Summary: The Council has properly decided it can meet Ms D’s adult social care needs in a cheaper residential home, despite Mr C’s strong wish for Ms D to remain living where she is. The Council will only consider moving Ms D once Covid-19 pandemic restrictions are lifted, and if there is a placement available to meet Ms D's needs to the same standard as her existing placement. Meanwhile, the Council is funding the placement in full, so Mr C and Ms D have no significant injustice.

The complaint

1. The complainant, who I will call Mr C, says the Council wishes to move his sister, Ms D, solely because of finances. Mr C worries how a move would impact Ms D’s health; she was unwell before moving to the residential home and has settled well and her health improved.

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The Ombudsman’s role and powers

2. 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)
3. 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

4. I considered:
• Information provided by Mr C and the Council.
• The Care Act 2014 and associated statutory guidance.
• The Mental Capacity Act 2005 and associated statutory guidance.
5. Mr C and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

6. Ms D moved to a care home after she was neglecting herself at home. Ms D was funding her care herself, until a few years later her money dropped below the government threshold and Mr C contacted the Council for support.
7. Ms D is settled and happy at her existing care home, Mr C does not want her to move. The Council assessed Ms D and decided she needed 24-hour residential care to meet her care and support needs.
8. Everyone whose needs the local authority meet must receive a personal budget as part of the care and support plan. The personal budget is an important tool that gives the person clear information about the money the Council has allocated to meet the needs identified in the assessment and recorded in the plan. The Council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning, with the final amount of the personal budget confirmed through this process. The detail of how the personal budget will be used is set out in the care and support plan. The Council must consider and respect the wishes of the person using the services.
9. The Council at first recorded a personal budget of £302.29 per week. In July 2020 the Council’s funding panel agreed a personal budget of £618.80 per week which would need a third party to top-up the costs to the care home’s fee of £825 per week. There was no-one willing or able to fund a top-up, and the care home would not reduce its fee.
10. The Council has assessed Ms D under the Mental Capacity Act and decided Ms D does not have capacity to decide where to live. The Council made a best interest decision that Ms D should stay in the residential home or move to a similar setting which accepts the national rates for care and can meet Ms D’s needs to the same level and standard she currently receives.
11. The Council has provided evidence it considered a move would be a breach of Ms D’s Human Rights. Moving Ms D could have a detrimental impact on her physical and psychological needs, and she would need intensive support to settle so costs could be higher anyway. Relevant managers would decide whether Ms D should stay or move.
12. In December 2020 the funding panel decided it would pay the £825 per week, minus Ms D's assessed client contribution. Once national lockdown restrictions are lowered it would look for a suitable placement within the personal budget of £618.80. The Council says it can usually buy a similar level of care for this amount, so it is possible to meet Ms D’s needs within that personal budget.
13. The Care Act guidance says in deciding how to meet needs, the local authority may take into reasonable consideration its own finances and budgetary position. This includes the importance of ensuring the funding available to the local authority is enough to meet the needs of the entire local population. The local authority may reasonably consider how to balance that requirement with the duty to meet the eligible needs of an individual in deciding how to meet an individual’s needs (but not whether it meets those needs). However, the local authority should not set arbitrary upper limits on the costs it is willing to pay to meet needs through certain routes – doing so would not deliver an approach that is person-centred or compatible with public law principles. The authority may decide on a case-by-case basis which weigh up the total costs of different potential options for meeting needs and include the cost as a relevant factor in deciding between suitable alternative options for meeting needs. This does not mean choosing the cheapest option; but the one which delivers the outcomes needed for the best value.
14. The Council has reviewed Ms D’s care and support needs in January 2022 and noted a decline in her health and abilities. The placement continues suitable to meet Ms D’s care and support needs. The Council also completed a risk assessment. The result was that if Ms D had to move it would be ideal if existing staff could support her through a transition period. That was unlikely to be possible during the Covid-19 pandemic. The Council noted an isolation period in a new home might be difficult for Ms D. The result was for the Council to decide whether to continue to fund the placement in full. I do not know the Council’s decision since this review.

Was there fault causing injustice?

15. I do not have evidence to show how the funding panel decided to move Ms D. However, it is more likely than not in doing so it had read the documents the Council has provided regarding Ms D’s best interests, her human rights, and the advantages and disadvantages of her moving.
16. The Council decided it will move Ms D once the national restrictions of the Covid-19 pandemic are lifted. The decision to move Ms D is a decision the Council is entitled to make, and it has said it will only move Ms D if there is a placement that is suitable to meet her needs to the same level and standard as the current placement but at a cheaper rate.
17. The Care Act guidance says “decisions should therefore be based on outcomes and value for money, rather than purely financially motivated.” Although Mr C believes the Council’s decision is purely financially motivated, the evidence suggests the decision is based on meeting Ms D’s needs for the best value, so is in accordance with government guidance.
18. As it is now over a year since the Council made this decision, it is once again under review to decide the best way to meet Ms D’s care and support needs.
19. I appreciate there is uncertainty for Mr C and Ms D about what might happen, but the delay in any move is caused by the Covid-19 pandemic rather than by fault of the Council. In the meantime, the Council is meeting Ms D’s needs at the preferred placement and is funding it in full, so there is no significant injustice caused to Ms D or Mr C.

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Final decision

20. I have completed my investigation on the basis there is no fault by the Council.

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Investigator's decision on behalf of the Ombudsman