Summary: There has been fault by the Council. It has failed to communicate with a service user with mental health problems and his family clearly, and has failed to reach a final decision, after 3 years, on whether his care will be classed as short or long term. This has caused significant distress to Mr B and his family, who have spent time and trouble dealing with the complaint. A financial payment remedies this injustice. The Council should also reach a final decision and carry out new assessments, so Mr B and his family can make informed decisions about his future.

The complaint

1. The complainant Mr B, who his sister Mrs C represents, complains the Council has been inconsistent when carrying out financial assessments for his contribution towards the cost of his care.
2. Mrs C also complains the Council has failed to outline the long term options to Mr B so his family can plan.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
4. 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

5. I read the papers put in by Mrs C and discussed the complaint with her.
6. I considered the Council’s comments about the complaint and any supporting documents it provided.
7. I have explained my draft decision to Mrs C and the Council and considered their responses.

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What I found

8. Mr B has mental health problems and has tried to commit suicide several times. He owns his own home.
9. In December 2016, after a voluntary hospital admission, his social worker recommended a stay in supported accommodation, Home A.
10. The Council carried out a financial assessment in January 2017 and Mr B paid £39 per week out of his benefits, which left him with little to pay the mortgage and running costs of his flat.
11. Mrs C says the family attended what they thought was a routine assessment on 20 September 2018. They say the Council officer told them that Mr B should have been transferred to a permanent placement and he owed the Council over £50,000 as the Council would take the value of Mr B’s home into account when assessing his ability to pay for care.
12. Mrs C made an official complaint to the Council, who upheld her complaint. The Council said that as the family knew they would need to fund Mr B’s long term care from 20 September 2018 they would need to pay the full cost of his care from this date. The Council did not carry out a financial reassessment at this point. Mrs C said they did not want to sell Mr B’s home to fund his care as they were expecting him to be able to go home.
13. At a meeting on 17 January 2019 the Council told Mr B’s family he would have to fund the full cost of his care from that date. Mrs C also complains the inconsistent advice has affected Mr B’s eligibility for benefits.
14. I made enquiries of the Council on this complaint but have not been able to get a final response, explaining the Council’s position on this complaint.
15. My view is there has been significant fault by the Council. The Council has failed to make a final, consistent decision on whether Mr B’s care is short or long term. This decision has a significant financial impact on Mr B, as if his care is classed as long term it is likely a financial assessment will take the value of his home into account. There has been delay by the Council and failures in communication and complaint handling that have left the family unable to understand the options available to them.
16. These failings have caused significant injustice to Mr B and his family. I have proposed a financial remedy for their distress and time and trouble in making the complaint.
17. Until the Council reaches a final decision, after financial and care assessments, it is difficult to quantify any other injustice to Mr B and his family as I do not know how he will be charged. However, I recognise the families frustration at the time this is taking and so I have proposed the Council make a final decision and carry out new financial and care assessment in a clear timescale.
18. I do understand Mrs C had hoped the Ombudsman could decide how the Council charges Mr B for his care. But, the Ombudsman does not carry out care or financial assessments, these decisions are the Council’s to make. We can give clear timescales for the Council to complete the assessments but we cannot decide for the Council. Once a decision is made and assessments completed, Mr B and his family can make a new complaint if they are unhappy.
19. I also understand that Mrs C wants a long term care plan for her brother. I have some reservations that this may not be possible, as neither social workers or medical staff can say with certainty what care her brother will need in the future. It may be possible for the social worker to suggest an independent advocate that can work with Mr B to help him to make long term decisions. Mrs C has said that she would like some help with getting an advocate.
20. In response to my draft decision the Council has said that ‘the full charge should not be implemented until after the new financial and care assessment has been undertaken and the cost incurred to date should remain at the short stay basic charge rate due to the lack of clarity’.

Agreed action

21. The Council should apologise to Mr B and his family for the time it has taken to reach a final decision on funding of the placement and pay £500 towards their time and trouble, uncertainty and distress within one month of the date of the decision on this complaint.
22. The Council should reach a clear and definitive decision about if/when Mr B’s property value will be taken into consideration within 2 months of the date of the decision on this complaint.
23. The Council should carry out a new financial and care assessment for March 2020 onwards so Mr B and family can make an informed decision on his future within 2 months of the date of the decision on this complaint.

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Final decision

24. I have completed my investigation of this complaint. This complaint is upheld as I have found fault by the Council which has caused injustice to Mr B. I consider the remedy above is a satisfactory remedy to the injustice that can be identified at present.

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Investigator's decision on behalf of the Ombudsman