NHS Continuing Care Question

[whendoesitend]

Hello all.

My relative was assessed as needing a more thorough NHSCC assessment after the basic checklist.

This was carried out within the last fortnight and we are waiting to hear back from the relevant people. At the end of the last week my relative was taken into hospital after a major seizure and a lot of further health concerns have come to light afterwards. We have kept his social worker and the NHS nurse who did the assessment aware of what has happened and his decision today has been deferred to wait for further information regarding his current health.


My question is - if he is awarded it and it gets backdated as they say it would do - it's roughly going to be approx £2250 because of the delay in his social worker filling the first round of paperwork.

IF (and I know it is a huge IF!) he does get it - is it subject to the same financial checks as the social services funding his care - IE: will he be financially assessed each year as he is with social services but by the NHS people?

My reason is because IF he does get it, I'd like to get him a new bed (suitable for the stand aid to go underneath), a new chair (suitable again for the stand aid - he complains bitterly about his bed and chair bless him!), a new chest of drawers that can double as a TV stand, a new storage unit and a full new set of bedding, underwear and easy on/off trousers and I don't want the NHS or SS people to think we're misappropriating the money.

Thanks for your help

 

[jenniferpa]

No he won't be assessed financially by the NHS at all, just as you aren't assessed when you go to an NHS hospital. Be aware that if he does get CHC his medical eligibility will be assessed on a regular basis.

Personally, before spending any money on the chair or bed I'd suggest getting an OT out to assess him. The bed in particular but possibly the chair as well might well be something that could be funded by the NHS.

Edit: is he currently in a care home and if so, who is paying? Because if it's the LA (in whole or in part) you would be expected to pay at least some part of the arrears to the LA (what their contribution was basically).

 

[whendoesitend]

No he won't be assessed financially by the NHS at all, just as you aren't assessed when you go to an NHS hospital. Be aware that if he does get CHC his medical eligibility will be assessed on a regular basis.

Personally, before spending any money on the chair or bed I'd suggest getting an OT out to assess him. The bed in particular but possibly the chair as well might well be something that could be funded by the NHS.

Brilliant! That is a massive help. Social Services have been really on us to have EVERY single receipt, every single scrap of paper and quick to comment on things they don't think he really needs - especially bizarrely when we buy in bulk to save money

Thanks love x

 

[whendoesitend]

Edit: is he currently in a care home and if so, who is paying? Because if it's the LA (in whole or in part) you would be expected to pay at least some part of the arrears to the LA (what their contribution was basically).

He is in a care home and has been for the last 3 years. We're up to date on the fees The back pay (IF he gets CC) will be roughly £2250.

 

[jenniferpa]

And he's self-funding? If so, why are you giving this information to the LA?

 

[whendoesitend]

And he's self-funding? If so, why are you giving this information to the LA?

He gets approx £155ish pension and pays £124ish of this as his contribution to the fees, the SS pay the rest.

The CC would be backdated from Feb 10th when this process began as far as we have been told - IF allowed.

 

[jenniferpa]

He gets approx £155ish pension and pays £124ish of this as his contribution to the fees, the SS pay the rest.

The CC would be backdated from Feb 10th when this process began as far as we have been told - IF allowed.

So is this is just the amount he has contributed from his pension? I'd still be asking for an OT assessment: if he needs the bed and the chair then that should be paid for out of public funds. But while you should keep very comprehensive receipts of any expenditure, I don't see any issue in principle using his funds for whatever he needs.

 

[Pete R]

He gets approx £155ish pension and pays £124ish of this as his contribution to the fees, the SS pay the rest.

From these figures I take it then that your relative has little or no savings?

I do agree that assessment by OT for the bed and chair is needed before you spend any money. The state may well fund them.

As already warned if the CHC assessment goes the right way these are reassessed after the first 3 months and the majority are then rejected.

I do hope your relative gets out of hospital soon.

 

[Saffie]

a new chest of drawers that can double as a TV stand, a new storage unit and a full new set of bedding, underwear and easy on/off trousers and I don't want the NHS or SS people to think we're misappropriating the money.

Does CHC really cover such expenses?
I've always understood it was for the cost of home fees, nursing care and what is applicable for the needs of the resident concerned, surely not furniture and clothing.

 

[whendoesitend]

So is this is just the amount he has contributed from his pension? I'd still be asking for an OT assessment: if he needs the bed and the chair then that should be paid for out of public funds. But while you should keep very comprehensive receipts of any expenditure, I don't see any issue in principle using his funds for whatever he needs.

Thank you, I have asked for this this morning and had to go via his social worker who has asked the gp, district nurse and OT to all be involved to assess him.

 

[whendoesitend]

From these figures I take it then that your relative has little or no savings?

I do agree that assessment by OT for the bed and chair is needed before you spend any money. The state may well fund them.

As already warned if the CHC assessment goes the right way these are reassessed after the first 3 months and the majority are then rejected.

I do hope your relative gets out of hospital soon.

He does have nothing at all sadly.

Thanks again, it's sad that they can't provide more help to those who clearly need it so much isn't it The lady who assessed him said that she didn't think that he qualified - 2 days before he had a major seizure. I was emailing her and the social worker with updates at the end of each day and she now says that - because of what has happened and how things have gone she does think he qualifies - hence being on hold until she visits him within the next couple of days to see if this matches up with what we've told (if you understand what I mean - she needs to see the 'evidence', not just get it from family).

I'm still working on the basis that he won't get it - less disapointment all round that way.

He was discharged last night 7pm. Thank you!

 

[whendoesitend]

Does CHC really cover such expenses?
I've always understood it was for the cost of home fees, nursing care and what is applicable for the needs of the resident concerned, surely not furniture and clothing.

CHC will go straight to them I believe - IF he gets it. The money I was talking about was a refund of his pension contribution to what Social Services have been paying since February when he was assessed so that we can purchase what he needs.

Sadly he has no other savings and I am a carer for my disabled mother (who became disabled through looking after him. I myself had a heart attack for the same reason) so we do not have the extra funds to be able to pay for what he needs though we do put in each week where needed to cover what we can.

Thanks all for your advice

 

[Saffie]

The money I was talking about was a refund of his pension contribution to what Social Services have been paying since February when he was assessed so that we can purchase what he needs.

Oh I see. Thanks for the explanation, I was a surprised to say the least!

 

[Pete R]

He was discharged last night 7pm. Thank you!

That is good news.

As he has no savings and if there is a backdated refund on CHC (which you explained in original post) then he (you on his behalf) can spend the money as he so wishes.

I wish you all well.

 

[whendoesitend]

Fabulous! That is a weight off my mind, thank you!

I'm waiting to see what the gp/district nurse/ot say regarding the bed and chair situation now. Hope everything else will go well with the chc lady but if they don't... eh. you can't miss what you didn't have.

Thanks to you all - much love to everyone fighting the same battles day in and day out xx

 

[Pete R]

eh. you can't miss what you didn't have.

If you don't ask you don't get..........The more you ask the more you get.

 

[whendoesitend]

Thank you all for your help and answers. I had an email this morning from the Nurse Assessor for our CCG after I updated her on a separate matter. I'm happy to say that he has been awarded it. That's all I know at the moment, apparently a letter will come through in the next few days with more information. I've spoken to the care home head office and asked them for a financial statement for the relevant period to show his contributions and we'll go from there

Thanks again all!

PS: He is getting a profiling bed from OT after he's fallen out twice post hospital discharge - and come close to falling out several times. He was due to have it within 4 days of being discharged... 2 weeks later it was only given to a worker 5 days ago and we're still no further ahead...

 

[nitram]

"I've spoken to the care home head office and asked them for a financial statement for the relevant period to show his contributions and we'll go from there"

My approach would be to ask the care home to refund all that he has paid since the CHC became effective and leave the LA/CCG to sort out the rest.

I took this approach with my wife and got a cheque by return post. I know of others who waited for the system to refund the money and it took ages whilst they all played around with balance sheets, to you it is cash in hand (or more likely bank) and not a balance sheet.

 

[whendoesitend]

Thanks for the advice, I will look into that, however before I do (because of the date issue) I'm a little confused again.


Our social worker made 'a mistake' (ie: took forever) when filing the paperwork with NHS CHC. I'll try and explain this as clearly as I can.

• The checklist was completed on the 10th February this year by the social worker, however for reasons unknown to anyone but himself he didn't send it to the relevant people until May.
• 8th May it was recorded as being received by the NHS CHC Team for them to complete the full assessment. We complained about the date and queried it as it was the 10th Feb - not May.
• 28th May Full assessment was done. Social worker was also present and apologised and told us that it would be backdated to 10th February as it was his mistake.
• 4th June It went before the panel but the decision was postponed because of his hospital admittance and an increase of needs.
• Decision finally made last week and the letter arrived today 24th June.
• Letter states that it's been allowed from 5th June.

I rang the number on the letter and they told me that the social worker had no business in saying that it would be backdated as they have a 28 day leeway to 'see people' and make a decision.

We explained the problem about our Social Worker and she became a little nicer (especially as she saw what we'd said was on the computer records once she'd logged into the computer) and said that she'd speak to their 'specialist department' and ring me back in the next couple of days.

Can anyone make a little more sense of what is supposed to happen please? Is it meant to be backdated to the original checklist date (post 28 days?)

Thank you

 

[whendoesitend]

I do believe they are in the wrong as I have found this:

If the CCG decides that you are eligible, but takes longer than 28 days to decide this, and the delay is unjustifiable, they should refund any care costs from the 29th day until the date of their decision

http://www.nhs.uk/conditions/social-care-and-support-guide/pages/nhs-continuing-care.aspx#refunds