1. Record all meetings. This will provide evidence if there is a dispute.
2. Know the National Framework. This enables you to challenge due process.
3. Challenge everything that is contrary to the National Framework and local policies.
4. Ask the medical experts that look after you/your loved one to assess you against the relevant Decision Support Tool domains so you can use it in an assessment.
5. Question the 'expertise' of the professional(s) conducting the meeting. If they are not experts in your medical condition, they need to accept the views of the experts (R (Clarke) v Sutton LBC).
6. Read between the lines. What are they not saying?
7. Be careful when they talk about 'care'. Stating that care is required does not differentiate between health care and social care without a primary health need. Ensure clarity because social care is means tested.
8. 'Poor communication' is not an acceptable excuse to carry on despite ignoring due process. Challenge this.
9. If possible, have someone with you at all meetings. They provide reinforcement and are a witness to proceedings.
10. Prepare in advance. Have everything ready, including your judgement of Decision Support Tool domains.
11. Use email and letters for everything so that you have everything in writing. The evidence could be crucial for complaints.
12. Domains should be assessed as if care is not in place. If someone (including a loved one) provides voluntary care, how would things be if it were not there. A primary health need either exists or it doesn't, it is irrelevant who is currently providing the care as the CCG are not allowed to assume that a voluntary carer is willing and able to continue.
13. Understand the principle of 'well-managed needs'. They are still needs and should be assessed as such.
14. If there is a care agency/home already involved, check the care plan / notes. Are they reflective of the needs? If not, be prepared to explain why not. Remember, in accordance with the National Framework, well-managed needs may not be recorded in care notes as effectively. This is not always understood by assessors.
15. Social care is permitted under Continuing Healthcare but CCGs sometimes try to share the cost of the package with the Local Authority. The Local Authority should only be involved when the care provided is not beyond their legal limit.
16. Make sure you can back up everything that you say.