Summary: Mr B complained the Council proposed increasing his father’s care contributions and it repeatedly failed to respond to his correspondence when he asked for clarification about the costs. He also says the Council has failed to resolve the issue of the additional costs for his father’s incontinence pull up pads. The Council was at fault for its delays in responding to Mr B’s correspondence and its complaints handling. It also delayed dealing with the issue of the incontinence pull up pads. The Council has agreed to our recommendations to address the injustice caused by fault.

The complaint

1. Mr B complained the Council proposed increasing his father’s (Mr C) care contributions and it repeatedly failed to respond to his correspondence when he asked for clarification about the costs. He adds the Council wrongly sent correspondence to Mr C and the officer he was complaining about responded to his complaint. Finally, he says the Council has failed to resolve the issue of the additional costs for Mr C’s incontinence pull up pads.
2. Mr B says the matter has caused distress and he has been put to time and trouble raising the issues. He adds Mr C’s basic care needs are not being met.

Back to top

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 may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by someone we consider to be suitable. (Local Government Act 1974, section 26A(2), 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)

Back to top

How I considered this complaint

6. I considered information from Mr B. I made written enquiries of the Council and considered information it sent in response.
7. Mr B and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

Relevant law and statutory guidance

8. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
9. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.
10. The financial limit, known as the ‘upper capital limit’, exists for the purposes of the financial assessment. This sets out at what point a person can get council support to meet their eligible needs. People who have over the upper capital limit must pay the full cost of their residential care home fees. Once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees. Where a person’s resources are below the lower capital limit they will not need to contribute to the cost of their care and support from their capital.
11. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area.

What happened

12. This chronology includes an overview of key events and does not detail everything that happened.
13. Mr C has dementia, and he lives in a residential care home. He does not have the mental capacity to make decisions about his care and support. Mr B deals with such matters on Mr C’s behalf.
14. The Council wrote to Mr C in January 2023 and enclosed a financial assessment for 2022-2023. It said it was increasing the amount he had to pay towards his residential care.
15. Mr B emailed the Council and questioned why it sent the letter to Mr C when he does not have mental capacity. He also queried the calculations from the financial assessment.
16. Mr B sent the Council several chaser emails asking for a response.
17. The Council completed a financial reassessment at the end of January and sent it to Mr C.
18. The Council emailed Mr B in February and provided a copy of the reassessment. Mr B responded and said it still contained the wrong figures. He said it referred to Mr C’s income from five private pensions, when he received income from six pensions. He said it miscalculated Mr C’s weekly income. He also reiterated that any correspondence should be sent to him and not Mr C.
19. Mr B complained to the Council on 20 February about its handling of the matter. He said it failed to respond to his emails since January. He asked it not to take any further money from Mr C’s account until it resolved the matter.
20. Mr B chased the Council for a response several times throughout February, March, and April. He sent a further email on 27 April and said the manager of the care home said Mr C required pull up pads to help manage his incontinence. The manager said Mr C would need to pay for the pads as the care home did not supply them. This would increase his monthly expense by £65. Mr B asked the Council to include the additional expense in its calculations of the contribution Mr C had to pay towards the costs of his care.
21. Mr B chased the Council for a response at the beginning of May. The Council responded and apologised for the delay in responding to his complaint. It said the care home supplied incontinence products.
22. Mr B responded and asked why it had failed to respond to his correspondence since February. He said the manager of the care home suggested buying different incontinence pads. He said the pads the care home used were no longer suitable for Mr C as he was regularly removing them.
23. The Council responded to Mr B’s complaint on 17 May. It reiterated its apologies for the delay in responding. It apologised for sending letters to Mr C. It said Mr C’s care and support plan did not state he needed specialist products. It said he needed to provide the last three months’ worth of receipts to show the expense of the products. It also said it assessed all six of Mr C’s pensions. It said once he received Mr C’s new award letter, and if he felt the updated income was not correct, he should provide proof of Mr C’s new pension awards. It said it did not uphold his complaint.
24. Mr B asked the Council to review its response. He said it was unacceptable the officer he was complaining about responded to his complaint. He said he could not provide receipts for the incontinence pads as Mr C could not afford them. He also continued to dispute its estimation of Mr C’s income.
25. Mr B sent the Council further information for it to consider. The Council responded in June and said it had conducted further reassessments of Mr C’s contribution to his care. It asked Mr B to check the reassessment and confirm if he was satisfied with the outcome. It said it referred the incontinence pads issue to the social work team.
26. Mr B emailed the Council and accepted its revised calculations.
27. The Council arranged a meeting in July to review Mr C’s care and support plan. Mr C’s social worker, the manager from the care home and Mr B attended. The manager from the care home said the only change in Mr C’s care was his incontinence. She said the care home did not supply the incontinence pads Mr C needed. She said Mr C was wetting himself because he was removing the normal pads.
28. Mr B emailed the Council on 14 and 31 August and chased for an update. The Council responded and said the social worker he had been dealing with had left. It asked for further information and said the matter needed to be referred to the bladder and bowel team through Mr C’s GP. Mr B responded on the same day and provided the further information.
29. The Council responded to Mr B and said it had contacted its finance team about whether it could deduct the costs of buying the incontinence pads from Mr C’s contribution. It emailed Mr C’s GP on the same day and asked for an urgent referral to the bladder and bowel team.

Back to top

Analysis

30. The Council repeatedly delayed responding to Mr B’s communication about the financial assessment and reassessment. This is fault. Mr B initially raised his concerns in January. The Council completed the reassessment at the end of January 2023, but it did not address the questions Mr B raised. Mr B then repeatedly chased for a response to his complaint Council throughout February, March, and April. The Council did not issue a substantive response until May, and the issue was not resolved until June. This Council’s fault caused Mr B frustration and he was put to time and trouble chasing a response to his complaint.
31. The Council also wrongly sent the financial assessments to Mr C, when Mr B deals with such correspondence on his behalf. I welcome the Council apologised for this when it responded to Mr B’s complaint.
32. The officer Mr B complained about responded to his complaint. The Council says the officer was originally a finance officer and she then progressed within the team to a complaints officer. It says the officer was unaware she should not address complaints about herself, and it has now told her all complaints about her conduct should be forwarded to the manager to deal with. While I note the Council’s comments and welcome the steps it has now taken, it was inappropriate for the officer to deal with a complaint about herself because it is not independent. The officer also said she did not uphold Mr B’s complaint, when she had apologised for wrongly sending correspondence to Mr C. This is a contradiction, and it left Mr B feeling the Council was not taking his concerns seriously.
33. Mr B told the Council in April about Mr C’s incontinence pull up pads. The Council did not take any steps to contact the care home to find out more about this issue until the review in July. This delay is fault especially as Mr B explained Mr C was regularly wetting himself. The Council also failed to communicate with Mr B appropriately after the review meeting, and he was put to further inconvenience chasing for updates. It only contacted the GP at the end of August and made a referral after prompting from Mr B.
34. The Council says it does not provide or fund incontinence products as this is a recognised health need. It says it should not be penalised for any delay from health services. While I note the Council’s comments, given the seriousness of the matter, it should have acted sooner in contacting the relevant organisations when Mr B brought the matter to its intention in April. The Council’s delay leaves Mr C with some uncertainty that the matter may have been resolved sooner. The Council needs to continue liaising with health services to seek a resolution in this matter.

Back to top

Agreed action

35. To address the injustice caused by fault, by 15 December 2023 the Council has agreed to:

• Apologise to Mr B for his frustration, inconvenience and time and trouble.
• Apologise to Mr C for his uncertainty.
• Pay Mr B and Mr C £250 each.
• Continue to liaise with health services to resolve the matter surrounding Mr C’s incontinence pull up pads. It should keep Mr B appropriately updated.

36. The Council has agreed to issue written reminders to relevant staff by 17 January 2024 to ensure they appropriately communicate with service users or their representatives about issues to do with financial assessments and their care without undue delay.
37. The Council should provide us with evidence it has complied with the above actions.

Back to top

Final decision

38. There was fault by the Council, which caused Mr B and Mr C an injustice. The Council has agreed to my recommendations and so I have completed my investigation.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman