If you are considering plans for your future care or that of a family member within a care setting, then it may be a stressful and upsetting time.
Funding for care can be complex and leave you wondering what to do next? If this is you then give us a call early on in the process – we’re really approachable and more than willing to have a chat about your issues free of charge in order to explore your options. We have helped many care fee applicants navigate the maze of regulations and ‘frameworks’ that govern the allocation of care fee application.
Here you will find what we hope is some useful information to explain the process you may be about to embark on – but sometimes it’s easier just to pick up the phone. We produce a guide to the application process which we hope will be useful.
We are rare amongst law firms in that we employ medics as well as lawyers as the process of assessment requires a fair degree of medical assessment. We are NOT a claims management firm – we are a well-established firm of Solicitors that has been serving its local community for over 30 years and we are now proud to be able to offer our local service to clients nationally.
If you would rather do a little reading first then have a look around our pages on CHC funding and maybe download our free guide to the whole process. For those of you that prefer to have hard copy, just give us a call or drop us an email – give us your address and we will send you a paper copy of our guide.
STARTING THE APPLICATION FOR FUNDING
NHS funding for care or Continuing Healthcare Funding (CHC) as it is known is a type of funding that that meets the total cost of care for a qualifying person. Whilst the setting in which the care is provided is often an nursing home, it is not an essential requirement for qualifying for the funding – it can be a residential home or even in the person’s own home.
CHC funding is not means tested. CHC – once the eligibility criteria have been met – is an entitlement – no ‘top up’ fees can be sought if you or your family member qualifies.
Access to CHC funding is by assessment – as to accessing the assessment procedure, it will depend on your circumstances at the time the process is started. The applicant for funding may be living at home, be hospital, being cared for in a nursing home or residential home. The first step is to get a Checklist done to establish if the claim will proceed to the next step.
THE APPLICANT IS LIVING AT HOME
If there are professionals involved in any care that is being delivered at the point at which you want to apply for funding such as Social Worker or District Nurse, they are a good place to start. Ultimately it is the responsibility of the CCG (Care Commissioning Group). The CCGs replaced the Primary Care Trusts, which you may be more familiar with, back in 2013. As there is usually a personal relationship with the professionals delivering care, we find that many clients get a more helpful response from them in terms of getting the process started by getting a checklist done. If the question of getting a Checklist completed is met with a negative response, then a direct approach to the CCG should be made. You can begin the process by approaching the CCG at the outset. Whichever of these approaches is adopted, do not take a refusal at face value – be persistent.
THE APPLICANT IS LIVING IN A RESIDENTIAL HOME
A residential home as opposed to a nursing home is unlikely to retain a Nurse Assessor or RGN on staff. Again if there are any professionals involved in delivering care such as a Social Worker or District Nurse, then they can be asked to undertake a Checklist. GPs can also undertake a Checklist but in our experience and generally those of our clients, GPs are usually pretty badly informed when it comes to CHC funding. A direct approach to the CCG is a further route if the Applicant is living in a residential setting – but in practical terms we find that where there is a personal relationship between the Applicant for funding or their families and the professional – they tend to be more supportive and pro-active in wanting the best for the person they care for. Again though – do not accept reluctance to undertake a Checklist. Be persistent.
THE APPLICANT IS LIVING IN A NURSING HOME
A nursing home differs form a residential home in many respects not least in the requirement for nursing homes to employ registered nursing staff. This may make the process more accessible as the home will be able to use their own staff already in situ to undertake a Checklist. It is the case (just to add to the confusion) that some CCGs have their own arrangements with specialist Nurse Assessors whose sole role is to undertake CCG assessments. We would hope that staff at the nursing home will be able to assist Applicants or their families with the local arrangements – but if in doubt contact the CCG directly.
THE APPLICANT IS IN HOSPITAL
As a matter of law if a patient is in hospital then it is the hospital that is required to undertake an assessment for CHC funding eligibility before the patient is discharged. Anecdotally there is a reluctance on the part of the NHS to fulfil what is, after all, a legal duty.
It may well be the case that the hospital admission or the condition that gave rise to the admission, has tipped the scales in a previously ineligible patient becoming eligible. An assessment is therefore essential – although it is not often volunteered by staff involved in the discharge. Request that an assessment is undertaken directly from those undertaking the patients care and if there is resistance speak to the Discharge Planning Nurse and if the reluctance remains make a complaint.
Residential Care Fees Protection Specialists
I’m Adrian Chambers and specialise in Residential Care Fees Protection matters. We aim to provide our clients with an outstanding legal service.
We will help and support you and most importantly we work hard for you.
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