Mr Y was in receipt of NHS continuing care but on a review, the Clinical Commissioning Group (CCG) decided that he was no longer eligible.
Advising the client, Wrigleys considered that the CCG had not applied the correct test on this review. We also asked for a period of care that had not been assessed to be considered.
At a CCG appeal hearing the CCG accepted that Mr Y was eligible during the unassessed period but denied he had been eligible during the appeal period.
Wrigleys considered this decision to be irrational and that the CCG panel had not applied the correct test. The matter was appealed to an NHS England Independent Review Panel. The panel held that Mr Y was eligible during the appeal period. The panel also held that the decision making process of the CCG was unsound.
Mum suffered from dementia. A care team was in place but one of the children did not accept many of the decisions relating to her welfare made by that team. This caused significant difficulties for the care team and was detrimental to mum's best interests. The local authority had not taken any action.
In this case Wrigleys care and health team successfully pressed the local authority to pursue Court of Protection proceedings and we provided tactical advice on the conduct of the proceedings to members of the family. For reasons of cost, we did not represent the family members at hearings.
A father is unconscious in hospital having suffered a brain injury following a stroke. There is a dispute between the medical team and the family regarding whether it is in his best interests to continue life-sustaining treatment.
Wrigleys Health & Care Team are able to offer practical advice on the best interests process and on the law and procedure regarding decisions to withdraw life sustaining treatment.
Issue
The council were delayed in their means assessment but eventually argued that Mr P had disposed of the property to avoid care fees and was therefore not entitled to financial support.
How Wrigleys helped
Wrigleys argued that the council's delay had prejudiced their own enquiry by failing to make enquiries of Mr P when they were able to do so.
Outcome
The council conceded that the delay amounted to maladministration causing prejudice and reinstated the financial support.
Issue
The council decided to treat her as still owning the property which disqualified her from financial support for her care, even though there was no reason to think that she disposed of the property to avoid care fees.
How Wrigleys helped
Wrigleys pursued the matter through the available complaints processes.
Outcome
Though never conceding that their decision was wrong in principle, the council took no enforcement action and the disputed care fees became time expired freeing Mrs I from the debt.
Issue
The council argued that Mr D's mother did not qualify for financial support because the value of her share exceeded the means assessment limit.
How Wrigleys helped
Wrigleys argued that the method of assessment was wrong and produced a valuation on the correct legal basis which stated that in the local market the share had only a nominal value.
Outcome
The council conceded the point and disregarded the share in the means test.
Issue
Many people die in residential care without their care needs being assessed to see whether they are eligible for their fees to be paid by the NHS due to their ill health.
How Wrigleys helped
The executors of the estate of Mrs S were advised by Wrigleys that their account of the health of Mrs S suggested that she may have been eligible for NHS continuing care in the nursing home where she was resident before she died.
Outcome
An appeal was pursued and the estate was awarded reimbursement of 6 months care fees amounting to £8000.
Issue
The local health authority decided that the health directed aspects of Mrs P's package of care was only incidental to the residential care service that she was receiving.
How Wrigleys helped
An appeal was pursued arguing that the health aspects of Mrs P's needs were clearly the main service provision in the home and so she should have been entitled to have her care fees paid by the NHS.
Outcome
She was found to have been eligible for a period of 2 years before her death resulting in a substantial reimbursement of care fees.
Issue
Mr C was assessed as lacking capacity to make that decision and the council refused to agree to him leaving.
How Wrigleys helped
Wrigleys intervened arguing that the council failed to follow any of the correct procedures.
Outcome
Following Wrigleys intervention it was determined that Mr C did have capacity to make his own decision and he left the care home. He was subsequently awarded compensation for unlawful detention and his care fees were written off.
Issue
The council proposed to stop the direct payments which paid for care by the mother arguing that the payments should be used to commission care from an agency instead.
How Wrigleys helped
Wrigleys argued that the decision was unlawful because they had wrongly assumed that the mother and daughter were living together.
Outcome
The council rescinded the decision and the mother continued to provide the care paid for by direct payments.
Issue
Damages were held in the Court of Protection. The council refused to provide financial support because these damages exceeded the means testing capital limit.
Outcome
Following an intervention by Wrigleys the council agreed to disregard the damages and financial support was provided.
Issue
The council recited that they had not been given enough information to be satisfied that a reduction in fees was due.
How Wrigleys helped
Wrigleys provided a detailed reconstruction of the financial history of the matter showing that support should have been paid but the council even so refused to alter the calculation arguing that this information had been provided too late.
Outcome
After criticising this position on legal grounds the council conceded and reduced the claim for fees substantially.
How Wrigleys helped
Wrigleys advised that it would be appropriate for the sister to buy a converted vehicle. This was a reasonable purchase meeting her clearly justifiable needs.
Outcome
The vehicle purchase had the effect of reducing her capital to near the means testing threshold and she qualified for council support not long thereafter.
Issue
A parents group thought the existing service was the very useful and did not think there were any alternative services that could be commissioned privately.
How Wrigleys helped
Wrigleys provided advice to the parent group allowing them to respond effectively to the consultation.
Outcome
The council withdrew the proposals.
