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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.

    Nursing and residental EMI care

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    kensmydad

    Nursing and residental EMI care

    Post by kensmydad on Fri 2 Apr 2010 - 16:55

    Hi all
    My father has Alzheimers stage 6/7, vascular dementia, is having TIA's and recently his second Subdural haemorrhage, he has hallucations along with aggressive behaviour issues.
    He has just been assessed not meeting the "eligibility criteria" for CHC and passed to the LA for residential EMI care. The PCT have not sent the results of the DST and are requesting proof of LPA, even though this was not needed to participate in the assessment, during the assessment we had to agree to differ on behaviour and cognition. He has has been awarded NHS nursing care which cannot apply if sent to residential care?
    Can you still get CHC if you are in a residential care home?

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Fri 2 Apr 2010 - 17:27

    kensmydad wrote:
    Can you still get CHC if you are in a residential care home?

    Yes!

    Whether you are living in your own home, in a residential care home (without nursing) , in a residential care home (with nursing), or on a boat floating on a cool calm river - you can get CHC.

    The 'setting ' of your care is totally irrelevant.

    There must have been an internal memo sent round all PCTs telling them to demand LPA from anyone wishing to appeal/challenge on behalf of a vulnerable, elderly person in need of healthcare. It is absolute bulls..t! So you challenge them in return, and ask them to provide the National Framework reference - or other reference - where it states that only LPA appointed persons can challenge them.

    VM

    katykat

    Re: Nursing and residental EMI care

    Post by katykat on Sat 3 Apr 2010 - 5:09

    Kensmydad, you dont say where your father is at present. If he is in hospiatl, you may have a stronger hand. Refuse to accept the DST decision and the advice to pass on th LA. Refuse to have any dealings with Social Services & absolutely refuse to give them any fianancial details. If you dont have LPA, you should apply to the Court of Protection for receivership as someone will need to take control over his finances. But even then, refuse to give SS any details until the challenge is settled. You should instigate a challenge ASAP. Until it is settled, the PCT is legally abliged to pay the fees, wherever he is receiving care. If your father is in hospital, the PCT will eventually place him in a home, but they are still obliged to pay the fees until it becomes the health ombudsman decision.I think you are still entitled to have a say in the choice of home, but I'm not too sure about that.

    kensmydad

    Re: Nursing and residental EMI care

    Post by kensmydad on Sat 3 Apr 2010 - 6:44

    Thanks Ladies
    He's been in hospital 12 weeks now, and I feel cabin fever is setting in?
    Social services have all our details after He was restrained (4 or 5 security/doctors) after punching his wife then security staff in the A&E dept. and needed to be sadated. It is a long story many procedural errors, will explain all on a new thread when I have more details.
    We have EPA signed and witnessed but not registered yet. I intend to call after the bank holiday and see if they will accept this? I do intend to appeal but need the DST results as the assessor and I, her words "we would have to agree to differ" on a couple of the catagories, then saying "I'll seek advice and check records" before entering a grade.
    Katykat I have been following your case across the forums as your case appears to be the closest to my own situation. I wish you and all good luck with our appeals.

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Sat 3 Apr 2010 - 7:43

    Was your Dad kept in hospital under Section 117 of the Mental Health Act, by any chance? Because if he was, then that alone may place the onus on the PCT and LA to fund his care after discharge from hospital. But it would depend on which section he was sectioned under, if you get my meaning?!

    And when was the EPA signed? As long as it was before 1 October 2007, then you are required to register it once the Donor loses the capacity to handle his own financial affairs. So you won't have any problems with registering it.

    Or is it an LPA, created after 1 October 2007? If it was an LPA, then was it a Property & Finances LPA, or do you also have a Health & Welfare LPA? Again, no problems should exist with registering either of those two LPAs.

    But the old-style EPA only covers financial matters - not health and welfare.

    If you don't have the Health & Welfare LPA, then you'd need to apply to the Court of Protection to be appointed Deputy - unless you think your Dad still has the mental capacity to agree to and sign a H&W LPA.

    As KK said, repeat until you're blue in the face that you challenge the assessment, and insist on all info being given to you. Make sure you're present at it, and do your own assessment too - with any evidence from 'other people'.

    Sign nothing; give no details of finances to anyone - and certainly not the SS; don't sign a contract with a care home if they place your father into one; make sure you are involved in the choice of care home, if that comes about. But as KK said, he's best kept in hospital for the time being. If your father is very aggressive, or likely to become so again, then there are very few dementia residential care homes that would be able to cope with him - and he would need a care home with nursing. But be prepared for the fact that there will always be a res. c/h that will accept him, and then decide they can't cope - and he'd need to move again .... and again ... and that can cause him even more disturbance.


    VM

    kensmydad

    Re: Nursing and residental EMI care

    Post by kensmydad on Sat 3 Apr 2010 - 8:54

    No he didn't get sectioned admitted with confusion?
    The EPA was signed in july 2007 but is not for health and wellfare. His wife participated in the DST and would have thought she should be privy to the results? We did say at the assessment when he fails for CHC we would appeal, We need to see the results to decide on what to appeal on? We have verbally told SS, PCT, the discharge coordinator and t5he hospital PALS that we will appeal.

    bodecia2007

    Re: Nursing and residental EMI care

    Post by bodecia2007 on Sat 3 Apr 2010 - 10:24

    Just read your post Ken.

    BEWARE the Nursing Care Contribution !! [ if I could add alarms here I would ]. This is a payment that the NHS make DIRECT to the Nursing Home of about £110 per week. BUT some care home companies KEEP this ON TOP of the fees [ £500 + per week depending on where you live ]. This is yet another scam to line the care home companies pockets. So in effect the person is no better off financially.

    It is NOT NHS Full Funding.

    It clearly states in the National Framework that relatives should be involved in all assessments. And how on earth can relatives possibly get an LPA [ which is a fairly newly introduced document ] when the person is mentally incapable of signing anything ? This is just another excuse for the NHS/PCT/SS to try to not involve the family !!

    Keep appealing Ken for NHS Full Funding.

    bodecia2007

    Re: Nursing and residental EMI care

    Post by bodecia2007 on Sat 3 Apr 2010 - 10:50

    And I forgot to add that they seem to have no problem with " involving the relative " LPA or not when it comes to paying the NURSING HOME FEES. So yet again one rule for them quite another rule for us !!

    From what you have described do not let him be dishcharged into an EMI/Residential home he needs an EMI NURSING Home . They will not be able to cope and it is totally unfair to him. As VM says they like to try Residential first. It happened with our Mum and on her 2nd night we got a call from them at 9pm asking us to move her to an EMI Nursing Home. It was extremely distressing for Mum and us as we had to get a taxi with all Mum's belongings in a black bin bag [ they couldn't find her case ] and totally undignified.

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Sat 3 Apr 2010 - 15:41

    Surely EMI being as we all know is elderly mentally infirm should qualify as free care in any event?

    Or am I missing something here?

    Bodecia I didnt anything know about this practice of care homes keeping monies like that.

    Are they allowed by law to do this sort of thing?

    Regards Dee

    Bob S

    Re: Nursing and residental EMI care

    Post by Bob S on Sat 3 Apr 2010 - 16:01

    You would think so Dee, but if they can avoid paying by any means then they will. The local authority in my father's area have stated that my father is appropriately placed in an EMI nursing home, but they still won't initiate the disputes process with the NHS, even though he was fully funded for two years, until the NHS "cooked the books" and said he was no longer eligible.

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Sat 3 Apr 2010 - 16:10

    Bob it makes you want to swear doesnt it?

    This all seems to me to be a form of legalised extortion and I query the legal bit there too.

    I feel I am dealing with a bunch of grave robbing bandits and rob dogs .I havent even got round to getting in touch with the NHS yet.So far its been a stinker as to the antics so pity help what is to come.

    Regards Dee

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Sat 3 Apr 2010 - 16:14

    Dee wrote:Surely EMI being as we all know is elderly mentally infirm should qualify as free care in any event?
    Dee,
    Being elderly doesn't qualify you for free care. Nor does being infirm. And dementia is not classed as an illness - for some obscure reason. It's seen as a 'problem' requiring social care alone. The CQC have done away with the term EMI - even though it's still used in parts of the country, but not in others, apparently. But the term now used when they register a care home for dementia care is De. They've now shrunk DEMENTIA down to just two letters - De. How long before DEMENTIA disappears completely from their thinking?

    The 'miracle cure' for all ailments of anyone who should be seen to be 'a vulnerable person' (with or without dementia) with health needs is the DST!

    Once they bring out the DST - lo and behold, massive improvements can be seen in people who still need care. Not for fun - but because of their health.

    Funny world we live in.

    VM

    Bob S

    Re: Nursing and residental EMI care

    Post by Bob S on Sat 3 Apr 2010 - 16:20

    Dee,

    There is very little that is legal about their antics. They routinely ignore the policies and guidelines and when you complain they come up with any old excuse to justify their unlawful actions.

    The one thing I have found though is that 6 months after they stopped funding my father, they have yet to take any formal action against us for refusing to pay his care home fees. It has been threatened but I think they realise that if they go anywhere near a court that their own failures to follow policies, procedure and the law will be exposed for all to see. They know they can't pursue me for the costs as I am not liable (despite the care home solicitors claiming to the contrary) and with the introduction of the Health and Social Care Act 2008, the old liability of relatives under Section 43 of the National Assistance Act 1948 has now been repealed, so they can not pursue my mother for any costs incurred by the local authority in respect of my father's care.

    bodecia2007

    Re: Nursing and residental EMI care

    Post by bodecia2007 on Sat 3 Apr 2010 - 16:54

    Dee no matter what the label is they won't fund anyway. Mum has been in an EMI Nursing home/s since 2004. Her present "care" home [ which they are ALL called now ] charges £500 per week PLUS they get the RNCC of £110 per week direct from the PCT which is NOT deducted off the bill. Apparently they use a " legal loophole " to do this. Well if you can believe that as I was told this by the PCT.

    Helkat

    Re: Nursing and residental EMI care

    Post by Helkat on Sat 3 Apr 2010 - 18:03

    Our relative was on a 'dual-purpose' unit where EMI nursing and EMI residential patients were cared for alongside each other - if their needs were 'upgraded' to nursing, they stayed exactly where they were, same care, same room,everything. When RNCC was awarded the home put up their fees by the same amount at their annual fees review.

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Sat 3 Apr 2010 - 19:55

    Well pardon the language but I am ruddy disgusted by what you have now all
    told me.

    It beggars belief there again is there anything at all
    about the scandal of denial of free care that doesnt?

    My Dad
    had no less than 3 terminal illnesses ( 2 were the named as causes of death too) as well as all the rest of his ill health
    problems and needs but even that didnt stop them the Council nor
    their partner the Care manager.

    Bob you said

    The one
    thing I have found though is that 6 months after they stopped funding my father, they have yet to take any formal action against us for refusing
    to pay his care home fees. It has been threatened but I think

    they realise that if they go anywhere near a court that their own failuresto follow policies, procedure and the law will be exposed for all to
    see.

    Sorry Bob but never ever underestimate the stupidity
    and arrogance of these people or their dirty tricks either.This
    lot here are gold medallists in all 3 events.Also dont forget the courts preliminary hearings - directions etc are held behind closed doors and cases can be led in a certain way when nobody is around to witness them too when you havent got a solicitor.

    Now dont think that wouldnt happen either.Because all roads seem to be pointing that way - so be warned.

    Do not underestimate the nature of the beasts you are dealing with.

    Regards Dee

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Sat 3 Apr 2010 - 19:59

    Dee wrote: Do not underestimate the nature of the beasts you are dealing with.

    As if we would!

    VM

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Sat 3 Apr 2010 - 20:02

    True.

    However the deeper into their labyrinth you are dragged the nastier the beast becomes.

    katykat

    Re: Nursing and residental EMI care

    Post by katykat on Sun 4 Apr 2010 - 13:46

    Yes, it is true about the Nursing care contribution. When my mum was transferred from residential to nursing- same home but different floor- the NHS contributes £106 pw, the fees went up £120 pw.
    Does anyone find that a strange phenominum eventually takes place? When mum first went into the home, I was STAGGERRED every time I wrote the monthly cheque out. i would rant for days about the huge amount. Now, I write "fees went up by £120" as though it is just pence.

    Ellow

    Re: Nursing and residental EMI care

    Post by Ellow on Mon 5 Apr 2010 - 17:17

    Just thought I'd comment on Victor Meldrews earlier point on this thread 'But the old-style EPA only covers financial matters - not health and
    welfare.'


    I am my mother's Attorney under the EPOA Act? Responsible for defending her financial interests in all that that entails. That must surely include almost all we are fighting in this battle with the NHS and their co-conspirators in the Social Services? If anyone forces a service onto the 'Donor' which he/she does not want, hasnt signed and lacks the capacity to know what they are signing anyway. No contract of any sort. Quite the opposite in the case I have in mind. Who else is going to prevent funds being extracted from the unwilling service users bank account? Quite within an Attorney (old school) remit, I think anyway. And surely that's got to apply to this funding issue too. Its worked for me for the last 4 years.

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Mon 5 Apr 2010 - 17:48

    That is the point I have made repeatedly on the forum, Ellow.

    Anyone with a registered EPA is required by law to protect the financial interests/assets of his/her Donor of the EPA.

    However, there seems to be a 'mind set' working within LAs and PCTs at present, attempting to deny those EPA attorney(s) the right to involve themselves in the CHC appeal process. They have apparently been quite happy to go along with the application for NHS CHC process, but .... surprise and surprise again, once that same person/EPA attorney/holder wants to challenge and appeal against a refusal, then s/he Attorney who has never been required to provide EPA evidence before now, is suddenly met with the wall of "show us it or else".

    And I don't agree with that' mind set' of the LAs and/or PCTs. Because unless the EPA holder is able to challenge every single piece of ..... that comes their way, then they cannot be seen to be protecting the assets of the Donor.

    Does that make sense? Hope so!

    VM

    Ellow

    Re: Nursing and residental EMI care

    Post by Ellow on Mon 5 Apr 2010 - 18:30

    I know exactly what you mean Victor and you can include a great many other organisations who act obstructively when the unpaid Attorney attempts to do his duty in the Donor's best financial interests!

    The other thoughts on this thread? It is surely not beyond our politicians to put a ceiling on what a 'carehome' can charge for a place? This instant upping of their fee's once nursing contributions are 'awarded' is obviously blatant profiteering which used to be illegal. Is it still I wonder

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Mon 5 Apr 2010 - 18:43

    Ellow wrote: The other thoughts on this thread? It is surely not beyond our politicians to put a ceiling on what a 'carehome' can charge for a place? This instant upping of their fee's once nursing contributions are 'awarded' is obviously blatant profiteering which used to be illegal. Is it still I wonder

    Yes I think it is beyond our politicians - because there's nothing in it for them. There would need to be a 'brown envelope' or the equivalent for them to care about vulnerable elderly people residing in care homes, and being robbed left, right and centre. Just because they are old and can't fight back. Oh, yes, I forgot ... most of their relatives will also be more-old-than-young. Law of probabilities!!

    My own MP will not even sign up to the EDM 805 on dementia .... because .... he doesn't believe in EDMs .... because EDMs aren't, routinely or even often, debated in the house .... and because there are more MPs of one particular party signing EDMs than from his own party. Well, what chance have we got?

    Tough shite (!!) , in my thinking .... I won't vote for an MP who doesn't believe in every single thing he can do for dementia. Not much chance of him putting forward an EDM to advocate limits on care home charges!

    VM

    Ellow

    Re: Nursing and residental EMI care

    Post by Ellow on Mon 5 Apr 2010 - 19:01

    Yes, its difficult to think who to give ones vote to on this issue alone. Certainly the sitting gang wont get mine. I hope you gave yours a piece of your mind.

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Mon 5 Apr 2010 - 19:14

    Ellow wrote: I hope you gave yours a piece of your mind.

    Of that you can be certain! More than he probably bargained for.

    And with a good few 'supplementary questions' asked at the same time.

    VM

    iwillwincc

    Re: Nursing and residental EMI care

    Post by iwillwincc on Mon 5 Apr 2010 - 22:14

    Hello Dee
    Not a 100% certain, you need to check with someone legalistic, but I don`t think they can pursue a debt after six months legally if they have not give notice to do so within the previous six months.
    Regards
    Alex

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Tue 6 Apr 2010 - 12:39

    Hi Alex

    The Council began sending demands out ( to the wrong address being my sisters - so work that one out) shortly after Dad passed away. The way they tried to instigate this 'debt' can be proven to be both deceitful and unlawful.

    Both the Council and the Court can be proven they are acting unlawfully and in breach of the HRA.

    However that doesnt stop them carrying on regardless so be warned folks.

    Regards Dee

    Guest
    Guest

    Re: Nursing and residental EMI care

    Post by Guest on Tue 6 Apr 2010 - 12:47

    Hi, Dee

    Funny you should mention HRA - look what I'm sitting here reading:

    http://www.justice.gov.uk/guidance/docs/human-rights-handbook-for-public-authorities.pdf

    A handbook for public authorities!!

    VM

    Dee

    Re: Nursing and residental EMI care

    Post by Dee on Tue 6 Apr 2010 - 12:55

    Thanks for the reminder VM I cant remember if I shoved that on my blog or not as there is so much stuff.

    I also found another excellent document on Public Authorities too but I can remember if I put it on the useful links section or not so I will check and if not will put it on.

    Anyway my Council doesnt believe in the HRA or the law in any event. They just carry on.

    Regards Dee

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