NH Assessment and NHS Continuing Care in Scotland - How does it work?

[mumof3]

I know there are a couple of continuing care threads running at the moment but as we are in Scotland I understand different rules apply so I didn't want to complicate things by adding to either of them.

Our situation is that my MIL is now in her 4th week in an EMI NH following an initial 2 week emergency respite placement. The respite came about as home care was withdrawn due to my MIL allegedly striking a carer (we had been informed that she had been aggressive towards home carers previously). Thankfully we managed to arrange the respite in the NH that we had already selected as being the most suitable for my MIL and had taken her to see it so actually the move was not as traumatic as it could have been. My MIL has actually settled pretty well although visits are always a bit traumatic especially when we leave.

Since my MIL has been in the NH the only contact we have had with her SW has been a bundle of forms sent to my husband to assess my MIL's financial situation. The NH told us at the end of last week that there should be an assessment of my MIL's needs by her SW before my MIL can be considered a permanent resident. We are assuming that we will be involved in this as my MIL's only relatives but have not heard anything so far. Wondered if this was unusual and if we should be pushing things along? The respite status is a nuisance as it means that medications etc still come through my MIL old GP surgery.

Also no-one has ever mentioned NHS continuing care to us and the 2 recent threads on the subject got me thinking this afternoon. We were told early on that my MIL would be self funding because she owned her own house. We wondered if NHS funding should automatically be considered or whether we would have to apply somehow. There seems very little information available after spending this afternoon looking online. Came across this document http://www.sehd.scot.nhs.uk/mels/cel2008_06.pdf

The criteria in Section 4 seem a lot less precise than the English equivalent but presumably the funding is equally elusive. I know the chances of my MIL receiving NHS funding are likely to be slim but it doesn't seem right that in her circumstances (vascular dementia diagnosed 2 years ago at 62 and in the NH's view in need of EMI care) that it is not even considered. Wondered if anyone has any experience of how the system works in Scotland.

Thanks everyone.

 

[Skye]

Hi

I think you should be chasing up your SW. You need an assessment, the SW should go to the home to talk to you and the head of unit to discuss care needs. I'd give him/her a ring tomorrow and get it set up.

Financially, the LA will pay the Scottish free personal care allowance, and your MIL will be liable for the rest. If you can persuade the LA to take out the contract with the NH, and bill you for the balance, it's better because the LA limit is less than they will charge you.

You could apply for NHS continuing care, but I have to warn you that it's even harder to get in Scotland than in England -- virtually impossible unless the situation is immediately terminal.

My husband has been in an EMI unit for a year, and I haven't bothered applying. I did mention it once to the head of unit, and he said 'What's that?' He was serious!

If you do apply, and manage to get it, please let me know.

 

[mumof3]

Thanks Hazel - we will try to get in contact with my MIL's SW tomorrow about the NH assessment. Do you know whether it's normal to have a medical input? My MIL was attending a weekly assessment centre and her care was being overseen by the Consultant there who now knows her very well.

In terms of the contract, the NH fees are almost £1000 per week in the EMI Unit and our local authority would pay about 1/2 that for a funded resident! We've already established that my MIL would have to pay the full amount until her funds run out and then the local authority would pick up the tab at the far lower rate and that the NH would accept this. The NH terms say that the contract must be direct and not via the LA if a resident is self funded - a way of depleting the funds sooner, my increasingly cynical mind thinks!

I had gleaned that continuing care funding wasn't often given but it does seem really unfair for the SW not to even mention it's existance especially with a degenerative condition. My MIL has changed so much in the last 3 years, who can say how she will be in 6 months to a year's time. There must be so many people in care homes who now meet the criteria for NHS funding who just have never been assessed or who were assessed years previously.

Thanks again Hazel

 

[Skye]

I'm not sure about medical input, John was transferred straight from hospital, so they had his notes from there. They may just ring the consultant, or they may want him/her to visit.

£1000 a week sounds incredibly high for Scotland, we're self-funding, and I don't pay anything like that. And my contract is with the LA, so our fees shouldn't go up too quickly.

You can apply for continuing care at any time, so if your MIL does deteriorate quickly, you can apply then. There's no harm in applying now if you want to, you can apply as many times as you like. But NHS will only pay if the patient would otherwise have to be in hospital -- and even then it's difficult.

Actually, SS are quite keen for people to apply, because if they get it, that transfers the cost of care from them to NHS, so the fact that SW didn't mention it probably means you'd be unlikely to get it.

No harm in applying, though!

 

[icare2]

it doesent apply in Scotland,well not yet!!!

in my experience,I put all the directives in to a full committee,during my wifes assessment for 24/7 care,but the assholle consultant that we have,doesent know anything and doesent want to know anything about it,al he does for his salary is sign for for patients that need to be put intoo care homes,its time he was retired..but the usual **** that we all get,is there is no other consultants in our area,that are experienced in this,but he is a pure disaster at his job,and should really be retired,as he is a no hoper of anything thats gonna make him do any new rules or even put them forward..

 

[Skye]

It does apply, one of our members got it for her husband -- but only when he became terminal!

He'd had a lot of problems, and spent a lot on time in an assessment ward, but even so he didn't qualify until near the end.

 

[alfjess]

Hi Mumof3

My Mum and Dad were in a residential care home which was costing £1005 per week, that is with 50% discount on the second person because they were sharing a room. Real price £670.00 ppw.

Mum became too much for them to handle and she was taken into the assessment ward of the local hospital. A terrible place, but she was there for approx 10 weeks. I was told she didn't have long to live. She was assessed as needing NHS continuing care, although no medical reason was given.

Mum was moved from hospital to a BUPA contracted home (I didn't really have much option)

I have to admit after intially having lots of reservations about this home, they have been great and Mum is still here, although becoming more and more frail. I have moved my Dad to this home, although a different unit. He is not NHS continuing care, but self funded

I am in Scotland. If you want to PM me, I will try to help. If I can

 

[connie]

For what it is worth, and for info only as I realise things are different in Scotland.

There was just one small box section for me to add input to the paperwork that ultimately went before the panel.

I bypassed the box - typed up an A4 sheet detailing the deteriation that Lionel had experienced since walking into the care home. Typeing his deteriation up like that, detailing how at every stage he had lost different abilities was so hard.
Weight loss, ability to read, comprehend, speak everything was described.

I emphasised the dengenerative nature of the illness and attached two photographs. All went on file. I like to think that this helped his case in some small way. I was told that, excuse the language "we did not have a cat in hell's chance of getting funding". But something worked.

Hope this helps.

 

[icare2]

hello Connie

no the only way up here to get NHS continuing care for A.D. is really at the end of life..PALATICAL CARE (END OF LIFE REALLY)MEANING DAYS OR HOURS TOO LIVE..

WHAT WE HAVE WELL US CARERS AT HOME HAVE BEEN WATCHING OUR PARTNERS FOR YEARS ON END

 

[alfjess]

Hi icare2

I didn't asked for NHS continuing care for Mum and didn't really want it, because at the time I didn't think the placement on offer was the best place, but as her agitation was soo bad, I didn't have much of a choice.

I am happy to say I have been proved wrong in my opinion of the home, the staff are good.

Mum was in a psychiarict assessment ward in hospital and I guess she ticked enough boxes.

Alfjess

 

[taylorcat]

I was in much the same position with my Mum.

My Dad and I were told we would have to start looking for a care home for Mum for when she came out of hospital. We were in the process of doing this when the consultant called to say any care home we chose for Mum would not be suitable and he recommended continuing care, where she is now and has been for over a year.

So very unfair for people who cannot access continuing care for whatever reason.