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State Pension and Full Funding - Help Please

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Re: State Pension and Full Funding - Help Please

Post by Dee on Wed 20 Jan 2010 - 9:55

Cherrybaby could I PM you on something?

regards Dee

Dee


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 19 Jan 2010 - 8:55

It is all madness & as you say Bodecia2007; my fight is in Northumberland and this has the 2nd lowest funding by NHS in the country so Mrs C had no chance from the outset.
The latest letter was posted at the weekend so I suppose we sit back & wait; don't suppose they will be so eager to arrange meetings now they know there are two of us fighting from one corner instead of one; hopefully they now have some 'work' to do by answering my questions that so far they've ignored but I'm not holding my breath as I'm certain they have many previously used underhand tactics under their belt to flabbergast us with

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Thu 14 Jan 2010 - 19:21

Jewel1958 - What have they got to gain - thanks for the info and maybe we would all react that way in order to keep our jobs. I remember many years ago a documentary did something similar to the statement you posted; They took 20 men; had them live together for a while so they became friends then they took them to a prison scenario making 10 of the friends prison guards & the other 10 prisoners; can't remember how long it took but the guards started behaving like guards rather than friends - shouting at them, running their batons along the rails to wake them or to annoy them etc. Maybe it's inbuilt in us all.
Lyn - thanks for the support on the letter; I never know if I'm on the right track! I will keep up the fight as it's a swarm of bees in my bonnet & I'm not one for giving up easily. Took a holiday company to court once; took 3 years & ended up in the small claims court; holiday company bought a London Barrister & Solicitor & flew the Rep from Tenerife against me & my daughter (we were bloody scared as hell) The Judge saw it our way and we got all the money back plus lots of costs etc; We went straight from court to the pub but boy the next day we suffered ha-ha.

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by lyn on Thu 14 Jan 2010 - 11:02

Good letter cherrybaby. We had an assessor sit in our house for over 4 hours taking a 3rd assessment, and it was still rubbish. It is not time (though 10mins. is just ridiculus) it is quality. I have all the information/reports sent in to the assessor to add to their assessment, and the reports do not relate to the assssors report, so she obviously did not take much notice of them. In fact our specialist parkinsons nurse report was so detailed from the first assessment that we should never have had to wait a year before we eventually got funding, but no one took any notice. Keep up the fight, I know how you feel, you get a bee in your bonnet, and you just have to fight on. I am hoping to help someone on this forum, only because this forum helped me so much, and you feel it is about time these ********* should do what they are paid to do, CARE, HELP AND TREAT PEOPLE WITH DIGNITY. lyn

lyn


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Wed 13 Jan 2010 - 22:37

I've drafted a letter regarding the meeting and would appreciate any feedback, corrections etc if anybody has the time. Hopefully one day I'll have so much knowledge on this funding malarchy I'll be able to return the favours and help someone just starting on the long and winding road!
Here goes; the letter

With reference to our meeting on xx; I thought it best to confirm the discussions we had regarding Mrs xx NHS Funding.

Regarding the assessment of Mrs xx on (date) Mr xx informed you at the meeting that the assessment lasted less than ten minutes & was a done deal before he arrived’. You did state that the ten minute assessment may have been due to the assessors having all the medical documents at hand prior to Mr xx’s arrival and this may well have been the situation; however both myself and Mr xx believe a full and proper assessment couldn’t possibly have been carried out in such a short period.
On (date) two assessments were carried out on Mrs xx. The first assessment was ‘NHS Continuing Healthcare Needs Checklist’ & the second ‘quickie’ assessment was ‘NHS Care Assessment’; The 1st Assessment records skin integrity as a ‘B’ – needs regular monitoring & assessment, nursed on a pressure relieving mattress, the 2nd Assessment records skin integrity as ‘No Needs’.
How is it possible that two assessments carried out within a few hours of each other changed so drastically from a‘B’ to ‘No Needs’? Maybe this was overlooked in Assessment 2 as this test alone would surely take almost ten minutes bearing in mind that the four individuals, ‘Staff Nurse xx, Social Worker xx, RGN Nurse Assessor xx & Mr xx would have had to look at the skin then agree the outcome.
There are other anomalies between the two assessments however we don’t see the need to go over these at the moment as the priority is to ascertain how a full quality clinical assessment of Mrs xx including communicating the findings fully with Mr xx could be carried out in less than ten minutes.
Mr xx stated at the meeting that he wanted to move Mrs xx to another care home as he disliked xx Lodge as he believed his wife was not being cared for properly. Mr xx was very upset at this point stating they’d been married for 53 years and thinking about her treatment still upset him very much resulting in his blood pressure being extremely high.
Mr xx didn’t gain access to Mrs xx’s bank account until after her death so he didn’t have the means to pay the account at the care home; he believed that unless the account was up to date he wouldn’t be able to move her. However had Mrs xx had a full and proper assessment of her needs full funding may well have been in place but unfortunately the quickie assessment meant Mr xx lost the chance to move his wife to another care home that he believed would look after his wife properly and give her back the dignity xx Lodge had stolen from her.
Sadly there is nothing that can now be done to remedy this situation as Mrs xx passed away in hospital with a perforated abdominal viscus and septicaemia of the left knee. When Mrs xx was admitted to hospital the Doctor at the hospital asked Mr xx how his wife had fallen and why they had waited so long after the fall to bring her to the hospital, the Doctor stated the injury was old due to the level of the septicaemia. Mr xx confirmed to the Doctor that he wasn’t aware she had fallen.
Mrs xx couldn’t communicate and would therefore have suffered terribly for some time; however what is even more damming is that the injury could only have happened at xx Lodge and they failed to report it preferring instead to let Mrs xx suffer in silence.

I look forward to your findings.

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Jewel19581 on Wed 13 Jan 2010 - 17:26

Hi Cherrybaby

I am full of admiration for you in helping your neighbour as you are - there aren't many like you.

You asked why the PCT staff 'have to gain'. A while ago I posted an extract from a book I read by a psychologist who worked in the NHS for decades. It's partly about how people do things in their own 'interest' either consciously or sub-consciously. Here it is again (my own underlinings):

‘Taking Care – An Alternative to Therapy’ written in 1987:



QUOTE At a less personal level, it may be easiest to see how, for instance, interest can disguise itself as necessity by examining the conduct of people other than ourselves; let me take directly from my own experience an example which I think at the same time illustrates processes typical of the ‘managerial’ ethos of so-called ‘post-industrial society’ on a much wider scale. The activity of some NHS administrators has in recent times undergone a striking change from the concerned, meticulous support of procedures of clinical care once characteristic of them to a kind of swashbuckling managerial bravado in which cuts in services to patients and jobs of staff are made with apparent indifference or even satisfaction. The same people whose conduct not long ago would have been cautious, balanced, concerned for fairness, now speak the hard, almost macho language of ‘the real world’ and of the need for ‘efficiency and effectiveness’, and actually express pride in cutting costs by measures which, ironically, are clearly neither in their own direct interests nor in those of the staff and patients for whom they are responsible. But there are ways in which their interests are caught up in this process. Their perceived interest lies in their ‘image’ of themselves as ‘managers’ – no longer are they seen by ‘colleagues in industry’ as bumbling clerical functionaries doing a second-rate job of administration in an over-protected public service: they are managers making the kinds of hard but necessary decisions made by executives of oil companies (as seen on TV). They conform to a style and rhetoric which has been sanctioned and endorsed from high above them by governmental power aimed at dismantling public health care. Their negative interest lies in the feeling that if they did not so conform there could be a threat to their jobs, though apart from this there is no tangible advantage to their conduct,* and indeed considerable impairment to the moral quality of their work. These are decent people whose conduct springs not from some kind of illusory personal autonomy, but from a social context structured by interest.



· * Since these words were written the British government has adopted an altogether more workmanlike approach to the manipulation of managerial interest. The Guardian, 3 Sept 1986, reports that: ‘Health Authority managers could be denied an annual pay rise if they fail to achieve their individual targets under the Dept Health’s new merit pay system … But those “consistently exceeding short-term objectives and making excellent progress towards long-term goals” will be awarded an extra 4 per cent on salary in the first year … Health service unions have attacked the plan as an incentive scheme for accelerating hospital closures and service cuts …’ The article goes on to describe how each tier of management will be ‘assessed’ by those next highest in authority. This provides as good an example as any of how interest can be manipulated via a pyramidal hierarchy (‘management’) in order to achieve higher-order political goals.UNQUOTE

Interesting 'insider view' isn't it ? ......

Regards and very good luck
Margaret

Jewel19581


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Re: State Pension and Full Funding - Help Please

Post by Pussycat on Wed 13 Jan 2010 - 17:19

Cherrybaby, the answer to your question 'what have they got to gain' is simple £££££££££££££££££ !!!
Also you are not on the wrong track as long as you treat these people as though they have two bodies, one you can see and one that is hidden . Unfortunately both bodies are not good, as the one you can see is normally with a 'sickly' 'sympathetic' 'friendly' voice and the one hidden is the one that is thinking money money money. Can't trust either.

Pussycat


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 12 Jan 2010 - 23:52

The good side of or maybe the stupid side of me thinks they wouldn't do this would they & what have they to gain? The 'what have they to gain' question has me somewhat mystified - can someone help on this?
However the more I think about it the more it does seem that this is what they were doing; I've written 3 or 4 letters to the PCT for Mr C and each time they state they are happy to meet with him to discuss; I completely ignore this when I reply as I'm not good in face to face meetings when I'm uncertain of the facts. However on Friday Mr C calls to tell me PCT have been on phone & he has agreed a meeting at 10 am Tuesday (today). I state I'd rather not meet & I can tell Mr C is flapping so I tell him no problem we'll meet; I think to myself what the hell get a grip & lets see what they have to say; I also think they must know he has someone helping him, in fact I nearly call them prior to the meeting to tell them I'll be at the meeting but I get bogged down with work & forget all about it. Also when I wrote requesting copies of the assessments they phone Mr C & ask him to collect them which he does & they pass the usual pleasantries & give Mr C the copied documents; maybe they were checking him out - he is slight, very nonthreatening & looks like the typical granddad!!
Someone please tell me I'm on the wrong track.

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Pussycat on Tue 12 Jan 2010 - 23:17

Cherrybaby, I would have liked to have seen their smug faces when they arrived at your neighbours expecting a frail old man on his own and a pushover!! Absolutely fantastic that you were there to slap these bafoons down and lay the law down ( their laws that they don't even know'). I bet they were smug on the way there in their car having a chat about 'this won't take long', but I bet there was a completely different conversation on the way home !

Pussycat


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Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 12 Jan 2010 - 21:45

's easy!

Water + apples/rhubarb/pears/whatever + sugar + yeast + leave to 'ferment' + stir + stir + stir along the way + leave + drain off the dregs = wine.

Give or take the odd intervention by a SS W = Social Services Witch. That is why you need to 'drain off the dregs'.

Then sit back and enjoy. But most of us haven't yet got to the point of draining off the dregs, so that we can all sit back and enjoy. BUT WE WILL!!

WE WILL GET THERE.

VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 12 Jan 2010 - 21:31

sorted

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 12 Jan 2010 - 21:28

cherrybaby wrote:Is jesus in hell cos he can turn water to wine

So can I!!!

VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 12 Jan 2010 - 21:24

Is jesus in hell cos he can turn water to wine

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 12 Jan 2010 - 21:04

Dee wrote:I think the Council here have reserved a very hot seat for me in Hell.I must be public enemy no 1.

As if I care.

reagrds Dee

Well, in that case, Dee .... move over, because that hot seat is destined to meet more than just your bum! Mine's already on the way to that VHS in Hell!

See you all there - can't wait! that should sum up most of us ... thus far!!

VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by Dee on Tue 12 Jan 2010 - 20:38

I think the Council here have reserved a very hot seat for me in Hell.I must be public enemy no 1.

As if I care.

reagrds Dee

Dee


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Re: State Pension and Full Funding - Help Please

Post by tired and fed up on Tue 12 Jan 2010 - 20:36

See you in the other place cherrybaby!

tired and fed up


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Re: State Pension and Full Funding - Help Please

Post by Dee on Tue 12 Jan 2010 - 20:29

Maybe I'm just evil for thinking such thoughts & I'll never go to heaven

Oh you will!You have caught them out a blinder good for you! Bet they didnt see this coming!

regards Dee

Dee


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 12 Jan 2010 - 20:23

Bob S; of course it makes sense that there must be something to compare with.
Due to my extensive knowledge of NHS Continuing Care ha-ha I pointed out at the meeting that Pamela Coughlan would fail their test (plagiarised from my friends above) & the reply was again, it depends on the intensity of the individual - what the effing hell is this intensity? it's as clear as mud & basically made the meeting a farce & a total waste of time. However as stated over & over on this forum that you mustn't trust them I'm sitting here glass of red vino in one hand laptop in the other pondering on the meeting & I'm thinking that the PCT may have insisted on a meeting as they had no idea that Mr C was being helped by me until they turned up for the meeting this morning & I was introduced to them as the letter writer, investigator & gobbledygook reader - bet they arranged the appointment cos they believed they would be meeting with one person - a very nice gentleman married for 54 years who misses his wife dreadfully aged 81! Maybe I'm just evil for thinking such thoughts & I'll never go to heaven..............

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Bob S on Tue 12 Jan 2010 - 19:19

Cherrybaby,

Well done for keeping the fight going. One thing that is totally bull sh*t is the claim by the PCT eprson that you can't compare cases. It states quite clearly in the National Framework that you can compare cases when trying to get continuing care.

Bob S


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Re: State Pension and Full Funding - Help Please

Post by bodecia2007 on Tue 12 Jan 2010 - 18:48

Forgot to say and our case is following a DST done June 2008 in which Mum scored 1 severe and 5 high's ........

bodecia2007


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Re: State Pension and Full Funding - Help Please

Post by bodecia2007 on Tue 12 Jan 2010 - 18:47

Well done CB. However be prepared for this procrastination to be " the norm ". Our case went to Health Ombudsman in June of 2009. Still nowhere in limboland ...........

bodecia2007


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Re: State Pension and Full Funding - Help Please

Post by Guest on Tue 12 Jan 2010 - 18:42

Well done, Cherrybaby.

Remember rule no 2 (or whatever!): write a letter now to your PCT person confirming everything that was discussed today. They all have a habit of 'not recording' verbal communications, so it's important for you to do it. Make it as long as you need it to be - send it by Recorded Delivery (or deliver it by hand and ask for a receipt) - and then check that it's been received. Again, it's amazing how many letters 'never reached us'.

Make sure you ask your PCT person to let you know BY RETURN details of the PCT's local review process and timescales - read paragraphs 150 - 152 of the NHS National Framework again (link below to it) and quote them in your letter. Ask for a copy of the PCT's local review process and timescales to be sent to you. A heavy workload is not a good enough excuse if the timescales indicate that it should be carried out promptly. Define promtply!!

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103161.pdf

Oh, one more thing - unless you push and push, that 6 weeks will turn into .... 12 weeks before you can even blink!

Good on Mr C for coming up with that important info. Did you ever get a copy of the full reasons why it was turned down last time? And full details of the then-ten-minute-assessment? If not, ask for them.

VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Tue 12 Jan 2010 - 18:12

PCT received my letter & arranged an appointment for this morning at Mr C's house to discuss the assessment. At the meeting I asked PCT person why they concluded that Mrs C's needs where not health but social & as expected I didn't get a 'normal' reply but was told the assessment was based on the 'intensity' of Mrs C's situation blah blah blah. However a rather upset Mr C went on to tell us exactly what happened (he'd never mentioned it to me previously); apparently Mrs C's assessment by the PCT took less than 10 minutes, he continued to state that it was a 'done deal' before he arrived as basically they went thro a list of questions asking him if he agreed & they ticked some boxes & asked him to sign the document which he did, he continued by stating he didn't have a clue what was going on or what they were talking about. (He was 80 when the assessment was carried out in December 2008).
I then asked the PCT person if a full assessment normally took less than 10 minutes & PCT person stated that maybe they had all the medical records & other relevant documents at hand. I objected by stating that it was impossible to assess someone correctly in such a short time & this alone needs to be looked into.
A few other things were discussed such as the Coughlan case etc. but again he said you cannot compare one person with another as it was down to the intensity of the individuals situation.........!! The meeting ended with me stating I wanted this to be taken further & that I was prepared to continue to the Ombudsman as I believed Mrs C had been incorrectly assessed; PCT person said they would look into it and get back with his findings but due to his workload it may take between 4 to 6 weeks for his response; I accepted this and PCT person left.
I guess we now sit back and wait for the gobbledygook to arrive in about 6 weeks.
Cherrybaby

cherrybaby


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State pension etc

Post by Alexb1 on Fri 8 Jan 2010 - 20:47

This will be very complicated,but my mum is in a nursing home fully funded at the moment as I cited Annex E of the NSF when they wanted to discharge her; she is still rceiving her pension ,the only thing to have stopped is her attendance allowance.
Who paid for her care when she was in? Who agreed to it;it is hard work but itis worth reading the NSF on continuing care and if her primary need was a health need then she shouldn't have to pay so you have nothing to pay back.
You may have to return the Attendance allowance if that was still being paid.
I am still trying to sort out my mums funding 15/12 after a major stroke leaving her unable to do anything much.
Don't sign anything or accept responsibility for things until you are exactly sure as to what is happening.
Alexb1

Alexb1


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Re: State Pension and Full Funding - Help Please

Post by Dee on Fri 1 Jan 2010 - 11:27

Good letter Cherrybaby.

My only suggestion is

By refusing my wife NHS Funding your team concluded that her principle need was accommodation and not her health;

However its fine as it is!

Good luck with this.

regards Dee

Dee


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Re: State Pension and Full Funding - Help Please

Post by Guest on Wed 30 Dec 2009 - 21:09

Here ya go V/M
HAPPY NEW YEAR TO ALL MAY 2010 BRING THE RIGHT RESULT

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by Guest on Wed 30 Dec 2009 - 20:58

cherrybaby wrote: Now where do I go to join that forum where everyone has a glass of wine in each hand?

No idea where you'll find that forum. This forum only survives on A Bottle of Champagne in each hand!!


Make your own cocktail out of the above!! Then shake and stir, or not as the case may be.

And, in case I don't get back before the start of 2010, may I wish everyone a very comfortable 2010.

I can't find a champagne cork popping to enthuse and add that bit of sparkle, but no doubt some clever person out there can do that for me.


VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Wed 30 Dec 2009 - 20:28

HI VM
Thank you so much and I will change it as you suggested. It has taken me almost 2 days reading up on this & getting my head around it all so I can write a couple of paragraphs; my husband was expecting to check a 10 page letter due to the time I've spent. Now where do I go to join that forum where everyone has a glass of wine in each hand?

cherrybaby


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Re: State Pension and Full Funding - Help Please

Post by Guest on Wed 30 Dec 2009 - 19:46

Good letter!

I suggest changing the words

" .... your team agreed that her principle need ..." to "your team decided that her principle need ...."

and

" ....my wife’s principle need was accommodation and health was secondary to the accommodation ..." to " my wife’s principle need was for accommodation and that her health was secondary to a need for accommodation"

That's just my first thoughts.

VM

Guest
Guest


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Re: State Pension and Full Funding - Help Please

Post by cherrybaby on Wed 30 Dec 2009 - 19:25

I've drafted a letter regarding Mrs C case and listed it below; if anybody has the time please can you have a quick look and leave some feedback good, bad, rubbish etc as I'm not really sure if I'm on the right track with this letter. I have plagiarised some your posts for parts of the letter; hope you don't mind!

Thank you for your letter of 30th November 2009 and the copies of my wife’s NHS Continuing Health care Assessments.
In my initial letter of 29th September 2009 I stated, ‘I am concerned that the tests in the Coughlan & Grogan cases were not applied to my wife’s case’. You responded in your letter of 14th October 2009 by stating, ‘Since the Grogan Judgement the Dept. Of Health has developed a national framework for continuing health-care that addresses the issue of a person’s ‘primary health need’, as stated in the Coughlan judgement & which sets out responsibilities for both PCT’s & Local Authorities in assessing a person’s eligibility for NHS Continuing Health-care’. You further state, ‘I can assure you that as your wife was assessed by our team in December 2008 at NTGH she was assessed under the new national framework which is used nationally & is Coughlan / Grogan compliant whereby she was identified as being eligible for funded nursing care but not eligible for NHS Continuing health-care.
I have now read the National Framework for NHS Continuing Health-care; it states (Annexe B: The Coughlan Judgement Page 51) ‘where a person’s primary need is a health need, the responsibility is that of the NHS, even when the individual has been placed in a home by the LA’.
Ms Coughlan’s case was decided in the highest court in the land therefore it is unlawful to provide anything less to other individuals. By refusing my wife NHS Funding your team agreed that her principle need was accommodation and not her health; if her principle need was health she would have received NHS Funding as stated in the Coughlan Judgement. Please supply a full explanation as to how your team concluded that my wife’s principle need was accommodation and health was secondary to the accommodation.
Upon a full response I will make a decision as to my next step regarding my late wife and her entitlement to funding.

cherrybaby


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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.

bodecia2007


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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.

Pussycat


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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

cherrybaby


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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

Guest
Guest


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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

cherrybaby


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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

Guest
Guest


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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?

cherrybaby


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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

Dee


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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

Guest
Guest


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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

cherrybaby


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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

Dee


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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,,,,,,,,,,,,,

cherrybaby


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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

iwillwincc


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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.

Guest
Guest


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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


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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

cherrybaby


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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

frankie


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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!

cherrybaby


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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

fimac4


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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

PedroPete


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