Case studies
Mrs Evangeline McConnell (deceased)
Eighty eight year old Evangeline McConnell suffered a
severe stroke in October 2002 and was admitted to the Royal Albert
Edward Hospital in Wigan. She was then transferred to Leigh
Infirmary in Lancashire for 6 months for rehabilitation. However,
the family were informed that she could not return home as she
required 24 hour nursing care. Mrs McConnell was then admitted to
the Arncliffe Court Nursing Home in Halewood, Liverpool in April
2003 and later to St Bartholomews Court Nursing Home in Huyton,
Merseyside where she sadly died on the 3 November 2011.
The family were told that due to
Mrs McConnell’s capital and income, she would have to pay for her
own nursing care costs. Mr Phil McConnell, Evangeline’s son, asked
the NHS for an assessment before she was discharged from hospital
in 2003. However, the NHS said that she was stable and not complex
and therefore not eligible. This meant that she became the
responsibility of the social services and due to her capital and
income, had to sell her home to pay for her nursing care fees of
£2,000 per month.
Mrs McConnell had suffered a
catastrophic stroke which resulted in her being immobile,
incontinent, unable to communicate and swallow. She was
totally reliant on two to three carers to attend to all
her needs and a tube was placed in her stomach to provide her with
nutrition and medication. Yet, the NHS maintained that she did not
have ‘health needs’ which meant she was entitled to NHS Continuing
Healthcare. The family, helped by Hugh James, had to prove that she
her health and living needs meant she should never have had to pay
her own care home fees.
Despite regular assessments, it was
not until January 2008 that Mrs McConnell was assessed as meeting
the criteria and all her future fees were to be paid by the
NHS.
Following a seven year fight
with the help of the Hugh James Nursing Care Team, the NHS have
admitted that their decision on care fees was wrong and the family
of Mrs Evangeline McConnell have finally been reimbursed with
£117,000 in wrongly paid care home fees.
Read more about Mrs Evangeline McConnell's
case
Related press
articles
Mrs Beryl Waite
(deceased)
Mrs Waite was admitted to a nursing
home from November 2004 until she passed away in January 2007. She
suffered with Chronic Obstructive Airways Disease, was confused and
unaware of her surroundings, immobile and had suffered a number of
falls. As well as this she also had difficulties with her eating as
she was at risk of asphyxiation due to her breathing
problems.
The Local Health Board were asked
to undertake a retrospective assessment together with a current
assessment whilst Mrs Waite was still alive in October 2006.
A current assessment was undertaken
just before she died in January 2007, but the decision was not
finalised. Since then a number of complaints have been made to the
both the Ombudsman and the Health Board about the delay and we are
still waiting for the Health Board to consider it.
Mr Kenneth Waite, Beryl’s son, has
instructed Hugh James to help him recover fees that he believes
have been wrongly paid. He has contacted his local AM to complain
and also appeared in both press and television programs.
Related press
articles
Massive delay for claims to reimburse cash for nurse
care
Western Mail
06 | 01 | 10
Wait for care home
fees refunds ‘could be three years’
BBC Wales
16 | 10 | 11
BBC Politics Show
16 | 10 | 11
Mr Harry Denham
(deceased)
Mr Denham was admitted to Beechwood
Park Nursing Home in July 2002. He was suffering with Alzheimer’s
disease and as a result was severely confused and disorientated
regarding time, place and person. He also displayed difficult
behaviour associated with the illness, including anxiety, agitation
and aggression. He was initially mobile, but walked with an
unsteady gait which meant that he was at a high risk of
falls.
However as his condition
deteriorated he required two members of staff to assist him to
mobilise and a wheelchair was required for long distances. By July
2006 he was no longer mobile and mainly bed and chairbound. He was
totally reliant on nursing home staff for all his activities of
daily living. Due to the closure of the Beechwood Park Nursing
Home, Mr Denham was transferred to St Annes Nursing Home on the 13
July 2006 and was a resident there until his death on the 5
February 2007.
Mr Denham paid a contribution of
£85 per week until his wife’s death in April 2003 and thereafter
had to pay approx £750 per week until his death. Hugh James
successfully challenged the Local Health Board’s decision to
refused Continuing Health Care Funding and Mr Denham’s estate was
awarded retrospective continuing health care from the date of
admission to Beechwood Park House and was reimbursed over £100,000
in nursing home fees.
Related press articles
Mrs H
We were successful in
challenging the refusal of continuing health care by the Primary
Care Trust for the above lady. Mrs H was a resident of a
Residential Home from 2001 to 2005, when she was moved to a Nursing
Home, where she currently resides.
Mrs H suffers from
arthritis, gout, strokes, which left her with paralysis of the left
arm and problems. She also suffers with advanced dementia, which
resulted in her being unable to communicate in any form, including
letting carers know when she is in pain. She is immobile and as
therefore at high risk of pressure damage. She is fed a
pureed diet due to her swallowing problems. Mrs H was totally
reliant on nursing home staff to attend to all her needs.
The Primary Care Trust
initially assessed the case and concluded that Mrs H was not
eligible for NHS continuing health care. Hugh James challenged this
decision and the Primary Care Trust concluded that Mrs H was
eligible for Continuing Healthcare and had been eligible since her
admission to the care home in 2001. Mrs H was then reimbursed a
total of £105,194.57 in past nursing home fees and was awarded
continuing health care status for the future, resulting in future
savings of £2100 per month.
Mrs N
Mrs N has been a nursing
home resident since 2002. Mrs N suffers from Osteoarthritis,
Parkinson’s disease, Cervical Sponylosis, Sciatica, Upper Thoratic
Scoliosis, Hypertension and Angina. She is unsteady on her feet and
at high risk of falls and has fallen on occasions. She suffers from
confusion and can be restless, disorientated and prone to
wandering. Mrs N is occasionally incontinent and requires toileting
every two hours. Mrs N suffers with severe Parkinson’s disease
which is variable from day to day. She also suffers from
Osteoporosis and was on a atromorphine pump daily, Fentenyl patches
changed every three days and additional pain relief when
requested.
Hugh James successfully
challenged the Primary Care Trust’s decision to refused Continuing
Health Care Funding and Mrs N was awarded retrospective continuing
health care from date of admission. She was reimbursed over
£120,000 in past nursing home fees and was awarded continuing
health care status from then on, resulting in future savings of
over £800 per month.
Mr Youell (deceased)
Mr Youell was a resident
in a Nursing Home in South Gloucestershire from May 2006 to his
death in October 2007. He suffers with rheumatoid arthritis and
frontal lobe dementia. He was unable to communicate verbally due to
confusion and memory loss. He had a history of depression and
anxiety. He was totally disorientated and confused. He was unaware
of his surroundings and disorientated in time, place and person. He
was also noisy and restless. He required full assistance with all
aspects of personal hygiene needs. He was unable to feed himself
and was at risk of chocking and therefore needs to be monitored
closely when eating. He was chair/wheelchair bound and required the
assistance of two carers and a hoist for transfers. He had a
history of falls and has been hospitalised as a result, he has
fractured his hip and sustained several head injuries as a
result.
Hugh James successfully
challenged the Primary Care Trust’s decision to refused Continuing
Health Care Funding and Mr Youell’s estate was awarded
retrospective continuing health care from September 2006 and was
reimbursed over £22,000 in nursing home fees.
Mrs Irene
Bury (deceased)
Mrs Irene Bury was admitted to a
care home in April 2003 and remained there until she died in August
2006. The family were told by the NHS that she was not their
responsibility and not eligible for NHS continuing care to cover
the cost of her nursing care fees. After a 5 year fight with the
help of Hugh James Nursing Care, the NHS have admitted that their
decision on care fees was wrong and have now reimbursed her estate
over £100,000 in wrongly paid fees.
Mrs Bury was admitted from her home
in Warminster in Wiltshire to Bath Royal Hospital in July 2002
following a fall. After a period in hospital, the family were told
that she could not return home and she was discharged to Broadway
Lodge Care Home in Surrey on the 11th April 2003. Due to Mrs Bury’s
capital, the family were told that she would need to meet the full
cost of her care fees.
Mrs Bury suffered with Alzheimer’s
disease, as a result of her illness, she was agitated, totally
confused and disorientated in time and place, she was aggressive
and was resistive to care. She was unsteady on her feet and
suffered falls which resulted in her fracturing her right femur in
May 2004 and left femur in November 2005. She was doubly
incontinent, blind, deaf and unable to communicate. In August 2005,
Broadway Lodge Care Home could no longer cope with Mrs Bury’s needs
so she was transferred to Jubilee House Care Home in Godalming in
Surrey where she remained until she died in August 2006.
Read case
history
Find out more on nursing care fees: