What is the process for determining that a nursing home v. residential home required,?

[limetrees32]

Are there different assessments?
One for applying for funding and another by the nursing home itself?
Who conducts them, how are they made?
Sorry if this is silly question, I have no knowledge in this area.

@limetrees32 I’d add that diabetes can be what means nursing level care is needed. For example, if nurses need to monitor blood sugar readings and adjust injectable insulin, if regular wound care is needed. Carers couldn’t do this for DF who was having nurse visits to home - he didn’t qualify for CHC, he did qualify for FNC (funded nursing care) - because registered nurses working in the nursing home could take over what the community nurses were doing.

After a failed discharge, the hospital may want - or could be persuaded - to go for an intermediate care/discharge to assess care home placement rather than discharging straight home again.

This would mean 4-6 weeks NHS-funded stay in a care home (from the hospital's standard list) so a more detailed assessment of her needs is made. This would give time to look around for a permanent placement.

If she's self funding, there's no benefit to going for a nursing home if she only needs residential. The FNC funding (even if she gets it) won't bring the fees down between those of a residential home. Although as others have said if she's likely to progress to nursing needs in time, it's useful to have a home able to offer both in the same.site to minimise the disruption of a move.

A PP mentioned hoists as one of the reason for needing nursing rather than residential. That's not been my experience. Many, if not all, residential homes have a variety of stand assists and hoists available and staff trained to use them.

This is literally my job, I'm a nurse working within a hospital discharge team, I work along side a social worker. The social worker will decide if the patient can safely go home, if not I assess the patients and decide if they need resi or nursing level care, social workers aren't trained to assess for nursing needs.

We then use the 'discharge to assess process' usually 28 days placement in appropriate facility, then patients are reassessed to determine longer term needs. If they have improved they can sometimes be discharged home. Fundingbis decided then asset depending.

Hoists are NOT a nursing needs!

Just out of interest, what was the reason for her readmission to hospital?

I don't have the full picture but she was collapsed on the floor and very confused .
Paramedics said very low blood pressure .

When we needed a care home for my parent not that long ago, the explanation I was given by the homes we spoke to was the level of medical nurse care needed. My recollection was that the nursing floors had a nurse there at all times, residential floors did not.

My parent was on various tablets, has some dementia, had a catheter but otherwise care needs were really personal care so residential was fine.

We were arranging and funding ourselves so I was keen to pick somewhere that also had a nursing wing should the situation change, to minimise impact on parent of having to move homes.