Thank you for all the advice and information over the last few days. We managed to get the Psychological and Emotional domain up from no needs to high! The outcome of the meeting was that the recommendation was that my mum was eligible for CHC in October 2010!! Of course we have to wait for the panel's decision but we feel that we had a result today.

The only down-side is that the guy from the PCT stated that through no fault of theirs, the meeting didn't take place until today and therefore the funding might only be in place from March this year when they first offered us a review. We have not hurried the process as have not been asked for any money since October 2010 and wanted to prepare for the meeting and arrange a date that my brother, sister and I could all attend.

Can they do this? No one at any time told us that there was any sort of time limit on appealing and from what I have read on this forum usually it is the PCT 'dragging their feet'

Excellent news jonsmum (I hope).

If a person is eligible for CHC from Oct 2010, they should get it at least until the next DST assessment, I believe.

I do not believe there is any time limit to appealing. Of course we need time to prepare, gather the information thjey have used etc etc.

You should get it from Oct 2010 until now and on to the next DST assessment / review.

If it was stated that she was eligible since Oct 2010, then that is when it should be paid from.

We appealed an assessment that took place in April 2007, and the IRP did not take place until Feb 2009. The IRP actally said MIL was borderline eligible back to start of Oct 2006 - and it was paid from Oct 2006.

Delay due to PCT has noth to do with date of eligibility.

jonsmum wrote:Thank you for all the advice and information over the last few days. We managed to get the Psychological and Emotional domain up from no needs to high! The outcome of the meeting was that the recommendation was that my mum was eligible for CHC in October 2010!! Of course we have to wait for the panel's decision but we feel that we had a result today.

The only down-side is that the guy from the PCT stated that through no fault of theirs, the meeting didn't take place until today and therefore the funding might only be in place from March this year when they first offered us a review. We have not hurried the process as have not been asked for any money since October 2010 and wanted to prepare for the meeting and arrange a date that my brother, sister and I could all attend.

Can they do this? No one at any time told us that there was any sort of time limit on appealing and from what I have read on this forum usually it is the PCT 'dragging their feet'

i did read about your case when you first posted on this forum, and I am glad have some good news, But will you refresh me on something. What about BEFORE Oct. 2010 ? What I am trying to get at is the length of time in a nursing home etc, as payment SHOULD start from there. If you mentioned this in your last thread, forgive me for not remembering it, but you may be eligible for more than they offer (beware Greeks bearing gifts). That is all I would like to know at present.

jonsmum wrote: The outcome of the meeting was that the recommendation was that my mum was eligible for CHC in October 2010!! Of course we have to wait for the panel's decision but we feel that we had a result today.

Well done! You do indeed have a result.

But don't hold your breath yet.

The 'recommendation' from today's meeting was that your Mum was eligible for CHC in October 2010. It is not unknown for the 'recommendation' to be overturned by the PCT even tho' the PCT should not overturn any recommendation without very good reasons. But it happens sometimes. So be prepared to challenge that one if it arrives on your doorstep.

If the PCT does not overturn that recommendation, then CHC is payable from the date of October 2010, according to today's meeting decision. But you may still need to mount a retrospective challenge, if you want CHC to be payable from before 2010.

Meanwhile, good news!!

VM

FM - before 2010 my mum was in receipt of full CHC from April 2009 when we first applied for it. At that time she was in a Residential Home. The decision to move her to an EMI nursing home was made with the full approval of the PCT in October 2009.

Glad you got a good result jonsmum.

jonsmum wrote:FM - before 2010 my mum was in receipt of full CHC from April 2009 when we first applied for it. At that time she was in a Residential Home. The decision to move her to an EMI nursing home was made with the full approval of the PCT in October 2009.

OK fine, and tks for that, but was she in a home before even then? In other words, she should have been receiving fully funded care from day one. Is the April 2009 date (when you made the application ) the same period when your mother went into a home? And you say "Residential Home" but I am assuming that this where she was ALSO receiving medical care?

Sorry to play around with words, but I think you have now got a good idea of what you are up against, and they could throw "nursing care" "social care" and "already in a home" at you later - a lot of nonsense of course, but I am attempting to give you some armour when that time might come. Hopefully it won;t

FM - Mum was in a Residential Home from June 2008, where she also received medical treatment. We are not thinking of claiming for the period before April 2009 as she was doing ok then. She deteriorated really rapidly in March/April 2009 and we quickly applied for and were granted CHC. By October 2009 she could not be managed at the Residential Home and was moved to an EMI Nursing Home by the PCT.

Well done Jonsmum

I just wish we had the same PCT as you !! If only they all followed the same rules

Congratulations Jonsmum.

They don't like it up 'em!

jonsmum wrote:FM - Mum was in a Residential Home from June 2008, where she also received medical treatment. We are not thinking of claiming for the period before April 2009 as she was doing ok then. She deteriorated really rapidly in March/April 2009 and we quickly applied for and were granted CHC. By October 2009 she could not be managed at the Residential Home and was moved to an EMI Nursing Home by the PCT.

I think you should consider claiming, but of course that is entirely your own decision, but I would be careful, From what you have told me, it seems to be OK, but the "two homes" might be used against you in the future, and there could be nit-picking ( these people are good at this) if some argument comes about at some time.

This is not a reason to give you anxiety, only attempting to warn you to keep a careful watch but I feel sure that you are doing this anyway.

Well done jonsmum I hope everything goes straightforward for you.

FinnMicky, I would be grateful for any `Armour` you could throw my way regarding `social versus `nursing care` and the `two homes` issue as I have a LRP pending and will probably end up at IRP.

As you know my mother entered `residential care` in Feb 2011 and we applied for CHC straight away, our first DST/MDT was May 2011 and we were turned down saying her needs were `social` and she was in her `prefered residential` blah blah.

We then put in for reveiw on change of needs grounds and our second MDT/DST was held Oct 2011 and we were told three weeks later we had been successful but they would only award from August 2011 as this was when palliative care became involved! I expressed that I think it should have been from May and I will appeal the period Feb to May but they have chosen to ignore me. They are now trying to move mum into nursing but unfortunately she has a severe chest infection ( she has lung cancer) and the palliative nurse says she is too sick to move and they should have done it sooner and is insisting that they nurse mum in her current `residential` home and move her to the hospice when her end is here {providing there is a bed) Needless to say it is not going down well with the CHC people.

My question is are we helping or harming our case keeping in her current placement? and if and when her infection clears would we be better to go along with them? and what should we reply to them regarding this issue of them only paying from march? As you say I am VERY wary of greeks bearing gifts!

She has had `health ` needs since entering care and has had frequent specialist and doctor visits but as you know they insist it all hinges on physical `nursing input`.

shaz1 wrote:Well done jonsmum I hope everything goes straightforward for you.

FinnMicky, I would be grateful for any `Armour` you could throw my way regarding `social versus `nursing care` and the `two homes` issue as I have a LRP pending and will probably end up at IRP.

As you know my mother entered `residential care` in Feb 2011 and we applied for CHC straight away, our first DST/MDT was May 2011 and we were turned down saying her needs were `social` and she was in her `prefered residential` blah blah.

We then put in for reveiw on change of needs grounds and our second MDT/DST was held Oct 2011 and we were told three weeks later we had been successful but they would only award from August 2011 as this was when palliative care became involved! I expressed that I think it should have been from May and I will appeal the period Feb to May but they have chosen to ignore me. They are now trying to move mum into nursing but unfortunately she has a severe chest infection ( she has lung cancer) and the palliative nurse says she is too sick to move and they should have done it sooner and is insisting that they nurse mum in her current `residential` home and move her to the hospice when her end is here {providing there is a bed) Needless to say it is not going down well with the CHC people.

My question is are we helping or harming our case keeping in her current placement? and if and when her infection clears would we be better to go along with them? and what should we reply to them regarding this issue of them only paying from march? As you say I am VERY wary of greeks bearing gifts!

She has had `health ` needs since entering care and has had frequent specialist and doctor visits but as you know they insist it all hinges on physical `nursing input`.

The straight answer is that you are totally entitled to fully funded care, and the rest of this is just 'mucking around'. She is obviously very ill indeed, and the 'social care' argument comes up time and time and time again. If you can spare some of that time, then take a trawl through the Stickies. Esquires has dealt with this over many years, but this social care nonsense is just a red herring - very red indeed.

As ever this is nothing more than emotional bullying. You and Jonsmum are in a very vulnerable state, and the health people know it, and take full advantage of it. No matter how they do it - good cop, bad cop, or more probably, good nurse, bad nurse - they only want one result. A signature on a piece of paper saying you - or your mother's estate - will pay. Don't sign. for goodness sake.

And DO NOT feel guilty about anything, and don't allow them to make you feel guilty in any way. You are doing the right thing by your mother, purely because she needs the right kind of healthcare. She needs experienced medical staff, and that is it. You have done everything necessary for your mother so far.

And, as I asked jonsmum, do you have Power of Attorney? That is a very important weapon in your fight, and believe me, it is a fight, and you will need strength as you are fighting for your mother and everyone else in your position - think of it like that.

Keep me informed.

Yes i do have power of attourney. I just await a date for the IRP at which i will be appealing against their refusal at mum`s first MDT back in may. Just wondered if there was anything i could put in writing now regarding their current offer for CHC only paying from august to try to `persuade` them to backdate it to the last MDT and then i will only have to appeal the period feb to may.

shaz1 wrote:Yes i do have power of attourney. I just await a date for the IRP at which i will be appealing against their refusal at mum`s first MDT back in may. Just wondered if there was anything i could put in writing now regarding their current offer for CHC only paying from august to try to `persuade` them to backdate it to the last MDT and then i will only have to appeal the period feb to may.

Well, it is worth trying, but don't let them negotiate you down or anything like that. You know how much is owed to you (plus eight per cent) so that is the figure you want. There is every possibility they will say NO, as they are reading from a script made up in Whitehall, but you never know. Unfortunately you are on the carousel of meetings, meetings meetings, and they will not give you the decision you want - these get-togethers have one purpose and one purpose only - to exhaust you.

So there is another weapon for you - you now know why this is happening.

Tell them that if they don't promptly pay up (with interest added at the 'County Court' rate) from the date your mum entered a care home you will file a complaint with the Ombudsman. This would entail a lot of work on their part so they may choose the easy option. Hint that if they don't pay you will commence litigation. They CANNOT refuse to pay simply because a patient moves/moved into a care home because 'care shall be provided free at the point of need'. This can be in a hospital, hospice or other institutional environment, in the patient's own home or that of a relative or carer or for that matter a garden shed or tent in a field - the location of the 'point of need' is irrelevant! Steve.