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

MIL was the same after a severe stroke, no CHC funding as her condition was stable and didn't need regular nursing care. FIL had metastatic prostate cancer and his intolerance of pain relief (gave him severe vomiting and diarrhea) meant his diabetes and heart condition were difficult to manage and he needed twice daily visits from the district nurse/diabetic nurse so he did get it because he needed daily nursing decisions and medication adjustments not routine care.

I appealed this on behalf of a friends father who had also had a catastrophic stroke . He was only mid 60s so could easily of lived a very long time in nursing care. The first appeal failed when the health assessment came back with the ridiculous assertion that he didn’t qualify as he could sit in a chair ! We continued the fight as this had no baring on his medical needs. Practically anyone can sit in a chair - if like him you were hoisted into it and propped up. The successful outcome came about because he was peg fed and this needed to be done by medically qualified staff and was considered a regular medical intervention that he could not live without. He lived another 8 years which would have cost him hundreds of thousands. This was in 2004. He died in 2012 and qualified until he died. They really didn’t want to ‘allow it’ though and was quite the fight.

We had the same situation with my MIL, the worst type of stroke and same resulting issues as you have with your DM. We got turned down for CHC which I have to say I was expecting having looked in to who qualifies. Therefore, we didn't appeal.
It isn't just based on the needs of the patient. In both our cases, these are seen as quite standard caring needs I think.
It is such a horrible situation, you have my greatest sympathy.

It's about the unpredictability of a condition. The criteria/threshold is very high.

Does she own her own home? If so, that can be sold to pay the care home fees. Very sadly the average length of stay in a nursing home is usually shorter than the value of the property, so the value of her home should cover the fees. BTW, the nursing contribution is paid by the NHS not the LA.

I'm very sorry your mother is so unwell, it must be very stressful

Unfortunately the bar for full CHC funding is very high - limited NHS funds so they will only award to a few people. Were you at the assessment meeting? Have you seen the reasons given for refusing funding and their criteria for awarding it? You need to have a copy of the criteria and then demonstrate (using medical records and care home records) that your Mum meets those criteria. Good luck.

I’m so sorry. More qualified people will be along in a minute to help but I wanted to say you are not alone.

I have experience of relatives getting CHC twice, and in both cases the applications were completed on their behalf by healthcare professionals - a Macmillan nurse in the case of DH, and a hospital palliative care nurse in the case of DF. I’m a bit fuzzy on the process as they were both extremely distressing circumstances but my understanding is that the unpredictability of the patient’s needs was one of the key factors. It wasn’t solely about how serious their condition was. Also, I seem to remember that the process was set up to exclude dementia as an assessable factor - I assume simply for cost reasons.

I do know that it is very hard to receive the funding. I’d advise asking if there is a medical person involved in her care who can help complete the forms.