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Refused care home care plan and daily records

panface

Registered User
May 29, 2016
32
0
Hi I have had so much great advice on here in the past and I hope that you can help me now. My mother in law has been in a care home for 6 years. Recently she had her assessment for FCN funding which was overdue. It was due in November last year. We had the meeting by video link and I had to correct the care home nurse and carer on quite a few occasions. One was that mil had not fallen since March 2018 but each time she had fallen I put on the family WhatsApp that she had fallen. I therefore knew that she had fallen 6 times in 2019 the last fall was in December 2019. On one occasion she had broken her nose and another time she had broken her hand. The nurse assessor said mil was eligible for a CHC checklist. I was concerned that mil care plan and daily records were not showing the correct care that mil needed. Before lockdown we visited every week and occasionally would check her daily records to see what she had been doing, she loves singing. I emailed the care home manager who has only been there since the start of lockdown, and asked for copies of mil care plan and daily records for the last 18 months. I didn’t know how far the CHC checklist would include as this was the first time that one had been done. The manager was very rude and told me that husband and I couldn’t have the 18 months we requested as the CHC assessment only request 3 months. He therefore gave me 3 months of nothing really! No daily records, no record of falls and a care plan dated 2016. I reminded the manager that we have power of attorney for finance and health. He still said we could not have the 18 months. We want this now as I am beginning to think that everything is not recorded. The CHC was refused and hopefully we can appeal. Has anyone else been refused their loved ones records ? Can we request them through GDPR? Thank you for reading this
 

Jessbow

Registered User
Mar 1, 2013
3,159
0
West Hertfordshire
Does she have a MEDICAL need to fulfill the criteria for CHC?

Does she need a qualified nurse to attend to her needs, rather than a carer?- thats pretty much the line from which it gets granted
 

nitram

Registered User
Apr 6, 2011
21,332
0
North Manchester
Does she need a qualified nurse to attend to her needs, rather than a carer?- thats pretty much the line from which it gets granted

It goes a bit deeper than that.
The clue is in the title Continuing Hospital Care, care that cannot be provided by the community nursing service but can be provided in a nursing home, a hospital infrastructure not being necessary.
The community nursing service can provide some complex care as long as the need for that care is not unpredictable and variable.

Edit
Continuing health care not hospital care, a senior moment, thanks @Louise7
The principle is the same, the patient needs more care than normally provided in the community and does not need the infrastructure of a hospital.
 
Last edited:

Louise7

Registered User
Mar 25, 2016
2,618
0
The clue is in the title Continuing Hospital Care,

CHC stands for Continuing Healthcare, not Continuing Hospital care. CHC can be paid in respect of care provided at home, you don't need to be in a nursing home (unlike FNC which is only paid if in a nursing home) :

https://www.nhs.uk/conditions/socia...-work-and-benefits/nhs-continuing-healthcare/

Has anyone else been refused their loved ones records ? Can we request them through GDPR?

There's no reason why you can't request them through a Subject Access Request but the manager is right, the CHC review assessors will usually only go back 3 months, not 18 months. From what you've posted, your mother in law has been in receipt of FNC and has recently had a review assessment - is that right? What would usually happen if a potential change of needs is identified at the review meeting is that a new CHC checklist would be completed, followed by a full CHC assessment if the checklist indicated that there may be eligibility for CHC. You say that CHC was refused - was this because your mother in law didn't get through the checklist stage, or did she get through the checklist but not meet the criteria for CHC when the full assessment took place? Is she still eligible for FNC? You can appeal a CHC decision but CHC can be very difficult to get and you will need to show that your mother in law's needs meet a high/severe level of intensity/complexity/unpredictabiliy.
 

Jessbow

Registered User
Mar 1, 2013
3,159
0
West Hertfordshire
It goes a bit deeper than that.
The clue is in the title Continuing Hospital Care, care that cannot be provided by the community nursing service but can be provided in a nursing home, a hospital infrastructure not being necessary.
The community nursing service can provide some complex care as long as the need for that care is not unpredictable and variable.

Edit
Continuing health care not hospital care, a senior moment, thanks @Louise7
The principle is the same, the patient needs more care than normally provided in the community and does not need the infrastructure of a hospital.
Of Course, yes its far far deeper and more involved than that. But its a good thought to start with.
My ( Now late) mother was a widowed, partially sighted , diabetic lewy body diagnosed. She didnt qualify.

then she developed a heart problem- you and i would have had an op- she couldn't and was then, and only then awarded CHC
 

panface

Registered User
May 29, 2016
32
0
Thank you all so much for your input. I am waiting for the letter of refusal to appeal. I do think mother in law is a candidate for CHC and I aware that it will be a long and stressful process but I feel that I owe it to my mil to try. I would still like to see her care plan and daily records to check what is written down as if they haven’t recorded her falls as they should have, I am wondering what is actually recorded on a daily basis and what her care plan is. As the manager has refused an I within my rights to request these reports for 12-18 months. Thank you
 

Louise7

Registered User
Mar 25, 2016
2,618
0
You are requesting a lot of information - do you need it all? A more focussed request might be better. You can ask for the current care plan, as you are entitled to see that, plus that would be relevant to your CHC appeal. You have said that your mil's last fall was in December 2019 so asking for details of all recorded falls plus any falls risks assessments will provide you with relevant information for the CHC appeal, plus confirm whether the home has recorded all falls or not. If you discover that the home has not been recording all of the falls then you should take that up with the manager but the relevance to the CHC assessment is whether there is a falls risk or not, and if so how is this being managed. As previously mentioned, the CHC assessor will not usually go back further than 3 months, and they definitely won't go back through 18 months of daily care records. If you have separate concerns that the daily records are not accurate I'm not sure how you would prove that unless you were present in the home every day?
 

Veritas

Registered User
Jun 15, 2020
69
0
A history of falling is unlikely to make much difference to a case for CHC funding, unfortunately. If the last fall you know about was in December 2019, and there really haven’t been any since then it’s not an issue as far as eligibility for CHC is concerned.

More important, in terms of your MIL’s welfare, is the issue of receiving a care plan dated 2016. That is not acceptable, whether any other information was provided or not. If you are concerned about the home’s attitude to record keeping you could raise it with the CQC. It is possible that the reason the new manager is being difficult about letting you have the records you’ve asked for is that he knows very well they are inadequate.

If you want to challenge a CHC decision I’d suggest starting from the NHS end. If they only got as far as going through the checklist, on what basis did they decide to go no further? Assuming you have POA you can ask for an explanation/clarification. If they went ahead and did a full assessment without consulting you that is very poor practice and should be challenged in any case, whatever the outcome.
 

panface

Registered User
May 29, 2016
32
0
A history of falling is unlikely to make much difference to a case for CHC funding, unfortunately. If the last fall you know about was in December 2019, and there really haven’t been any since then it’s not an issue as far as eligibility for CHC is concerned.

More important, in terms of your MIL’s welfare, is the issue of receiving a care plan dated 2016. That is not acceptable, whether any other information was provided or not. If you are concerned about the home’s attitude to record keeping you could raise it with the CQC. It is possible that the reason the new manager is being difficult about letting you have the records you’ve asked for is that he knows very well they are inadequate.

If you want to challenge a CHC decision I’d suggest starting from the NHS end. If they only got as far as going through the checklist, on what basis did they decide to go no further? Assuming you have POA you can ask for an explanation/clarification. If they went ahead and did a full assessment without consulting you that is very poor practice and should be challenged in any case, whatever the outcome.
Thank you