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Should we Appeal the CHC decision?

broken gd

Registered User
Sep 17, 2014
2
Hi guys, we'd really appreciate any advice you have on this, any personal experience etc.

so we have been turned down for CHC for my bedbound grandma (who has Alzheimers and vascular dementia) we have agreed on the scores, but based upon what they scored they have turned her down. We however feel she meets the criteria they have set.

Her scores are as follows:

Behaviour: High
Cognition: Severe
Psychological: Moderate
Communication: Moderate
Mobility: High
Nutrition: Moderate
Continence: Moderate
Skin: Moderate
Breathing: No Needs
Drugs: No Needs
Altered States: Moderate

So in total she has 1 severe, 2 high and 6 moderate.

We aren't sure whether it is worth the energy of appealing if they will turn around straight away and there is no way we will get CHC. if you guys think that there is a chance she could be eligible then we will give it a go.

Any advise or suggestions really gratefully received.

Thanks,

Gem
 

Jessbow

Registered User
Mar 1, 2013
3,015
West Hertfordshire
if you have the strength, go ahead an appeal. I don't see what you have to loose.

its gruelling, but no pain no gain.

( suprised she scored high on behaviour if sh'e bed bound)
 

marts1711

Registered User
Oct 25, 2014
44
Hi guys, we'd really appreciate any advice you have on this, any personal experience etc.

so we have been turned down for CHC for my bedbound grandma (who has Alzheimers and vascular dementia) we have agreed on the scores, but based upon what they scored they have turned her down. We however feel she meets the criteria they have set.

Her scores are as follows:

Behaviour: High
Cognition: Severe
Psychological: Moderate
Communication: Moderate
Mobility: High
Nutrition: Moderate
Continence: Moderate
Skin: Moderate
Breathing: No Needs
Drugs: No Needs
Altered States: Moderate

So in total she has 1 severe, 2 high and 6 moderate.

We aren't sure whether it is worth the energy of appealing if they will turn around straight away and there is no way we will get CHC. if you guys think that there is a chance she could be eligible then we will give it a go.

Any advise or suggestions really gratefully received.

Thanks,

Gem

Hi Gem
We too are in the same predicament. Dad scored 4 highs 3 moderates 4 lows and 1 no needs and he was also turned down for CHC.I just can't decide if the battle is worth it but dad is getting worse all the time. If your grandma scored a sever and dad didn't in any domain then who the hell gets this funding?
Yes I too would like to hear other peoples views on the chances of appeals being successful.

Martine
 

LYN T

Registered User
Aug 30, 2012
6,960
Brixham Devon
My Husband had a CHC checklist done June 2013. He was in a Mental Health Unit at the time and about to be placed in a CH that I found him (Hopeless SW sent me to check out totally inappropriate places:confused:) He 'failed' the checklist-even though the 'powers that be decided that I could no longer give him the 24/7 care he needed as his presentation was so bad. The checklist was sent to me (I had to request it) and the narrative as to why Pete had failed was there in black and white; unfortunately, the numpty who completed the checklist had written two paragraphs mentioning my Pete and two paragraphs mentioning Pete A, who was another gentleman in the MHU at the same time. She had mixed two patients up.:eek::mad:

I was furious when I read that and I complained; of course I was told the checklist was correct for my Pete the names had just got mixed up:mad: Anyway, long story cut short, Dec 2013 another checklist/ assessment was completed and Pete received the funding within an hour. It didn't even go to panel. Another case of a Dementia patient not treated with dignity by the authorities. What I can't understand is when a Carer is told that the Dementia needs 24/7 support (in Pete's case due to violence) why is it so difficult for CHC funding to be given.:confused:

I would advise that everyone should appeal if they genuinely think that CHC should have been awarded. However, finding the energy to do so is a big ask.

Carry on fighting

Love

Lyn T
 

marts1711

Registered User
Oct 25, 2014
44
My Husband had a CHC checklist done June 2013. He was in a Mental Health Unit at the time and about to be placed in a CH that I found him (Hopeless SW sent me to check out totally inappropriate places:confused:) He 'failed' the checklist-even though the 'powers that be decided that I could no longer give him the 24/7 care he needed as his presentation was so bad. The checklist was sent to me (I had to request it) and the narrative as to why Pete had failed was there in black and white; unfortunately, the numpty who completed the checklist had written two paragraphs mentioning my Pete and two paragraphs mentioning Pete A, who was another gentleman in the MHU at the same time. She had mixed two patients up.:eek::mad:

I was furious when I read that and I complained; of course I was told the checklist was correct for my Pete the names had just got mixed up:mad: Anyway, long story cut short, Dec 2013 another checklist/ assessment was completed and Pete received the funding within an hour. It didn't even go to panel. Another case of a Dementia patient not treated with dignity by the authorities. What I can't understand is when a Carer is told that the Dementia needs 24/7 support (in Pete's case due to violence) why is it so difficult for CHC funding to be given.:confused:

I would advise that everyone should appeal if they genuinely think that CHC should have been awarded. However, finding the energy to do so is a big ask.

Carry on fighting

Love

Lyn T


Lyn thank you so much for letting us know your story. Dad was put into a NH after being fitted with an indwelling catheter. For two days he took the bag off and actually totally removed the catheter one night. The home carers could not cope and we had to get the crisis team in and get him into care. He has now gone down hill very quickly. I really don't understand how they come to these decisions about CHC I suppose its all about money but that doesn't help us.
I am going to appeal and unfortunately I think I may have to pay a solicitor as I have not the time nor the knowhow to cope with it.
More money disappearing into the black hole that is dad having dementia!!!!
Wish me luck :(
 

Angel Eyes

Registered User
Mar 3, 2015
25
So sorry you have been refused but if you have the fight in you I would appeal. My father was recently assessed and the DST meeting concluded that he should qualify but the discharge manager (who was writing the report) changed her mind post meeting and advised that the case would be referred to panel as a split decision. I asked to attach a report summarising why I felt he qualified and thankfully CHC was awarded and he has been discharged to a great nursing home. Make it clear that you know the guidelines (I kept referring to them in my report) & also stress that the condition will not improve. One of my paragraphs was 'I believe my father should receive CHC funding as he has one severe assessment and high/moderate needs in most other domains. This totality of care need is as a result of his medical condition which I believe therefore constitutes a health need as defined by the National Framework. His needs are currently managed but again the guidelines state ‘well managed needs are still needs' '
I found the 'care to be different' website a great help
I know how drained I was just fighting at this level so wish you well x
 

Chemmy

Registered User
Nov 7, 2011
7,591
Yorkshire
So sorry you have been refused but if you have the fight in you I would appeal. My father was recently assessed and the DST meeting concluded that he should qualify but the discharge manager (who was writing the report) changed her mind post meeting and advised that the case would be referred to panel as a split decision. I asked to attach a report summarising why I felt he qualified and thankfully CHC was awarded and he has been discharged to a great nursing home. Make it clear that you know the guidelines (I kept referring to them in my report) & also stress that the condition will not improve. One of my paragraphs was 'I believe my father should receive CHC funding as he has one severe assessment and high/moderate needs in most other domains. This totality of care need is as a result of his medical condition which I believe therefore constitutes a health need as defined by the National Framework. His needs are currently managed but again the guidelines state ‘well managed needs are still needs' '
I found the 'care to be different' website a great help
I know how drained I was just fighting at this level so wish you well x
As a point of interest, which domain was rated severe?
 

SueShell

Registered User
Sep 13, 2012
395
Orpington
Mums gone through CHC. She passed the initial assessment but I was already told she won't pass the full assessment. She
Failed all the memory tests, she's rattling with different meds, gets very agitated, bed ridden, doubly incontinent and no memory to speak of and has very fragile skin (care home are treating bed sore she got in hospital). The CHC Snr Nurse told me the bar is set extremely high and only those with very complex medical conditions get through. Not sure what their definition of complex is!

Appeal by all means, but not wishing to put a downer on it, its stressful and unlikely the outcome will be any different.
 

broken gd

Registered User
Sep 17, 2014
2
Thank you all for all of your supportive comments. I think we are going to give it a go and see what happens. If it gets too much we can just pull out. Then we will know we have absolutely done everything we can.

Thanks with kindness

Gem
 

Kon Dealer

Account Closed
Apr 25, 2015
18
Hi guys, we'd really appreciate any advice you have on this, any personal experience etc.

so we have been turned down for CHC for my bedbound grandma (who has Alzheimers and vascular dementia) we have agreed on the scores, but based upon what they scored they have turned her down. We however feel she meets the criteria they have set.

Her scores are as follows:

Behaviour: High
Cognition: Severe
Psychological: Moderate
Communication: Moderate
Mobility: High
Nutrition: Moderate
Continence: Moderate
Skin: Moderate
Breathing: No Needs
Drugs: No Needs
Altered States: Moderate

So in total she has 1 severe, 2 high and 6 moderate.

We aren't sure whether it is worth the energy of appealing if they will turn around straight away and there is no way we will get CHC. if you guys think that there is a chance she could be eligible then we will give it a go.

Any advise or suggestions really gratefully received.

Thanks,

Gem
I really do sympathise with you. My mother had 2 "severe", 2 "high" and 5 "moderates", yet the CCG still refused to fund. I took it all the way to the Independent Review Panel (IRP), who found in my favour. The CCG then refused to accept the recommendation of the IRP! I'm still trying to get funding.
 
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