Warwickshire County Council (18 008 196)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 14 Jan 2019

The Ombudsman's final decision:

Summary: Mr X complains the Council failed to properly advise his step father, Mr Y or his family about the cost of an emergency respite placement at a care home. Mr X also complains the Council delayed in carrying out a risk assessment on Mr Y’s home, a capacity assessment and a financial assessment. This increased the cost of Mr Y’s care. The Council’s delay in carrying out the financial assessment and home environment assessment amounts to fault. The Council has made an appropriate offer to remedy the injustice caused by this fault.

The complaint

  1. The complainant, whom I shall refer to as Mr X complains the Council failed to properly advise his step father, Mr Y or his family about the cost of an emergency respite placement at a care home. The family understood that while the placement was temporary or respite, Mr Y would not be charged. They were therefore shocked to receive a bill.
  2. Mr X also complains the Council delayed in carrying out a risk assessment on Mr Y’s home, a capacity assessment and a financial assessment. This delay has increased the costs for Mr Y’s care. Had the family been aware of the cost of the placement they would have considered other options.

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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. As part of the investigation, I have:
    • considered the complaint and the documents provided by Mr X;
    • made enquiries of the Council and considered the comments and documents the Council provided;
    • sent a statement setting out my draft decision to Mr X and the Council and invited their comments. I have considered the Council’s response.

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What I found

  1. Mr Y was receiving care and support in his home, but following concerns about his safety the Council held an emergency meeting on 25 May 2018 at Mr Y’s home. The Council had made enquiries with a care home prior to the meeting and representatives from the care home attended the meeting. Mr X and other family members also attended this meeting.
  2. The records of this meeting state Mr X did not have any information about Mr Y’s finances. There was no Power of Attorney in place, and Mr Y managed his own finances. The social worker asked Mr Y how he would feel about going to the care home for a few days and noted he would be happy to go. The records state:

“[Mr Y] was given information about charges and his contribution towards the care following a financial assessment which will take place soon.”

  1. Mr Y signed an Individual Placement Agreement. This agreement sets out the amount the Council has agreed with the care home to pay for Mr Y’s placement, but does not specify Mr Y’s contribution.
  2. Mr X states they asked the officer how much the care home would cost and were told that if Mr X’s current home care was free, the residential care would also be free. Mr X states they understood that Mr X’s responsibility to pay would be based on the level of his savings. As these were below a specific threshold, he would not have to pay.
  3. The Council has provided copies of the charging leaflet and information given to Mr X’s sister at the meeting. It has also provided a form signed by Mr Y confirming the charges had been explained to him and he had received the charging leaflet. The social worker states the leaflet and information was given to Mr X’s sister at Mr Y’s request.
  4. According to the Council’s chronology Mr X chased the Council in June 2018 for an update on the financial assessment. Mr Y’s social worker contacted Mr X on 21 June 2018. The notes of this conversation state Mr Y was semi-independent and the care home was providing only minimal support. Mr Y’s care needs did not require him to remain in residential care. The social worker said they would
    • ask Mr Y’s GP to assess him;
    • ask an Occupational Therapist (OT) to visit Mr Y’s home to carry out a home environment assessment; and
    • extend Mr Y’s placement at the care home for a further two weeks.
  5. Mr Y spoke to the OT who confirmed that as the Council considered Mr Y had mental capacity, they could not prevent him going home. The Council may need to support him with package of care. The OT arranged to visit Mr Y’s home with his new social worker on 6 July 2018.
  6. The records of this visit note that Mr X had complained about the length of time it had taken to arrange for Mr Y to return home. The Council had still not carried out the financial assessment, so Mr X did not know how much the care home costs would be. He told the social worker that they had been told the first six weeks of Mr Y’s stay would be free. The social worker advised Mr X this was incorrect as the only free service the Council offers is for up to six weeks re-ablement. They agreed to meet again on 16 July 2018 when Mr X brought Mr Y home.
  7. Unfortunately, Mr Y died on 12 July 2018.
  8. The social worker made a referral for a financial assessment on 3 July 2018. This was completed and Mr X received a copy of the assessment on 19 July 2018. The financial assessment calculated Mr Y’s contribution would be £227.84 each week. Mr X states it was only at this point that he realised the assessment would take account on Mr Y’s income as well as his savings. Had they been aware of this they would have considered other care arrangements for Mr Y.
  9. Mr X complained to the Council. The Council’s response sets out the action it had taken since the initial visit. It was satisfied the case had progressed, and suggested that any delay had been due to the need to transfer to a new social worker when Mr Y’s original social worker left.
  10. Mr X is not satisfied by the Council’s response and has asked the Ombudsman to investigate. He notes the original social worker did not leave until late June 2018. He asserts it was only when the new social worker was appointed that there was any real progress. Mr X would like the Council to cancel Mr Y’s care charges.
  11. In response to my enquiries the Council states there was some discussion about finances at the initial meeting. The duty social worker explained there would be a financial assessment to assess Mr Y’s contribution. The Council acknowledges that the delay in requesting a financial assessment was unacceptable, particularly as Mr X had been chasing the Council.
  12. The Council also accepts there was some delay in implementing the next steps for Mr Y. It acknowledges this meant the family were not able to make decisions about the options as early as they might have done. The family may have chosen for Mr Y to return home with a care package rather than staying in residential care.
  13. In recognition of this the Council has offered to reduce the invoice for the period after the first two weeks of residential care by £500. This is on the basis that had Mr X returned home with a care package at this stage it is likely he would had paid a lower contribution towards his care.
  14. The Council has also offered to reduce the invoice by a further £100 to reflect the family’s time and trouble in pursuing this matter.
  15. This would reduce Mr Y’s outstanding care charges to £962.33.

Analysis

  1. Mr X’s account of the initial meeting differs from the social worker’s. It is clear there was some discussion about the cost of the placement and Mr X understood there would be a financial assessment. But as there in no detailed record of what was discussed, I am unable to confirm what was said.
  2. However, the Council also provided Mr Y with written information on the charges and how his contribution would be calculated. The leaflet on charges for residential and nursing homes confirms the Council will calculate Mr Y’s contribution based on his income and capital. This written information would have assisted Mr Y and his family in understanding Mr Y’s liability for the cost of his care.
  3. There is no dispute the Council delayed in carrying out a financial assessment or the assessment of Mr Y’s home environment. These delays amount to fault.
  4. Having identified fault I must now consider whether it has caused any injustice. The Council accepts that but for the delays the family could have considered other, potentially cheaper options for Mr Y’s care sooner. The records confirm Mr X did not need to stay in a residential home after the initial two weeks, and could have returned to his own home with a package of care. Mr Y would still have had to contribute towards this care package, but it would have been less than his contribution towards the care home fees.
  5. The Council’s offer to reduce the outstanding charges by £500 recognises this, and is an appropriate remedy.
  6. I also consider the Council’s offer to reduce the charges by a further £100 to reflect the time and trouble Mr Y’s family were put to is appropriate.

Agreed action

  1. The Council has agreed to reduce Mr Y’s outstanding care charges by £500 in recognition of the delays in assessing Mr Y’s finances and home environment.
  2. The Council has also agreed to reduce the outstanding fees by a further £100 in recognition of the time and trouble Mr Y’s family have been put to in dealing this matter.
  3. The Council should take this action within one month of my final decision.

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Final decision

  1. The Council’s delay in carrying out the financial assessment and home environment assessment amounts to fault. The Council has made an appropriate offer to remedy the injustice caused by this fault.

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Investigator's decision on behalf of the Ombudsman

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