Sorry if this has been asked before but I cannot find it in the forum, If a patient leaves hospital and is transferred directly into a "Care home" (No contract has be signed or agreed) should the patient be automatically accessed for CHC by the local PCT or has this to be requested by a relative (The patient has be deemed to lack capacity),

Thanks

Yes, neixs04, before someone is discharged from hospital there should have been the required assessment for CHC.

A relative does not need to request this - it is the required Discharge from Hospital procedure. Especially if someone is deemed to lack the capacity to request that him/herself. It is part and parcel of the discharge from hospital procedure.

Here's a link to the Alzheimer's Society factsheet - not that I'm a supporter of the Alzheimer's Society:

http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=173

In the interests of fairness, here's a much better factsheet from Age UK about discharge from hospital:

http://www.ageuk.org.uk/Documents/EN-GB/Factsheets/FS37_Hospital_discharge_arrangements_fcs.pdf?dtrk=true

With references in that last link to other factsheets that might help.

VM

Hi Victoria, thanks for your quick response, this information will help as I am challenging my local PCT regarding assessment, they may claim they carried out this assessment but I will ask them why I was not notified or given any information.

Ask them for a copy of it in full - and make sure it's dated and signed appropriately.

Google the local NHS for the area you're dealing with - search out their own Hospital Discharge Procedure for the NHS involved .


VM

Hi Neixs04. I posted this under a different thread and hope it helps as along with VM's recommendation I suggest the AgeUk factsheet on CHC procedure, becuae it sets out what should happen nice and clearly. Also read the stickies on this forum. All you need is up here - just a lot to wade through!



Not before the PCT have assessed (at checklist level as a minimum) is the very short answer I think, although as VM writes the LA will quote their duty to work in co operation with the NHS as soon as they believe patient may need support upon leaving BUT the NHS should ask your permission to alert LA before doing this.


I found the Age UK fact sheets very helpful. No. 37 Published in May 2010 AM064 called Hospital Discharge Arrangements outlines the lawful and appropriate entry point of the LA if your rel is in hospital.

http://www.ageuk.org.uk/Documents/EN-GB/Factsheets/FS37%20Hospital%20discharge%20arrangements%20May%202010%20-%20AM064_fcs.pdf?dtrk=true

This factsheet will take you through the S2 notice procedure under The Community Care (Delayed Discharges Act) 2003 and direct you to The Delayed Discharges (CC) Directions 2009 which is states what the NHS should do re CHC assessment before they notify LA.

It also directs you to NHS Continuing Healthcare (Responsibilities) Directions 2009 which applies if the case is not covered by the 2003 Act, or where the patient lives at home or in a care home.

There are other excellent factsheets in this series including one on CHC.

http://www.ageuk.org.uk/Documents/EN-GB/Factsheets/FS20%20NHS%20continuing%20healthcare%20and%20NHS-funded%20nursing%20care%20September%202010%20-%20AM067%20-%20AM069.pdf?dtrk=true

They are always clear and give links to the statute and regs addressing the specific area.

It is also important to remember the stage you are at in CHC assessment at any given point, as this also impacts on when the PCT can lawfully have the case transferred to the LA - as the refs above will show.

Overall, bear in mind S21 National Assistance Act and whether your rel's case is outside the remit of the LA. If it is then it can't be transferred - although there will be a major squabble at that point with the PCT about what is a health need, or a primary health need, and what are social needs, (50p and a cupcake says the PCT will deem them all social needs!) and at that point you can decide whether or how you want to appeal that decision.

So,start with the basics and see if they have been followed is my suggestion. Thereafter be clear about who and what you are challenging.

Have a good look at the AgeUK factsheet on finacial assessment before considering whether you will complete it. Don't get rushed into doing this, or let your rel. complete it alone - especially if their capacity is questionable.

Not sure where you are with your rel's case, but I hope that helps.

This thread raises an interesting point regarding discharge procedures and the importance of obtaining all medical and associated records as soon as possible. It is all very useful ammunition later. When my father in law who was in a nursing home at the time was being reviewed for CHC, the assessor wrote to us and said that she had been unable to find the consent form signed by fil or his advocate for the CHC assessment on discharge from hospital. She enclosed a new consent form and asked us to sign it.
Having obtained all his hospital records we actually had a copy of the ‘consent form’ from the hospital in our possession. It had been signed by a nurse ‘with my husband’s permission’ apparently!
We did fill in the new consent form at the time of the review but worded it as follows
‘The NHS informed us that xxxx has to be in a nursing home because he needs 24 hour care. We have not been informed that Social Services have accepted the responsibility for his care. This consent is for the review process from date onwards and is for continuing healthcare eligibility ONLY. It does not give retrospective permission for any previous assessments carried out in xxxx hospital, when no information about the assessments was given and no consent to do an assessment was given by Mr xxxx or his advocate at the time.’

We also had a copy of my father in laws referral information to Social Services (notification under section 2(3) of the Community Care (Delayed Discharge Act 2003)) which stated that an assessment had been completed (some weeks before his discharge) and that he did not require Continuing Health Care funding. It also stated that he would be going home to his bungalow with a package of care provided by social services! This assessment had been done before he had acute kidney failure etc etc. In other words the hospital had not carried out the correct discharge procedures. As I said – all interesting ammunition for later.