NHS Continuing Healthcare funding assessment process – should you leave it to a care home to start this?
Many people ask this, and here are some tips to help you:
Let’s suppose your relative needs to go into a care home. They may currently be in hospital or perhaps still at home.
You know about NHS Continuing Healthcare funding, and the care home has also mentioned it.
But will the care home be proactive in securing that funding for your relative?
The first thing to find out is whether the home has already had people who’ve been funded through NHS Continuing Healthcare. If they have, the Continuing Healthcare team at the CCG can’t argue that the home is too expensive for such funding.
However, it’s vital that you as the family are proactive in pushing for NHS Continuing Healthcare – don’t leave it to the care home.
There are several reasons for this:
- No one knows your relative like you do – and you are (generally) best placed to make sure all their care needs are taken into account and that the NHS Continuing Healthcare understand the full picture of needs and risks.
- If your relative is new to the care home, the staff may not have had a chance to really understand the ins and outs of your relative’s needs.
- Never assume that a care home will have solely your interests at heart. A care home is (more often than not) a commercial business. They get paid through care fees, and they will – naturally – want to secure good revenue from each resident/room. The care home will be paid less through NHS Continuing Healthcare funding than they will if your relative pays as a ‘self-funder’.
- If the care home does offer to help, make sure you are fully involved and that you, as your relative’s representative, are the main point of contact for the Continuing Healthcare team.
- Staff in care homes may not understand much about NHS Continuing Healthcare, and we hear many stories where contributions from staff have been damaging to a person’s funding case.
- If your relative is not yet in the care home, the care home won’t yet have any daily care notes. So make sure you get to see the hospital notes and/or any other care needs reports and assessments that will be used for the NHS Continuing Healthcare assessment – and highlight anything that’s not right or that plays down your relative’s needs.
- It’s also very typical for a care home to want to show that they’re providing good care, and that there are no problems with a person’s care, and that there are no risks – because, of course, risks could (potentially) reflect badly on the home. BUT it’s always the underlying needs that should be assessed – so a care home has no reason to feel ‘on trial’ in an NHS Continuing Healthcare assessment, and yet many seem to feel it’s an assessment of their ability to provide care – which of course it isn’t!
- It’s not unusual for a member of care home staff sitting in an NHS Continuing Healthcare assessment meeting to say things about your relative such as: “He’s fine. There’s no problem. We don’t have to do anything outside the usual routine.” etc. – and yet the assessment isn’t about whether or not care is ‘routine’ – instead it’s about your relative’s individual day-to-day needs, as if no care were in place. An example that can help illustrate this is an Intensive Care Unit (ICU): The care that is delivered in an ICU is probably ‘routine’ for an ICU, and yet the day-to-day care needs of the patients in an ICU are huge.
It’s important to add that there are some exemplary care homes, who will support you throughout the Continuing Healthcare assessment process. It always good to hear reports like that. A good care home that is on your side can be invaluable.
Unfortunately, we also receive reports from families that indicate some care homes may actually try to sabotage the process.
So if your relative is going into a care home or starting to receive care from a care provider, make sure you (as the family) are proactive in pursuing NHS Continuing Healthcare funding on their behalf.