Summary: Mr X complained about the Council’s delay in considering his request for his mother (Y’s) residential care home fees to be paid through a Deferred Payment Agreement (DPA). He also complained of the Council’s poor communication in relation to this. The Council was at fault because it took 10 months to issue the DPA contract. The Council should make a payment to recognise the distress, frustration and uncertainty this caused. However, there is no fault in how the Council communicated with Mr X regarding the DPA.

The complaint

1. Mr X complained about the Council’s delay in considering his request for his mother (Y’s) residential care home fees to be paid through a Deferred Payment Agreement (DPA). He also complained of the Council’s poor communication in relation to this.
2. Mr X says the matter caused him distress, frustration and uncertainty.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
5. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

6. I have considered information Mr X has provided.
7. I considered information from the Council.
8. I considered the relevant law and guidance.
9. Mr X and the Council had an opportunity to comment on this draft decision. I considered comments before making a final decision.

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What I found

Relevant Law and Guidance

Financial assessment

10. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment.

12-week property disregard

11. The regulations under the Care Act 2014 create space for people to make decisions as to how to meet their contribution to the cost of their eligible care needs. A local authority must therefore disregard the value of a person’s main or only home for 12 weeks in the following circumstances:
• when they first enter a care home as a permanent resident
• when a property disregard other than the 12-week property disregard unexpectedly ends because the qualifying relative has died or moved into a care home
• In addition, a local authority has discretion to choose to apply the disregard when there is a sudden and unexpected change in the person’s financial circumstances. In deciding whether to do so, the local authority will want to consider the individual circumstances of the case. 

Deferred Payment Agreement

12. A Deferred Payment Agreement (DPA) allows someone to defer paying care costs until a later date. By entering into a DPA, a person delays paying care costs until a later date, usually by having a legal charge placed on their property by the local authority.
13. The local authority must offer a person DPA if they meet all the following criteria:
• the local authority agree the person has care needs that should be met through a care home placement, and;
• the person has a legal or beneficial interest in a property that is their ‘main or only home’, and;
• the person has less than or equal to £23,250 in capital, excluding their share in the value of their home, and;
• the home is not disregarded in the financial assessment; and
• the person agrees to the conditions in the deferred payment agreement.
14. The Care and Support Statutory Guidance says where relevant, local authorities should provide information and advice on DPAs at the earliest appropriate opportunity during the period of the 12-week disregard. Local authorities should aim to ensure that people are able to make a smooth transition from the 12-week disregard to the DPA if they opt to enter into an agreement. This means ensuring as far as possible that a DPA is available by the first day of week 13.

What happened

15. Mr X complained on behalf of his mother Y who moved into a care home permanently in October 2022. Mr X was considering renting Y’s property out to cover care costs and wished to enter into a DPA with the Council.
16. The same month Y’s social worker sent Mr X a financial assessment form for him to complete so the Council could determine whether Y was eligible for a DPA. Mr X responded two weeks later saying he had been on holiday but would return the form the next day.
17. In December 2022, Mr X called the Council and said he had tried to contact the social worker as he was struggling to complete the form but she had not responded. The same day the social worker called him back, but Mr X was busy and could not take the call.
18. In February 2023, the social worker emailed Mr X requesting he return the financial assessment form. The social worker had two phone calls with Mr X shortly after to help him complete the form. Mr X sent the completed form to the social worker in March 2023.
19. The same month Mr X contacted the Council as he started receiving invoices from Y’s care home and did not know why. The Council explained Y did not qualify for a DPA as she was over the capital threshold. However, there was an unpaid invoice of approximately £14,000 which Y owed the Council for unrelated building works the Council had previously carried out on her property. The Council explained once Y paid this it would carry out a re-assessment of her finances as this would put her under the capital threshold. In April and May 2023, the Council reiterated to Mr X on two separate occasions that once Y had paid the invoice, it would re-assess Y’s finances and DPA request.
20. Mr X settled the £14,000 invoice with the Council on Y’s behalf in October 2023. In December 2023, Mr X told the Council he wanted to apply for DPA and it carried out a financial re-assessment.
21. In February 2024, Mr X made a complaint to the Council because of the delays with setting up a DPA. He also complained of poor communication regarding the financial assessment form and the invoices he was receiving from Y’s care home.
22. The Council issued a final response in May 2024 saying overall there had been consistent communication. However, it did note some gaps which it attributed to competing demands and staff leave. The Council apologised for this. It also agreed the DPA process had been protracted. It apologised for the delays it was responsible for but said some of the delays were a result of Mr X’s inaction.
23. Mr X remained unhappy with the Council’s handling of the matter and complained to us.
24. The Council issued the DPA contract to Mr X in October 2024.

The Council’s response to our enquiries

25. The Council accepts there were delays with the DPA which it was responsible for. The Council says it issued the DPA application form in April 2024, but Mr X did not return this until June 2024. The Council requested further evidence in June 2024 which Mr X submitted the same month. It then issued Mr X with the DPA contract in October 2024.

My findings

Deferred Payment Agreement

26. In December 2023, Mr X told the Council he wanted to apply for DPA. However, the Council did not send Mr X the DPA application form until April 2024 which was four months after his DPA request. Once the Council received further information from Mr X in June 2024, it did not issue the DPA contract until four months later in October 2024. The Care and Statutory Support Guidance suggests a Council should have DPA in place within a 12-week timescale. However, it took the Council 10 months to issue the contract which was fault and caused the matter to drift without meaningful progression. The delays in the DPA process have caused Mr X distress, frustration and uncertainty.

Poor communication

27. Mr X says he tried to contact the social worker numerous times about the financial assessment form but she did not get back to him. Limited evidence has been provided to support this. The case records show the social worker emailed Mr X the financial assessment form mid-October 2022 and called him late October 2022. The records also show Mr X requested a call from the social worker in December 2022 for help with the form. The social worker called him back the same day but he said he was busy. In February 2023, the social worker emailed Mr X again requesting him to complete the form and they had a phone call at the start of the March 2023 to help him complete and return this. The evidence shows consistent communication with Mr X and therefore, the Council was not a fault.
28. Mr X says he informed the Council he was getting invoices and final demands regarding Y’s care fees. However, he received no updates or communication from the Council about this. In March 2023, Mr X contacted the Council about receiving invoices and requested a call back. The Council called him in March, April and May 2023 advising he was receiving invoices because his mother was over the capital threshold to qualify for a DPA and a financial re-assessment would take place to assess capital depletion once Y had paid the £14,000 bill. The case records show the Council explained why Mr X was receiving invoices for Y’s care and therefore, was not at fault.

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Agreed action

29. Within one month of the final decision the Council has agreed to take the following action:
1. Apologise to Mr X to recognise the distress, frustration and uncertainty the delays in the DPA process have caused. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology.
2. Pay Mr X £150 to recognise the distress, frustration and uncertainty the delays in the DPA process have caused.
3. Review the time taken to get from Mr X’s DPA request to issuing the DPA contract to determine what caused delays and what action can taken to reduce such delays in future.
30. The Council should provide us with evidence it has complied with the above actions.

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Final decision

31. I completed this investigation. I found fault and the Council agreed to my recommendations to remedy the injustice caused by the fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman