Case Study | Success navigating continuing healthcare funding

Covering the cost of long-term care can be both emotionally and financially challenging for many families. However, some may not realise that financial support could be available. If a person's need for long-term care is primarily due to health reasons, they might be eligible to have the full cost of their care covered by the NHS.

This case study explains how Sharon Edwards of Moore & Tibbits solicitors supported our clients and was successful in securing free NHS continuing healthcare funding. 

I have been supporting Mary and Jack for a number of years and sadly seen a decline in Jack over the past few years.  Jack has Parkinson’s disease and is in 24-hour care. After a fall and hospital admission, he was transferred from his long-term care home to a new facility that could better meet his increased needs.

At first, there was confusion over who was funding Jack’s care. Both the care home and the local authority had assumed it was Continuing Healthcare (CHC), but it was actually funded through a "discharge to assess" arrangement for about six months.

During this time, Mary struggled with unclear communication from both the local authority and the care home about care fees and reached out to Moore & Tibbits for support. 

As Jack’s condition worsened, I advised Mary that he should be assessed for CHC.  When a date was set for the Decision Support Tool (DST) meeting, I encouraged Mary to start documenting Jack’s falls and I also coordinated with the care home to ensure their records were complete, stressing the importance of accurate care notes in the assessment process.  The care home were very supportive. 

The care home manager also implemented 1:1 care due to Jack’s high needs and fall risk. This was a strong indication that CHC funding could be appropriate.

I spoke in detail with a senior carer involved in Jack’s daily care to complete a pre-assessment report aligned with the DST domains. The carer was very cooperative and ensured that someone familiar with Jack’s needs would attend the meeting.

I reviewed the report with Mary and asked whether she wanted us to attend the DST meeting. She said she would feel more confident with my support, and I was pleased to be able to support her.

On the day of the DST meeting:

• I met Mary beforehand to explain the process.
• I brought a copy of our report and a blank DST for reference, explaining how the procedure worked.
• During the meeting, I helped ensure that accurate and full information was provided, working through each domain carefully.  I was able to supplement the assessor’s notes with additional fall records gathered from the carer and notes.
• I challenged an attempt to lower one of Jack’s scores in the medication domain, successfully arguing for a higher score based on his needs.

Just over a week later, Mary shared the good news: CHC funding was awarded! Mary sent a lovely thank-you message which was heartening.  These meetings are never easy – discussing intimate aspects of a loved one’s care in a formal setting can be distressing.  I made sure to check in on Mary afterwards and she admitted how difficult the process was and how relieved she was to have someone by her side.

She expressed her gratitude and said she would like my help again for the upcoming three-month review, which is standard procedure. Annual reviews will then follow.

This case highlights how complex and emotionally difficult the CHC process can be for families. Having someone experienced involved provides clarity, confidence, and support during an already challenging time.

(Names have been changed to protect identity)