Care Home Fees Mis-Assessments
Elderly health care & the NHS
Approximately 50% of the 440,000 care home residents in Britain pay their fees themselves - and the sad truth is that many of them should not be self-funding.
While NHS Continuing Care is supposed to ensure that those with serious health issues do not have to pay for the resultant care home fees, mis-assessment is rife amongst local health authorities and in many cases people do not receive the funding they are entitled to.
This widespread mis-assessment is down to a number of reasons. The main one is that the guidelines for who should receive NHS Continuing Care are known to be fairly vague, and every local authority tends to interpret them in their own way. This often leads to unfair outcomes which many never think to challenge.
One of the most incorrectly assessed situations involves elderly people who require nursing care due to conditions such as senile dementia or Alzheimer’s. Many local health authorities have classed these conditions under social issues, as opposed to medical – and hence not the responsibility of the NHS. Unfortunately, this is an incorrect classification and means that many older people with mental health needs are struggling to pay fees which should be covered under Continuing Care.
The confusion is only compounded by the fact that local social services are able to offer some limited health assistance, and their jurisdiction has changed over the years. For example, before 2001, it was possible for them to offer Registered Nursing Services – this is now exclusively the remit of the NHS.
Nonetheless, the rules are clear – if the primary reason for moving into a nursing home is a medical one, whether the cause is a physical or mental condition, the NHS must cover the costs. If you have a relative in this situation who has been funding their own care, then you should know that they are eligible to claim those fees back.