Frequently Asked Questions
There is a lot of confusion about care home fee claims; about whether people are eligible to make a claim or not so to try and help we have compiled a list of our most commonly asked questioned about care home fee claims.
If you can’t find the answer to your question here, then please don’t hesitate to get in touch.
A family member is about to go into care. I think they are entitled to NHS continuing care but the Primary Care Trust says no. Is there anything I can do?
Yes there is. As part of our extended service, we can examine your case and see if your loved one is eligible for NHS continuing care. In some case, patients have been incorrectly assessed, or not assessed at all. If this is the case, we can carry out an assessment and, if we believe they are entitled, we can appeal a decision on your behalf. Contact us today for more details of this service.
If your claim has been rejected, and you strongly believe you are eligible for redress, we may be able to help you submit an appeal.
We will review your case and, based on our evaluation, advise you on its strength and possible outcome. Should all parties wish to proceed, we can then submit an appeal on your behalf.
I’ve registered a claim myself but now I’m unsure what to do next. I’d like some help but I don’t know if I have to continue to pursue it on my own?
This question is being asked more and more and the answer is no, you don’t have to deal with this alone. You are fully entitled to ask for help from a solicitor at any point within the process.
After registering a claim, you are likely to receive a form, around 10-12 pages long. The answers provided here will form the basis of your claim so it is essential it is completed thoroughly and objectively and we strongly advise you seek the help and advice of a legal professional if you are at all confused.
If you are at all worried or concerned about completing the form, or if you simply don’t have enough time to dedicate to it, our team of qualified solicitors and litigation executives can provide this service for you.
Many people think care home fees are based on a person’s level of income or assets. This however is not the case.
If the person in a care home is there because of a primary health need they are eligible for NHS continuing health care which is paid for, in full, by the NHS regardless of personal wealth.
NHS Continuing Health Care, also referred to as fully funded care, is a care package which is arranged and funded by the NHS for an individual who requires care due to health reasons e.g. Alzheimer's or dementia. Their care can be received in hospital, in a residential care home or at the individual's own home.
The NHS must fund care in full if a primary health need is established. Please contact our specialist team who will be able to discuss this in more detail with you and advise you further.
The local Primary Care Trust is responsible for all assessments which should examine the individual's social and health needs.
In England, an assessment initially involves a checklist to be undertaken and, based on the results of this, the PCT will then determine whether a full assessment is required. If this is the case, a minimum of two professionals should complete the Decision Support Tool which is designed to help them reach a decision about eligibility.
It is possible that a claim can take up 12 / 18 months. However this will depend on a number of factors, including any backlog at the Primary Care Trust and/or whether an appeal is necessary.
Yes an appeal can be made to the relevant Primary Care Trust (PCT) if procedures have not been followed correctly or if the application of the eligibility criteria was incorrect.
The service was outstanding, from my very 1st phone call to completion. I am trully amazed at the superb service. Especially Richard Espley and Jennifer Oaks. It was completed within 4 WEEKS. Easily the best firm I have ever dealt with.
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