NHS Continuing Healthcare

[poisonedbypen]

Thanks to all who offered advice on my other thread. Due to further health issues my father is still in hospital although we will be looking at nursing homes again soon.
Has anyone successfully got full funding under the Continuing Healthcare (I think that is the correct term)? No-one ever mentions it, just "Will your father be self funding?" but after reading around this I believe he should be eligible although I know the bar is set very high.
I would be interested in peoples success stories or otherwise. Thanks in advance.

We found Dad's home ourselves - no mention was even made of the hospital doing this to us. I have to be honest but a couple were a bit sniffy when I said he had chc funding. I'm not sure why as its guaranteed payment and where he is now they receive full payment or you can top up if its more. It may be because they think his needs are very complex?
The manager of the home did come and visit him in hospital to see if they would 'accept' him.

If I were you I'd get on the phone and ring around and even get on waiting lists. It's not any fun but at least you might take back some control.

Good luck

Yes, I've been doing that, Summer, thank you. I phoned our preferred place and they have spaces & accept chc funded residents, but of course they would have to visit & assess him. I gave this name to the social worker at my DST meeting. Anyway, I've emailed the continuing care team & told them this so will follow up with a phone call tomorrow.

That sounds positive Pen . Once we had a place, been accepted the hospital then wouldn't release him as hadn't had chc funding confirmation - I told them someone in their hospital had approved it and gave her name and they asked me for her number!! By the time they got hold of her the ward then said they couldn't release him as too late to get hospital transport (everything was actually in place by 11am but the lack of comms meant we were at 6pm by this point). I went to the hospital, got him discharged and drove him to the home myself - they were happy for him to arrive at 7.30pm.
Honestly, it's like herding cats but you will get there I'm sure

Oh dear. Had the CHC meeting today and was basically told that I'd be lucky if any care home even remotely in the area accepts Dad. He didn't score as highly as I expected in some areas because it's linked to cognition (he hasn't got a clue where, when or who he is; wanders all the time and has to be sedated in order to sleep) - while cognition is severe, everything else was marked down to avoid double-counting (so he isn't actively non-compliant with taking medication in that he isn't refusing it; but since he doesn't understand what it is, he has to be supervised and the pills put in his hand).

His condition is so severe in behavioural terms that I can't imagine he is a 'social' problem; but we have no diagnosis either so I can't see how they can class him as a 'health' problem either!

Well, there you go, that's how they stiff you.

In theory, you can sample their suggested homes and turn them down, then you go on to the next until you find one you like. But frankly, you are between a rock and a hard place because hospitals are not good places for old people.

So they can locate your rellie out in the stick, how are you going to keep an eye on them? How long do you think they can last out for? Almost as if that's the idea, right?

We did find out before getting CHC that we could retrieve the situation and go self-funding with a home of our choice if we wanted to. Oh, that said our mother got placed on CHC at the Reigate Beaumont, in Surrey. When we went on a waiting list to move, they conspired with Social Services against us, and sent a letter over the Christmas period threatening to have us barred, just as the CHC was about to be ended. Possibly so they could keep her there and cream off our cash. would do it. Charmers. This was in Christmas 2014.

We moved her out within a week.

My mum had CHC and they would have chosen the home, but it was a good one - the level of care she needed meant there were specific needs that few homes could meet.

This is the problem we are having, silverduck, the homes they have contacted are good ones, but two have turned him down so far, others don't have spaces, and some haven't replied

I can't see anywhere taking Dad, regardless of who contacts them.
Hospital is a disaster for him but I nearly lost my shit when the CHC assessor said "We'll put him down as a low behaviour risk because many people calm down in a nursing home, so we have to expect the best."

Really?? Really?? In his case, the best would be going back home to live by himself, driving around and doing his own shopping as he would have done two days before admission to hospital, but we know that ain't going to happen. He has upwards of 10 interventions every single day and has to be sedated to sleep at all; and if he's down as a low risk then they'll expect a dear old chap who can't move around much and is a bit doddery, rather than someone who sleepwalks, runs around during the day and rips cabinets off walls on a regular basis.

And nobody gives a flying fuck about a diagnosis, even a vague one, except that no nursing home will accept him without one. According to the CHC assessor "any care is based on how he is at the moment, not on any diagnosis, so it's quite irrelevant". Hm, except that we're "expecting the best"...

Oh, and another weird thing - has anyone else had the experience where everyone you meet only ever gives their first name in meetings?

So the nurse and I had to give our full names for the form to be filled in, but the social worker introduced herself as "Sarah" and the CHC assessor "Anne". Happened at the Best Interests meeting too.

Yeah, that tends to happen. Social Services have a very bad rep in this country, and I have to say in view of my personal experience of Surrey's, it's entirely justified. Using only first names is a way of keeping you at a distance; in part they proceed with the attitude that all members of the public are basically dangerous scum who might hunt them down in a fit of vengeance should they feel betrayed. It's like South Yorkshire police vs Hillsborough fans, that kind of mentality.

Another reason is to be all chummy and on first name terms with you, to lull you into a false sense of security, though I can't really say they are doing that with you. To be fair, they may be putting him down as low risk cos it's the only way they can get him into a care home, by conning them a bit. I mean, honestly, are you saying that a bona fide nuthouse would be better for him? But also, I'm afraid to say, they may get him in and get the chemical cosh on him. Frankly, if he's ripping cabinets off walls I can't say that wouldn't be for the best, but you might want to preempt this by discussing with them the options for mood stabilisers, and research it yourself, cos if you don't have PoA in Health and Welfare, no one has to tell you diddly squat about any chemical cosh they may covertly be putting him on.

Oh, and in Best Interest meetings, they may get you to sign a Confidentiality Agreement. That's for their benefit, not yours or your relative's. If you don't sign, you won't be allowed to attend. It's all about protecting themselves.

Yes, you can get CHC funding for care at home. It is usually for those with limited life expectancy. I manage a home care service and we are often part of a team supporting people at end of life who wish to move back or remain at home. District Nurses do the assessments in the community.

Please don't listen to NewspaperTaxis they clearly have an axe to grind and I'm not at all surprised that they seem to have a difficult relationship with all the health and social care professionals they come across.

Pigeon it sounds like in your situation the CHC was being completed incorrectly. If I was the SW in that meeting I would have been professionally 'kicking off' if a nurse assessor said something like that!

I've never really thought about the name thing, I think I often only introduce myself using my first name in meetings but not for any deliberate reason, other than perhaps an assumption that they already know my name and I'm now just putting my name to my face. I wouldn't have any issue if people asked what my surname was, and I usually leave my contact details at the end anyway.

Well said hatgirl. The system is not perfect and you really need to understand the process if you are going to get things done and obtain CHC, but my experience of applying for CHC for my Dad has not been one of corruption and incompetence either. I imagine that CCGs are under huge pressure, both on an individual basis for the staff, and on a financial basis. Professionals are also humans.

Actually hatgirl, don't put me down like that, it's very disrespectful.

I can back up everything I say about social services, particularly in the Surrey area. I only found out about what they are up to after I filed a Subject Access Request against the Council.

Have you read those stories in the paper recently about relatives who complain about care homes getting barred? Well, care homes do that with the full cooperation of Social Services. Still, hatgirl, doubtless you reckon they had it coming, don't you.

I don't find your victim-blaming at all admirable.

Besides, you don't sound exactly neutral yourself, hatgirl.

Of course the council has the right to choose a home for a person if they are paying. Just as if a patient is self-funding, they can choose where they go (within reason - no one would take mil). Otherwise everyone would be swanning off to the very best care homes in the expectation that the council - or rather the taxpayer - would pick up the bill.

Sadly there are too many people coming along requiring care so there can't possibly be "cradle to the grave" free care. And as someone upthread mentioned, dementia is not in itself life limiting. Fil has been in a home for five years. One gentleman in the home has been there for seventeen years - he became senile in his 80s. All the pil's savings and their house has gone in paying for care. But I guess that's the upshot of no one feeling up to caring for themselves within the family. Fil has been receiving a large public sector pension for 35 years. I think it's fair that it should be returned to the public purse. I don't think relatives should profit at the expense of taxpaying schmucks.

1. The council ie. Social Services can stop you moving your relative from a failing care home even if you are self-funding.
   Unless you got Power of Attorney in Health and Welfare beforehand.

2. They - that is NHS Clinical Commissioning Group, they are all in cahoots - can usurp control if you are self-funding by 'kindly' offering NHS Continuing Healthcare. This means it's free, so as RhodaBull has pointed out, they get to decide where your rellie goes. Even if you were self-funding...

While I accept RhodaBull's point about there being too many people to offer free care from cradle to grave, it seems the NHS are bringing the 'grave' part of it forward to save money. It is beyond me why, as my mother is self-funding, she is being put forward for free NHS Cont Healthcare, seeing as they are all so hard up. Of course, the medication costs a fair bit doesn't it...? And once she's dead, that's a saving.

I'm getting warm, aren't I?