Ask Sheila - Archive England

Sheila Scott OBE has now retired and therefore is no longer available to answer your social care questions. However, you might still find the answer you’ve been searching for down below.

04th April 2019

Can a residential care home refuse to carry out a Continuing Healthcare Assessment prior to transferring my mother to a Nursing Home?

Hi Sheila, my mother has vascular dementia and breast cancer with diabetes 2 and high blood pressure with irritable bowel. She is frail but can walk with a stick, she was placed in a residential care home by social services and is currently funded. She has been there 18 months but she has refused all medications, she is verbally abusive to everyone and tells residents the food is poisoned so they refuse the cooked meals. The home has now said she needs to be in a nursing care as they cannot meet her needs. I understand this and  I have asked them to do a Continuing Health Care Assessment while she is still with them. I don’t feel they are happy to do this and they have suggested a nursing home but I would like the assessment done before she is moved. Can they refuse to do it and if so who can I get to do it for us?


Dear S,


Thank you for your question.


The process for applying for NHS continuing healthcare can seem complex so I have looked to simplify the details of how to apply and the best advice available.


The NHS has a useful question and answer fact sheet on its website and part of their initial advice is that an initial assessment for NHS continuing healthcare should be carried out in all circumstances.


This initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker.


This guidance also says that:


To be eligible for NHS continuing healthcare, the person must be assessed by a team of healthcare professionals (a multidisciplinary team). The team will look at all care needs and relate them to:


  • What help is needed
  • How complex the needs are
  • How intense the needs can be
  • How unpredictable they are, including any risks to health if the right care isn't provided at the right time


Eligibility for NHS continuing healthcare depends on assessed needs, and not on any particular diagnosis or condition.


You can read this fact sheet here


You will see that the above guidance says:


The process involved in NHS continuing healthcare assessments can be complex. An organisation called Beacon gives free independent advice on NHS continuing healthcare.


Visit the Beacon website on or call the free helpline on 0345 548 0300.


Beacon says that:


You can seek an assessment from a health or social care professional, such as the GP or social worker, at any time. If you are unsuccessful at the assessment stages, there are a range of dispute resolution options available to you.


Your Mother certainly has some complex health conditions and although I cannot comment on whether or not she is likely to qualify for NHS continuing healthcare I would suggest that if the assessment has not been applied for you should speak to your Mother's GP for an initial assessment.


I hope this is helpful.


With best wishes.




*All information is correct at the time of publishing.

About Sheila

Sheila Scott OBE has now retired and over the years , prior to her retirement she has answered thousands of your social questions. You can still access the many questions below.

For Sheila Scott OBE as the former CEO of National Care Association (NCA), care is Sheila's life. She possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business, and as a leader in the care sector.

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