Temporary Absence due to trial in a care home

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  • #23231
    davies3k
    Participant

    A claimant goes into a care home on a trial basis with a view to becoming permanent. After 8 weeks, the claimant then goes into hospital to receive medical attention.

    His temporary absence has now gone to 52 weeks. However, he will be going back to the care home shortly.

    On his return to the care home, do I start his 13 weeks absence from home again or just allow the 5 remaining weeks, as he’s already had 8 weeks?

    #11556
    Anonymous
    Guest

    I think this claimant might be caught by Reg 7(12) – if the 13-week trial falls within a longer period of absence from home it is still subject to an absolute 52-week limit. If that has already run out, he cannot get HB during this trial without going back home first.

    #11557
    davies3k
    Participant

    Ooops! Sorry but I’ve misled you. I meant that I realised that the absence could now extend to 52 weeks, rather than it had already done so!

    The point of my query was to find out if on his return to the care home after, say a month in hospital, a fresh 13 weeks should start, or should the original 8 weeks count towards the 13 weeks maximum for a trial period in a care home.

    Thanks,
    Karen

    #11558
    Anonymous
    Guest

    I think that this may be best explained by adding numbers of weeks to the periods:

    1st scenario:

    Claimant moves to Care Home on Trial Basis.
    Claimant is in Care Home for 8 weeks.
    Claimant moves to hospital.
    Claimant is in hospital for 8 weeks.
    Claimant returns to Care Home to continue trial.

    In this case, the claimant could be paid until they left hospital. The absence is all one absence. Whilst they are in the care home, they have 13 weeks to decide, once they go to hospital, this is extended to 52 weeks, so the payments can continue whilst they are in the hospital. Once they return to the care home, they are no longer in the hospital, and have been away from their home for over 13 weeks. As this is all one continues absence, the 13 weeks is counted from the start of the absence, and so they are no longer entitled to benefit under the temporary absence rules.

    2nd scenario:

    Claimant moves to Care Home on Trial Basis.
    Claimant is in Care Home for 8 weeks.
    Claimant moves to hospital.
    Claimant is in hospital for 2 weeks.
    Claimant returns to Care Home to continue trial.
    Claimant is in care home for 6 weeks.

    In this case, the claimant could be paid until the 13th week after they went into the care home. The absence is still all one absence. Whilst they are in the care home, they have 13 weeks to decide, once they go to hospital, this is extended to 52 weeks, so the payments can continue whilst they are in the hospital. Once they return to the care home, they are no longer in the hospital, and have not yet been away from their home for over 13 weeks. As this is all one continues absence, the 13 weeks is counted from the start of the absence, and so they are no longer entitled to benefit from the 13th week after they left their home under the temporary absence rules.

    3nd scenario:

    Claimant moves to Care Home on Trial Basis.
    Claimant is in Care Home for 8 weeks.
    Claimant moves to hospital.
    Claimant is in hospital for 8 weeks.
    Claimant returns home for a couple of days.
    Claimant returns to Care Home to continue trial.

    In this case, the claimant could be paid until the 13th week after they went into the care home the second time. The absence is now two absences.

    The first time they are in the care home, they have 13 weeks to decide, once they go to hospital, this is extended to 52 weeks, so the payments can continue whilst they are in the hospital. Once they return to their home, they are no longer in the hospital, and have not yet been away from their home for over 13 weeks, and so the temporary absence ceases. When the return to the care home to continue their trial the start of the absence is reset, and so they have another 13 weeks after they left their home for the second time under the temporary absence rules.

    Hope this long-winded explaination helps (and is correct, I’m going to have to do a lot of re-thinking if its wrong, coz thats how I’ve been explaining it for the last 3 years :))
    Jon

    #11559
    davies3k
    Participant

    Thanks for that I think the 2nd scenario is this answer I was looking for.

    Karen 😀

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