Many families report that their older relatives are often forced out of hospital and into long term care – or back home – before proper health needs and funding assessments have been carried out and before suitable care provision has been put in place.
If a hospital decides someone no longer has ‘acute’ health needs, it will want to hand the person over to the local authority as quickly as possible – and will often put pressure on the local authority (and on you as the next of kin) to get the person discharged.
If you have an elderly relative in hospital and you’re being pressured into finding a care home for them – or the discharge team are threatening to find one for you – follow these tips:
1. Your relative should be assessed for NHS Continuing Healthcare funding before they’re discharged. This is NHS funding and it covers 100% of the costs of ongoing full-time care if you need it primarily for health reasons, i.e. you have what’s called a Primary Health Need. Many people are discharged without this assessment having been done – effectively forcing them to pay for care before it has been properly established that they need to.
2. Make sure the hospital knows you want to attend all assessments. If you have power of attorney for your relative, this should be straightforward. If you don’t, but your relative still has mental capacity to give consent to you being their representative, this should also be reasonably straightforward. If you don’t have power of attorney or consent, it can be more difficult to get to see assessment notes – but always ask. You don’t have to tell the hospital that you don’t have power of attorney. It’s up to them to ask you.
3. Make the Discharge Team aware that you know about NHS Continuing Healthcare funding. Also, make sure you have been given the opportunity to attend these assessments and appeal any flaws in the process that has been used – before your relative is discharged. Once the Discharge Team is aware of your knowledge, they may stop pressurising you so much. Without this process being complete, no reliable decision can possibly be made about who is actually responsible for paying for care.
4. At the point where the hospital decides your relative is no longer their responsibility, the hospital will issue a ‘Section 2 notice’; this is effectively a notice to Social Services that the hospital is handing over responsibility for your relative’s care to the local authority. However, if your relative needs ongoing care for health reasons, this handover should only be done after a proper assessment for NHS Continuing Healthcare funding has been carried out.
5. Once your relative is ready to be discharged from hospital, make sure that on the day of discharge they are still properly cared for – and not left in a Discharge Lounge for hours. (We do hear of this happening.) Your relative should be properly dressed and fed, given enough drinks, and have any continence needs addressed throughout. Just because the hospital may want to free up their bed in the morning, doesn’t mean the NHS can wash its hands of responsibility for care while your relative is still on the premises.