Paying or paid care home fees? You could be due a refund!
It is commonly misunderstood that residents of care homes must automatically pay for their own fees. If you or a family member is residing in a residential or nursing home you may be entitled to a refund of care home fees from the NHS.
NHS continuing healthcare is a package of care whereby the NHS funds 100% of the patient’s care home fees. In order to be eligible for NHS continuing healthcare funding, the patient must be assessed as having a “primary health need” i.e. their needs are mainly health-related as opposed to social needs.
In order to establish whether someone should be or should have been eligible for NHS continuing healthcare, health boards across Wales will need to undertake an assessment of your relative’s needs which will consider a wide range of factors including their behaviour, cognition, mental health, nutrition, continence, skin, mobility and medication. Even where an assessment has already taken place and determined that your loved one is not eligible, we are still able to help you consider whether or not the assessment is fair and if there is any scope to challenge the health board’s decision.
The average price of care home fees in Wales is approximately £600 per week, that’s a huge £31,200 per year! You could therefore be entitled to claim thousands of pounds from the NHS.
The Welsh Government has recently set a deadline of 31 October 2016 for anyone intending to make a claim for wrongly paid care home fees that were paid between 1 October 2014 and 30 October 2015. You are still able to bring a claim for reimbursement even where the patient has passed away.
Devonalds have already recovered hundreds of thousands of pounds for local families across Wales and we could also help you. If you think that you or a relative may be eligible or should have been eligible for NHS continuing healthcare funding then call us today on 01443 404700 and ask to speak to our Abbi Williams who has over two years’ experience in dealing with these claims, or email us on CHC@devonalds.co.uk.
Check out our FAQ below:
Frequently Asked Questions
Understanding NHS Continuing Healthcare can be difficult, to try and help we have created a list of the most commonly asked questions. However if you are still unsure of anything, please feel free to contact us.
What is NHS Continuing Healthcare?
NHS continuing healthcare is care that is funded completely by the NHS for those who have a “primary health need”. If you or your relative is in a care home, this means the NHS will meet the cost of the care home fees regardless of income, savings and capital assets.
How do I know if I am eligible for NHS Counting Healthcare funding?
Anyone who requires long-term care should have their needs assessed and continuing health care funding must be considered during this process. The assessment is undertaken by the NHS, who will often involve the local authority and other professionals involved in providing the care.
The assessment considers the individual’s social and health needs and if the individual has a ‘primary health need’ they should qualify for continuing healthcare funding. The decision is not just based on a diagnosis but will look at the person’s day-to-day needs.
What if the assessment has already taken place?
If this assessment has already taken place, you should have been involved and informed in writing of the outcome of the assessment. However, the NHS has already acknowledged that thousands of these assessments have previously been wrongly decided.
If you feel that your loved one is eligible, Devonalds will be able to examine your case and assist in determining whether there is reason to believe that your relative may have met the eligibility criteria for continuing health care.
Is there a deadline for submitting my claim?
The Welsh Government has issued deadlines for the submission of claims for retrospective reviews of continuing health care.
The deadline for cases that fell within the claim period of the 1st of April 2003 – 30th of September 2014 has unfortunately now passed. For cases falling within a claim period from the 1st October 2014 onwards, the period to be considered by the NHS will now be no longer than 12 months prior to the date of the application.
If you believe that either you or a loved one may have been eligible during the period of the 1st of October 2014 – 30th of October 2015, you have until the 31st of October 2016 to register the intention to bring a claim.
How long will the review take?
The Welsh Government has stated that cases that fall within the newly announced deadline of the 31st of October 2016 will be reviewed within 6 months.
We aim to start the process on your behalf as quickly as possible. As soon as you contact one of the members of our experienced team and are happy to proceed, we will post our specialised tailored questionnaire to you. This will help us understand your case more and help us advise you on the next steps.
We keep our clients updated regularly and appreciate how important it is that family members and loved ones are involved throughout the process.
What are the average care home fees per year?
On average you can expect to pay around £29,250 a year in residential care costs, rising to over £39,300 a year if nursing care is necessary*.
Why use Devonalds to help with your claim?
We have a team of specialised, experienced professionals who will provide you with assistance throughout your claim.
Our professionals have extensive experience in bringing claims of this nature, having recovered thousands of pounds for our clients already.
Unlike many other solicitors firms, you will deal with the same individuals during the whole process, who are dedicated to your particular case and who are able to explain each stage of the process carefully to you.
We are also usually able to take on your case under a no-win-no fee agreement, so if you are unsuccessful in your claim you will not be liable for any legal costs.
Ultimately, we understand how important decisions concerning either you or your loved one’s care are. We are passionate about understanding your circumstances and ensuring we achieve fair outcomes.
* Laing & Buisson Care of Older People UK Market Report 2014/15.