Summary: We will not investigate Mr X’s complaint about his mother’s discharge from hospital to a care home because there is insufficient evidence of fault to justify our involvement. We asked the Council to take steps to remedy the uncertainty caused by its lack of information about the cost of his mother’s care and the avoidable time and trouble Mr X was put to trying to resolve the matter. It has agreed to apologise, make a symbolic payment and take steps to improve its services.

The complaint

1. Mr X complained about the way the Council decided his mother, Mrs Y, should be discharged from hospital into a care home in early 2024. He also complained the Council failed to share relevant information with the family and respond to their requests for information after she moved to the care home. In particular, he complained the Council was not open about the costs of Mrs Y’s care. He also complained about poor complaints handling.
2. Mr X said the Council’s failings caused avoidable stress and anxiety at an already difficult time, and he was put to avoidable time and trouble pursuing the Council for information.

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The Ombudsman’s role and powers

3. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
4. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any injustice is not significant enough to justify our involvement, or

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

5. I considered information provided by Mr X and the Council.
6. I considered the Ombudsman’s Assessment Code.

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My assessment

Discharge to a care home

7. Mrs Y, who had dementia, was living on her own at home with a care package before being admitted to hospital after a fall in November 2023. A needs assessment carried out in early January 2024, when Mrs Y was still in hospital, recorded:
• Mrs Y was struggling to manage at home and was trying to engage in tasks independently when carers were not there, despite the high risk of falls;
• the hospital reported her needs had increased and her mobility decreased whilst she had been there;
• her sons, Mr X and Mr Z, reported concerns about how she was managing at home, although they “initially had different views” on what should happen when she was discharged;
• the social worker concluded Mrs X needed residential care.
8. The social worker carried out a review of the care in February 2024 and recorded Mrs Y was happy at the care home and had capacity to make decisions.
9. Mr X complained the Council had not followed a proper process before deciding Mrs Y needed a care home, had not involved the family in the assessment and had not sent them a copy of the assessment. In its complaint response, the Council said:
• Mrs Y was discharged under Pathway 3 to a long term placement;
• this was discussed with Mrs Y during a hospital visit that Mr X attended and it would send Mr X a copy of the assessment;
• Mrs Y had capacity to decide her discharge destination, so a “best interests” decision under the Mental Capacity Act 2005 was not needed;
• alternative options were discussed with her but were not suitable.
10. The law says a person is deemed to have capacity unless they are assessed as not having capacity. Capacity may fluctuate and the fact someone has a dementia diagnosis does not automatically mean they do not have capacity to make a specific decision on a specific day. The social worker assessed Mrs Y as having capacity to make decisions about her care in January and again in February, and it is unlikely that further investigation would establish otherwise. On balance, if a “best interests” decision had been made the outcome would have been the same because Mrs Y had been struggling before the hospital admission and the hospital reported her needs had increased. There, is therefore insufficient evidence of fault to warrant further investigation.
11. The needs assessment did not fully record the alternative options discussed and the reasons they were not suitable (although the Council did provide some further explanation in the complaint response) and the Council did not sent Mr X a copy of the assessment until after he complained. However, this did not cause a sufficient injustice to warrant further investigation.

Communications and costs information

12. There is no record the Council confirmed Mrs Y was a permanent resident in the care home, nor that confirmed the outcome of a safeguarding enquiry investigated by another council until the complaint response in July 2024.
13. For the first few weeks Mrs Y was in the care home, her care was funded by a health body. In late February, it was decided that Mrs Y did not qualify for NHS continuing healthcare funding. In its complaint response, the Council said the care home fees had not been paid since April 2024 after health funding stopped.
14. In April and May, the Council carried out two visits to assess whether Mrs Y had capacity to make decisions about her finances. The assessment concluded she did not have capacity. Following this, on 31 May, the Council sent information to Mr Z and Mr Z about a fresh financial assessment. This was completed in mid-July. At that point, the Council agreed to apply a 12 week property disregard, which ended on 12 June 2024, following which Mrs Y would need to pay the full cost of her care. The Council said there was an urgent need to agree a deferred payment agreement, but it gave no other information about this, so Mr X had to ask what that meant and what he needed to do about it.
15. There is no record the Council told Mr X the weekly care home costs until the complaint response in July 2024.
16. The situation was complicated because there was no-one with a Lasting Power of Attorney who could legally manage Mrs Y’s finances for her. Mr X and his brother, Mr Z, applied to the Court of Protection to be appointed as deputies for her and were appointed in November 2024. It is unclear whether the Council considered or took any steps to secure Mrs Y’s placement in the meantime, but nor have I seen any evidence the placement was at risk.
17. If we investigated further, it is likely we would find the Council at fault for not sharing all relevant information with the family and for delays in responding to requests for information. It is likely we would also find it at fault for not providing appropriate information about the costs of Mrs Y’s residential care before mid-July 2024, six months after Mrs Y moved to the care home. This caused uncertainty for Mr X, who was put to avoidable time and trouble pursuing the Council for information.
18. We asked the Council to take specific steps to remedy the injustice caused and it has agreed to take the following action within one month of the date of this decision:
• apologise to Mr X for the uncertainty and avoidable time and trouble caused by the poor communication and lack of costs information. The Council should have regard to our guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice;
• pay him £400 to remedy that injustice; and
• remind relevant staff of the importance of providing as much information as possible about the likely costs of adult social care, as soon as possible after the care is arranged.

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Final decision

19. We have upheld this complaint because the Council has agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused and improving its service for others.

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Investigator's decision on behalf of the Ombudsman