Mr M was living in a care home for 4 years prior to Compass CHC being instructed. Compass CHC were contacted by his family as his funds were running low and they felt that he shouldn’t be paying for his care as his needs were primarily health needs. On securing the available care records we drafted detailed representations supporting the contention that the needs were primarily health needs. Thereafter we instigated the NHS assessment process.
The Clinical Commissioning Group (CCG) initially, incorrectly, refused to complete a Checklist as they stated it was not their responsibility to do so. On referring them to the National Framework they eventually agreed to complete the assessment. With our advocate in attendance we were able to ensure that Mr M progressed on to the Decision Support Tool (DST) assessment. Even though he more than met the threshold the CCG were reluctant to compete the DST and wanted to put it on hold. They then wanted to complete a further checklist. With our persistence and knowledge of the National Framework we were able to get them to agree that the mistake was theirs. They then completed a DST with our advocate in attendance and we were able to secure full funding. This decision was reviewed after 3 months, again with our advocate in attendance, we were able to ensure the funding would be in place for a further 12 months.
