We recently secured NHS continuing healthcare funding for a family struggling with the cost of care
Mr KP’s family contacted us in 2016 to instigate the Continuing Healthcare process. Mr KP had been living at a Nursing Home for approximately 3 ½ years prior to contacting Compass CHC and at no time was a referral made by the Nursing Home for a Continuing Healthcare Checklist, despite Mr KP’s declining health.
Mr KP has intense and complex healthcare needs. In brief, Mr KP is severely cognitively impaired with advanced dementia further to suffering several strokes. He is unable to speak or communicate his basic needs in any way and is fully dependent on staff to do everything for him. He is at risk of aspiration and choking due to his reduced swallowing function and behavioural issues, placing him at considerable risk of harm. Mr KP’s nutritional status is also at risk due to refusing food and fluid, which also places him at risk of UTIs. Mr KP is immobile and suffers with pain which has an impact on his compliance with care, as well as his psychological and emotional needs. He has a dislocated shoulder and is unable to assist or co-operate with transfers or repositioning. Due to the risks of serious physical harm carers must handle Mr KP with caution.
We conducted a stage 1 investigation where we gathered and reviewed the Care Home records. We encountered issues along the way as the Care Home were reluctant to the disclose records which delayed matters. We drafted detailed representations which we submitted to the Clinical Commissioning Group (CCG) to support our contention that Mr KP was eligible for NHS continuing healthcare funding. We requested a Checklist to be carried out as soon as possible.
The CCG cancelled a number of continuing healthcare Checklists, which delayed matters, and initially refused to carry out a Checklist as the family did not have Power of Attorney. We requested that the Checklist be carried out in Mr KP’s best interests in accordance with the National Framework. At the initial meeting, The Care Home manager was hostile and it was apparent that she had already made her mind up that Mr KP should not be in receipt of continuing healthcare funding. Our CHC Team continued to chase the CCG for a Checklist date over telephone and through correspondence.
Our advocate, Natasha Cattel, represented Mr KP at both the Checklist and Decision Support Tool meeting (DST). We secured a date for the Checklist in May 2017. Mr KP satisfied the CHC Checklist criteria and we pushed for a full assessment to be carried out as soon as possible. We also requested for a Social Worker to be present at the DST. At the DST in June 2017, the Care Home staff appeared to have inaccurate knowledge of Mr KP’s needs and downplayed his needs in a number of domains. Our experienced advocate was fully prepared for the meeting and could put forward evidence to contradict the inaccurate information provided by the carers, and therefore achieved higher levels of need in key domains.
Due to the efforts of Advocate Natasha and the entire Compass CHC team, Mr KP was recommended for full NHS continuing healthcare funding at the DST meeting.
Should you, or a relative, have any concerns regarding NHS Continuing Healthcare funding, or you are thinking about starting the funding process, our expert advisors can assist by explaining the ins and outs of what can be a perplexing and complicated process. There is no time limit placed on this free, no obligation consultation. Should you wish to discuss matters further, do not hesitate to contact us directly on 0121 227 8940