Watchdog: Families left 'in real distress' around care home fees
Public Services Ombudsman says current system is "unsustainable''
The system for deciding who pays care homes fees in Northern Ireland is "unsustainable'', a watchdog said.
According to the Public Services Watchdog families 'are in real distress' amid a lack of certainty around who should pay for continuing care and failure of health trusts to carry out assessments of need.
If an assessment finds someone has primarily a health care need rather than social care then the trust is responsible for paying for that care regardless of setting.
If the primary need is identified as social care then trusts are entitled to recover the costs of that care.
Ombudsman Margaret Kelly said: "I believe the current system is unsustainable, which is why I am calling on the trusts, together with the Department of Health and others to agree a uniform approach for assessing all future applications for continuing healthcare in Northern Ireland, and to make this information available to those in care and their families.''
She said health trusts are reluctant to apply the existing Department of Health guidance because they are awaiting the results of a consultation it carried out in 2017.
"The failures to carry out the assessments caused the families who complained to us real distress and frustration.
"It's vital that other families who may be facing a decision over whether to use life savings or sell the family home to fund the care of a loved one are given clarity over whether they are entitled to CHC.''
The Ombudsman investigated claims from a family that the Southern Health and Social Care Trust failed to carry out a continuing healthcare assessment for their father.
It upheld the complaint and concluded that the failings caused the family frustration and distress over a prolonged period.
The Ombudsman asked the Belfast Health and Social Care Trust, in consultation with the other trusts and health and social care organisations, to agree a uniform approach for assessing all future applications for continuing healthcare in Northern Ireland.
In a statement a spokesperson for the Department of Health said:
"The Department of Health carried out a comprehensive review on the current continuing healthcare policy.
"This was a complex piece of work involving a number of activities including analysing current practice across each HSC Trust; obtaining information from key stakeholders including Age NI and representatives from the Commissioner for Older People; and carrying out research on continuing healthcare practice across other jurisdictions.
"The review found that there was some confusion about continuing healthcare and its applicability and the risk of variance in continuing healthcare practice across Northern Ireland.
"The findings from this exercise facilitated the identification of a number of options in order to clarify continuing healthcare policy in Northern Ireland.
"A public consultation exercise was launched on 19th June 2017 and closed on Friday 15th September 2017.
"A total of 43 responses were received and analysed. It is intended to publish the Consultation Analysis of Responses Report on the Department’s website shortly.
"The Department will then set up a working group with key stakeholders within the HSC to implement the preferred option and develop associated guidance."