NHS Continuing Healthcare funding cap?

A question about : NHS Continuing Healthcare funding cap?

A friend's husband has been admitted to a care home under a guardianship order. He has advanced alzheimer's requiring 24 hour care and has multiple care need due to his condition. Our friend has been informed that most of his care home fees will be funded but Ј400 a month will come from his pension. Apparently this figure has been agreed between the council and NHS at a meeting our friend did not attend. This contribution will mean our friend will have to claim pension credit.

Our friend believes her husband is being funded by NHS continuing healthcare. However it was my understanding that a CHC award meant that all care home fees would be met by the NHS.

Has anyone had a CHC award capped or any knowledge that this capping is possible?

Best answers:

• Hi
  My friend is in the same position with her father and is having to top up the shortfall (hers is in the region of Ј160/ month) she was given a maximum amount per month they would fund but very few homes were charging this and with one home she looked at the shortfall was Ј85 per week.
  I just had a quick search and found this taken from a Bromley Council document The standard rates for 2013/2014 are: Residential care Ј 530.00
  Residential care for people with dementia (Sometimes called Elderly Mentally Infirm care) Ј556.00
  Care homes with nursing up to Ј720
  It would appear that any charges over the tariff have to be paid
  Marg
• If your friend is being asked to pay towards care, it means that he did not qualify for NHSCC and is being funded by the Council as such his income with a sum deducted for a residential allowance pays towards the cost of his care. She should have had a letter from the NHS explaining that he did not meet the criteria for NHSCC.
• I can see why she is confused - if savings are over the threshold then he would not attract council funding! The support rates from the council would entirely depend on his income. Normally you are not asked to pay towards care if health are paying (unless the home selected is too expensive and they have put a cap on what they will pay). She should contact the discharge planning team at the hospital and ask to speak to the nurse who completed the DST (decision support tool - completed at the meeting your friend did not attend) they will be able to advise if he has been put forward for NHSCC
• Me and Mrs D have inherited the responsibility for an uncle with dementia/downs.
  We are surprised to find he does not get CHCF, instead he is under the care of Social Services.
  He has been placed in a new home and we are going through procedures to get him referred and assessed for CHCF. I came here to look at the old threads, only to find them gone.
  We have also found that the rules have changed since we were last involved with the procedures. Any help welcome.
• Is this the thread you're looking for?
• NHS funding; Be Warned! Don't take it lying down Fight Back!
  Last week I participated in a meeting with an NHS assessment nurse and my father, who is in a nursing home in Gillingham, Kent to see if the NHS would contribute to my 92 year old fathers nursing fees. She produced pages of a tick box score system which apparently goes to a local panel of 'professionals' for them to decide if they would provide funding.
  My father is currently bed ridden, doubly incontinent, unable to feed himself and can hardly move. Yet I get a phone call today to say that 'the panel had met and deliberated my fathers case, and had decided that he was not entitled to any funding because he does not meet the criterion'
  One has to question just how ill do you have to be to meet the 'criterion'?
  it was quite clear from the start that the scoring method was crudely weighted to ensure the NHS gets away with paying nothing. For example; my father, double incontinent and bed ridden On that page the score was 'MODERATE' as it was for most other pages as there is a higher level of illness with the classification of 'SEVERE' In this case, to qualify you have to have a daily surgical procedure for your incontinence!
  How can a government department get away with such cynical trickery and treating people as idiots? The meeting was a charade, a waste of everyones time and I wonder how so called 'professionals' can bring themselves to participate in such a dishonest sham.
  I now realise that this is going on across the country and most of it is illegal. This needs to be challenged, maybe through a 'Class Action'. In an Election Year this could have very serious ramifications and well deserved payouts to all those who have been shafted!
• This might be useful as regards the assessment:
  https://www.gov.uk/government/upload...list-FINAL.pdf
• Inholms , CHC funding is based on health needs not nursing needs. A person such as your father has many nursing needs but does he require specialist nurse care for example an individual may need help with feeding, anyone can feed someone (nursing need) but has that person also been assessed as have difficulty swallowing, risk of choking maybe need thickend fluids etc (this is now a health need) and should mean in a care setting only someone who is trained not necessary a qualified nurse should be feeding that person. Can you see the difference. CHC is complex difficult to obtain depends on having several health needs and can be taken away even after its been awarded.
• Yes, I now understand this and as you will appreciate as we only have two parents, most of us take time to 'get up to speed' I think now that having more knowledge of the subject I am more concerned about the process brought in by the Tories in 2013:
  it may well be that my father will fail an appeal ( I'm sure he will) but what I find most disturbing is the process; The government has created a 'tool' that is so distorted and weighted, most decent people have been manoeuvred and shafted out of their rights (you know, the ones they thought they would get when they voted for the inception of the NHS).
  I'm also concerned as who selects the people who undertake the assessments, both for the NHS and Social Services; It cannot be a coincidence that the dragons that do this work across the country seem to be generally nasty and seem derive pleasure from telling people they will not get funding. I wonder if there a bonuses involved?!!!!!
  It's like living in Russia or the old Communist Block!
• Sorry, there's one more point I forgot to mention. My father has been in the residential home for three years and until recently he was 'Residential' status. As soon as he became incontinent he was moved to the 'Nursing' floor, and the fees were whacked up by another Ј200 a week! They don't seem to follow the same care / nursing definitions as the NHS. Do you see the dichotomy we are facing?
• Inhomes I do really understand your fustration. Those who decide if CHC funding should be granted have very strict guidelines. A CHC fully funded care place could be Ј1,000 + a week the care recipent is also entitled to keep all there state penson, private penson, etc so very expensive to fund an ever increasing number of people with health and care needs.
  Just to add the fees for the home went up because of requiring a greater amount of nursing care intervention and thus more staff, a higher staff care reciever ratio. There maybe also a need for extra pads, special equipment ie air bed etc. Sorry a rise in fees is generally standard practise in many homes.
• My sympathies to anyone fighting the system. I failed to get funding for my mum, until posthumously, the authorities agreed that for the last six months of her life, her needs exceeded what they deemed social care. Her needs hadn't changed since I first submitted her details - unable to move independently so liable to pressure sores, doubly incontinent, thus exacerbating the tendency to sores, prone to choking, but by far the worst of her conditions, to my mind, was her inability to communicate - pain or fear - a dimension that didn't fit into their 'score card'. While there were people on the panels of the meetings I addressed who showed sympathy, whatever their vote was once I had left, there were individuals who were openly as hard as nails. I couldn't believe they came from the nursing profession in which my mother had worked for almost half a century.
• Pineapple,
  you seem to be supporting this disgraceful scam. Why?
  This is going on secretly across the the country. Who are these 'hard as nails' people? under who's authority are they working?
  You may ask 'what has this got to do with this forum?'
  Well, let me explain; My father, fought for his country, paid his NI all his 50 years working life and voted for the inception of the NHS. Do you honestly think that the way he has been tricked and intimidated is what he and everyone else like him is what he thought he was going to get? No! this is a national disgrace and the reason the 'Dragons' are employed is to intimidate and frighten decent people from fighting their case;in other words stopping them from getting their rightful benefits.
  Thats what it has got to do with this site and it has to be exposed and publicly debated.
• Sorry, by my book they are quislings. No professional should morally be involved in a government instigated process that works against the best interests of the decent hard working people of this country. If they had any pride they would refuse to do the governements dirty work and I am shocked that it is happening in our country.