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Our Nursing Care department is one of the leading national experts in the recovery of wrongly paid care home fees; our specialist nursing care team have successfully recovered over £200 million for our clients since the department was set up in 2006.
If an individual is in a nursing or care home because of physical or mental health needs, the cost of their care should be covered by the NHS Continuing Healthcare funding scheme, regardless of the individual’s wealth. However, with around 40% of Britain’s 440,000 care home residents self-funding their care, thousands of families in England and Wales could be wrongly paying care fees.
Therefore, if you or a relative are paying care home fees, you could be due a refund.
Our team of specialist nursing care lawyers can help you whether you need to request a NHS Continuing Health Care (CHC) assessment, make an appeal for an CHC funding decision or you need to claim back nursing care fees that should not have been paid. We will always do our very best to get you the result that you are looking for. However, there are very strict deadlines so it is important that you fill in the form below as soon as possible to give you the best chance of success.
Our team have been working in this area for over 15 years and have been successful for over 6000 families in securing free funding. We have also recovered £200m for our clients. The most any one firm has recovered in the UK.
There are many firms who provide advocacy services in this area, so why should you instruct a solicitor?
As solicitors we must be open and transparent about the cost to instructing us. We offer a number of funding options which will be provided to you in writing. It is important you fully understand the options available to you.
We have put together the most frequently asked questions we are asked when someone is considering a nursing care claim. However, if there is a question that we haven’t covered here or you would like more information, contact one of our specialist lawyers
It is possible for you to pursue a claim independently without instructing a solicitor or advocate. However, it is a difficult process, and we have many clients who have initially tried themselves and found the process challenging.
There are many companies who specialise in this area. However, as solicitors we are regulated and very experienced in what we do.
The team at Hugh James have more than 15 years of experience and have won awards from The Law Society and Age Cymru for their work.
Some of our clients question how non-medically qualified professionals can challenge health decisions. Whilst the people making decisions regarding eligibility for continuing healthcare are health and social care professionals, their decisions are being challenged and it is our job to demonstrate they are unsound by analysing medical evidence and applying it to the criteria. Whilst the process is not legal, it is a dispute resolution process and many Independent Review Panel chairs are former solicitors and barristers.
Due to Hugh James experience and depth of knowledge, we are respected by health and social care professions and panel chairs for the work we do.
The skills developed by lawyers – analytical, evaluating, interpreting and advocacy is key in being successful and it is of no surprise that all companies employ law graduates to undertake this work.
Unlike solicitors, unregulated advocacy companies are not obliged to provide clients with the best advice and be clear and transparent about their charges. They cannot advise on the option of court proceedings against health authorities for unsound decisions by way of Judicial Review, as they cannot by law undertake reserved legal activities. Read our blog answering can you challenge an Independent Review Panel decision?
The other added advantage of instructing a solicitor is protection if something goes wrong. Sadly, we have seen first-hand, companies not providing accurate advice leading to clients losing the chance to proceed or companies no longer being in business. Solicitor practices are far more stable, but in the unlikely event that something does go wrong, clients can at least rely on solicitor’s professional insurance policy. They can also have recourse to the Solicitors Compensation Fund.
Our team have been working in this area for over 15 years and have been successful for over 6000 families in securing free NHS funding through current assessment and/or retrospective reviews.
We provide a free initial assessment, and we will advise you at the outset whether you have a case.
We have recovered £200m for our clients. The most any one firm or company has recovered in the UK.
We act on behalf of individuals, families and for advocates. We instigate current assessments, appeals and retrospective reviews. We have also acted for families in securing s.117 aftercare funding from the local authority and in cases where families are paying a top-up. We will also proceed with bringing court proceedings against health authorities by way of judicial review claims. Read our blog answering can you challenge an Independent Review Panel decision?
Whilst we will ask the case proceeds as soon as possible we have no control over the speed in which the health authorities progress the claim and it depends on the decisions made by the health authority. In our experience, it takes 24 months for a case to reach a retrospective panel. However, current assessment should be undertaken in a timely manner and are usually completed within 3-6 months. We will always keep you up to date as your case progresses.
We continue to appraise the case as it progresses and provide you with advice at each stage. We do not raise our client’s expectation and if we consider that your claim is unlikely to succeed at any stage, we will let you know. The NHS Continuing Healthcare appeal process is difficult for individuals and their families, and it is not in our client’s interest to proceed with a claim if it will fail.
Although the review process is effective and most claims settle, we cannot guarantee success.
If you remain dissatisfied at the end of the review it may be necessary at that stage to consider issuing court proceedings. The purpose of those proceedings would be to challenge the decision of the review panel. We should point out that challenging those decisions are not straight forward and the grounds for challenging are limited.
We are pleased to say most claims settle without the need to issue court proceedings. In the unlikely event that consideration needs to be given to issuing court proceedings we will discuss matters further with you at that stage and there will be no obligation on you to proceed.
Hugh James is the UK’s the leading law firm in the recovery of wrongly paid care costs.
Our team have been working in this area for over 15 years and have been successful for over 6000 families in securing free NHS funding through current assessment and/or retrospective reviews.
We have a 60% success rate and have recovered over £200m in wrongly paid care fees for patients and their families. The most any one firm or company has recovered in the UK. Our biggest single recovery so far is £450,000, with an average settlement value of £30,000.
We provide a free initial assessment, and we will advise you at the outset whether you have a case.
Below are some examples of how we helped our clients.
Doreen Homewood entered a care home in Wakefield in 2014, at the age of 82, due to a number of deteriorating health problems. She was unable to communicate her needs and required comprehensive assistance in daily life and taking her medication. She remained at the care home until she sadly died in October 2018.
Her family applied to NHS Continuing Healthcare for reimbursement of her care fees. They were turned down on multiple occasions. Following numerous appeals and finally, assistance from Hugh James, care fees exceeding £100,000 have been reimbursed to the family.
Doreen’s son, Tony Homewood, said: The assessment procedure is gruelling and no matter how well you think you can fight your own corner, trust me, it’s difficult, time-consuming and the whole thing is loaded against you.
Barbara Stretch was diagnosed with Alzheimer’s disease and lived at Ashburnham House care home in Morecambe from November 2003 until she died in June 2011.
Due to her Alzheimer’s disease, she was unable to manage any of her own care. Barbara could also demonstrate aggressive and unpredictable outbursts of behaviour and was sectioned under the Mental Health Act.
Her daughter applied for a retrospective review of eligibility for NHS care funding in 2012. Midlands and Lancashire Commissioning Support Unit (CSU) was asked to review the case on behalf of Morecambe Bay Clinical Commissioning Group (CCG). Unfortunately, it took them until 2016 to deny the funding, which Hugh James appealed.
The appeal was rejected on several occasions. Hugh James then sought an independent review in 2019. The family recovered over £43,000 this year, for fees that should never have been paid. Due to the unreasonable delays by Morecambe Bay CCG, an interest payment of almost £12,000 was included in the figure.
Barbara’s daughter, Mrs Greenwood, said:
Continue. Don’t give in. It hurts when they say no to funding. They said my mother wasn’t ill at the first meeting. I will never forgive them for that.
Florence Mitchell was admitted to hospital age 84, after fracturing her hip in a fall at home. She was transferred to Harrowby Lodge in Grantham, Lincolnshire to be closer to her daughter and lived at the home until she died in 2007.
Mrs Mitchell suffered from Alzheimer’s disease which made her confused, disorientated and caused short- and long-term memory loss. She was totally dependent on care staff for all her needs.
She was awarded NHS care funding in 2006, but it was removed six weeks before she died. In 2012, her family asked Hugh James to help them get a retrospective review of full NHS funding.
Arden and GEM Commissioning Support Group (CSU) were asked to review the case on behalf of Lincolnshire Clinical Commissioning Group. After four years, they refused to review the case as Florence had been assessed before she died. Hugh James challenged this and eventually, they reviewed her case but decided Florence was not eligible for care funding. Following a number of appeals, her family have now secured full NHS funding for the whole period and have been refunded £75,000 for care home fees which they should never have had to pay.
Florence’s daughter, Jacqueline Mitchell said:
This is not money we have ‘won’ – it is money that never should have been taken from my mother in the first place. When mum went into care, we were simply told she would have to sell her home pay for the costs of her care. That’s not right.
Eric Halloway was diagnosed with Alzheimer’s disease and lived in care homes in South Kent from 2004 until he died in 2009. He sold his home to pay his care fees.
Mr Halloway suffered with severe dementia. He was also anxious and depressed, unable to communicate, incontinent and in pain. In 2012, Hugh James requested a full retrospective review of Mr Halloway’s period in care. In July 2016, an organisation working on behalf of the NHS concluded that Mr Halloway was not eligible for NHS funded care at the time.
Following numerous appeals and partial overturns, the case went all the way to an Independent Review Panel in January 2020. The panel decided that Mr Halloway was eligible for a full refund of all care fees. After 8 years of fighting, the family recovered a total of over £170,000 in settlement of the claim – all fees plus interest.
Eric’s son, Richard, said:
My father spent 22 years in the RAF – we felt it wrong that he should have been forced to sell his home and use his savings to fund his care. This process has taken 8 years to complete. I urge other families not to be swayed by the system.
Sheila Flower has been a resident in a care home in Newport since in 2004 at the age of 61 due to her deteriorating mental and physical health.
Mrs Flower suffers from bi-polar, diabetes, depression and hallucinations. Mrs Flower has often refused to eat and take medication and has been admitted to hospital a number of times.
Mrs Flower’s daughter contacted Hugh James in 2012 after she was denied continuation of NHS healthcare funding. A retrospective review of Mrs Flower’s needs was requested. Unfortunately, it took until 2019 for the health board to reach an initial decision regarding part-funding. Following negotiation, Mrs Flower was refunded £75,000 covering three years of wrongly paid care fees and interest.
Mrs Flowers’s daughter said:
The assessment process feels like a tick box exercise and is not a reflection of my mum’s needs. Whilst we’ve had some victory, we are still waiting for the whole claim to be determined.
Mrs Patricia Heywood Patricia Heywood suffers with Alzheimer’s disease and due to her health is currently cared for in a nursing home on the outskirts Huddersfield.
She entered a residential home in 2018, but as her health deteriorated, she was moved to a nursing home in 2019. Due to suffering with dementia, Patricia can exhibit challenging behaviour, is disorientated to time, place and person. She cannot communicate effectively, requires all her medication to be administered to her and is mobile, but at a high risk of falls.
Mrs Heywood’s daughters approached Hugh James in 2019 and we requested an assessment of her current needs and a retrospective review from Mrs Heywood’s entry to the residential care home in 2018. A Decision Support Tool was completed in August 2019 which found Mrs Heywood eligible for NHS Continuing Healthcare and her ongoing care home fees of over £3000 per month to be met by the NHS.
A retrospective review was then completed and following resolution meetings in 2021 confirmed that Mrs Heywood should have been eligible for NHS Continuing Healthcare since her admission to the care home in 2018. Mrs Heywood was reimbursed over £40,000 which included all the care home fees she paid from 2018 together with interest.
Debbie Emms said:
I would not hesitate to recommend Hugh James. Without their legal expertise I definitely wouldn’t have been able to secure mum’s retrospective reimbursement.
Hilda Underwood was diagnosed with dementia and lived in a care home in Leigh On Sea in Essex from 2007 until she died in 2011.
Mrs Underwood suffered with severe dementia. Due to her dementia, she had challenging behaviour, unable to communicate effectively and required all care to be provided to her. Initially, she was able to mobilise, but suffered a number of falls. As her health deteriorated, she became immobile.
Hugh James requested a retrospective review, in 2012, of Mrs Underwood’s past care. Following numerous appeals through Arden and GEM Commissioning Support Unit and to an NHS England Independent Review Panel, the NHS concluded that Mrs Underwood was eligible for NHS Continuing Healthcare for the last year of her life and her care fees should be refunded. Her family recovered over £35,000 in wrongly paid care fees and interest.
Lisa Morgan
Lisa Morgan is a Partner and Head of the Nursing Care department. She is regarded as an experienced and specialist solicitor leading in the niche area of continuing healthcare.
She has been instrumental in developing a niche legal department in Hugh James, which comprises of 40 fee earners who solely act for the elderly and families in recovering wrongly paid nursing fees.
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