Mrs Stanbury was diagnosed with dementia and had a past medical history of breast cancer, congestive obstructive pulmonary disease (COPD), a hiatus hernia, hypothyroidism and recurrent urinary tract infections. She became a resident at Silver Court Care Home in September 2017. She remained a resident at this care home until her death on 28 October 2018.
Mrs Stanbury’s daughter approached Hugh James Solicitors in February 2022. We requested that the local Integrated Care Board (“ICB”) undertake a retrospective review of the late Mrs Stanbury’s needs from date of her entry into the care home.
A retrospective review was subsequently completed and the ICB initially concluded that Mrs Stanbury was not eligible for NHS funded continuing healthcare. Hugh James appealed the decision and attended a local resolution meeting alongside Mrs Stanbury’s daughter.
We asked the appeal panel to reconsider their decision for the period from 10 September 2018 onwards. Mrs Stanbury’s cognitive impairment had increased over the period, and by this date she was no longer able to communicate her needs, and so was totally dependent on staff to anticipate and meet her needs in her best interests. From September 2018, the documented evidence confirmed that Mrs Stanbury’s health and nursing needs fluctuated due to recurrent chest infections, which were no longer responding to antibiotics, and there was a clear increase of needs across a number of care domains as she became increasingly short of breath and lethargic. Mrs Stanbury had lost weight since her admission and by September 2018 was declining food regularly and noted to be underweight and was increasingly experiencing nausea. She developed swallowing issues in September 2018 and was noted to be at risk of aspiration. An end-of-life care package was late introduced from 23 October 2018.
The ICB accepted our submissions at the appeal meeting and in January 2024 agreed to retrospectively award Mrs Stanbury NHS funded continuing healthcare from 10 September 2018 onwards. The ICB agreed to reimburse the estate of Mrs Stanbury just over £10,000 which included all care home fees paid from this date together with interest.
Mrs Brookes, who is the daughter of the late Mrs Stanbury stated,
“I am very positive about the experience I have had” and would “definitely recommend to anyone who may be looking at claiming for continuing healthcare”.
