East Sussex County Council (17 017 748)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 11 Jul 2018

The Ombudsman's final decision:

Summary: Mrs C complained about the lack of support she received from the Council, when her husband had to leave his nursing home because it closed down. The Ombudsman finds the Council failed to provide sufficient information to Mrs C to enable her to make a fully informed decision. The Council will reimburse the difference in fees Mrs C has had to pay and apologise for any distress she experienced.

The complaint

  1. The complainant, whom I shall call Mrs C, complained on behalf of herself and her husband, whom I shall call Mr C. Mrs C complained her husband ended up in a care accommodation that was much more expensive than his previous nursing home, because the Council:
    • Never offered a suitable nursing home to him, when his nursing home closed and he had to move.
    • Never properly explained to her, at the time she had to decide, what impact a move to his new care accommodation would have on the contribution he would have to pay.
    • Never properly explained to her, at the time she had to decide, that moving her husband to this type of accommodation, would mean that her own income would reduce, because the Council would no longer leave her with half of her husband’s Occupational Pension.

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The Ombudsman’s role and powers

  1. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
  2. If we are satisfied with a council’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

  1. I considered the information I received from Mrs C and the Council. I shared a copy of my draft decision statement with Mrs C and the Council, and considered any comments I received before I made my final decision.

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What I found

  1. The Government’s “Care and Support Statutory Guidance” says that:
    • (3.19) Councils should ensure that information supplied is clear. Information and advice should only be judged as clear if the individual who receives it understands it and can act on it.
    • (3.21) All reasonable efforts should be taken to ensure that information and advice provided meets the individual’s requirements, is comprehensive and is given at an early stage. Councils must seek to ensure that all relevant information is available to people for them to make the best-informed decision in their particular circumstances.
    • (3.36) Financial information and advice is fundamental to enabling people to make well-informed choices about how they pay for their care. It is integral to a person’s consideration of how best to meet care and support needs, immediately or in the future. People with good and impartial financial information and advice have a better understanding of how their available resources can be used more flexibly to fund a wider range of care options.
  2. Where a council is responsible for meeting a person’s care and support needs and their needs have been assessed as requiring a particular type of accommodation in order to ensure that they are met, the council should identify a suitable care home that can meet the person’s needs.

What happened?

  1. Mr C has Parkinson's disease, arthritic spine and dementia, which affects his memory and cognition. He moved into a nursing home in November 2015, which was around 90 miles away. However, Mrs C told the Council on 23 October 2017 that the nursing home would closed on 17 November 2017. This meant Mr C had to move to another suitable care home.
  2. Mrs C told the Council she wanted to know what would happen next, because she did not want her husband to move away any further. The Council carried out a review of Mr C’s needs the following day. Mrs C told the Council on 26 October that she was keen for her husband to move to Care Provider X. This care provider has a nursing section and a care suite section.
  3. The Council advised Mrs C on 30 October 2017, that the costs for the care suites were different than those for a normal residential care home. The cost for the care suites consisted of an amount to be paid for accommodation (rent, service charge etc) as well as an amount for the cost of the care support. The accommodation element is eligible for Housing Benefit. However, Mr C would not be eligible for this because, as a home owner, he would not be eligible for housing benefits.
  4. The Council therefore offered a nursing home as an alternative. However, Mrs C told the Council the home offered was unsuitable because it was too far for her to drive (more than an hour for her). The Council says the distance was on par with the home Mr C had to leave. Mrs C told the Council the following day that she would no longer be able to travel such a long distance, due to her age and health conditions.
  5. The Council told me that:
    • Mrs C became very anxious and distressed about the home closure. As such, the Council decided that its proposed nursing home was no longer a suitable option.
    • Unfortunately, there were no other nursing homes available at the time, which meant that all agreed for Mr C to move to care provider X.
  6. However, Mrs C told me that, at the time she had to decide, she did not realise what devastating impact a move to this type of accommodation would have on their finances. She only found out after the move, that her husband’s weekly contribution would more than double to £676 per week.
  7. The Council told me that:
    • While it provided information to Mrs C about the Housing Benefit, it failed to provide an estimate of the weekly cost of rent (£116), service charges (£154) and the costs of food/drink (£41). These costs are applied in addition to the assessed contribution, which significantly increased the amount Mr C would have to pay towards his care.
    • It carried out a financial assessment on 9 November 2017, before Mr C’s move. However, there was a delay until 28 November (which was after he moved) before it told Mrs C of the outcome. This was because the visiting officer was unsure if the Council would continue to cede half of Mr C’s occupational pension. As the care suite occupancy is on a tenancy basis, rather than a standard nursing home placement, the Council correctly completed the financial assessment as a non-residential assessment. This meant the Council would take all of Mr C’s occupational pension into account when calculating how much he could contribute. While this was correct, the Council accepts the visiting officer failed to explain this to Mrs C during his assessment visit.
    • It always aims to give people clear information about the different elements and the breakdown of specific costs. However, it recognises Mrs C should have been better informed about the implications. It would like to apologise to Mrs C for this oversight. It would also like to assure her that it will make all staff fully aware what information it should provide in respect of the care suites of care provider X.
  8. More recently, Mr C has moved to the nursing home section of care provider X. The cost Mr C has to pay for this is assessed in the same way as a normal residential care placement. The Council will therefore review Mr C’s contributions accordingly. This means that half of Mr C’s income from his occupational pensions and retirement annuities will again be disregarded from the financial assessment.
  9. In response to my enquiries, the Council told me that:
    • It recognises the circumstances around Mr C’s move were unique and the impact upon Mrs C’s wellbeing and finances were significant, as the cost for the Care Suite was significantly higher than the charge for a Nursing Home placement.
    • It made attempts to support Mr and Mrs C with the best of intentions. However, evidently Mrs C received insufficient and unclear information in advance, about the financial implications of a placement for her husband at the Care Suite.
    • In light of this, it would like to offer its apologies to Mrs C and waive the difference between the costs she incurred from the point Mr C moved to the Care Suite to when he moved into the Nursing placement, to the value of £5,842.39. We would also like to offer Mrs C a payment of £200 in light of her distress and the time and trouble afforded taking the case to the Ombudsman.

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Agreed action

  1. I recommended the Council, within six weeks of the date of the final decision:
    • Provide the remedies referred to above in paragraph 15 (third bullet point).
    • Inform all relevant staff about what information they should provide in respect of the care suites of care provider X.
  2. The Council has told me it has accepted my recommendations.

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Final decision

  1. For reasons explained above, I have upheld Mrs C’s complaint. The Council failed to provide sufficient information to Mrs C to enable her to make a fully informed decision, when she had to decide where her husband should move to. This was fault.
  2. The remedy proposed by the Council is sufficient to address the injustice Mr and Mrs C suffered.
  3. I have therefore completed my investigation and closed the complaint

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Investigator's decision on behalf of the Ombudsman

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