Paying for care: When should I not be paying care fees?

    Paying for care: When should I not be paying care fees?

    If you, or a loved one, are struggling to manage at home, the thought of getting some kind of care can be stressful, not least because of the costs involved. The good news is that there are several situations where you should not be paying for care home fees or paying for care at home.

    When should I not be paying for care home fees or paying for care at home?

    • If eligible for NHS Continuing Healthcare (CHC) Funding
      However, this is not for life and can be short term. It does not cover additional expenses, such as chiropody, hairdressing and alternative therapies.
    • If eligible for NHS CHC Fast Track Tool
      This tool is used when an individual requires immediate access to and an urgent package of continuing healthcare due to a rapidly deteriorating condition that may be entering a terminal phase, and has an increased level of dependency.
    • If eligible for S117 Mental Health Act 1983 aftercare funding
      This is also not for life but it is clear that the Local Authority must not charge for s117 aftercare.
    • If eligible for an Intermediate Care Package
      This is a package of short term health and social care services that can be offered free of charge, usually for up to 6 weeks. The outcome is to get a person back on their feet to return home and be independent rather than to permanent long term care in a care home.
     

    The Local Authority should also not charge for certain other support services, such as:

    • Community equipment (aids and minor adaptations) of £1000 or less
    • Care and support for people diagnosed with Creutzfeldt-Jacob Disease
    • Any assessment of care needs or financial assessment
    • Any NHS service which may be part of a care package and is the responsibility of the NHS
     

    What is the NHS Fast Track Tool?

    This is very different process from that used to determine eligibility for NHS Continuing Healthcare and there is no Checklist and no Decision Support Tool. It can only be used by an ‘appropriate clinician’, such as a consultant, GP and registered nurse.

    It is a simple document that is sufficient on its own to determine eligibility, which makes the process much quicker. This allows a funded package of care to be put in place very quickly where urgent assistance is required and if appropriate end of life care arrangements can be made.

    What is S117 Mental Health Act 1983 aftercare funding?

    Certain people who have been in hospital under the Mental Health Act 1983 (‘sectioned’) can get free aftercare when they leave hospital. Section 117 begins when you leave hospital.

    You are entitled to section 117 aftercare if you have been in hospital under section 3, 37, 45A, 47 or 48 of the Mental Health Act 1983. Your aftercare should only stop when you do not need any more help from the NHS or social services.

    S117 aftercare funding success

    I have recently had success securing a full package of S117 aftercare funding after it was previously declined in error by the Local Authority. The Local Authority was adamant that my client was not eligible. A complaint was escalated to senior management by this firm and care fees were refunded in excess of £27,000 with an ongoing package of care in the home of over £800 per week.

    Do you need help and advice with funding issues?

    Our experts can help you understand the process, give you the best advice, then provide whatever support you need to secure the best possible funding arrangement.

    For further advice on the qualifying criteria or to assist with the process, please do not hesitate to contact our team who will be happy to help.

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