NHS CHC funding assessment / Nursing home fees

keekee

New member
May 27, 2020
2
0
Can anyone help please.
My Dad was discharged from hospital on 13.1.20 into a discharge to assess bed (d2a bed) awaiting an NHS CHC funding assessment.
The hospital told the Nursing home that while he was there he needed 1 to 1 care as he is at very high risk of falling
dad had the NHS CHC funding assessment within 4 weeks of being in the d2a bed but the assessor said she needed more info from the Nursing home regarding the 1 to 1 care to decide if they would pay for the 1 to 1 care. (not the actual Nursing home fees though).
While she was awaiting the additional info from the Nursing home the Coronavirus lockdown came in and he has now been in the d2a bed for 19 weeks and I still have nothing at all in writing about his NHS CHC funding assessment results or his 1 to 1 care.
I believe that the d2a bed is free until you have had the NHS CHC funding results.
I have yet to have any request for payment of Nursing Home fees.

My question is:-
Can the County Council of Local Authority ask me to pay for the 15 weeks (19 - 4 = 15) Dad has spent in the d2a bed.
 

Louise7

Volunteer Host
Mar 25, 2016
4,694
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Welcome to the forum @keekee My mum went through the D2A process. You are correct, the bed is free until the CHC decision is made. However, the bed is being paid for by the NHS - not the local authority - so they shouldn't be requesting that you make any payment for the 15 weeks (or longer) that it takes to reach a decision about funding.

These type of placements are managed by the local Clinical Commissioning Group (CCG) and I'm aware that because of the covid-19 situation CHC assessments have been put on hold for the time being, plus extra funding has been made available to pay for the additional costs to the NHS that the delays in making CHC decisions will cause them. I'm sure that the nursing home manager wouldn't have let the situation to go on for so long if the NHS had stopped paying for your dad so hopefully this has put your mind at rest.
 

keekee

New member
May 27, 2020
2
0
Welcome to the forum @keekee My mum went through the D2A process. You are correct, the bed is free until the CHC decision is made. However, the bed is being paid for by the NHS - not the local authority - so they shouldn't be requesting that you make any payment for the 15 weeks (or longer) that it takes to reach a decision about funding.

These type of placements are managed by the local Clinical Commissioning Group (CCG) and I'm aware that because of the covid-19 situation CHC assessments have been put on hold for the time being, plus extra funding has been made available to pay for the additional costs to the NHS that the delays in making CHC decisions will cause them. I'm sure that the nursing home manager wouldn't have let the situation to go on for so long if the NHS had stopped paying for your dad so hopefully this has put your mind at rest.
Thank you for your reply Louise it is very useful.
I don't trust these people therefore my thoughts are that they will ''try it on''.
My stance would be that although I have been told verbally Dad doesn't qualify for funding I have had nothing in writing therefore I shouldn't have to pay the retrospective fees,
only fees from the date I receive written confirmation of Dad not qualifying.
We shall see.
 

LongDistanceCarer10

Registered User
Jan 5, 2020
39
0
Thank you for your reply Louise it is very useful.
I don't trust these people therefore my thoughts are that they will ''try it on''.
My stance would be that although I have been told verbally Dad doesn't qualify for funding I have had nothing in writing therefore I shouldn't have to pay the retrospective fees,
only fees from the date I receive written confirmation of Dad not qualifying.
We shall see.
Hi folks

Currently in a very similar situation with an elderly aunt. She went from care home to hospital (unconscious for long time but then much the same when came to). Found to have Covid and kept in hospital to isolate for 2 weeks. Original care home declined to take her back stating her needs had changed over recent months, needed 1:1 care and likely nursing placement rather then residential. She was then D2a to a different care home, still residential as the hospital said she was settled and didn't need 1:1. They also said she had a student nurse sat with her all day, so conflicting in what they said. As the D2a process reached the end of the funded 4 weeks, the home said she was very unsettled and couldn't stay. The S/W tried to arrange nursing funding assessment. However then it all went wrong - the social worker was reassigned, the home said she was settled one week and unsettled the next, the RIT team (mental health?) refused to visit and the home care nursing team wouldn't help because the RIT team weren't involved!! Now she has no social worker.

No one has asked for money yet although she was previously self funding but the home had not been paid for two weeks.

Is this information still up to date - that the NHS continues to fund the D2a until they can get their act together and actually finish the paperwork?!

They are experimenting with medication via GP to try to settle her but she's up and down and problematic. I want to move her as the new home failed CQC inspection and is in special measures but I can't move her without knowing the outcome of the D2a and whether she is nursing or residential.

Feels very stuck!

Thank you
 

LongDistanceCarer10

Registered User
Jan 5, 2020
39
0
Hi folks

Currently in a very similar situation with an elderly aunt. She went from care home to hospital (unconscious for long time but then much the same when came to). Found to have Covid and kept in hospital to isolate for 2 weeks. Original care home declined to take her back stating her needs had changed over recent months, needed 1:1 care and likely nursing placement rather then residential. She was then D2a to a different care home, still residential as the hospital said she was settled and didn't need 1:1. They also said she had a student nurse sat with her all day, so conflicting in what they said. As the D2a process reached the end of the funded 4 weeks, the home said she was very unsettled and couldn't stay. The S/W tried to arrange nursing funding assessment. However then it all went wrong - the social worker was reassigned, the home said she was settled one week and unsettled the next, the RIT team (mental health?) refused to visit and the home care nursing team wouldn't help because the RIT team weren't involved!! Now she has no social worker.

No one has asked for money yet although she was previously self funding but the home had not been paid for two weeks.

Is this information still up to date - that the NHS continues to fund the D2a until they can get their act together and actually finish the paperwork?!

They are experimenting with medication via GP to try to settle her but she's up and down and problematic. I want to move her as the new home failed CQC inspection and is in special measures but I can't move her without knowing the outcome of the D2a and whether she is nursing or residential.

Feels very stuck!

Thank you
I shall now answer my own question now that it has become clearer!

The discharge to assess bed is funded by the NHS for an absolute maximum of 28 days. At the end of that period they can make a decision by reviewing the file only, no need to visit the person and see how they're doing ?

The govt policy states that if CHC or NFC funding assessment is delayed then the CCG has to continue paying. The local authority interpret this to only apply to nursing home situation, not residential it would seem

The discharge to assess process is only funded by the government/NHS scheme until 31st March so be very careful if you've got any of that going on now.

?
 

karenbow

Registered User
May 24, 2021
106
0
hi everyone, just reading your posts and it was exactly the same with my mum, unable to get any direct guidance on the procedure, confusion over timescales , who was responsible for what etc- it was really stressful trying to keep on top of it all as well as going through all the emotions involved and yes i didn,t trust anybody, i think its hard to trust when you have little contact with the authorities-my dearest mum passed away in october advanced alzheimers needed 24hr care ,mum went to an assessment hub after a short stay in hospital and then to a nursing home she was very very poorly- it was decided the chc assessment would be done whilst mum was in the home and this didnt happen until 9 weeks after mum went into the home- all fees including home/nursing apart from personal charges ie chiropody were covered by the nhs - i was told the self funding begins the day after the assessment so im sure it will be the same for everyone- just one more thing to say , mum passed away 10 days after the assessment, i knew mum was end of life was in a terrible way-couldn,t believe chc was refused anyway that is another story but best wishes to you all.
 

LongDistanceCarer10

Registered User
Jan 5, 2020
39
0
I'm so sorry to hear about your Mum, I know how hard it is and can only tell you that in time your memories will be mostly about happier times and the more 'normal' person rather than the time leading to her passing. It's a journey and I'm sorry to hear the difficulties you had with the system as well.

My aunt has finally been assessed as "nursing" but not without something of a fight - doesn't feel like a huge victory yet as they could reverse that decision at the end of the 28 day D2A period, but here's hoping. And I'm hoping she's less stressed and anxious in a more suitable environment, but also aware the effects of the illness might mean that's not possible.

Hoping for some better days ahead for her