Summary: We will not investigate Mrs X’s complaint about the Council’s refusal to pay her mother’s full care home fees and its decision that her mother can be safely moved to a cheaper care home. This is because the Council agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused by the likely fault.

The complaint

1. Mrs X complains about the Council’s refusal to pay her mother’s full care home fees. She says the Council decided her mother can be moved safely to an alternative care home. She says this meant she felt forced into continuing to pay a third party top up to ensure her mother can stay in her current care home. Mrs X says she is struggling with the financial commitment of the top up fees.

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The Ombudsman’s role and powers

2. 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)

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How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. In August 2022, Mrs X decided to move her mother, Mrs Z, into a care home. The Council confirmed it was not involved in this decision.
6. In October 2022, the Council explained to Mrs X that its rate of contribution for a dementia residential bed was just over £620 a week. The Council said Mrs Z’s current care home cost over £1400 a week. The Council told Mrs X that if she wanted Mrs Z to remain in the current care home, she would need to pay a third party top up of around £820 per week. The Council confirmed it could not fund above the Council’s rate and that there were care home placements available at that rate.
7. In November 2022, Mrs X signed a third-party agreement. This contract set out clearly the amount of third-party contribution required and Mrs X’s responsibility to make this payment. The contract also detailed that failure to keep up payments may result in the resident having to move to another home.
8. Mrs X contacted the Council for financial assistance as she was struggling to pay the third party top up she had agreed to.
9. In November 2023, the Council completed a mental capacity assessment. This was to determine Mrs Z’s capacity to make decisions about her care needs and placement. The outcome was that Mrs Z lacked capacity.
10. The Council then completed a best interest decision to decide where Mrs Z would live given Mrs X’s difficulties with sustaining the third party top up fees. The best interest decision noted the Council had assessed Mrs Z as low risk if required to move to another care home and so the Council could meet her needs in a more cost-effective way placement.
11. However, the care assessment the Council had completed did not show any reflection or consideration of what the level of risk was to Mrs Z should she be moved to a new care home. It would have been good practice for the Council to demonstrate consideration of the impact of a move on Mrs Z’s wellbeing, especially given her diagnosis of dementia and the view that she was happy and settled in her current care home.
12. Without evidence the Council had properly considered the matter, there is uncertainty as to whether it is proportionate and appropriate for Mrs Z to be moved to a more cost-effective care home. Therefore, if we were to investigate, it is likely we would find fault as the Council’s decision making during the best interest meeting was flawed.
13. We therefore invited the Council to remedy this by now completing an assessment. The Council is to evidence its consideration of the impact to Mrs Z if she were to be moved to a new care home, including consideration as to whether the move would cause any risks/detrimental impact to her and whether steps can be taken to mitigate those risks. The Council also needs to consider, and evidence its rationale, whether it is satisfied it is appropriate and proportionate to move Mrs Z to a cheaper care home to meet her needs.

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Agreed remedy

14. To its credit, the Council agreed to resolve the complaint and will complete the above within four weeks of the final decision statement.

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Final decision

15. We have upheld this complaint because the Council agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused by the likely fault.

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Investigator's decision on behalf of the Ombudsman