My Mum has sadly been diagnosed with mixed dementia. She has deteriorated rapidly since she was first diagnosed and is in a residential care home. As her needs have increased the care home have requested an assessment for CHC funding. Sadly she passed the first assessment with flying colours, scoring 5 As. A date has been arranged for the next stage assessment which will be in about 2 weeks. However, I’ve been given the name of the ‘senior nurse’ by the ICB who will be carrying out the assessment, with a social worker, and she doesn’t appear to be senior at all. Her name is quite unusual and it appears that she only qualified as a nurse in 2023 from checking the NMC register. My understanding is that a ‘senior nurse’ is one who is NHS band 6 or above and usually that takes a number of years to achieve. Am I being overly suspicious here? I will be calling the ICB contact back tomorrow to ask but I would be grateful for anyone’s thoughts/observations.
First of all, there’s no specific rule about a “senior nurse” doing the assessment. The assessment is carried out by someone from the ICB but all of the professionals involved with your Mum, and you, should be involved. That includes a social worker, if there is one. What’s important is the “domains” - and what effect they have on your mum.
The checklist is a broad brush stroke that is intended to make sure as many people as possible who MIGHT fit the criteria are given the chance to be assessed, so relying on it for evidence is not going to be any help.
What you need to do is look at the “domains” and think about what difficulties your mum has in them. Take notes with you so you don’t forget anything. You’ll find some useful information here - and a link to the Decision Support Tool they’ll be using. NHS continuing healthcare - Social care and support guide - NHS
@Yorksfairy I think if she got 5 As then she will qualify for CHC. You certainly have the basis to ensure she gets her care funded. I found it took an argument to get care for dementia but you seem to have a good grasp of the issues. I think a Senior Staff Nurse may be different from a Senior Nurse, who is just higher than a RGN. I am sure you will get help on definitions from others with expertise here.
Good luck with getting the support you deserve
Thanks everyone for making me welcome here and for taking the time to reply, I really appreciate it.
I don’t yet have a copy of the completed initial checklist but I have requested a copy. The Community Matron who completed it did give me the ‘scores’ though. She scored As for Mobility, Skin, Cognition, Communication and Continence. Since then she has also been diagnosed with Strep B infected leg ulcers. She scored Bs for Behaviour, Psychological & Emotional needs and Nutrition. The only areas where she has no needs are Drugs, Altered States of Consciousness and Breathing.
I’ve had an appointment letter through today and it’s a different named nurse than the one I was told about in the phone call. However, the letter says that the assessment should take about 1 hour. My understanding is that is rather short to fully assess 12 categories in any detail. Having done some googling I have seen other people reporting that assessments for their relatives took up to 4 hours. Which seems a long time but thorough. Surely 1 hour cannot be enough time for an assessment of this type?
Very grateful for your thoughts, experiences and observations.
The only way a meeting like that can be done properly in an hour, at least from my experience, is if all the evidence is available and to hand, and the situation is straightforward. In my line of work at the time, that just didn’t happen!
@Yorksfairy it is unusual to have such a short meeting, unless they think that with those scores there is really just a confirmation of needs and that CHC requirements are met.
Have you got someone to go to the meeting with you? Take notes and make sure they explain all the terms, as there will be a lot of jargon and it can be baffling.
It is inappropriate for them to use any jargon and abbreviations at a meeting like this.
The first time they do it, stop the meeting and use my exact words.
Keep stopping them each time.
After the fourth or fifth time they will make themselves look incredibly stupid, and effectively you can take control.
If they go too fast, ask them to repeat what they just said. Again, keep saying this.
At one of mum’s CHC meetings I wrote the agenda, printed off more than enough for everyone and asked them to pass them round. Clearly no one had ever done that before!
Thanks everyone. I now have a copy of the checklist. It appears to be pretty thorough but things have changed since it was completed - for example the Strep B leg ulcers infections - so I will need to ensure that is accurately recorded. Her GP notes states that they couldn’t review her leg as there was nobody available to dress it afterwards. No nurses available…..
I also enquired regarding the timing of the assessment and was advised that 1 hour is just for family involvement and that the assessment involving the carers etc would take much longer than that.
I will see how it goes but I will most certainly be objecting if it appears to being rushed through.