Has anyone successfully obtained CHC funding for a relative ?

[gunnersgold]

Thanks in advance

She isn't in a care home , she is at home with a live in carer . She had a stroke and the hospital OT did an assessment and said she would need 24 hour care . As she is self funding we were left to it to organise ! 🙄🙄

Melanie Parsons offers some really good advice on her facebook site. I think the site is called 'Safeguarding Futures Health and Social Care Support'. From memory, I think you can click on Files within that where CHC funding is discussed.

That's not true. Anyone who wants a Care Act assessment is entitled to have one even self funders. There will be a waiting list prioritised first by urgency and then by date requested.

OP I can say without hesitation you are massively wasting your mums money pursuing CHC via a solicitor at this stage. She hasn't even been assessed properly by anyone yet by the sounds of things. you are several million miles ahead of where you need to be.

The OT at the hospital has no authority to say she needs 24 hour care. Chase up that social services assessment.

Even as a self funder she should have been checklisted at the hospital.

That's the thing , we are not getting any help but I'm so exhausted from her and sorting out her affairs I haven't had time to fight the nhs . I have asked but nothing has happened ! I even spoke with her GP a few weeks ago and still nothing has happened . I asked for a financial assessment and a social worker ..

I know I'm probably not doing things in order but I currently in a 'putting out little fires ' situation as they come along and barely functioning !

It's a ridiculous situation to be in but in it we are !

And the hospital OT was a neuro OT and did a home assessment on her . To be fair she can't be left alone , she gets muddled and doesn't remember to use the toilet or get food !

I did, was pretty simple but we had a great social worker

I am a social worker, I regularly participate in DST meetings for self-funders. The DST has to be multi-disciplinary which in my area means both a CHC nurse assessor and a social worker from the local authority, regardless of who is funding.

There are three 'hoops' to jump through for CHC. The first is a positive Checklist which unfortunately is a low bar. I say 'unfortunately' as I believe it gives relatives a false sense of hope. We have so many positive Checklists for people that are never going to get CHC.

The second is a DST meeting which as PP said is a much higher bar. However, even if the DST comes out with a lot of high needa, you aren't there yet.

The last 'hoop' is that the needs have to be high on Nature, Intensity, Complexity and Unpredictability. This is where it is easy to fail - a person can have a very high level of need, but if those needs are predictable and are being safely managed by care workers in a care home, then the person doesn't have primary Health needs, they have primary Social Care needs.

These are the sorts of things I see for CHC eligibilty:
Care workers have to have advanced skills or special training
Care needs are very unpredictable day-to-day
Person has significant behavioural issues that regularly put themselves or others at risk
Meeting needs in one domain means that things deteriorate in another domain (for example moving the person to maintain skin integrity has a negative effect on their breathing)

Oh and I managed to get a custom at home package, social worker was surprised they agreed. This was 3 years ago

@JeanBodel That is really helpful.

I am currently looking after someone who is easily Checklist positive but once you look at the DST, it's not nearly as clear that they will achieve the necessary As and Bs.

We've already applied once a year ago and got the answer no, are going again as their condition has become more complex but are not remotely convinced we will get a Yes this time.

We'll probably go round again in another year...

@gunnersgold who is providing thr nursing care, the District Nurses?

@Schooldil3ma a private care company . She has too much money to get it free !

We were just awarded CHC funding. To be honest it came as a surprise, we’d wanted the 1:1 care fees covered (FNC? I get a bit lost with all the acronyms) and they make you do a full assessment and we got full CHC. What @JeanBodel ring true for us. My df has dementia, and significantly increased needs following both a chronic and acute brain bleed. These change day to day, sometimes he is worse than others. He is physically capable to get himself out of bed but not physically capable to stand. He is unpredictable and needs watching 24/7 or he would fall. He cannot have bed bars as he would climb them and fall further. He can be violent, is strong, and changing him/dressing him is a challenge.

@gunnersgold I'm a bit confused as you said private carer, is it actually a registered nurse or a carer?

@Schooldil3ma I mean a private care company that we are paying for . She has a live in carer . It's organised by the company .

@gunnersgold I really do mean this kindly, but you need to stop and think. You don't really seem to understand the system (understandably, it's very complicated) but if she isn't receiving nursing care and is being managed safely then you aren't demonstrating any nursing need, let alone CHC.
She sounds as though her needs could be managed in a residential setting or at home.
Chase up the social worker and stop throwing money at Solicitors etc until you better understand what it is your Mum needs.

@Schooldil3ma I appreciate your input but she does have nursing needs .

As I said above im happy to 'throw ' money at a solicitor so im not bothered by that ..

I would like to ensure her care is funded and that she doesn't run out of money wether that be by the local authority or by herself via equity release or a care annuity or via chc.

Im exploring all options and felt it was worth a try to get chc

No im not an expert on care but am learning quickly . I do know she and I haven't had any help / support or guidance because she has assets and money which I feel is very wrong even though I have asked for it .

I do also accept that her money may go down to the cut off of £23k ish and I also accept I may not get the LA to fund her at home care after that so I'm trying to exhaust every avenue before that happens so I have a plan .

It sounds like it's all been very stressful.

Number one most important thing for you to do is chase your local authority. The GP has no power in these situations and it's as good as a wasted phone call chasing them to chase social services. At best the GP will send an email requesting an assessment and this will be added to your mum's electronic file.

Ring the local authority, state she needs a Care Act assessment and possibly residential care. Ask for an estimate of how long they think it will be.

Do not release any equity in your mum's property until you have had both the care act assessment and the local authority financial assessment. Equity release schemes generally are usually a bad idea in these situations.

The local authority will 'back date' any funding your mum is eligible for from them to the date you first contacted them. If she is still in her own home they only consider her savings and not the value of the property. They are highly unlikely to back date 24 hour live in care. At best they will back date the equivalent cost of their rate of residential care (as it doesn't sound like she has any nursing care needs).

As part of the care act assessment the social worker will do the checklist for CHC. If the checklist is positive then they will contact all of the relevant people at the NHS to arrange the DST. You don't have to do anything.

Cancel the solicitor. There is no point engaging the services of a solicitor until you know if there's even anything to fight about. It sounds to me like your mum is unlikely to meet the CHC criteria if she's manageable at home with a live in carer and no nursing input, but the social worker doing the assessment will be able to advise you more.

Finally, request a carers assessment for yourself (at the same time you chase the care act assessment).

I think what @Schooldil3ma was meaning is if the carer isn't employed as a nurse and the district nursing team aren't coming in then that would suggest very minimal to no nursing needs.

Which nursing team is meeting her nursing needs if its not the carer and not the district nurses?

I did my mums after doing a lot of reading and having the dst with me.
It was done via zoom with NHS/social care and can't recall who else.
Mum has dementia and is NBM. She was awarded partial CHC funding with CHc taking overall responsibility which they have no experience of doing in my area. My mum apparently is the first to have joint care which is managed overall by CHC
It is all so very confusing.
How do people manage who haven't got someone to advocate

If there are no family/friends involved then social services will commission an independent advocate to get involved if the person doesn't have capacity to advocate for themselves.

They advocates really do act independently as well, and often know their stuff around the law and the care act v chc etc. It's not usually a disadvantage to the person.

@gunnersgold I think what @Schooldil3ma is saying is does she have care needs or nursing needs?

CHC is awarded to those who have demonstrated high complexity, beyond what a standard carer can deliver.

So even if you have a live-in carer, if they are doing basic care tasks this would not count as nursing needs.

Nursing needs would be things like managing suctioning, a tracheostomy, complex medication that frequently altered, feeding tubes, dressings and so on.

The sections labelled High and Priority on the DST describe very complex care that only fits a minority of those who have care needs.

@hatgirl it's been horrendous ! I'm resilient but this is another level !

I will do as you suggested thank you

Again as above to everyone who has commented , I don't care if I lose the money . At the moment she has a lot ( all earnt herself ) but it will run out eventually.

I mean I don't are if I lose the money for the solicitor .✅

@gunnersgold I'm not trying to sound critical, and I really am a subject expert in this area, but why waste 5k?
Is it your money or Mums? As LPA appointee you have a legal duty to spend her money prudently, and engaging a 5k solicitor when you have no need to would not be deemed prudent. You could land yourself in hot water with the CoP.
There are some very knowledgeable posters on here, trying to advise you.
You obviously want the best for your Mum, but you are slightly ill advised at present.