Were you turned down for Continuing Health Care?

Sorry things are piecemeal here at the moment. I am coming across very good bits of law and regulations and, in time I will get them organised. Just walk on by if this is not you.

Everyone who is assessed for Continuing Health Care should be sent a copy of the Decision Report Tool.

If the Decision Report Tool recommended that you received CHC then the Funding Panel have to giver you funding. There are extreme extenuating circumstances, but they are extreme. Such as there was a major error and names got transposed across two different DRT documents.

So if you were turned down get a copy - it is your right and check.

Best to you all

Kevin

3 Replies

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  • Hi Kevin.

    We have CHC but I have only every had one brief letter of two paragraphs telling me that F was now funded in Nursing Home.

    Now going through process again to get him home. It's seems to be going ahead fine but the lack of information is frustrating. I find the way the professionals , and they do all work hard, talk to me is bordering patronising and certainly over protective. It's a little like being an expectant mother again. They all assume that as a carer I no longer have a brain and should concentrate on being the carer.

    We have been fortunate the awarding of CHC has although been slow has run smoothly. It's the finding of an agency to fulfilling the care package that is impossible. I was told by the CHC admin lady that it's Social Services who are in charge of organising the finding of the carers. This puzzled me but as I have no literature, reports etc to refer to I have no way of challenging or querying the process. It's all a bit to smoke and mirrors.

  • Hi Hellebore

    I have rewritten this post.

    Your post leaves me with many questions.

    F has had the Nursing home funded under CHC. If it was an urgent placement then that would likely be on Fast Track CHC.

    Now you are being told that Social Services are going to fund the home care. Well that implies that F is no longer on Continuing Health Care (after the nursing home), but has been referred for Social Care from the Social Services which is means tested.

    For this to happen there needs to have been a full Continuing Health Care Assessment which should have included an assessment (Using the Decision Report Tool) to which any close carers should have been invited. Following that Assessment there should have been a formal letter with the CHC decision for the care at home.

    Things seem to have reappeared above water further down the line where a referral for Social Care (Social Services) has taken place and now they need to start the Means Testing process before putting care in place with a possible split of costs between F and themselves.

    The CHC decision can easily be challenged.

    If there is anything more than absolutely minimal Nursing Care needed then the Social Services are not legally permitted to provide a service and the NHS must provide a service which is free at the point of delivery.

    It appears that their distant and haughty attitude is covering up a multitude of sins and possibly unlawful decisions. (This is quite common by the way - the regulations are complex and it is common for the assessing staff not to know the law at all well).

    I would do two things immediately.

    (I am assuming you mare a close relative or a carer closely involved.)

    1 Start keeping diary notes of everything and everyone you speak top on this. Go back as far as you can form memory. This is potentially crucial evidence of it comes to an appeal.

    2 Write to the manager of the Care Commission Group (do not telephone - letters go on file and carry weight) with the following included:

    a) There appears to have been a referral to Social Services which in turn means that there must have been an assessment for Continuing Health Care. If this is the case may I please have a letter giving reasons for and decision and a copy of the Decision Support Tool. If there has not been an assessment for Continuing Health Care would you please undertake an assessment now as she appears to have been on Fast Track Continuing Health Care in the Nursing Home.

    b) If there has been an assessment for Continuing Health Care and she has been turned down I would like you to consider this letter to be a request for a formal appeal. I shall write further giving reasons for the appeal after I have received the relevant documents as requested above.

    Do not worry about biting the hand that feeds. The whole process is a legal framework which confers, onto them, various duties and obligations. They know this fully well and your letter will be seen as informed and appropriate. Just keep it polite and formal.

    I do hope this is not unwanted advice and that it might be helpful.

    I have had to make some assumptions - So please come back to me here or by private message should you with.

    Best

    Kevin

  • Hi Hellebore

    I have rewritten my post to you after re-reading yours.

    Best

    Kevin

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