Summary: The Ombudsman will not investigate Mr X’s complaint further. It is not clear Mrs X has given consent to the complaint on her behalf.

The complaint

1. Mr X (as I shall call him) complains the Council failed to assess properly his mother’s needs. He says the Council decided her needs could be managed at home although Mrs X wished to remain in a care home. As a result he says the Council has charged Mrs X unnecessarily for her care.

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The Ombudsman’s role and powers

2. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
3. We can decide whether to start or discontinue an investigation into a complaint within our jurisdiction. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended)

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How I considered this complaint

4. I considered the information provided by Mr X and the Council. I spoke to Mr X. Both Mr X and the Council had the opportunity to comment on a draft of this statement before I reached a final decision.

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What I found

5. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
6. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
7. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.
8. The financial limit, known as the ‘upper capital limit’, exists for the purposes of the financial assessment. This sets out at what point a person can get council support to meet their eligible needs. People who have over the upper capital limit must pay the full cost of their residential care home fees. Once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees. Where a person’s resources are below the lower capital limit they will not need to contribute to the cost of their care and support from their capital.

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What happened

9. Mrs X suffered a stroke in January 2021 and was admitted to hospital. Before that, she lived at home with her adult son Mr X. Mrs X said she wanted to return to her own home.
10. Subsequent assessments of Mrs X’s needs by the Council assessed that her needs could be managed at home with a care package. Mr X said he believed his mother’s needs were such they should be met in a care home. He said Mrs X frequently forgot what she had decided and he had to explain the circumstances to her again.
11. Mrs X decided she would like to stay in the care home. She confirmed to the assessing social worker she knew she would pay the full cost of her residential care as the Council had assessed that her needs could be met at home.
12. In November 2021 a social worker visited Mrs X to discuss her care needs. Mrs X agreed with the statement of her needs completed by the social worker but said she would rather stay in the care home than return to her own home. She said she had signed some documents Mr X had given her. She said she trusted him to manage her finances. The case recording states, “(Mrs X) understands that her home may need to be sold to pay her care home fees which she understood and stated that it was her house, and she can sell it if she wants to. (Mrs X) wishes to remain at (the care home).”
13. Mrs X signed a contract with the care home to pay her own fees at the end of November 2021.
14. Mr X complained on Mrs X’s behalf that the Council had not assessed Mrs X’s needs properly and said it should fund her care in the care home. He complained to us.
15. Mr X sent a copy of a consent form signed by Mrs X with her consent for him to make the complaint on her behalf.
16. A social worker visited Mrs X to review her needs assessment. Mrs X said she was aware of the complaint but did not know what papers she had signed. The Council points out Mrs X had clearly stated it was her choice to remain in the care home although she agreed with the social worker’s assessment of her needs. Mr X does not believe Mrs X understood the care assessment.

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Final decision

17. I have decided to discontinue investigation of this complaint as there is doubt that Mrs X gave valid consent to it being made on her behalf.

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Investigator's decision on behalf of the Ombudsman