Do you have to move into a nursing home if you’re eligible for NHS Continuing Healthcare?
We hear many reports from families whose relatives have secured NHS Continuing Healthcare funding, but who are then told their relatives will have to move if they want to actually receive the funding.
So where can a person receive NHS Continuing Healthcare funding?
If you qualify for NHS Continuing Healthcare funding:
- and you receive care at home
- or you receive care in a residential care home (without nursing)
…you don’t have to move into a nursing home to be given the funding. You can stay right where you are – as long as it’s appropriate for your needs.
NHS Continuing Healthcare funding does not depend on what kind of place you live in. Simple as that.
Let’s look at what the NHS Continuing Healthcare guidelines say…
Page 10, paragraph 13 of the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care states:
“Eligibility for NHS continuing healthcare places no limits on the settings in which the package of support can be offered or on the type of service delivery.”
…and page 21 paragraphs 56 and 58 state:
“NHS continuing healthcare may be provided in any setting (including, but not limited to, a care home, hospice or the person’s own home). Eligibility for NHS continuing healthcare is, therefore, not determined or influenced either by the setting where the care is provided or by the characteristics of the person who delivers the care.”
“The reasons given for a decision on eligibility should NOT be based on the… setting of care.”
Page 122 gives a definition of NHS Continuing Healthcare:
“NHS continuing healthcare: It can be provided in any setting. Where a person lives in their own home, it means that the NHS funds all the care and support that is required to meet their assessed health and care needs. Such care may be provided either within or outside the person’s home, as appropriate to their assessment and care plan. In care homes, it means that the NHS also makes a contract with the care home and pays the full fees for the person’s accommodation, board and care.”
In all this, the NHS is however able to take into account relative costs of providing care in different settings; at the same time, any such costs must be genuine costs for the individual in question – and the individual’s needs still remain paramount in this.
It’s worth having a look at page 107 paragraph 83.2 in this respect, which confirms that:
“The starting point for agreeing the package and the setting where NHS continuing healthcare services are to be provided should be the individual’s preferences.”
Regarding care homes, families often report being told that Continuing Healthcare isn’t available in this care home or that care home. If you’re told that, keep the above in mind.
You could also reassure yourself by asking the care home manager whether they currently have – or have had in the past – residents with NHS Continuing Healthcare funding. If the answer is yes, then the NHS cannot really justify telling you your relative can’t be there.
Remember also that if your relative qualifies for NHS Continuing Healthcare funding, the contract for that funding is between the care home and the NHS. The care home shouldn’t not ask you for any top ups for that funding.
If the Continuing Healthcare payment from the NHS isn’t enough to cover your relative’s needs, the care home must take that up with the NHS. This should be done as a matter of urgency, to ensure the safe ongoing care of your relative.
So if a funding assessor tells you and/or your relative you have to move to be eligible for NHS Continuing Healthcare, quote their own National Framework guidelines back to them.