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Forum to assist all patients to obtain NHS care 'free at the point of need' which has been the statutory right of every resident British citizen since the 1946 National Health Service Act became law.

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State Pension and Full Funding - Help Please

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cherrybaby

State Pension and Full Funding - Help Please

Post by cherrybaby on Sat 14 Nov 2009 - 19:17

Hi, this is my first post - yikes!
I have a number of questions I hope someone can help me with. I am trying to help my elderly neighbour whose wife (recently deceased) was charged for the care home she was in following a stroke; she was in the care home for 10 months.. Neighbour has not paid anything towards the care home yet but he has a bill from them for £22,457. His wife's state pension, pension credit and attendance allowance were paid into her bank account while she was in the care home and this amounted to £213 per week so there is a substantial sum sitting in her current account as neighbour hasn't touched it. Neighbours wife was obviously entitled to her state pension but should this have been paid to the care home? What should be done about pension credit and attendance allowance that was paid; I'm not sure if this should have been stopped when she went into the care home, if it should have been paid to the care home towards the fees, if it needs to be repaid back to DWP or if neighbour should keep it, obviously we want to do the right thing. (The DWP has now been informed of her death so all payments have now been stopped).
I have just started the process of obtaining a review of why she was not eligible for full funding by writing the 1st letter so will keep you updated when I receive a reply: I'll likely have lots of questions as it is very confusing and I'm sort of kicking myself for offering to help but that bit of me that hates injustice and endless red tape to keep the truth confined will keep me involved until the end.

Bob S

Re: State Pension and Full Funding - Help Please

Post by Bob S on Sat 14 Nov 2009 - 19:36

Hello Cherry,

Welcome aboard!

I'd like to say how commendable it is that you are helping out your neighbour over this.

Let's get down to brass tacks. Did your neighbour own the property and if so, was he still living in the home while his wife was a resident in the care home? If this was the case then your neighbour would not have been liable for the care home costs, assuming they did not have substantial savings. If they had savings of less than £23000 (and if they had joint savings the authorities could only look at the 50% share of your neighbours wife) then they would not be regarded as self funders.

If you can answer the above it will help us with assisting you further.

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Sat 14 Nov 2009 - 20:30

Hello Bob S
They owned their house jointly no mortgage and Mr C lives in the home; they had savings in individual names and Mrs C had more than £23,000 in savings and stocks & shares.
Thanks

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sat 14 Nov 2009 - 21:44

Hi, cherrybaby!

Good on you for helping your neighbour with this one! I’m sure he will appreciate your help. And sorry to hear that his wife is no longer with him.

Who was involved in the care home placement of your neighbour’s wife? Was it Social Services who arranged it? Or did Mr C make the arrangement himself?

And did your Mr C sign a contract with the Care Home? Has he been receiving regular bills from them, before this outrageous bill for £22,457? Or is this the first bill?

Yes, there should have been an asseessment carried out for fully funded NHS Continuing Healthcare before Mrs C was placed there. Was she in hospital before? Or still living at home?

Sorry for all the questions, but it helps to understand what you’re dealing with.

More tomorrow, but for now, welcome!

VM

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Sun 15 Nov 2009 - 12:26

The Facts:

Mrs C had a stroke in 2008 and was discharged from hospital into a care home in December 2008 & remained there until she died in September 2009. She was 77 years old when she died.

I haven’t seen the notes from the hospital so I have asked for a copy of her notes. I do however have two assessments from Social Services dated December 2008 and July 2008 and a letter regarding the assessment stating that evidence presented at the first stage of the assessment has indicated that Mrs C is not eligible for fully funded continuing healthcare. The outcome of the second stage of the assessment is that Mrs C is eligible to receive a nursing contribution of £103.80 per week paid directly to the nursing home. A second letter states that based on her financial information supplied she was assessed to pay the full standard charge and to inform them if her capital fell below £22,250.

Brief details from Social Services Assessment: Under all the heading of the FACS Branding her needs for personal care, transfers, medication, communication & diet were classed as ‘Substantial’. Mrs C had a left total arterial circulation stroke, she was dysphasic therefore her speech was limited to yes & no questions but they were not always reliable. She also had to be monitored due to the risk of aspiration. She was nursed on an airflow pressure mattress & her skin monitored for skin breakdown. She was unable to weight bear and required a hoist at all times & two staff. Her sitting balance was poor and she tended to slide over to the right side. Mrs C had a diet of soft food & due to a tremor had to be fed by staff; she also had a habit of holding food in the side of her mouth. Her fluid needs had to be monitored, prompted & supervised. She required two staff for all her personal care tasks. She required one carer to prompt & supervise her medication. She was incontinent of bowel movements & she had a catheter. She had a tendency to be very weepy & depressed & required social interaction to avoid further withdrawal; she was more reactive with family members.

I have asked for copies of all documents regarding the funding including the decision & the reason why she was determined as not meeting the eligibility for fully funded continuing healthcare. I don’t know if Mrs C was eligible for funding and research on the internet bought me to this excellent forum so I decided to request copies of all documents and take it from there, is this the best way forward?

However I am also concerned about Mrs C’s £218 weekly pension, pension credit & attendance allowance that were paid into her bank account while she was in the care home; I have no idea what should happen on this front. Mr & Mrs C were very careful with their money and managed to live off Mr C’s pension, they had one holiday a year in their caravan in Scotland & Mrs C prepared all the food for the trip so they never went to restaurants or pubs etc when they were on holiday. Mr C has an allotment so all of their (and the neighbours) fruit & veg requirements were grown by Mr C & Mrs C provided everybody with her delicious homemade cakes & jams. It is this unspent pension money that was used as the capital above the £22,250 government threshold prior to her going into the care home. They own their own home outright & Mr C lives there.

The care home sent a bill monthly for Mrs C’s care; Mr C was obtaining power of attorney so the care home didn’t push for payment, after Mrs C died a final statement for £21,827 was sent to Mr C.

Hope this helps.

Dee

Re: State Pension and Full Funding - Help Please

Post by Dee on Sun 15 Nov 2009 - 12:59

Welcome Cherrybaby. Thanks for giving us a full insight into poor Mr & Mrs Cs case and I cannot praise you highly enough for stepping in to help poor Mr C in all this.Without good folk like you people would be left thrown to the wolves and vultures. It angers me that those who scrimp and scrape to get by who are very careful with their money then get punished like this.I am new to all this too so I cant help as such but I do think you have got a good grasp of all this already and seem to be going the right way about things.I do hope that the help and support on here will lead you to victory for Mr C. I am sure your grit and determination to help him out in his time of need will achieve this.If there were more people around like yourself this country would be a far better place to grow old in.

regards Dee

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 18:05

Thanks for the facts, cherrybaby. And sorry for asking.

Copy of notes: well done. That’s step 1. Be prepared for the “Data Protection Act” to rear its ugly head, or even the FOI.

Social Services cannot carry out the required full assessment for NHS CHC – it can only be carried out by the PCT, via a MDT (multi-disciplinary team) assessment, by ‘suitably trained health professionals’. Social Services are not health professionals, not trained to evaluate health needs.

As I understand it, Social Services are only allowed to assess for social care needs, not for health needs. Even though there is now an ‘artificial distinction’
between the two. But the assessment for fully funded NHS CHC has to be carried out before an assessment for so-callled 'social care'.


We need to ask the wider world to think about this question: why do most people move into a care home? Not for fun. Not by choice; but because their health needs require a kind of ‘care’ that is not otherwise available in the community, in the society, in the social care system available from the SS.

But if I’m wrong, I hope that someone will come along and correct me there.

Have you a copy of the ‘skin integrity’ = Waterlow assessment - read here: http://www.judy-waterlow.co.uk/

Who have you asked for all these copy documents? If it is the SS, then perhaps you should ask the PCT Continuing Healthcare team for the area, rather than the SS.

The pension situation: the money is in the bank, so don’t be concerned about that. It will still be in the bank account, long after you have got to the bottom of this all.

The DWP and Benefits Agency continued to pay that money into the bank account, which leads me to think that ..... .... ... if the SS had bothered to do so, then they have links with the DWP and with the Benefits Agency, if only so as to verify whatever ABC or XYZ tells them about the benefits being received by Mr/Mrs ABC or by Mr/Mrs XYZ.

It may all hang on who carried out the required assessment for NHS CHC properly and as required, before discharge from hospital to care home. Who signed contracts, if
ever? Was anyone ever informed of the right for Mrs C to be fully assessed .... and was that ever carried out?

The history of Mr & Mrs C’s life is the history of my parents’ life too. And of the life of most people posting on this forum, trying to help others.

No frivolities; no luxuries; no squandering of monies; no wish to require support from the state, even though they contributed their full whack to that state, over their lifetimes, in the belief that if ever they needed “social assistance” as it was called in their day, then it would be available to them, simply and purely ... because they had kept to their part of the contract. But since then, the contract has been broken by government.

Sorry, cherrybaby, but I can’t add any more now. It disturbs me to read all these stories. Back tomorrow, and I hope someone else can come along and give more input to your efforts to help Mr C.

VM

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 20:40

@ cherrybaby


After reading your story, Undoubtably your neighbours wife had a primary health need, therefore the total responsibility of the N.H.S she should have been fully funded, Despite having any funds, I am glad to hear that your neighbour has not parted with any monies





he is entitled to keep all state pension, But he will have to repay the attendenc allowance that should have stopped when his wife was put into nursing care he can repay that without any fuss from the authorities I'e the D.O.P





Has your neighbour got L.P.O.A (lasting power of attorney) If not get this with urgency, then proceed down the compliants proceedure at no point pay any monies to them let them try to prove that a primary health need did not exsist, if you need any help Email Stephen Squires he will willingly help you with all information you may need, Good Luck


Regards


Mick

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 20:47

Hi, Mick!

Just to save cherrybaby the effort: the neighbour's wife (Mrs C) is no longer alive, and so Mr C is now on his own. PoA is not available to him/them.

VM

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 20:55

[quote]The care home sent a bill monthly for Mrs C’s care; Mr C was obtaining power of attorney so the care home didn’t push for payment, after Mrs C died a final statement for £21,827 was sent to Mr C.[quote]
Hi V/M
Just re read the above so hopefully the L.P.O.A Should have been granted, As it was applied for Before Mrs Cs Passing
Mick

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 21:03

Mick,

Quick thinking, Robin!!

But does power of attorney continue after the death of the donor? Dunno! It's late on Sunday evening, am a bit wearied!!

How's you? And your mum? And the family?

VM

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Sun 15 Nov 2009 - 21:24

V/M
The P.O.A Should still be granted on the financial affairs side as it seems that it was applied for whilst Mrs C was alive, if the application was submitted before her passing there should be no problem

V/M
Mother is doing fine under the circumstances, FFCC continues for another 6 months untill the next assessment, we have been restricted whilst visiting. not allowed in the lounges any more, as i have peed them off with all the evidence i had gained, This is what P.A.L.S Do when you prove your self right, you become the enemy not the offended they just contain things and sweep it under the carpet, No one listens no one cares not even the ombudsman none of the complaints departments want to know NOTHING changes When the time is right i will hit the press with all of the evidence

My appologies for high jacking this thread

Mick

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Sun 15 Nov 2009 - 23:48

Thank you for your posts and your help; however I think I am more confused than ever ha-ha; well did I expect anything else when the problem is government related – thank god for the glass of red wine in my left hand!

The money in the bank question is answered thank you – will tell Mr C to leave it where it is unless he needs it; will tell him the carer’s allowance should be paid back.

Mr C has been to see his solicitor so I assume he has the correct authority regarding his deceased wife as his solicitor knows the facts – will check with him in the morning.

The two assessments I have are headed, ‘North Tyneside Health & Social Care Services’.

Now for some help on my total confusion please.

I wrote my first letter at the end of September to Northumberland Care Trust using the letter template from ‘Age Concern’ that mentions the Grogan & Coughlan cases. This letter was passed to PCT who answered the letter on 14th October; I’ve scanned their letter and copied it below;

The Letter from PCT

I have received a copy of your letter from Ms Jackie Welsh, Commissioner for continuing care for actioning, as 1 am the Clinical manager for the Nursing assessment team, with responsibility for assessing clients eligibility for NHS Continuing care.

Firstly may I provide a response to your points outlined in your letter dated 29th September 2009.

In response to your comment about the outcome of the Grogan Judgement, I am aware of the judgement findings and in 2006 following this, the Strategic Health Authority and the PCT were asked to review their criteria and how it is implemented in line with Grogan. If there were changes to criteria, SHA’s were asked to check whether this changed any previous decisions and identity any people to be reassessed.

This resulted at the time in PCT’s reviewing all of their high band funded nursing care clients as there had been criticism of the lack of distinction between High band nursing and continuing care across the country.

Since the Grogan judgement the Department of health has developed a National Framework for Continuing Healthcare which addresses the issue of a person’s “primary health need”, as stated in the Coughlin judgement and which sets out responsibilities for both PCT’s and Local Authorities in assessing a person’s eligibility for NHS Continuing healthcare. This was implemented in October 2007 and following review a revised national framework has been brought in October 2009.

If you wish to view the current guidance it is now available on the Department of health website titled “The National framework for NHS Continuing Healthcare and NHS funded nursing care (July 2009)

I can assure you that as your wife was assessed by our team in December 2008 in North Tyneside General Hospital she was assessed under the new national framework which is used nationally and is ‘Grogan/Coughlin compliant’ and again was reviewed in April 2009 whereby she was identified as being eligible for funded nursing care but not eligible for NHS Continuing Healthcare. Both these assessments collated all the available information in relation to your wife’s healthcare needs and were carried out with yourself present, the nurse assessor, a social worker and a member of nursing staff on each occasion.

Following the assessments the information was used to apply the NHS Continuing Healthcare eligibility criteria which at each assessment it was felt, at that time she did not meet, but was then assessed for funded nursing care contributions which she was identified as being entitled to

In line with Department of Health Guidance you have the right to request an appeal of the decision to not award NHS Continuing healthcare for your wife.

Initially this will comprise of the PCT reviewing their decision not to award Continuing Healthcare and will involve examination of all of the information available in relation to your wife’s needs, i.e. Medical/GP/Local Authority/Care home notes.

I have included a consent form for you to sign and return allowing me to access the notes if you wish to pursue your appeal.

Following the PCT’s re-examination of your wife’s case we will write to you outlining our findings and outcome. If you do not agree with the outcome you can ask for an Independent review panel at the Strategic health Authority

You are welcome to have copies of the assessments carried out on your wife, which documents all her identified needs and application of the NHS Continuing Healthcare criteria.

If you have wish to challenge the criteria used by our Primary Care Trust I suggest you address these concerns to the Strategic health Authority who’s address I include;

Mr Jeff Featherstone

Portfolio Manager

North East Strategic Health Authority

Riverside House

Goldcrest Way

Newcastle upon Tyne

NE15 8NY



I’ve written a letter requesting copies of assessments but not posted it as Mr C was going to call in and sign it in the morning; it appears from your posts that I need to ask for certain documents by name; I also get the feeling that the copies of the assessments mentioned in the letter above will be the assessments I have from social services. What exactly do I ask for & should I get Mr C to sign the consent form?

There was a mention of emailing Stephen Squires; is it OK to do this & will he not mind?



Thank you so much for all your help.

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 10:57

Contact Stephen Squires by email - he prefers it that way and will not mind at all!

VM

Pussycat

Re: State Pension and Full Funding - Help Please

Post by Pussycat on Mon 16 Nov 2009 - 11:19

Oh Cherrybaby, I wish we all had a neighbour like you. How wonderful to have such a caring person as you for a neighbour. As VM has stated, email Stephen Squires he will get you on the right road as he has done for so many here. It looks like you are doing a fantastic job up to now but just need a few little pointers for the right direction. Good work Cherrybaby.

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Mon 16 Nov 2009 - 14:55

Silly question; what is Stephen's email address?

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 15:01

Good question!

Have a look at this link:

http://gpss.npl.com/nhscare/

Scroll down and then you can click on The Steve Squires page where you can scroll down again, and find the email address. (Unless it's changed!)

VM

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 15:30

Hi Cherrybaby,
What a caring neighbour you are.
Hope you don't mind me butting in but I have a general question in relation to AA.

Mick has stated
"he is entitled to keep all state pension, But he will have to repay the attendenc allowance that should have stopped when his wife was put into nursing care he can repay that without any fuss from the authorities I'e the D.O.P"

However my Dad is self funding and in a nursing home and getting AA.

On the web it states:
"If you go into hospital, your Attendance Allowance normally stops after 28 days. You will need to write to the Department of Work and Pensions (DWP) when you go into hospital and also when you are discharged.

If you go into a residential care or nursing home, your Attendance Allowance also stops after 28 days, unless you are paying the full costs of your care fees yourself."


So would it perhaps be best to wait until you do get NHSCC before paying this back,
and indeed if you are granted NHSCC are you required to pay it back??

Best of luck Cherrybaby,
Regards,
S/V

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 15:52

Yes, S/V, I spotted that too, but Cherrybaby said it was the carer’s allowance that Mr C was going to pay back, so I was a bit confused as to whether it was a reference to carer’s allowance or attendance allowance.

AA continues to be paid to self-funders, once in care. But carer’s allowance would stop being paid to whoever was claiming it as their carer. I think!

And, presumably, if CHC is agreed backdated to X-date, then perhaps the Benefits agency would reclaim the AA paid from X-date onwards. (Does that make sense??)

Cherrybaby, I agree with S/V: I would definitely not pay anything back to anyone at all. Until such time as the NHS CHC is achieved. And until such time as 'whoever' requests it. And then I’d still ask for full ‘reasons why’.

DWP and the Benefits agency were very fair indeed with us, and gave loads of time to think about everything, without any aggressive demands to pay back.

VM

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 15:52

cherrybaby wrote:Silly question; what is Stephen's email address?
Hi cherrybaby
I have sent you a private message with the email address you need, please do not put it up on the forum as it will get Spamed, Good Luck
Regards
Mick

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Mon 16 Nov 2009 - 20:26

Thanks everyone going to email Stephen now.
It is attendance allowance Mrs C received not carer's allowance; just me getting confused with all the terminology. I've told Mr C not spend the AA but to hang on to it until this battle ends!!
Kind Regards

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 20:40

Correct!

Keep it in the bank account. Until and unless ...

It will not earn any interest there, but just keep it.

QUESTION: Why do they all make these systems so difficult for us 'normal human beings' to navigate?

ANSWER: Because we are all normal human beings - but they are ABNORMAL HUMAN BEINGS!!

Night night!

VM

Esquires
Moderator

Re: State Pension and Full Funding - Help Please

Post by Esquires on Mon 16 Nov 2009 - 21:12

A couple of points to remember: 'Grogan' was heard in a lower court and the Coughlan judgement by the Court of Appeal therefore takes precedence. They ruled that ALL Pam Coughlan's care was the sole responsibility of the NHS and "beyond the scope of Local Authority services".
The law is summarised by the Law Society in their submission to the Commons Select Committee: "The judgement in Coughlan clearly establishes that where a person's primary need is for health care, and that is why they are placed in nursing home accommodation, the NHS is responsible for the full cost of the package."
This is not 'just legal opinion' but established FACT: ALL Pam's care and accommodation is indeed provided 'free at the point of need' (at Mardon House, Exeter) by the NHS and social services have no role to play.
The unequivocal fact is that anyone with health needs equal to or exceeding those of Miss. Coughlan MUST be entitled to 100% NHS funded care. To provide anything less amounts to gross discrimination and is therefore unlawful. Also note that Pam would not qualify for NHS care under ANY of their 'eligibility criteria' which must therefore be wrong and unlawful because the Appeal Court cannot be!

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Mon 16 Nov 2009 - 21:23

Thank you everyone for all your help; now that my pension query has been answered should I start a new post for the continuing care review for Mrs C or just continue with this post?

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Mon 16 Nov 2009 - 21:31

Go on, be brave! How about a new thread called:

Mr & Mrs C's Continuing Care Review

then we'll all be with you, kindly caring neighbour cherrybaby, and will know who you are and what you're up to on behalf of Mr C.

VM

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Mon 16 Nov 2009 - 22:18

Ha-Ha thanks VM; I know everybody thinks I'm being so kind helping Mr C when in reality he asked me a question regarding the care home etc and I did some research on Internet and it got me somewhat angry so I volunteered to sort it for him; jeez I've got enough to do with bloody work and family blah blah but he is a nice gentleman. The reason I thought of the new post was I need as much help as possible and I didn't want the pension bit on the header putting people off helping me coz they think the post is a pension query. I take it you don't approve.....

fimac4

Re: State Pension and Full Funding - Help Please

Post by fimac4 on Mon 16 Nov 2009 - 22:33

Hi cherry baby, welcome.
Tell your neighbour to hold back on paying anybody back at the minute. If he wins a claim for retrospective NHS funded continuing care he will not be expected to pay back ANY 'retained benefits"...pension, Attendance Allowance etc. The NHS can take these benefits into account when deciding which rate of interest to pay when paying recompense for funds lost. They have to pay EITHER RPI ignoring the value of retained benefits or 8% making an adjustment for any retained benefits.
It might be of interest to new posters to note that pensions are no longer downrated on admission to hospital.
The omb report "Retrospective continuing care funding and redress" pulished MArch 13th 2007 and the DOH "NHS Continuing Healthcare: Continuing Care redress" 14th March 2007 give more details of what is downrated and what is allowed. Attendance Allowance is cancelled after 28 days for anyone funded by the NHS for example.
Just go ahead with the retrospective claim and sit tight until that is dealt with.
Good luck.
Fimac4

PedroPete

Re: State Pension and Full Funding - Help Please

Post by PedroPete on Tue 17 Nov 2009 - 0:32

Finmac4
" Attendance Allowance is cancelled after 28 days for anyone funded by the NHS for example." not true if the care is delivered in your own home.

Peter

fimac4

Re: State Pension and Full Funding - Help Please

Post by fimac4 on Tue 17 Nov 2009 - 9:13

Hi Peter
yes it is cancelled after 28 days as is disability living allowance, but if you are making a retrospective claim you are not expected to pay it back directly. The PCT has to work out both rates of interest and pay the one most beneficial to the claimant.
The important thing for new claimants to know is that they don't have to start handing money back, it will be sorted out when they get to the redress stage and the PCT have to pay them.
Like everything related to NHS funded care it is not made easy and law abiding people can get very worried as it is difficult to understand how this wretched system is supposed to work let alone how it does work.
Fimac4

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 17 Nov 2009 - 9:19

Document from Warwickshire which is fairly up-to-date : April 2009

http://www.uki.net/php/files/welfarepages.uki.net/pb55.pdf

Here's one from Age Concern dated Feb 2008 - and it shows how complicated the whole business has been made:

http://www.ageconcern.org.uk/AgeConcern/Documents/IS13CarehomefundingandAAFeb08.pdf

Good luck!

VM

PedroPete

Re: State Pension and Full Funding - Help Please

Post by PedroPete on Tue 17 Nov 2009 - 13:25

Hi Fimac4
I still disagree because I have it in writing from my Dept of Work & Pensions office that if I win NHS CHC my DLA will not be withdrawn or reduced in any way, even the care component.
May we beg to differ.

Regards
Peter

fimac4

Re: State Pension and Full Funding - Help Please

Post by fimac4 on Tue 17 Nov 2009 - 18:14

Hi Peter, I hope you are right, hang on to the letter or whatever that gives you that assurance in writing.
I don't have your knowledge of DLA just put that in as an example taken straight from the DOH report NHS Continuing Healthcare: Continuing Care redress, which states that DLA will be "reduced to nil ater 28 days". It adds in the notes that "the DLA higher rate mobility component will continue to be paid over to Motability's service providers in relation to a hire purchase/contract hire of a "motability" vehicle. Any amount of DLA remaining will not be paid over to the customer".
This information is at the back of the report and given some of the "misinformation" many of us have been given over the last few years i have little faith in anything the NHS tell me.
This is such a minefield but we are all on the same side here.
Best wishes Fimac4

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Wed 18 Nov 2009 - 0:57

Letters requesting copies of documents posted; guess I just sit back and relax for a while!

frankie

Re: State Pension and Full Funding - Help Please

Post by frankie on Wed 18 Nov 2009 - 15:05

My understanding is that if someone is living at home the care component of DLA will stop once someone is deemed to be eligible for CHC, however the mobility component will continue. This will not affect any other income related benefits. If in a care home or supported living environment both stop with 28 days notice.
The previous comment is correct that the PCT would have to deduct any "state " related payements made as the "stat" should not pay twice, however as Mrs C never made a payment this is going to make matters messy for Mr C and Cherryboy as noone has paid therefore if eligible the PCT might clear the bill then leaving Mr C to repay any payments received.
I would suggest that you have a conversation with the care home in case they start any legal proceedings against Mr C to reclaim the money as they might well say its not there problem and Mr C and PCT need to sort out and they can't afford to loose the money!

Frankie

www.embracecontinuinghealthcare.co.uk

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Thu 19 Nov 2009 - 14:44

I thought the full funding would be NHS pay care home less state pension as this seems fair to me. If the care home get funny and start threatening legal action I will get Mr C to pay the pension to the care home to keep them quiet for a bit. Will keep you informed.
Mr C is still in the process of probate as there was no will so he cannot access the money yet so care home have no choice but to wait untill probate is sorted.
Regards

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Thu 19 Nov 2009 - 15:13

Cherrybaby,

This is the way I understand it all:
NHS CHC is, as you say, full funding.

NHS CHC can be paid to anyone over the age of 18 once the assesssment has been done and NHS CHC agreed.

So the fact that someone is in receipt of the state pension has nothing to do with it. Please don’t let Mr C pay the pension to the care home, because it won’t keep them quiet. If the care home get funny, point them in the direction of the PCT.

And Mr C is not responsible for paying the care home – or any other bill left by the deceased Mrs C anyway – the ‘estate’ of Mrs C would be, if it were proven that a debt was owed. The probate process must be gone through first, and anyone with a claim on Mrs C’s estate will just have to wait patiently. And that includes the care home – who can most probably afford to do so, more than Mr C.

Frankie, may I disagree with you on what you have suggested to Cherrybaby? The care home would be extremely unlikely to start legal proceedings against Mr C, because the debt (if there is one) is a debt of Mrs C's estate - nothing to do with Mr C. And I dare say Cherrybaby or Mr C have already told the care home the 'state of play'. The care home will just have to wait until the slow slow probate process has completed, and even then they care home will have to wait until the PCT have done the necesary.

Does everyone else agree with my thinking on this 'debt' (if there is one)?

VM

Guest
Guest

Pensions are NOT deducted under any circumstances since 2006!

Post by Guest on Thu 19 Nov 2009 - 15:50

Cherrybaby

The correct information is:-

1. Mr C must not under any circumstances pay any pension to the care home. If NHS CHC is achieved after appeal, then NOTHING is deducted, ALL pensions
are payable in full, no deductions since 2006.

2. If in receipt of NHS CHC, then the full pension is KEPT (note to frankie), what on earth is your comment, 'cos the state pays twice'
What is that all about??, why not something like the 'elderly, vulnerable abused by the NHS and LA person pays twice, three times when these authorities can get away with it by cheating them out of NHS CHC masquerading as Social Care only)

Enclosed the link to the redress document , which has a matrix at the end.

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/@pub/@ppg/documents/digitalasset/dh_073093.pdf]

The state pension used to taken off a person once in hospital.
In 2003 it changed to after 52 weeks.
In 2006 it changed completely and was abolished, now I wonder why that was?????? maybe something to do with human rights, discrimination........

A retirement pension has been earned, not to pay for care as a lottery, Mr F, if the govt could keep it, they surely would, so from 2006, and before of course, they have to find other ways
to get it from this vulnerable portion of people.

Another extortion scam is businesses offering their 'services' for a service that it immeasurable, unless there is an underlying hidden agenda regarding NHS CHC that they know and we don't?

Cherrybaby

If Mr C has not signed any contract with the home, he is not responsible.
Yes the SS/LA if they aren't allowed to assess or refused, can assess as having an ability to pay, and will defer the debt and try to put a charge on property if they can.

They just wait in prey building up the debt, until they can, supposedly invoke it on some poor unsuspecting soul, at the first opportunity.
Yes VM is right, the debt in doubt, is Mrs. C's, the home cannot take action against Mr. C.

iwillwincc

Re: State Pension and Full Funding - Help Please

Post by iwillwincc on Thu 19 Nov 2009 - 19:39

Hello Cherrybaby
Please contact ESquires as soon as possible and in the meantime welcome to hell on this earth. There is one piece of good news for you I notice you have not yet joined the advanced club of which I consider myself the founder member with a glass in both hands!!!???
In your position I would ask for a copy of the notes related to the staff training courses run to train the so called professionals in your PCT/SHA. Then I would look and see how they compare with "AGNES" the ALZHEIMERS example in the notes of Lynn Phairs a Consultant Nurse for the elderly in the CRAWLEY PCT. If you google her name and the PCT you will readily find the information, if not ask me for it on this site.
Regards
Alex

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Mon 28 Dec 2009 - 23:44

Apologies for the delay in returning to the forum but the usual work/family stuff has kept me busy.

Thank you for the information regarding the care home; to date Mr C has not paid anything towards the account although he is itching to pay something due to the demand letters from the care home who state they are aware he now has probate over Mrs C’s affairs (think Mr C’s solicitor must have told them that probate is sorted as care home wrote to solicitor soon after Mrs C died (I have copy of the letter to solicitor from care home). I will ensure Mr C does not pay anything to care home, however Mr C did sign as guarantor on the care homes ‘Acceptance of Terms & Conditions of Admission & Residence’.

I know have copies of the documents requested from the PCT including the covering letter that states in the last paragraph, ‘May I offer you the opportunity to meet with me & the nurse assessor who completed your wife’s assessments, once you have had the time to examine the documents, to discuss the information gathered & the process of assessment / application of continuing care criteria?’

I’ve now read & analysed the copy documents from the PCT & I really need lots of help. After my 1st letter to the PCT I received a response (scanned in earlier post) referring us to the current guidance on the Dept. of Health website titled, ‘The National Framework for NHS Continuing Healthcare (July 2009). I’ve read this & I’ve sort of got my head around the decision tool however this states that the criteria are based on an answer of ‘A, B, or C’.

The NHS Continuing Healthcare Needs Checklist from the hospital on 24.11.2008 when Mrs C was discharged is completed with ‘A, B or C’ & the results are A: 4, B: 4, & C: 3.

The decision tool used by the PCT in the care home some 10 days later on 03.12.2008 is completed with ‘Priority, Severe, High, Moderate, Low & No Needs’& their results are Priority: 0, Severe: 0, High: 3, Moderate: 4, Low: 0 & No Needs: 4.

Why have they not used the national frameworks decision tool with A, B or C? (Yes I know the answer; to confuse us blah blah blah! How do I compare the two assessments?

Do we meet with the PCT as they suggest & confront them with the different criteria or do I put it in a letter?

All of your suggestions help greatly accepted & appreciated & I hope you can understand my ramblings,,,,,,,,,,,,,

Dee

Re: State Pension and Full Funding - Help Please

Post by Dee on Tue 29 Dec 2009 - 8:31

Cherrybaby

Personally I would do everything by letter and keep it all 'on
record' I would send the evidence and a copy of the NHS framework tool with a covering letter - this is your evidence to present further .You can then take the letter to any meetings and make
sure that it is the focal point of the discussion as they may very well
try to swerve you off course to suit their agenda.

I would write first and see what they say before agreeing to a meeting. Those are my thoughts maybe someone else will beg to differ as they are more experienced and knowledgable than me.

regards Dee

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 29 Dec 2009 - 12:04

Hi Dee
Thanks for the help; makes sense to keep everything in writing; plus I'm not very good at meetings & tend to forget things. Will do the letter today; have a feeling it may take more than 5 minutes!
Regards Cherrybaby

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 29 Dec 2009 - 12:23

Hi Cherrybaby,

I may be wrong - and hopefully one of the 'experts' on this forum will come along and correct me, if I am indeed wrong - but, as I understand it the Checklist comes first in the process.

The Checklist is intended to identify people who need consideration for CHC and who may or may not be referred for full consideration after the Checklist has been carried out.

Then, the Decision Support Tool comes into it, and it does have different 'scoring methods/domains'.

Have a look at this link, and make sure you scroll down to the dates relevant to you:

http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Continuingcare/DH_073912

Where it says:
The versions of the tools in effect until 30 September 2009 can be accessed by following the links below.



VM

Dee

Re: State Pension and Full Funding - Help Please

Post by Dee on Tue 29 Dec 2009 - 13:08

Someone please correct me if I am wrong.I am consistantly having problems understanding this assessment and toolkit thing.

As I wasnt involved in my late fathers care I dont know a jot about these tool kits and assessments etc - maybe this is a good thing I dont know.

I tend to totally ignore this aspect as a result of not knowing anything about it as I feel its a ploy to drag you down another route distracting you from the facts and being able to manipulate issues off the funding entitlement under the Health Act.

The facts being there is a proven health need - full stop- so the care must be funded. Never mind about level this that or the other its all a load of bunkum or am I wrong?

If there is strong evidence ( as it would seem in this case) of a health need which can be proven by Medical Evidence and also specific benefit entitlement then the rest no longer comes into it surely?

Or am I looking at this far too simplistically and I am way off track?

Sorry I truly dont wish to confuse issues for anyone - far from it but I am sorry no matter how I try I just cannot grasp all this tick boxing stuff and absorb the fact that it decides if care is free or funded by the person.

Please can someone put me out of my misery and explain why I just cant get this?

Have I missed something vital that ensures the proven health need is totally ignored and the box ticking takes over and has full precedence?

Thanks sorry to be a pain but I just dont get it.

Dee

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 29 Dec 2009 - 13:54

Excuse the language but bloody hell this is bloody ridiculous; how is anyone supposed to understand all this bloody red tape? Guess I know the answer; they don't want us to understand it they just want even more of our hard earned cash!!
Thanks for the info; I think I understand - the document from the hospital with the A, B & C was to find out if Mrs C was eligible for funding. The document from the PCT with the priority, severe, high, moderate, low & no needs was the actual decision tool.
OK; why is the PCT decision tool so different from the hospitals checklist? Surely the hospital are the experts!
When I write a letter is my argument, why have the PCT 'downgraded' Mrs C from the info on the hospital checklist eg. Continence got an 'A' from the hospital but only a 'Moderate' from the PCT etc.
Also how do I find out the criteria for full funding from the PCT - the hospital decision tool states more than two or more domains with 'A' require a full assessment for CHC - this is fairly simple.
How many severe, high, moderate etc qualify for full funding? Where are the guidelines for this?
Am I on the right track?

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 29 Dec 2009 - 14:18

The Checklist was to find out whether Mrs C could be considered for NHS CHC funding. If the Checklist had determined 'no', then it would not have gone any further unless spouse/family/carers specifically asked the PCT to undertake a full assessment for CHC funding. And most don't because they don't even know they have that right. And it is a legal right.

The DST is the one with the domains all listed, but differently!

Pages 4 and 5 of that DST doc give more of an indication of how the decision goes further. It is the totality of someone's needs that should make them eligible.

Remember that this "Primary Health Need" jargon is fairly nonsense. If I remember correctly, the "primary" was originally "primarily" which is different. But I can't remember all the ins-and-outs of the Coughlan and Grogan judgements. If my memory serves me well, Judge whatever-his-name-was said that Coughlan's needs were primarily health needs, and that the NHS was legally responsible for providing for those health needs, and nothing to do with social services.

But in brief: IT'S ALL A LOAD OF CODSWALLOP! Designed to confuse, irritate, vex, anger .... all people, apart from the SS and the PCT who don't understand it all either.

That's not very helpful is it, but you're right - it is bloody ridiculous. And it doesn't apply to any other section of the population, as far as I can see - only the older generation. Why on earth does anyone move into a care home? Not by choice, normally. But because their health has deteriorated to such a stage that they need .... health care. Primarily. But then, the authorities wouldn't be able to rob the old, would they, if they acknowledged that. Ggggrrrrr,,,,,!!!!

VM

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 29 Dec 2009 - 14:36

OK I've found the document that tells how many highs, moderates etc are needed for full funding (link below) so will digest the gobbledygook and get back with my findings ha-ha watch this space!
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103329.pdf

Guest
Guest

Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 29 Dec 2009 - 14:44

Careful, Cherrybaby, that one's for 2009. You need the one that was in place in 2008.

VM

cherrybaby

Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 29 Dec 2009 - 15:20

Thanks VM; Just as well I didn't print the 60 pages! Hopefully the link below is to the various years!
http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Continuingcare/DH_073912

Pussycat

Re: State Pension and Full Funding - Help Please

Post by Pussycat on Tue 29 Dec 2009 - 20:54

I am sometimes in awe at the fantastic help that is given on this board. VM, you are brilliant. You are always there with the help and guidance needed for anyone at almost anytime. And you still always give me a titter at some of the funny little quips you come up with. Long may you reign.

bodecia2007

Re: State Pension and Full Funding - Help Please

Post by bodecia2007 on Tue 29 Dec 2009 - 21:15

Its a mandatory " pass " for NHS FULL FUNDING if the person scores 1 Priority or 2 Severes. The rest is, frankly, a shambles because you are at the subjective mercy of the PCT panel. My Mum scored 1 Severe and 5 High's and was denied Full Funding. But if we lived in another area then they may have " passed " her with these scores. Madness.
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