Help me understand CHC fast track and eligibility please

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So my grandma fell at the end of November. Broken femur, hospital stay and op and basically she's never picked up. She is now bed ridden, catheterised, supposedly at risk of aspiration (we are dubious about this, she has had problems with hiatus hernia for years and because we can't see her we don't know if this is the problem or a worsening) and incontinence. She has a pressure sore that requires four hourly repositioning and the gp who saw her before Christmas deemed her end of life and anticipatory meds have been prescribed though not yet required obviously. She was on a funded discharge to assess placement in a nursing home and the transitional team have now insisted on moving her to another nursing home on a self funded basis with £180 a week nursing contribution.
Prior to the fall she has none of these medical problems and lived alone with minimal support.
So my question is - how could she NOT be eligible for full fast track funding for continuing health care at the end of life? Why has she been asked to self fund the majority of her current care? We have a meeting later this week to determine if she is receiving the right funding, it looks like this is for a DST to be completed but why is that needed if she has been deemed to be end of life?
She is nearly 99 btw....

Don't know OP but bumping in case anyone can help...

Poor granny, have you spoken to her g.p and is it documented that she has reached end of life care, the g.p should visit and sign the fast track funding application. Does she have the mental capacity to agree to a move and pay for her care or does someone have poa.

My mum has financial authority so can pay, the question about capacity is unclear. I suspect she has capacity though she also has a degree of cognitive impairment. We asked for an assessment but I don't think it's been done. The gp is a problem, she's now in the second nursing home and neither are under her previous gp so nobody seems to be doing anything!

The carehome should have registered her with the gp they use or she keeps her own gp. The end of life decision must be documented somewhere. Do you have poa? She is entitled to a care needs and capacity assessment which they need for the DST anyway.

Fast track CHC funding is for people who have a rapidly deteriorating condition and may be entering the terminal phase of life.

You can have palliative care needs but still not reach that threshold. You can be considered as being towards the end of your life but not have a 'rapidly deteriorating condition'

Most elderly people in care homes have the '4 core drugs' prescribed drugs to make you comfortable at the end of your life).

If your grandma's condition is stable and she isn't actively rapidly deteriorating then she may not have reached the threshold yet.

If she hasn't had a DST yet to ascertain her eligibility for fully funded continuing healthcare and was discharged from hospital under discharge to assess then she shouldn't be paying any money towards her care yet.

Fully funded continuing healthcare is not the same thing as fast track continuing healthcare. It's a separate process and a different assessment but they both ultimately lead to health funding the care if eligible.

Thank you. That is really helpful. Given how much she has lost in such a short time it feels like she should qualify as rapidly deteriorating but I think part of the problem is we know how she was but not how she is because we can't see her, the people providing care know how she is but not how she was!