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Obtaining CHC funding - Mission Almost Impossible - Carers UK Forum

Obtaining CHC funding - Mission Almost Impossible

Share your ideas about the practical side of caring.
My parents are both in their 80s and have various health problems. Mum lives in her own home, with support from a carer and myself, and Dad lives in a very good residential care home (he has dementia and other problems).

Dad is self funding for now, but I will apply for funding next spring, when his savings drop below the limit. I expect that I will have to battle to prove that Dad qualifies for funding, and that his needs cannot be met other than through residential care. However, I was under the impression that once his dementia reaches the end stage, he would qualify for Continuing Health Care (CHC), so the money worries at least should subside at that point. However, from reading about other people's experiences on this forum, now I'm not so sure, as it seems that it is nigh on impossible to meet the criteria for CHC. Image

I have read about all sorts of tactics that local authorities use in order to try to avoid funding CHC, even when people are seriously ill and quite often near the end of their lives. It sickens me that at a time when relatives are under huge stress, trying to seek support for their very poorly, frail relatives, they are put in a position of having to jump through endless hoops and enter into a running battle with the LA, to get something that we have been led to believe would be free for everybody - end of life nursing care for those who need it. From reading other posts on this forum, here are some of the vile tactics that authorities have tried to use, to force families to pay for nursing home fees:

- Saying that key decision makers are not available for meetings etc, so the family will need to pay charges in the meantime, until a meeting can be held later.
- Playing down all the health issues a person has, in an effort to show that they only require 'social' care, even when they cannot walk/talk/dress/feed themselves and have bed sores/various injuries from falls and/or are incontinent.
- Suggesting that a place is available, but only in an expensive home that is above the funding limit, so the family will have to pay.
- Asking the family to pay as funding cannot be agreed for a few weeks, but the patient is violent, and the hospital cannot cope, then adding that if the patient gets out into the community and harms somebody it would be the family's fault for not accepting/paying for the place they have found in a secure unit.

I'm sure others will have more to add to this list. Hopefully it will be handy for others applying for CHC to see what kind of tactics may be used against them.
The law is clear. If you have substantial health needs, the NHS should pay for your care, without any charges; not Social Services. (Google Coughlan Case for more information). The problems are created because the NHS has introduced a Framework which seems determined to exclude as many people as possible. My mum has been very seriously disabled for many years, but following a major illness in the summer she has lost the use of her legs and now needs hoisting in and out of bed. She has a shoulder which needs replacing, cannot use her arm on that side to brush her hair, or to eat her food. She cannot position herself in a chair, or in bed. Less than a week before Christmas, the hospital seem determined to discharge her before the holiday. I have been given less than 24 hours notice of a "Discharge Meeting" - although I have Power of Attorney it is clear from the tone of the letter that they hope I won't be able to attend! Tomorrow, my son with severe learning difficulties will be home for Christmas, two weeks of non stop work! So once again, I'm awake before 4am, with indigestion, too stressed to sleep properly, and I'm so tired. The NHS first wanted mum to go into a nursing home after major surgery in 2005, and again in 2011. Only my support has enabled her to live in her own home. Social Services have provided carers 3 times a day, to dress/feed/wash mum, leaving all the other jobs to me. I'm under strict instructions NOT to provided any care to anyone. This doesn't seem to register with anyone!!
Here in the West Midlands my cousin is going through exactly the same thing, her Mum, has been self funded in a care home for 18 months, she suffers with vascular Dementia which has got considerably worse over the last 6 months. She has had numerous falls the last resulting in a fractured neck, the poor lady has gone down drastically in just 2 months. She wears a brace around her neck, cannot feed herself and has to be hoisted in and out of bed. once a very robust woman she now weighs something nearing 6 stones. She has been in hospital now for about 2 months, my cousin had to push to have a CT scan done 2 months ago which the hospital reluctantly did, this showed the fracture in her neck. They then left the cot sides down on the bed and the poor lady fell out and now they are telling her she has to be out by Christmas and that she definitely does not qualify for continuing care. They have had two discharge meetings and my cousin has now backed down and accepted that my Aunty's home will have to be sold to pay for her care which is now going to be in the region of £850 per month. I have told her so many times not to back down and refuse to sign the discharge forms but she has lost the will to fight she is so tired and depressed herself that she has given in. NHS have the result they desired. Personally I would be fighting to the hilt and also telling them that the fall out of bed would be followed up too.
JHR, There may be a simple solution for your cousin, regarding the falling out of bed. When my husband died, I took legal advice, and was told to look at my house contents insurance, to see if I had "Legal Expenses Insurance". I did, and the Prudential paid for about £10,000 of solicitors fees concerning the medical negligence of the doctors concerned. The same would apply equally to hospital negligence.
We had no problems with getting father inlaw CHC funding all relevant forms were filled in and assessments they checked bank account anyway and he went to panel and passed if he had failed the CHC it could be re done but then he would self fund for board and the nursing care would be paid by nhs
Thanks BB, I do get a little confused by which organisation pays for which costs, as I've heard that even when you obtain CHC funding, sometimes you have to pay for the "hotel/bed & board" costs, unless the person has no savings or assets whatsoever, in which case I guess the local authority/council would pay that element?
They have had two discharge meetings and my cousin has now backed down and accepted that my Aunty's home will have to be sold to pay for her care which is now going to be in the region of £850 per month.
JHR57 - looks like another case where they've tried every way they could to wriggle out of taking the costs, however, surely the £850 per month isn't for the full cost of the nursing care, but rather the "hotel" element? From what I've heard, full nursing home costs range from around £850 - £1200 a week? From what you say, this old lady sounds very poorly indeed so I doubt your cousin will use much of the sale proceeds from her house. All very sad though, to have all this stress, especially at this time of year.

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The NHS has always used delaying tactics as their primary legal tactic, in the hope that they can win the war of attrition. I used to work at a fairly senior level in the NHS, and it is a form of embedded organisational culture, because they deeply resent admitting fault or paying any money to anyone. They all have legal teams, and if you want to take them on, you need nerves of steel and the patience of Job. They automatically take a deeply defensive mode. I hate the idea of taking them on, they are very clinical professionals at what they do, and will lie through their teeth to escape blame or payment.
Today, I had a reply to my letter addressed to CHC a month ago. It is supposed to explain clearly why mum wasn't entitled to CHC, most of it was obviously a standard letter. I raised very specific issues with them, not one has been addressed properly. It's all a disgrace, especially when you think that this is the organisation which was supposed to support people "from the cradle to the grave". Liars!
Today, I had a reply to my letter addressed to CHC a month ago. It is supposed to explain clearly why mum wasn't entitled to CHC, most of it was obviously a standard letter. I raised very specific issues with them, not one has been addressed properly. It's all a disgrace, especially when you think that this is the organisation which was supposed to support people "from the cradle to the grave". Liars!
OK, I would write to the Chair of the Board, and cc it to my local MP. If they don't give a decent response in two weeks, go to the local Press. The NHS hates MPs and they hate the Press. The Ombudsman is bloody useless, and the Courts take eons.
Having taken the solicitors advice, I'm about to have mum assessed by two different nursing home Matrons/Managers. I've already been to five different homes, each say that because mum needs two nurses and a hoist to be moved, that she needs nursing care. As fees vary according to need, they will write and say what care they think they will have to give mum - hopefully extra ammunition. It seems that the NHS can give a "nursing home contribution" of about £120 per week towards mum's fees, if she counts as self funding. I have the sneaky feeling that this is a plot hatched between SSD and NHS to reduce the amount of CHC clients. Am I getting too cynical? According to a recent government paper, the number of people receiving CHC in Bournemouth (on Costa Geriatrica) has reduced from 300 to 100 in a very short time. Yet one thing is certain, the number of elderly moving to our area is most definitely not going down!