Case 1

It is possible to apply for care home fees to be refunded even where a care home resident has sadly died.

Mr Smith recently received a repayment of over £60,000 in respect of his late mother who had been paying care home fees for a number of years. In her later years Mrs Smith suffered from significant health problems due to advancing dementia and epilepsy.

Mr Smith said “Although I was aware in certain circumstances the NHS could provide free care whatever a person’s financial circumstances, it never occurred to me to challenge the continuing care assessment and I just accepted the advice that my mother would have to fund all of her care home fees because she had Capital assets.

Fortunately we didn’t have sell my mothers home because we were able to find a suitable tenant and the rent helped towards the fees but it makes me wonder how many elderly people have been forced to sell their homes needlessly or have used up hard earned savings to pay fees which should be met by the NHS.

I would advise anyone in this position to take independent legal advice and would recommend Browell Smith & Co”

Applications for retrospective funding can be made in respect in respect of any period of care after April 2004 and there is no time limit for requesting a review.

Case 2

Mrs A was an elderly lady in her eighties who suffered from Dementia. She was first taken into care in 2004 as her husband who was also in his eighties could no longer manage to look after her at home.

Mr and Mrs A had to fund the cost of the care home fees out of Mrs A’s pension and their hard earned life savings, although Social Services did ignore the value of the family home as Mr A was still living there. Mr A did however have to continue to pay all of the household bills as well as his wife’s care home fees.

When Mrs A first went into the home she was still quite mobile and could manage to do a lot of things for herself although she was very confused. Mr A and his son used to visit regularly and take her out for days. As time went on however, Mrs A’s health deteriorated as a result of her advancing dementia.

By 2006 she was doubly incontinent and could no longer walk. It took two nursing staff to transfer her from a bed into a chair and she spent most of her days in her room. She could no longer communicate her needs to staff and was unable to feed herself at mealtimes. She was totally reliant on the care home staff for all the activities of daily living and needed to be closely monitored.

Despite her very poor state of health she was still paying the full care home fees although it had been agreed that the care home could receive a contribution towards the cost of her nursing care. Mr A asked for a review of her case and was initially refused. An appeal was therefore pursued on his behalf The Courts have held that where a person’s primary need is health care that the NHS should meet the cost of continuing care.

By 2006 Mrs A’s needs were clearly health needs as opposed to social care. The review board therefore eventually agreed that the NHS should provide the cost of care In addition care home fees of £400 per week were repaid by the Health Authority providing a substantial refund and alleviating a lot of worry for Mr A.

How many more people are like Mr and Mrs A?

Anyone with significant nursing needs can apply for a review of their case at any time even if they have been in the care system for a number of years. It is very often the case that a person’s health can deteriorate following their admission to care and their eligibility for free NHS funding should be reviewed on at least an annual basis.