Decision Report 201400665

Summary

Mr C complained to us about the apparent lack of assessment of his late mother (Ms A) for NHS Continuing Care funding. Ms A was admitted to hospital from a care home with a broken ankle. However, she was not able to fully rehabilitate, and was subsequently transferred to a nursing home for ongoing care. Mr C complained that the board did not fully assess whether Ms A was eligible for NHS Continuing Care funding when she was discharged from hospital, or during her time at the nursing home.

We took independent advice from a consultant geriatrician (a doctor specialising in medical care for the elderly) on the assessment of Ms A's care needs when she was discharged from hospital, and on the evidence of her care needs while she was in the nursing home. Our adviser said that Ms A's care needs had been appropriately assessed before her discharge, and she had been given appropriate opportunities to rehabilitate prior to discharge. He said that her care needs clearly did not meet the criteria for NHS Continuing Care, and that this was so obvious that it had not been documented. Given subsequent events, he noted that it would have been helpful if it had been documented, but he considered this to be a minor issue. He also noted that, from the evidence available, Ms A was not eligible for NHS Continuing Care at any time during her stay in the nursing home.

In our decision we noted that the board had provided information which showed that they had made a similar assessment to our adviser. However, this information had not been provided to Mr C. We were critical of this, though overall we were satisfied that the board had appropriately assessed Ms A's care needs, and that it had been reasonable not to document a full NHS Continuing Care assessment.