Reclaiming £40k in Care Fees

This week we saw another positive result for a family who had been wrongly charged for care.  Despite their relative presenting with extremely challenging behaviour, such that her safety and that of those around her was placed at serious risk, the CCG assessed her as having only a “HIGH” level of need in the Behaviour domain.

The family appealed the outcome of the assessment, before coming to Farley Dwek Solicitors for expert support with the Local Resolution process.

Farley Dwek Solicitors obtained copy of the patient’s care records and drafted a Written Submission, detailing every instance of challenging behaviour in the three months leading up to the CCG’s assessment.  At the LRM, we presented our evidence to the CCG and argued that its assessment of the Behaviour domain was patently inaccurate and clinically unsound.

Faced with the evidence we had collated, the CCG was forced to agree to increase the level of need in Behaviour to “SEVERE”.  Along with an agreed “SEVERE” level of need in Cognition, the patient was automatically found eligible for CHC and reimbursed almost £40,000 in wrongly paid care fees and interest.  This was for a three-month period, so we can only imagine the ongoing costs to the patient had her family not sought our expert assistance.

We were so pleased to help this family achieve justice for their relative and secure the funding to which she was legally entitled.