Reablement before NHS Continuing Care?

I’ve spent the weekend googling info about care options and there’s something I’m not clear on.

My Dad is currently in hospital and while it is proving slightly difficult to get accurate information on his current state, which is potentially end of life. If he does leave hospital it is unlikely he would be able to come straight home, and potentially he might need long term care.

At the moment my Mum is getting alarmed by calls from the hospital talking about care at home in the near future while other calls talk about him being unsafe to not have round the clock supervision. I’m working on the basis that they can’t just send him home if my Mum says she can’t cope with his care needs. I’m exercising power of attorney on Monday to enable me to speak directly to the doctors who at the moment will only speak to her as next as kin but in the meantime I wanted to have some information on what the right path forward potentially is before speaking to them.

In the long term NHS continuing care seems likely but there’s also reablement. My biggest query is what happens if the reablement route is taken? Can he go into that while continuing care is arranged or does moving to reablement mean the end of the road with the NHS. The NHS site says about reaching the end of reablement ‘your team should work with you and your family or carers to agree what happens next’ but as it mentions social services I’m not sure if that means the NHS have washed their hands of the situation once you’re out of the hospital and into reablement and any care past that relies on social services. Or is it all essentially the same thing and continuing care would involve social services anyway?

Also a quick query on funding. My understanding is that, as my Mum still lives in their house, the value of the property will be disregarded when considering who pays for care and their main bank account is a joint account so presumably they can only count half the money in there. That means his assets won’t cover more than, at most, a few weeks care. We think he had money in a savings account which nobody knew about but not sure how much, we found some paperwork when looking for the power of attorney papers. That raises the question of how do they assess how much capital someone has? If the person in question has money in accounts you aren’t aware of whose responsibly is it to declare it as you can’t declare what you don’t know?!

Social Services should NOT do a financial assessment or charge for care until the Continuing Healthcare assessment has been done.
If he qualifies for CHC all needs are FREE, as they would be in hospital.
If between them mum and dad have over £46,000, and dad doesn’t qualify for CHC ( a postcode lottery) then he will have to pay for his care. Only half counts as dad’s.
You can only complete a financial assessment based on the information you have evidence for.
If you Google “Charging for Care” all the rules are on the .gov site.

Covid, and the latest government to hospitals to chuck out 30% of patients supposedly fit for discharge, is undoubtedly making lots of problems.

Maybe it’s time for Carers UK to step in on behalf of family members of these people.
I’m increasingly concerned at the failure to consider carers needs.

Interesting about the £46K. Do they look at combined assets rather than individual? From what I can tell most things are in separate names apart from their day to day banking joint account. The house is jointly owned with a tenants in common agreement, but from what I read on Age UK the value of the house is disregarded if there is a partner still living there.

So would it just be his share of the joint account and anything he has in a savings account? Or would anything my Mum has in her name come into it? I know she inherited some money from my grandparents but that is in her name only so surely they can’t demand that to cover my Dads care?

Yes, just his share of the joint account and his savings.


There is info here Paying for care | Working out the costs of elderly care | Age UK

but bear in mind BB’s advice about requesting a CHC assessment first.

I’ve emailed the doctor over the weekend asking to arrange a call to speak about CHC. Hopefully should hear back shortly.

The next issue with regards to any means test is speaking to my Mum she has no idea if my Dad has any other accounts in his name apart from their joint account. I can get onto their main online banking and see there are no other accounts with that particular branch but how can you be sure you’ve declared everything you’re supposed to if the person in question can’t provide the details themselves and there are unknowns?

Do you just fill it in to the best of your current knowledge? I guess that would have to be it and then if anything comes to light down the line you’d have to pay the additional costs accordingly.

Yes, fill it in to the best of your ability.
However, if there is more money somewhere there must be some more paperwork somewhere.
My mum was dreadful at putting things away safely, then forgetting where it was, especially her Halifax book.
I finally found one declared lost years before, under the lino at the bottom of her wardrobe when I emptied her house before sale, that took my sons and I a year as it was so rammed full of furniture!

Once dad is hopefully sorted, then you can suggest to mum that you go through dad’s papers carefully to “put them in order”.

There will without doubt be paperwork as I’ve discovered there’s boxes and boxes of stuff in the loft. Bills, pension info, payslips, bank statements etc going back decades.

The downside is nothing is in any order whatsoever so its going to take an age to sort through everything and pick out the relevant stuff.

It’s an enormous task.

My brother owned a house near me, diagnosed with pancreatic cancer when in Uruguay where his wife lived, had surgery there and then unfit to fly back to the UK.
My dad had always managed his financial affairs and kept his filing in wonderful order. Then dad died. I would go to his house periodically to sort out the mail, then he went through it when in the UK, and I left him to do his filing. When he was ill I discovered that “filing” meant stuff it in a drawer!

Unbelievable for an aircraft engineer who had to document every last nut and bolt.
I had 10 years of filing to go through, I found two pensions schemes that paid out after a terminal illness diagnosed, that my brother didn’t even know he had, a godsend to them.

I did a trial sort first, getting rid of all the junk mail and ancient utility bills.
Then rough piles, then sorted each pile into date order, then in a polythene wallet or sleeve, but it’s a mammoth task.
I had some Bisley 10 drawer office drawers that I’d used in my business, certainly help the filing process.

How are you getting on? It does seem like he would be eligible for CHC but I’m not sure who is responsible for the assessment.

I’ve recently been through / going through similar. My Dad went into into hospital at the beginning of December having lived alone and totally independently up to that point but he suddenly went blind. He got weak, caught various bugs, stopped eating & drinking etc and we didn’t think he’d make Christmas. Two consultants, the OT, all the ward staff said he would need 24 hour care, Adult Social Care said he would be discharged in a couple of days with 4 visits of 30-60 minutes!! Eventually they agreed to NHS Reablement providing a live in carer for 28 days to assess how he settled back in (this ends Wednesday) but I had really fight for it because most councils seem to have this ridiculous 4 visits a day only policy - you have to try it and then they’ll help you if you struggle (or make you carry on struggling while they think about it!). He’s not eligible for CHC so now he needs to move on to something else, i.e. start paying for care, but we only had the needs assessment last Thursday (which involved me picking up the SW from the bus station and taking her back or she would have had to cancel). They’ve agreed to extend the care for 2 weeks because they’ve not allowed time for the relevant tech / OT stuff etc to be arranged but after that he will have to pay for everything. His house is also in a tenant in kind situation but his partner passed away 10 years ago so her family are waiting for their share of the money. They will keep him in the house for as long as possible so they have to disregard his half anyway. We don’t have POA and all his accounts are in his own name so from the moment he went into hospital we have felt like we’ve had to account for every penny or they will call it a dispersal of assets. His paperwork is a mess. It’s ‘lucky’ I had to give up my business before all this or I would never have had time to deal with it. You definitely have my sympathies & my empathies!

You had to pick the SW up from the bus station?!?!
This has set my alarm bells ringing.

You say that he doesn’t qualify for Continuing Healthcare. Did the assessor follow the proper guidelines.

Can I just check that the assessor was from the CCCG - Clinical Care Commissioning Group, not Social Services?
Was there a formal meeting attended by physio, OT etc with reports?
Were you involved in this assessment, or did she just deal with dad?
Have you and dad been given a copy of the “checklist assessment” at the time of the visit?

I volunteered to pick her up - she had car trouble and was having to get several modes of public transport or postpone but I was desperate to have the meeting!

We’ve not had any assessment for CHC - I looked at the checklist and it’s borderline so I’m going to mention it to the social worker when I speak to her shortly. He has 4 Bs and one that could be interpreted as a B or C.