 days later.
    I can only assume she was given CHC funding but I never saw any paperwork.

  8. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    To qualify for CHC the primary need is a health need so whether at home, in an assessment unit or hospital it is the health needs that count not ordinary care that can be carried out by carers.
  9. missmarple

    missmarple Registered User

    Jan 14, 2013
    I said I'd update when there was a decision so I'm back. After quite a bit of negociation which basically all hinged on whether Dad's behavioural needs were severe or high (CCG argued high, i argued severe, they scored him severe on cognition) reports were solicited from Dad's dementia team and his CPN. I saw the report from the dementia team and it stressed Dad had been turned down by an EMI and had had to go home on the day such was his behaviour, with a self funded care package at home which meant he was never alone when out of the home. They then outlined various incidents which for the sake of Dad's dignity I won't elaborate on. All things i had explained at the DST meeting, but it seems to carry more weight coming from a professional. The CCG has agreed to fund 3 months and then review. i suspect they hope by then the Alzheimer's will have progressed and he'll be more placid and thus score lower on behaviour. We'll see.
    Thanks to everyone who has given me excellent advice along the way.
  10. Raggedrobin

    Raggedrobin Registered User

    Jan 20, 2014
    I read this thread and am really glad you have started on funding, it certainly sounds like your Dad should have it. My Mum just 'failed', she hasn't been difficult enough of late!:D
  11. fr0d0

    fr0d0 Registered User

    Dec 23, 2009
    Mid Wales
    Incorrect. If the primary care need is for health reasons, then all care, social or medical, needs to be funded by the NHS.
  12. missmarple

    missmarple Registered User

    Jan 14, 2013
    Thanks everyone. I shall continue posting as i hope the information will be valuable to others going through this demanding process. The review will come along soon enough, will let you know how it goes.
  13. SueShell

    SueShell Registered User

    Sep 13, 2012
    My Mum got one severe, three highs, one moderate but didn't get full CHC funding. However she did get funding for nursing care. Its all about how things are on the day of assessment. They do tend to 'play down' situations as they really are,mainly all to do with money of course, so be aware of this when you add your comments to the document once they send it to you for comments Sue
  14. katek

    katek Registered User

    Jan 19, 2015
    Thinking about Miss Marple's situation where her father has been given CHC for three months in his own home (as opposed to a nursing/care home setting), and wondering about how he will be re-assessed at the review meeting. I imagine that the professional(s) caring for him at home have to keep notes, and that these will form the main 'evidence' for the re-assessment on the DST.

    SueShell, when you talk about adding your comments to the document once they send it to you, it sounds as if that is a relative's only chance to contribute but of course this is better done at the meeting itself, which of course you have a right to attend. You rightly say that needs tend to be played down, but when you say it depends on how they are on the day, that shouldn't necessarily be the case as the care notes should be consulted to give the full picture of how the needs manifest themselves over a period of time, not just on one day.

    Apologies if I have misunderstood your comments!

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