An unexpected turn of events means that mum had a visit from NHS CHC to complete the checklist and has now triggered for a full assessment.
Can anybody please help me understand the process? The CHC man said it is around £700-800 per week but mum’s fees are a lot more than that. From what I’ve read on the various websites, nursing homes should not ask you to pay a top up in these situations. So how does it work?
I’m terrified that they will chuck her out to find somewhere cheaper.
Thanks
I would assume the other part is either funded by your mum or social services depending on her situation financially. The healthcare element isn’t based on her finances - I think.
The threshold for private funding is £23500 I believe, so if she has this sort of money she will have to fund or part fund her care. I would suggest contacting your local county council as they are responsible for the social care element e.g the none healthcare element.
Social care generally will do an assessment of her needs, a financial assessment including property, savings and incoming benefits etc then determine what the funding they will be provide is. Generally they don’t like moving people but there is also the additional option of providing a private top up if they don’t fund it all.
To be honest the carehome will be used to the processes and will just want to ensure they get paid.
The official guidance you may want to read is here
Thanks for your reply. There is a difference between social care assessment, which mum has already had done and CHC- the continuous health care- which isn’t means tested and from what I understand you are not allowed to top up. I’ve been told different things by professionals so even harder for your average person to work out!
NHS continuing healthcare (sometimes called NHS CHC) is a funding programme. If you're eligible, it pays for all your social care, including care home fees or carers if you're living in your own home. NHS continuing healthcare isn't means-tested, so it doesn't depend on how much money you have.
If an individual has primary health needs, then they are entitled to NHS continuing healthcare funding to meet the costs of care in full. It is not required that they pay a penny towards the cost of their care and it is irrelevant whether they have funds exceeding the Social Services means testing limit or whether they own a home.The first and only test is whether their needs are primarily health needs. If they are because they have the required nature, complexity, unpredictability, or intensity or any combination of the above, then they are eligible for NHS continuing healthcare funding in full to meet the costs of their care.
Once, and only once it has been determined that an individual is not eligible for continuing healthcare funding to meet their care should there be any discussion about means testing. Where it has been determined that an individual’s need for care is not primarily a health need, the test then is one of means testing, namely do they have assets exceeding £23,250 on the basis of the current means testing Social Services criteria.If they do, then they are not eligible for support or financial assistance from the local authority, and they are obligated to meet the cost of their care, in full, until such a time as their assets fall below the means-testing threshold. If their assets are below this threshold, then that will be the point at which Social Services will intervene and contribute to or meet the cost of their care in full depending on their particular circumstances.NHS continuing healthcare funding and Social Services funding for care are two separate and entirely distinct matters. Social Services funding is means tested, NHS continuing healthcare funding is not.Every individual in care should be assessed to determine whether their needs are primarily health needs or not. Only once this has been done in full and concluded should it be the case that they are financially assessed to see whether they should be meeting the cost of their care under the criteria for Social Services means-tested funding for care costs.Unfortunately, very often individuals cannot be assessed when it should, in fact, be the case that their needs dictate that they are entitled to NHS funding in full.Equally, a patient may not be entitled to NHS continuing healthcare funding at their point of entry to care, but if their health needs were to deteriorate, they might then meet the threshold for full NHS continuing healthcare funding. This can only be determined if an assessment is undertaken within the criteria of NHS continuing healthcare.
So you will not have to pay anything it will either be entirely funded by NHS or joint NHs/social care hope this helps
PM me if you have any questions as I’ve been through the same process and understand how difficult and worrying it can be
Hi Willowden,Walking18 granted you great info there. I've been through the CHC process for my father twice. He was rejected first time and we have appealed with professional services to help. I'm not attached to that outcome but on principle it was the right thing to do.
The second time was just last week at the nursing home my dad has just been placed into after 5 weeks in hospital after his live in care package broke down as my mum suffered a breakdown.
I have a year plus of research and I have been burying myself in it as much as time will allow.
Like Walking18, if you want to chat I'm happy to try and help. Probably better to have a phone call if you're up for it.
In all honesty it is very complex made more complex by the complexity of PSP and we definitely have to 'fight' and gather as much information and 'evidence' as possible to support and back up what our loved one is experiencing. Your 'word' and experiences are evidence but you need to be prepared to explain your points thoroughly and to counter the scoring system of the assessment criteria to show how one domain can impact on the others. Ie 'cognition' is one domain of 12 - cognitive impairment impacts on behavior, nutrition and mobility and we need to discuss how and why to support this (all 12 to be honest but we need to evidence why and how). It is intense but possible. We were told during the meeting this time by the Chc nurse assessor that it is HIGHLY likely that dad will be put forward for the funding and the nursing home manager was in agreement and said so which helps. The social worker had this time to support dad was very thorough unlike the first. Don't get me started aagh. At the same time this means little as it then goes to the CCG board but I am positive and we will instantly appeal otherwise.
Have a look at this re your question. Professionals in the care system most definitely do get the information wrong! It is very confusing and complex even for those in the profession. Crazy. I've seen it personally now so many times in the last few years.
continuing-healthcare.co.uk...
Also this site is a brilliant thorough resource for all things related to CHC.
caretobedifferent.co.uk/#:~....
I bought and downloaded the digital book from the site. It was absolutely worth it. But there are heaps of free accessible blogs on that site relating specifically to breaking the assessment down that are invaluable and what CHC funding is versus social services/local authority contributions etc.
I hope this helps. It is overwhelming but if you prepare it is much much easier.
Big hugs
Xxx
I'm no expert as I've failed three times to get funding. But I did find loats of useful info on a facebook CHC funding page. They were really helpful and knowledgeable and of I wasn't so frazzled, I may have done better. It's all based on evidence so ask the care home for all their notes as these will help and make your own observations and prepare well.
On the top up fees I think you can just refuse them. I found something on google, will try and find it. Good luck xx
Thank you. I hope you and your mum are doing ok. I’m wading through all the information 🤯
We are muddling through, as is everyone else on here 
Sending you lots of love and lovely vibes, this journey is HARD. But here we are xx
Try the care to be different website and search care home top up fees. X
Hi, My father has now been in a carehome or 3 weeks which is CHC funded. It's a BUPA carehome and isn't cheap, but I wasn't able to find out what 'budget' would be allowed, but this carehome knew that they were on a CHC approved list - ask this question when you visit a carehome. The first assessment the district nurse did was rejected, I then spoke to another DN who came out and repeated the assessment. By then dad had deteriorated a little between the first and second assessment, but the 2nd DN also said you needed to make sure you used the right wording on the assessment to get approval. In the meantime I also researched and visited several nursing homes in the area and decided which one would be the best and had availability. The DN then put our preference on the form which got approved. The other thing that helped was getting the GP to put my dad on Fast track - ie expected to live less than 6 months. The GP admitted that for neurological conditions that is very hard to gauge but that no-one has every 'told him off' if someone lived more than 6mths!! Once the CHC was approved it was very quick - nursing home got notified to reserve a room for my dad and within 10days he'd moved in - this could've been even quicker, it was just our choice on timings. Be persistent and try to find people who understand the process and condition, which isn't easy! Best of luck
Hi. Excellent advice above just wanted to add that my Mam was accepted for CHC on her second assessment. Her care home is fully funded, the cost would be £1200 , no limit was mentioned to us, although she went to the home after a hospital stay. Good luck.
CHC FUNDING
CHC Funding
Success rates with CHC funding application 
