Funded Nursing Care refunds: should a nursing home reduce your fees when it’s already paid by the CCG for providing nursing care?
The Local Government and Social Care Ombudsman has published new guidance about Funded Nursing Care refunds. (Funded Nursing Care is also known as FNC.)
Funded Nursing Care is paid directly to a nursing home when a person is found ineligible for full NHS Continuing Healthcare funding, and yet the person still has nursing needs.
That sounds like a contradiction it itself – and it certainly can be. Many families believe their relatives have been wrongly denied full NHS Continuing Healthcare funding and ‘given’ Funded Nursing Care instead – which is a lower cost for the Clinical Commissioning Group (CCG).
(Note: Funded Nursing Care payments are not made to ordinary residential homes nor to providers of care at home.)
Another problem families report is CCGs failing to assess people properly for full NHS Continuing Healthcare funding before decisions are made about Funded Nursing Care. It’s vital that the assessment process for full Continuing Healthcare take place first – always.
What’s more, where Funded Nursing Care payments are made to a nursing home for a specific person’s nursing care, there are many complaints from families that the person in care does not see any reduction in their fees. Let’s remember that nursing care in the UK (generally speaking) is free of charge. So why are some people in nursing homes paying for their nursing care?
Funded Nursing Care refunds – should your relative receive one?
The new guidance from the Ombudsman highlights some of the things that go wrong when a nursing home receives a Funded Nursing Care payment to cover the cost of nursing care for a resident.
It looks at these 4 scenarios involving potential Funded Nursing Care refunds:
1. where the total care fees include nursing care
2. where nursing care fees had previously been reduced for a resident, but then the level of Funded Nursing Care payment available to the home increased
3. where there was no contract to start with between the home and the resident
4. where there was a contract, but it failed to address the subject of Funded Nursing Care
If your relative receives Funded Nursing Care, they may or may not have seen a reduction in their care fees.
Funded Nursing Care payments are currently £155.05 per week in England. Read more here about the rates. It’s hard to see how that amount could cover the actual cost of nursing care in some instances, but that’s another debate.
Although the new Ombudsman guidance is aimed at nursing care providers, there are some vital points that families can draw from it:
- Make sure you always have a written contract with the nursing home, and that you know on what basis they are charging you fees.
- Make sure you have a written breakdown of those care fees and that it’s very clear what (if anything) is being charged for nursing care – and on what basis this might happen in the future.
- If the total care fees include nursing care, then it’s logical to expect the total care fees to reduce once the nursing home starts receiving Funded Nursing Care payments from the CCG. If not, the home is effectively being paid twice.
- If you feel you are being wrongly charged nursing care, address it with the nursing home first. You might also want to copy your letter to the CCG and also the Head of Adult Care at the local authority.
Read the Ombudsman guidance here: Funded Nursing Care payments – guidance for care providers – on the right hand side of that page click the link under ‘Downloads’.
What’s your experience with Funded Nursing Care?