Summary: Mr X complained about how the Council carried out a financial assessment in respect of his mother, Mrs Y’s, care home placement. There was fault in how the Council carried out Mrs Y’s financial assessment and how it responded to Mr X’s complaint. This caused Mr X avoidable distress for which the Council agreed to apologise and pay a financial remedy. It also agreed to review when it refers people for financial assessments and arrange a briefing for staff on costs of disregarded properties.

The complaint

1. Mr X complains, on behalf of his mother, Mrs Y, about the care act financial assessment it carried out in 2024. He says the Council failed to make the right allowances for costs associated with a property she owns.
2. As a result, Mr X says the Council has charged Mrs Y more than it should do for the care she receives and has caused him a financial hardship. He wants the Council to increase the allowances the Council made for the costs of Mrs Y’s property.

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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. 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:
• their personal representative (if they have one), or
• someone we consider to be suitable. (Local Government Act 1974, section 26A(2), as amended)
6. 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

7. I considered:
• the information Mr X provided and discussed the complaint with him;
• the Council’s response to Mr X’s complaint and other documents it sent him; and
• relevant law and guidance.
8. Mr X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Charging for care in a care home

9. 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.
10. 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.
11. If someone in a care home owns their former home, the Council must ignore the value of that property in some circumstances. This includes if the property continues to be occupied by certain relatives of the person. (Care and Support (Charging and Assessment of Resources) Regulations 2014, Schedule 2, paragraph 4)
12. The Council must leave someone with a minimum amount of money after any charges for their care. The usual allowance is just over £30 a week. (Care Act 2014, section 14(7) and Care and Support (Charging and Assessment of Resources) Regulations 2014, regulation 6)
13. When deciding how much the minimum allowance should be, the Council must also consider whether it needs to allow for costs the person has resulting from any ignored property. (Care and Support Statutory Guidance, Annex C, paragraph 46(d)).

Information about care and support

14. Section 4 of the Care Act 2014 says councils must provide maintain a service for providing people with information and advice relating to care and support. This should include information about understanding care charges and, where necessary, should be tailored to individuals.

What happened

15. Mrs Y had been receiving care in her own home (which she shared with Mr X and his family), arranged by the Council for some time. She paid the Council a contribution towards the costs of that care.
16. In late 2023, it was becoming difficult to provide Mrs Y with the care she needed at home. Mr X and Mrs Y discussed with the Council the option of Mrs Y moving into a care home. From the outset, Mr X asked the Council for information about how much Mrs Y would be expected to contribute.
17. Mrs Y moved into a care home, on a temporary respite basis, towards the end of 2023. Mr X continued to ask the Council how much Mrs Y would need to pay. The Council explained it would carry out a financial assessment of the costs when it was decided whether Mrs Y would permanently move to a care home.
18. The decision was made for Mrs Y to permanently move to a care home at the start of 2024. Once the decision was made, the Council referred Mrs Y for a financial assessment. The Council sent Mr X general information about care charging for care in a care home.

The first decision

19. Around a month later, the Council told Mr X it expected Mrs Y to contribute all her income, apart from the standard minimum allowance. Mr X told the Council Mrs Y had several costs associated with her former home which she should be allowed to continue to pay. This included an equity release loan, council tax, insurance and maintenance.
20. The Council decided, around a week later, that it would not make a further allowance for the costs Mr X had asked about. It told him the rules did not require it to make an allowance.
21. Mr X was not satisfied with the Council’s first decision, so he complained to the Council. Just over a month later, Mr X chased the Council for a response. It told him it would review his request for most of the costs he had asked about, but not the council tax, as the remaining residents of the property were now responsible for this.

The second decision

22. Between April and June 2024, the Council exchanged several emails with Mr X gathering the information it said it needed for its review. During this process, the Council officer gathering the information included their opinion of Mr X’s request in one of their responses. This led Mr X to believe that the Council had pre-determined its decision.
23. A senior officer wrote to Mr X in June 2024 to explain the Council would allow a share of the maintenance costs, but not the other costs as these were either optional payments Mrs Y did not need to pay, or were costs that were the responsibility of the remaining residents.
24. Mr X was still not happy with the Council’s decision, so he complained further to the Council. Around a month after the second decision, the Council upheld Mr X’s complaint. It said it had originally given him some incorrect information and the officer collecting the information should not have given their own opinion about the matter. The Council agreed to a further review, and later agreed the decision would be made by a more senior officer.

The third and final decision

25. Mr X had a phone call with the more senior officer in mid-July 2024, followed by an exchange of emails in which Mr X provided more information and evidence.
26. In mid-August 2024, the more senior council decided that, in addition to a share of the maintenance costs, the Council should also allow the cost of building insurance. However, it refused to allow the other costs. The more senior officer sent Mr X detailed reasons for their decision, setting out the facts and guidance they had considered. The officer invited Mr X to provide further evidence, if any of the facts they had relied on were incorrect.
27. The Council sent Mr X a summary of that decision a few weeks later and confirmed this was its final response to Mr X’s complaint.

My findings

28. Since Mr X complained to the Ombudsman, Mrs Y has died. I am satisfied Mr X is a suitable person to continue the complaint on behalf of Mrs Y.

How the Council made its decisions

29. It is not the Ombudsman’s role to decide what allowances the Council should have made for the costs Mrs Y claimed; that was the Council’s responsibility. Our role is to consider whether the Council made its decisions in the right way.
30. I consider there was some fault in how the Council dealt with Mrs Y’s financial assessment and Mr X’s complaint about this:
• The Council failed to provide Mr X and Mrs Y with accurate and complete information about the possible costs to her of moving to a care home. The Council has a duty to provide information and advice to people about the costs of care. It had several opportunities to do so before Mrs Y went into respite care and before she became a permanent care home resident.
• The Council delayed referring Mrs Y for a financial assessment until she became a permanent care home resident. Mr X had asked, from the outset, how much Mrs Y would need to contribute towards the costs of her care. The Council had several opportunities to refer Mrs Y for a financial assessment before she needed to make decisions about her care, but if failed to do so.
• When making its first decision, the Council failed to consider the proper guidance and incorrectly told Mr X that the rules made no allowance for the costs of Mrs Y’s former home.
• When making its second decision, the officer gathering the information wrongly gave their opinion about the decision, leading to the impression that the Council had already made up its mind.
• It also failed to properly explain the reasons for its second decision, only sending Mr X a short summary of the effects of its decision.
• When responding to Mr X’s complaint, and gathering the information for the third decision, the Council sent Mr X confusing and inconsistent responses to his complaint.
31. However, I do not consider there was any fault with how the Council made or explained its final decision about the allowances it should make for Mrs Y. The Council carefully considered the relevant rules and guidance, and explained in detail the reasons for its decision. Since there was no fault in how the Council made this final decision, I cannot question the outcome.

Impact on Mrs Y and Mr X

32. Mr X said that, if he and Mrs Y had known about the full costs, she would not have decided to go into a care home.
33. I am not satisfied the evidence shows the lack of information about the costs meant that Mrs Y decided to go into a care home when she otherwise would not have done. Costs of care are one consideration when deciding about care, and there is evidence Mrs Y went into a care home because of the struggles of receiving care at home.
34. I am also mindful of the fact that, although there was fault in earlier decisions, the Council’s final decision was not substantially different. It has now made the appropriate allowances in respect of the costs it has allowed.
35. However, I am satisfied the fault on the part of the Council caused Mr X avoidable confusion, frustration and inconvenience over an extended period of time. The Council should apologise to Mr X for this and pay him a financial remedy to recognise that distress.

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Agreed action

36. Within one month of my final decision the Council will:
• apologise to Mr X for the distress caused by fault I have found above; and
• pay Mr X £300 to recognise that distress.
37. Within three months of my final decision the Council will:
• review its process for referring people for a financial assessment. It should ensure, whenever possible, that people have the necessary information about the contribution they will be expected to pay towards their care before they need to make decisions about the care they want; and
• provide a briefing to its financial assessment staff and practitioners about how the Council should consider allowances for costs to people of their disregarded properties. This should include the relevant rules, guidance and Council policy.
38. The Council should provide us with evidence it has complied with the above actions.

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Final decision

39. I have completed my investigation. There was fault in how the Council carried out Mrs Y’s financial assessment and how it responded to Mr X’s complaint. This caused Mr X avoidable distress for which the Council agreed to apologise and pay a financial remedy. It also agreed to review when it refers people for financial assessments and arrange a briefing for staff on costs of disregarded properties.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman