NHS Continuing Care - Claims Management Companies

[RGG]

NHS Continuing Care

We are new to this -

Does anyone have any experience of any sort with these companies?

Looking through the companies that advertise online doesn't reveal success rates and we are unsure as to any real benefits to using such a company - or whether to simply apply ourselves.

Similar to applying for LPA or using a solicitor for example.
For LPA we successfully applied without using a professional but are unsure about an NHS Continuing Care application.

Anyone done this successfully or unsuccessfully as an individual or through a company?
Any advice, experience, suggestions or pointers grateful accepted.

[The Gauge]

Arranged it ourselves for our terminally ill mum. Expect resistance from the system and even denials that CHC even exists, and that was for an elderly lady who was dying.

There are two types of CHC assessment..

1) Decision making tool - pages of questions that make the assessment last a few hours.

2) Fastrack - one page of questions and all care & equipment needed is free of charge and is in place within 48hrs.

For someone who is end of life they qualify for fastracking but despite mum being terminal they did the lengthy assessment. Thankfully they authorised all her care to be paid for, despite her financial status meaning she could afford to pay.

It s a battle, and one I d expect a terminally ill person to not have to fight. How wrong I was.

Try and get the assessment done via the persons GP or social care if the GP is useless, like mums was.

Edited by The Gauge on Friday 5th December 18:50

[RGG]

The Gauge said:

Arranged it ourselves for our terminally ill mum. Expect resistance from the system and even denials that CHC even exists, and that was for an elderly lady who was dying.

There are two types of CHC assessment..

1) Decision making tool - pages of questions that make the assessment last a few hours.

2) Fastrack - one page of questions and all care & equipment needed is free of charge and is in place within 48hrs.

For someone who is end of life they qualify for fastracking but despite mum being terminal they did the lengthy assessment. Thankfully they authorised all her care to be paid for, despite her financial status meaning she could afford to pay.

It s a battle, and one I d expect a terminally ill person to not have to fight. How wrong I was.

Try and get the assessment done via the persons GP or social care if the GP is useless, like mums was.

Edited by The Gauge on Friday 5th December 18:50

Thanks very much for sharing your process experience, and also the sensitive family side of things.
I'm sorry for you all.
When you say "social care" was that the allocated social worker that worked with you in the whole sense of things?
We are not quite at that stage but it is imminent, I believe and I'm trying to get my "ducks in a row" to get the best possible outcome for the person.

Thank again

[Phooey]

Beacon get some fair reviews, they also *i think* are endorsed by Age UK. CHC is very very difficult to get, you need to have a very very strong reason for being awarded it.

[RGG]

Phooey said:

Beacon get some fair reviews, they also *i think* are endorsed by Age UK. CHC is very very difficult to get, you need to have a very very strong reason for being awarded it.

Thanks for this - I'll look into Beacon and Age UK

[Phooey]

I think Beacon will give you a free 90 mins of call-advice just quickly looking on their site

[RGG]

Phooey said:

I think Beacon will give you a free 90 mins of call-advice just quickly looking on their site

Thanks, Ive just been looking on their website - they're clearly associated with Age UK which is promising and present themselves as "non solicitors" I believe - presumably health care oriented people.

Thanks for this

[Phooey]

RGG said:

Thanks, Ive just been looking on their website - they're clearly associated with Age UK which is promising and present themselves as "non solicitors" I believe - presumably health care oriented people.

Thanks for this

My pleasure. I haven’t used them myself but did come across them via some forum so I would say do your own due diligence just in case. The reviews were mainly positive and seemed genuine. Hope all works out well

[RGG]

Phooey said:

RGG said:

Thanks, Ive just been looking on their website - they're clearly associated with Age UK which is promising and present themselves as "non solicitors" I believe - presumably health care oriented people.

Thanks for this

My pleasure. I haven t used them myself but did come across them via some forum so I would say do your own due diligence just in case. The reviews were mainly positive and seemed genuine. Hope all works out well

Appreciated

[LosingGrip]

RGG said:

NHS Continuing Care

We are new to this -

Does anyone have any experience of any sort with these companies?

Looking through the companies that advertise online doesn't reveal success rates and we are unsure as to any real benefits to using such a company - or whether to simply apply ourselves.

Similar to applying for LPA or using a solicitor for example.
For LPA we successfully applied without using a professional but are unsure about an NHS Continuing Care application.

Anyone done this successfully or unsuccessfully as an individual or through a company?
Any advice, experience, suggestions or pointers grateful accepted.

Ill message my mum in the morning. My brother gets CHC funding (although they are trying to stop it).

Her job until a couple of years ago was to assist families who CHC funding sort out care packages.

Feel free to PM me if I dont reply after the weekend. Im on lates and may forget!

[The Gauge]

RGG said:

When you say "social care" was that the allocated social worker that worked with you in the whole sense of things?

Yes, but we never met them.
Me, my brother and sister were all firing in requests to anyone we thought relevant- GP, social care, palliative nurse, district nurse supervisors, GP surgery practice manager etc. Then one day it just happened and I m not sure which route achieved this.

I assumed when you were really ill all the care would just happen and fall into place, it doesn t, you have to fight for it. I m not sure how families cope who aren t at least assertive in some way as it was a real battle.

Prior to CHC mum received 3 carer visits a day from the NHS Short Term Intervention Team (STIT) at breakfast, lunch and bedtime but we had to cover teatime visit. sTIT is free for 6 weeks and is then withdrawn and you have the option of the local authority sending private contracted carers (which we chose) at a cost to the patient, or arrange your own private carers.

If they know there is willing family around they will offer you the least help possible so act dumb and try and get as much free carer visits as possible, family can then visit as family members rather than stepping in as carers. Sadly mum kept telling the district nurse supervisors how wonderful her three children are and how great it is that we live nearby to help her, so they reduced the carer visits. Thanks mum!

Ensure there is a health LPA in place, you ll need it even for things like arranging and collecting medication, requesting NOMAD packs etc. without an LPA it could become really difficult

If having carers I suggest safeguarding any valuables as whilst the STIT carers were amazing and we usually had the same carers visit each time who we gradually got to know, the private carers were a mixed bag of different people visiting each time, we didn’t want to leave any temptation so mum gave us her bank cards and expensive jewellery etc. plus if an item gets lost you’ll always wonder if a carer has stolen it and become suspicious unnecessarily

Edited by The Gauge on Saturday 6th December 07:19

[TheHeadhunter]

We looked at this a couple of years ago. As said above, it's difficult, they will resist like crazy and find every reason to show you don't qualify. From memory, it is centred around the need for nursing care.

Our advice was to avoid companies as their success is low and costs high. We just read into it, and then got a friend who had been successful for both of his parents. It is just understanding the process.

I can dig out our notes, but others above seem to be more informed.

Good luck, it's disgusting that everything in this area is such a battle.

[RGG]

LosingGrip said:

RGG said:

NHS Continuing Care

We are new to this -

Does anyone have any experience of any sort with these companies?

Looking through the companies that advertise online doesn't reveal success rates and we are unsure as to any real benefits to using such a company - or whether to simply apply ourselves.

Similar to applying for LPA or using a solicitor for example.
For LPA we successfully applied without using a professional but are unsure about an NHS Continuing Care application.

Anyone done this successfully or unsuccessfully as an individual or through a company?
Any advice, experience, suggestions or pointers grateful accepted.

Ill message my mum in the morning. My brother gets CHC funding (although they are trying to stop it).

Her job until a couple of years ago was to assist families who CHC funding sort out care packages.

Feel free to PM me if I dont reply after the weekend. Im on lates and may forget!

Thanks very much for this - it's helpful just to hear it.
I'll try and find some time to message you.

[RGG]

The Gauge said:

RGG said:

When you say "social care" was that the allocated social worker that worked with you in the whole sense of things?

Yes, but we never met them.
Me, my brother and sister were all firing in requests to anyone we thought relevant- GP, social care, palliative nurse, district nurse supervisors, GP surgery practice manager etc. Then one day it just happened and I m not sure which route achieved this.

I assumed when you were really ill all the care would just happen and fall into place, it doesn t, you have to fight for it. I m not sure how families cope who aren t at least assertive in some way as it was a real battle.

Prior to CHC mum received 3 carer visits a day from the NHS Short Term Intervention Team (STIT) at breakfast, lunch and bedtime but we had to cover teatime visit. sTIT is free for 6 weeks and is then withdrawn and you have the option of the local authority sending private contracted carers (which we chose) at a cost to the patient, or arrange your own private carers.

If they know there is willing family around they will offer you the least help possible so act dumb and try and get as much free carer visits as possible, family can then visit as family members rather than stepping in as carers. Sadly mum kept telling the district nurse supervisors how wonderful her three children are and how great it is that we live nearby to help her, so they reduced the carer visits. Thanks mum!

Ensure there is a health LPA in place, you ll need it even for things like arranging and collecting medication, requesting NOMAD packs etc. without an LPA it could become really difficult

If having carers I suggest safeguarding any valuables as whilst the STIT carers were amazing and we usually had the same carers visit each time who we gradually got to know, the private carers were a mixed bag of different people visiting each time, we didn t want to leave any temptation so mum gave us her bank cards and expensive jewellery etc. plus if an item gets lost you ll always wonder if a carer has stolen it and become suspicious unnecessarily

Edited by The Gauge on Saturday 6th December 07:19

Thanks again, there's some really useful information here that you've took the time to present - thank you.

[RGG]

TheHeadhunter said:

We looked at this a couple of years ago. As said above, it's difficult, they will resist like crazy and find every reason to show you don't qualify. From memory, it is centred around the need for nursing care.

Our advice was to avoid companies as their success is low and costs high. We just read into it, and then got a friend who had been successful for both of his parents. It is just understanding the process.

I can dig out our notes, but others above seem to be more informed.

Good luck, it's disgusting that everything in this area is such a battle.

Thanks, your viewpoint and experience mirrors what going through my head already, before even applying.

[RGG]

OP asking a further question.

"At present, what they say at the early part of the discharge process, is 2X carers will visit 4X a day plus multiple nurses will provide nursing care.
Given that we are liable for full costs (I believe), it looks like the overall cost to us could well exceed the cost of nursing home costs?

The person doesn't want to go into care and we don't want this to happen either.

Does anyone know what the daily cost of 2X carers 4X a day might be?"

[The Gauge]

RGG said:

OP asking a further question.

"At present, what they say at the early part of the discharge process, is 2X carers will visit 4X a day plus multiple nurses will provide nursing care.
Given that we are liable for full costs (I believe), it looks like the overall cost to us could well exceed the cost of nursing home costs?

The person doesn't want to go into care and we don't want this to happen either.

Does anyone know what the daily cost of 2X carers 4X a day might be?"

Mum initially had 2 x carers three times a day and although mum received CHC there was about a month of time prior to the CHC approval where mum was paying, this was for the time after the STIT team withdrew and CHC being approved. I think the cost of those carers was about £800/month. Then CHC kicked in and it all became free of charge, and soon after she also needed 2 x carers to visit her twice through the night, so five visits per 24hrs. She kept receiving the invoices for the care, with a total, and then a t'otal to pay' which was £0

Consider applying for Attendance Allowance, mum received about £100/week AA, which can help offset care costs. AA can be cleaned if you need someone to give some kind of help, such as make a meal, clean the house etc. It can be anyone, family, friend, neighbour etc with no receipts needed, it's a benefit that gets paid each week.

We also got mum a blue badge for when we took her to hospital appointments etc.

If you think the time might come when the patient can't take their own medicine you can get it prescribed in NOMAD packs which is a. blister pack with all the tablets for each part of the day within one blister bubble, with time and day printed on, that means that when authorised a carer can pierce the blister pack and offer them the tablets, but the patient has to put then into their mouth themselves as the carers aren't allowed to. if you go this route then search in advance for a chemist that will entertain this, as some don't. You then have to request the NOMADs via the GP. All of this can take time, and they would only speak with the person named on their records as being approved by mum. Mum wrote a letter to her GP in advance. But the time may come when there person is to ill to do this, so get them to write a letter to the GP before needed, naming the people who the GP can speak with.

Edited by The Gauge on Saturday 6th December 19:55

[The Gauge]

The whole thing drained us of energy, there was always something needed doing, things to consider, or plan, and that's with three of us all helping each other (me brother & sister) and with us taking turns to give mum her evening meal. I am not sure I could have done it all by myself and held down full time work.

Thankfully my employer offers 6 weeks carers leave with full pay for staff with a terminally ill relative, followed by 6 weeks half pay then 6 weeks no pay. I managed to take the 6 weeks paid leave just in time before mum died, so I didn't loose any pay. I then took one week compassionate leave, followed by 4 weeks sick leave to recover, start sorting mums financial affairs out, and plan the funeral etc.

[RGG]

The Gauge said:

The whole thing drained us of energy, there was always something needed doing, things to consider, or plan, and that's with three of us all helping each other (me brother & sister) and with us taking turns to give mum her evening meal. I am not sure I could have done it all by myself and held down full time work.

Thankfully my employer offers 6 weeks carers leave with full pay for staff with a terminally ill relative, followed by 6 weeks half pay then 6 weeks no pay. I managed to take the 6 weeks paid leave just in time before mum died, so I didn't loose any pay. I then took one week compassionate leave, followed by 4 weeks sick leave to recover, start sorting mums financial affairs out, and plan the funeral etc.

Thanks again - I've "dropped" a note into a discharge review contribution asking if anyone has done it yet? Is anyone going to do it? - Can the patient and carer be involved? -

So, we will do our best to get some traction at the next meeting in a few days time - "Joy of Joys" [sarcasm]

Thank you for taking the time to share all of this - I'm very grateful and wish you all the very best.

[The Gauge]

What made things really difficult for us was whilst mum knew she had fibrosis that couldn't be treated, she had always said she wouldn't ever want to now if she was terminally ill, so we had to arrange everything and look after her without ever discussing or even mentioning her terminal state