Getting continuing healthcare

[notaflyingmonkey]

DM is about to be discharged from hospital to a nursing home, following a debilitating stroke. She is now bedbound, and given she already had dementia, is further altered mentally.

Hospital are pushing for her discharge, as they feel they can do no more for her medically. They phoned me today and the first question was about if she owns her own home.

I asked for an assessment to be done for continuing healthcare, and got a bunch of what sounded like waffle back.

If anyone has been through this, do you have any tips or links that you could share please?

@NormaLouiseBates

Same *@notaflyingmonkey* My mum is literally like an elderly baby and needs constant care and supervision. People keep telling me to appeal but I just don't think I've got it in me.

I wasn't going to appeal, it sounded complicated and I had so much on my plate at the time, I really couldn't face it. What tipped it for me was a patronising HCP repeatedly telling me I had absolutely no chance of winning an appeal, and that ordinary people just didn't understand how it worked.

Because they were so insistent that I wouldn't get anywhere it made me a bit suspicious, if they knew I wouldn't win then what was the problem?
I must have changed my mind half a dozen times because it did sound complicated, I couldn't afford to use a specialist firm either.

Then I decided that I had nothing to lose, I just needed to knuckle down and do it. I wanted to put my own mind at rest that I'd done everything I possibly could for my dear old dad. I knew at some stage I might be facing the same thing again with my mum, or in-laws, or elderly Aunts, so another part of it was just wanting to learn as much as I could so that if there was a next time then I'd be fully armed.

The Ombudsman did a report in November 2020, Getting it right the first time, it's interesting reading. IIRC it's basically saying that staff should ensure they are making the correct decisions on the initial assessments because otherwise their time is taken up with dealing with past decisions on appeal.

That's interesting @SylviaTrench. The information around the process seems to be as baffling and full of jargon as possible, which I guess serves to put many of us off taking on the process ourselves.

I went through something similar with getting my son a statement where I had to learn everything I possibly could on the process.

@SylviaTrench did you get it awarded on appeal?

CHC funding has virtually no relationship to the care that is put in place, it’s literally just about which funding pot the money comes from.

Beacon advocate for people through the process and do get good results. But yes, as others have said the threshold is very high.

With dementia the highest chance is if your relative scores a ‘severe’ on cognition and behaviour. Two ‘severed’ generally means you should get it.

Deeeee breath with this one.

CHC is the NHS agreeing to pay for care on (more or less) the basis that the patient needs so much nursing oversight that if he wasn't in that home with that nursing care he'd pretty much have to be in hospital or would have HCPs visiting him at home several times a day.

The most important thing is that your dad gets the best quality of the care that he needs. CHC funding is unlikely to make any difference to the care he gets, it's often mostly about who pays for it (you/the NHS/local council).

So you might also/first need to put some focus and emotional energy in making sure he gets into the best home for him with the best care for him right now. If he has money/a property then you have some control over this.

Just a thought.

Sorry, MUM!

I am a palliative care nurse and the process is becoming increasingly difficult and frustrating. When I apply for patients it's usually always denied now. It takes hours of work to justify why someone should qualify.
I absolutely hate it. It's soul destroying when my patients are so unwell and have a short time to live.
I wish you the best of luck x

[quote NormaLouiseBates]@SylviaTrench did you get it awarded on appeal? [/quote]
Yes I did.

Now my dad has died I’ve had more time and mental energy to clearly look at the process. I can see mistake after mistake after mistake by the staff concerned. At the time I was just so worried about my dad that I didn’t know which way was up. I think that’s part of the problem that people don’t necessarily know how the care, and CHC, systems work until you need them but then you’re often trying to juggle so many plates that the idea of trawling through the whole process is just too daunting.

Precisely. This has all happened so fast for me, that I am still having to come to terms with the fact that DM is now massively altered since the stroke, and everything that is likely to mean. I've been asked by the social worker if I'm looking at nursing homes, but until DM is assessed I have no clue what sort of criteria I need to look for.

It’s difficult but not impossible. Have a look at the CHC checklist online and see where they fit into that. They’re a key which indicates if a full assessment is needed. A full assessment is called a DST and you can be supported by your local adult social care team

@TonkinLenkicks

It’s difficult but not impossible. Have a look at the CHC checklist online and see where they fit into that. They’re a key which indicates if a full assessment is needed. A full assessment is called a DST and you can be supported by your local adult social care team

The checklist is a very low bar compared with the full assessment. Most people who “pass” the checklist won’t get CHC. The most important thing to look at is the assessment tool downloadable here

When my mother was seeking attendance allowance 40 years ago, she had to appeal. She reckoned they turned everyone down on the principle that if you didn’t appeal you weren’t really serious about your application. Looks like there’s a bit of that thinking about CHC

In our area less than 10% of people who pass the initial checklist will get CHC.
The appeal success rate is between 20-25%

@SylviaTrench, sorry I missed your reply yesterday. I am definitely going to appeal I have now decided... the way I see it, we've got absolutely nothing to lose.

Are you claiming attendance allowance (£89 per week) and funded nursing care - no where near as much as CHC but they do help with some of the costs. Funded nursing care is easier to get.