17 top tips to help you with NHS Continuing Care funding…
In the UK, as a general rule of thumb, nursing care is free – in law – and should never be means tested. And yet there are currently tens of thousands of elderly people in care homes or receiving full time care at home, in the UK, who are being wrongly charged for nursing care.
Why are they paying for nursing care? Three key reasons:
- They may have been told they have to pay for care without anyone having done – or even mentioned – an assessment for full NHS funding.
- They may have simply been told they ‘don’t qualify’ for NHS care fees funding – or that it’s not relevant for them – because they only have ‘social’ care needs (when in fact they have nursing needs).
- They may have had an NHS Continuing Care assessment, but it’s been carried out incorrectly and their family has faced so much obstruction by the health and care authorities (as frequently reported by families commenting on our blog articles) in trying to challenge the outcome, that the person just ends up wrongly paying for care.
It’s one of the biggest scandals in health and social care today. With all the maladministration and misinformation surrounding NHS Continuing Care assessments and funding, it means in effect that the state is stripping people of their personal assets to fund care that should be paid for by the NHS.
If you have a relative with health needs who requires full time care – or who is already in full time care and paying care fees – these top tips will help:
- If you receive NHS Continuing Care funding, it covers 100% of the costs of your care. It is for people primarily health needs. There is a Continuing Care assessment process to go through to ascertain whether you will be eligible, and there is a set of Continuing Care eligibility criteria against which your health needs should be measured.
- Mainstream news reporting often overlooks the fundamental difference between ‘social’ care and ‘health’ care. They are not the same thing.
- Social care is provided by a local authority (Social Services) and is means-tested. (Social care generally covers things like help getting washed and dressed, help getting to the toilet, etc.)
- Healthcare and nursing care on the other hand are provided by the NHS and should never be means tested. Discussions on radio and TV and reports about care fees in the press generally fail to make this distinction and, instead, lump everything together as social care – and so it’s no wonder that many families believe that everyone has to be means tested.
- The recent discussions about a future cap on care fees is all about social care (means tested care), not healthcare or nursing care. There should never be a financial cap applied to nursing care – because NHS Continuing Healthcare funding must cover all assessed care needs, whatever they are. And it doesn’t matter how old you are or whether or not you’re in a care home. (UPDATE: The proposed cap on care fees is now unlikely to happen.)
- Most families’ first point of contact with the various care authorities is with Social Services. Social Services are part of the local authority – and so straight away you are probably dealing with someone whose focus is on means testing and on care provided by the local authority. They might not even tell you that NHS Continuing Healthcare funding is available.
- The first questions you’ll be asked will probably be about money. They should be about health needs, not money. No one who needs full time care and who has health needs should have a financial assessment until they’ve first been assessed for NHS Continuing Care funding. If someone asks you about your property or savings and yet no one has assessed you for Continuing Care, ask that person why. This almost always happens in hospital, where the discharge team (often headed by someone from Social Services) will frequently ask about money before health needs have been properly assessed, and you will probably come under pressure to leave hospital before the proper assessment process is complete.
- Forcing someone with health needs to pay care fees without a proper NHS Continuing Care assessment is not only a breach of Dept of Health guidelines, but it can also be considered financial abuse and an attempt by the authorities to defraud.
- To get the ball rolling with NHS Continuing Care, ask the local NHS for a ‘Checklist assessment for Continuing Healthcare’; you can also ask a social worker, district nurse, your care provider or another health or social care professional. The Checklist is the first stage. If you get through that, you then have a full assessment.
- The full assessment must be carried out by a multidisciplinary team of people, not just one. The person/people who actually carry out Continuing Care assessments should understand both the process and the eligibility criteria – and should be properly trained in this. They must also understand the care needs being assessed.
- NHS Continuing Care is available whether you’re in a residential care home, a nursing care home, in your own home or somewhere else. The setting in which the care is provided does not matter.
- It also does not matter who is delivering the care, i.e. it does not have to be a nurse; instead, it’s the nature of the care that matters. If it is effectively nursing care, you should not have to pay for that care.
- Getting the person who needs care to set up a Power of Attorney is absolutely vital – whether you think you’ll need to use it or not. The family member holding a Power of Attorney should be involved in all assessments for NHS Continuing Care.
- If you’re waiting for a Continuing Care assessment – or if you’ve had one and you don’t agree with the outcome – read up about it as much as possible, and at the assessment itself, and afterwards, challenge anything you don’t agree with. If you have an assessment and are told you don’t qualify, there is a Continuing Care appeal process.
- Continuing Care is NOT the same as the weekly nursing care contribution that some people receive in nursing care homes (known as Registered Nursing Care Contribution or Funded Nursing Care).
- If you do agree to be means tested, the value of your property should not be included during the first 12 weeks of you being in a care home.
- If you don’t want to sell your home to pay for care, you may be able to negotiate a Deferred Payment Arrangement with your local authority.
Always remember the golden rule: In the UK, as a general rule of thumb, you don’t have to pay for nursing care.