CHC funding, are there any experts out there?(9 Posts)
My mum has advanced Alzheimer's and is in a Care Home. I was present for the CHC assessment, where she scored 1severe, 5 high, 3 moderate, 1 low and 2 nil. The report refused CHC on the basis of mum having no Primary Health Care need, but did award some Nursing Funding. I know CHC is very hard to get, but I'm thinking of appealing and thought Mumsnet might help me decide if it's worth it or not.
There are several things in the report I disagree with. I think there's a very strong case to make for her having a Primary Health Care need; mainly due to her taking strong medication to minimise the hallucinations and extreme anxiety she suffers from. They barely mention this side of her condition and seem to have swerved it, so have decided she wouldn't get the funding based on the nature, intensity, complexity and unpredictability mix, being low. I admit that Mum is now relatively calm most of the time, but this is only because of the extreme drugs she's on, which they basically heavily sedate her to try to make her life tolerable. Even with those drugs she has daily incidents of extreme anxiety, which need careful and skilled management. The assessor has barely acknowledged this and the final reports declares that as mum's broadly compliant and predictable, she only has Care needs.
Also, the assessment was undertaken by just one assessor, as the social worker didn't turn up. This goes against their own guidelines, which insist on at least 2 assessors. I honestly feel that they've misunderstood my mother's condition and reported her needs inaccurately, but does anyone have any insight into CHC who knows how successful appeals can be? I feel exhausted just thinking about it!
Definitely appeal. The social worker isn't an assessor...I'm a social worker and we're asked to attend to make sure health do it properly. Its the nature/complexity/ unpredictability/ intensity bit that seems to count more than the domains.
The key phrase is ‘a managed need is still a need’. Just because your mum is calm whilst medicated it should be viewed how she would be without the medication.
There is loads of info available online, if you are in England google Beacon CHC, they have a wealth of information on appeals and how to go about it. I do believe they will offer help and advice too. Good luck, we appealed after my mum had a similar first score but we didn’t get anywhere. The following year with different nurse assessors and we were given it without even trying. It’s a complete lottery it seems.
My husband appealed and got care paid for by the HA. They were slippery and very very difficult. He went to loads of meetings, but he won in the end.
Let me know if you need to know anything
I've argued 'managed need is still a need ' so many times, they ignore their own guidelines. There are companies now that you can pay to appeal/ oversee because its so crap
for such quick replies. It's really kind of you. Alwaysaware, yes I quoted that to the Assessor, as I'd read it in the guidelines before the assessment. He told me I didn't fully understand the issue - patronising in the extreme... I'll look at Beacon CHC, that's a good tip, thank you.
To be honest, I'm a bit worried that they'll re-assess, then decide take away the Nursing Funding or agree to give her the CHC funding, but say it's on the basis of her moving to a Nursing Home. At present she's in a Care Home, but it's lovely and she's settled well there. Also my dad can walk to see her every day, so the last thing we want to do is to move her. It's all so tricky and sad.
It's so difficult getting the help you need sometimes, you say she is in a carehome, if she is awarded FNC then is she in a nursing home with registered nurses.
Neckless, the woman who did the initial assessment said that mum should get the funding automatically as she scored so highly. She was an ex-District Nurse and a whole different kettle of fish to the MDT guy. So much seems dependent on the person who runs the assessment. Which is of course, ridiculous!
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