Has anyone successfully appealed CHC funding for a parent in nursing care?

@CHCShitshow would you be able to share more about how you successfully appealed? we have just submitted our appeal for parent with advanced neurological condition and would appreciate any insights into how to approach the next steps!

You could try arguing the need is still there - it’s just being successfully managed in the placement! That’s what they are paying for!

I live in the world of young people with learning disabilities - they have challenging behaviour and ICBs try this argument on!

I successfully appealed a decision not to award CHC.
I have to say the staff involved were not only incompetent but also liars, the whole system is absolutely shocking.
The CHC manager actually met with me to advise me not to appeal because in their opinion it would be a complete waste of time.

I managed to get CHC for my mother. I put everything into chatGPT and it explained helped convey complexity and interwoven needs.
I managed to get priority in behaviour thanks to nurse at home. This nailed it. Coming up for review soon and I’m not sure we’ll get it again as she’s sedated a lot so easier to manage.

The cases discussed in this thread are heartbreaking. Are the rules very different in Wales?

My dear elderly aunt in Wales had dementia which made her very cross and she needed a walking stick. To complement family popping in she had a carer four times daily, with most of the costs being paid by the council.

Last year she had a couple of minor falls (nothing broken) and was kept in hospital after the second one while a care package was sorted out. There followed a seamless transfer to a dementia nursing home. At the home they began using incontinence pads on her, we think for their own convenience.

After this there was an official meeting to sort out funding. This was covered in full with no argument, despite my aunt being a wealthy lady with comfortable capital reserves.

My aunt recently passed, leaving a family forever grateful to the system…..

Our family were also recommended Beacon and Farley Dwek for advice on whether to pursue CHC. In our case at the time it wasn’t advised but we appreciated the free phone call and information.

Beacon are very good - both in terms of the free resources and their charged for services. You can get 90 minutes free advice but obviously check resources so you don't waste that time. I haven't used them myself but regularly refer to them via my job. Beacon CHC

You most likely won’t be able to sell the home, she will need a financial assessment from the LA. Thus was the situation my stepfather was in. The LA ended up disregarding his share of the home as his share was only worth about £25k.

Non-problematic peg: moderate
preventat skin care several times a day: moderate
Did you question Low level on those?

Having a serious stroke is catastrophic for both the person and their family.

Unfortunately in CHC terms, the care needed by the person is not complex - washing, dressing, turning, running a PEG feed, routine skin care etc. None of these score above a low needs on the DST.

Another daughter of a stroke victim here. And no, appeal wasn't granted.

Basically, if the person doesn't need constant nursing/medical attention (as opposed to care that can be carried out by a carer, with occasional nurse supervision) you've no chance.

I’m sorry you are going through this. It’s terrible.

The system is rigged so that you suffer as much distress as possible whilst being gaslighted by the CHC assessors and private nursing homes. The CHC assessors will knowingly and purposely manipulate information and situations so that they don’t have to grant CHC funding. The nursing home owners don’t want you to get it either - if you do get it that means they only receive the lower LA rate. If you don’t get it they get to wrongly keep the nursing element AND you pay them private funded rate on top. You’ll find the nursing home will be extremely passive and do the bare minimum to prepare for the CHC assessment meeting.

I could write a book on this but here is my own experience. DM - she absconded from the nursing home and got a connecting bus to a destination 15 miles away. Complete chaos ensued. I had been begging the nursing home for a scan because I’d been telling them for months she had dementia and this behaviour was WILD for my DM and a sign she was delirious and confused. The CHC assessor gleefully seized on this information and wrote that DM was so mobile and socially capable that she went for social meet ups with friend via bus. This was so far from the truth it was sickening. Two months later when she was at a different care home I finally got a diagnosis for her of mixed dementia. And her risky behaviour was deemed to due to delirium.

MIL entered a nursing home with a diagnosis of Alzheimer’s. She was extremely violent. The behaviour element is pretty much the only area which you have a chance at getting CHC funding for when it comes to dementia. She met all the criteria. So they doubled her antipsychotic medication to medicate the behaviour out of her, and then declared she had no behavioural needs. She is pretty much a highly sedated shell of a woman now due to that drugs and they are all happy because they can say she has no needs.
We asked them not to drug her to that extent but they don’t care - even when you have POA.

There was far more to how much the assessors deliberately misrepresented my relatives’ primary health needs to avoid funding them, but the two aspects above are the ones that really stuck in my throat.

Sitting in two CHC assessment meetings and having to sit and listen to professionals lie and manipulate to avoid funding is one of the most distressing experiences of my entire carers history. I can’t believe what they get away with.

name changed for obvious reasons. I know the CHC process v well (work within it!).
Eligibility is decided by the Nature Intensity Complexity and Unpredictability of needs.
Nature includes the stability of need and condition, decline, skills needed, etc.
Intensity generally involves the type, duration and frequency of need interventions.
Complexity is looking a lot at interrelated needs which adds significantly to the complexity of meeting the needs.
Unpredictability looks at rapidly changing needs which have to met by changing the care needed to meet the needs. Also the frequency etc of this happening.
can the needs be met under the social care legislation? If it is above that threshold then a Primary Health Need is present.
its so complex as there’s not a clear definition of PHN.
There are loads more questions for each part of the NICU which are looked at.
have a look at the National chc framework. There are some good CHC Facebook groups which give free advice.
All the best with it.

@HazzleMcDazzle so sorry you are in this situation. You will find lots of good advice and support on here. Also consider joining us over on https://www.mumsnet.com/talk/elderly_parents/5503705-cockroach-cafe-spring-to-summer-2026

Great place to vent. Hope you get some advice and support you need. 💐

I suggest you look at the Pam Coughlan case. On paper, she didn’t meet the criteria; but the judge looked at the overall impact of her conditions and decided she did on that basis.

Get a specialist solicitor to advise. A family member of mine had her mother’s CHC funding application refused. She instructed solicitors and was successful.

This sounds a horrible situation OP for you and your DM. Unfortunately on the description you have given, it is very unlikely that she qualifies for CHC as the bar is set very high.

I think @SchrodingersKitty is referring to Fast Track CHC which can be awarded for those with a very short prognosis and has a lot less assessment involved.

The full CHC assessment is very time consuming, onerous and rarely successful. There are 2 stages - completing a Checklist and then the Decision Support Tool.

The bar for the Checklist is much lower than the Decision Support Tool so it sometimes raises hopes that CHC will be awarded.

That does sound difficult OP. My advice (I'm a former Older People's Social Worker) would be to get a specialist clearance firm in to clear the property and then sell it to a builder/developer. HOWEVER, we always advise people to get independent financial advice on how to cover care home fees if they are self funding..

Is she not eligible for LA funding until the house sells?

Hi, I only have experience of unsuccessfully appealing I’m afraid. It was for my dm who had multiple needs and it seemed ridiculous to me she didn’t get it. It was finally awarded the day before she passed away but yes we had to sell her house to fund her care in the end.