Reclaim Care Home Fees

Don't miss out on NHS Continuing Care

If you have an elderly family member living in a residential care home, you - or they - could be paying out thousands of pounds in fees that you shouldn’t have to foot.

Under an NHS scheme, many of those elderly people who require 24 hour continuing care or nursing care are entitled to funding by the Primary Care Trust or their Local Health Authority. Despite this, a great deal of local health authorities administer the test incorrectly, resulting in people’s savings being drained, debts being accrued and even family homes being sold to cover the cost. In a great number of cases, this should not have to happen.

If this sounds like a familiar situation, you may be able to reclaim the money spent on care home fees and receive compensation.

The NHS scheme in question is supposed to meet the costs incurred when the person involved has medical needs which are considered "complex and unstable". This includes such conditions as senile dementia and Alzheimer’s, with the payout being intended to cover both medical bills and any residential care necessities.

The problem is that many local health authorities have misclassified disorders like Alzheimer’s and dementia as being "social factors", meaning that those suffering from them are not considered to meet the requirements for NHS funding. This is incorrect, and stems from an overly unforgiving approach to the (admittedly strict) eligibility criteria involved. These afflictions should be recognised as medical conditions rather than social ones.

These issues tend to arise when a person who needs continuing care has more than £23,000 in savings - a sum which often includes assets such as the family home. This is the threshold at which they would usually be considered capable of paying for their treatment themselves, but it is not intended to apply in cases where ongoing nursing care or continuing NHS treatment is required.

The situations in which an individual qualifies for NHS funding under the Delayed Discharge (Continuing Care) Directions 2007 are:

• If they are afflicted with a rapidly worsening condition, which may be entering a terminal phase
• If they have been discharged from hospital, particularly if it seems as though being placed in a residential care home may soon be necessary
• If their care needs are under frequent (likely annual) review
• If their physical or mental condition is severely deteriorating and the current care received seems insufficient.

Standards are high in qualifying for NHS Continuing Care but if you suspect you or someone you know has been affected by an incorrect assessment of their clinical needs, it’s definitely worth looking into.

If you feel that you or your loved ones have been affected by paying out for care home fees unfairly, Law on the Web can help. Just click here and we’ll put you in touch with a solicitor who can assess your case and help you make a claim.

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