Summary: Mr X complained the Council failed to offer a deferred payment agreement to fund his mother’s care until she sold her property. Mr X also complained the Council failed to complete an income-based assessment of his mother when it placed her in a care home. The Council completed a financial assessment of Mr X’s mother and offered a deferred payment agreement. We did not find fault with the Council.

The complaint

1. Mr X complained the Council failed to offer a deferred payment agreement to fund his mother’s care until she sold her property. Mr X also complained the Council failed to complete an income-based assessment when they placed his mother-in-law in the care home.
2. Mr X said because the Council failed to offer a deferred payment agreement, they needed to do this with the care home. Mr X says this has resulted in a debt now owed by the estate following his mother passing away. Mr X says the care home is now threatening them with court action over the debt.

Back to top

The Ombudsman’s role and powers

3. 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)
4. If we are satisfied with an organisation’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)

Back to top

How I considered this complaint

5. I have considered all the information Mr X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
6. Mr X and the Council had opportunity to comment on my draft decision before I made my final decision.

Back to top

What I found

Financial assessment

7. Following a needs assessment the Council must offer a financial assessment to decide who will pay for the eligible care needs. Councils can charge for care services. The Council should provide clear information about charges and how it assesses them at the time it finds out care needs. If a person refuses a financial assessment they must self fund their care.
8. Persons who have over £23,250 of eligible capital will be expected to pay for the full cost of their care home fees. However, once their capital has reduced to less than £23,250, they only have to pay an assessed contribution towards their fees.

Deferred Payment Agreement

9. A person needing care can enter into a “deferred payment agreement” with the Council. This lets a person use the value of their home to help pay care home costs. The Council does not write the deferred payment off. It is repaid later, usually from the proceeds of the person’s house sale.
10. The Care Act 2014, the Care and Support Statutory Guidance and the Care and Support (Deferred Payment) Regulations 2014 sets out the establishment of a universal deferred payment scheme towards the cost of care homes. Or supported living accommodation.
11. Deferred payment agreements are designed to prevent people from being forced to sell their home in their lifetime to pay for their care. By entering into a deferred payment agreement, a local authority agrees to defer the payment of charges due to it from the adult, for the costs of meeting needs in a care home or supported living accommodation.
12. The guidance notes that the payment for care and support is deferred and not “written off”. The costs of provision of care and support will have to be repaid by the individual at a later date.
13. Local authorities must offer deferred payment agreements to people who meet the criteria (below) and who are able to provide adequate security. Subject to the criteria, local authorities must offer deferred payment agreements to people who meet their own needs.
14. The criteria:
• A person is ordinarily resident in the local authority area
• The person has needs which are to be met by the provision of care in a care home.
• The person has less than (or equal to) £23,250 in assets excluding the value of their main or only home.
• The person’s home is not disregarded, for example it is not occupied by a spouse or dependent relative. (paragraph 9.3-9.5)
15. In principle, a person should be able to defer the entirety of their care costs; subject to any contribution the local authority is allowed to require from the person’s income. The local authority will need to consider whether a person can provide adequate security for the deferred payment agreement (paragraph 9.36).

What happened

16. In 2019, Mr X’s mother condition worsened meaning the Council and family decided she needed to move into a care home. Following this decision, the Council sent Mr X a financial assessment form and leaflets about long-term care on 11 June 2019. These leaflets confirmed the Council would complete a financial assessment of any person entering a care home to decide how much they would need to pay towards their care. The leaflets also explained about the 12-week disregard for a person’s main property and that a person can agree to a deferred payment agreement with the Council for the property after the 12-week disregard expires.
17. At the end of June 2019, Mr X’s mother’s condition worsened faster and the Council needed to complete an emergency placement for her in a care home. The Council spoke with Mr X and confirmed he understood the 12-week disregard process.
18. In July 2019, the care home contacted Mr X to advise him to contact “social services” before the end of the 12-week disregard to seek a deferred payment agreement. Mr X contacted the Council on the back of this contact. The Council provided Mr X with leaflets about deferred payment agreements and provided a contact number for its financial assessment team to discuss this further.
19. The Council’s financial assessment team contacted Mr X at the end of July 2019 and discussed financial assessments and deferred payment agreements with him. The Council sent Mr X the financial assessment forms with leaflets which explained the financial assessment process and about deferred payment agreements.
20. In August 2019, Mr X returned the completed financial assessment forms to the Council. The Council completed its financial assessment of Mr X’s mother at the start of September 2019. The Council wrote to Mr X to tell him how much his mother would need to pay until the end of the 12-week disregard and that she would be a self-funder after this point. This letter also reiterated that Mr X could seek a deferred payment agreement with the Council.
21. Mr X agreed to a payment arrangement with the care home directly for his mother’s care.
22. In November 2020, Mr X contacted the Council about funding for his mother. Mr X said she had no capital left because the fees owed to the care home were now equal to the value of his mother’s property.
23. The Council completed a provisional financial assessment of Mr X’s mother and said she was eligible for assistance. The Council explained it would only be able to provide financial assistance to the date Mr X contacted in November 2020 to seek assistance.
24. The Council completed a review of Mr X’s mother’s financial assessment in June 2021.
25. In November 2022, Mr X raised a formal complaint with the Council. Mr X said:
• The Council failed to offer a deferred payment agreement for his mother’s care home costs.
• The Council failed to complete a financial assessment and provide funding.
• His mother now has capital below the threshold caused by lack of funding by the Council.
26. The Council provided its complaint response in February 2023. The Council said:
• It completed a financial assessment of Mr X’s mother in September 2019 and decided she would be a self-funder after expiry of the 12-week disregard.
• It provided Mr X with information about how to apply for a deferred payment agreement with the Council in September 2019.
• Following Mr X’s contact in November 2020 it completed a further financial assessment and put in place financial support from the date of Mr X’s contact in November 2020.
• Since Mr X agreed a payment agreement with the care home which secured a debt to Mr X’s mother’s property, the Council could not now agree a deferred payment agreement for the same property.

Analysis

Financial assessment in 2019

27. The Council must offer a financial assessment to a person it has arranged a care home placement for to decide if they are eligible for financial support for their care.
28. The Council provided Mr X with the financial assessment forms for Mrs X and provided relevant information leaflets about the financial assessment process. Mr X provided the completed forms enabling the Council to complete a financial assessment at the start of September 2019.
29. The Council’s financial assessment detailed Mr X’s mother contributions for the first 12-weeks of her care while the 12-week disregard was in place. The Council’s financial assessment also outlined that following expiry of the 12-week disregard, Mr X’s mother would be a self-funder because of the capital in her property.
30. The Council completed a suitable financial assessment of Mr X’s mother based on the information Mr X provided. The Council completed this financial assessment within the 12-week disregard period and within just over two weeks from receiving the completed financial assessment forms from Mr X. I have found no fault in how the Council completed the financial assessment in 2019.

Deferred payment agreement

31. The Council must offer a deferred payment agreement to people who meet the criteria set out in paragraph 14. There is no dispute in this matter that Mr X’s mother met the criteria for a defer payment agreement.
32. The Council provided information to Mr X about deferred payment agreements in June 2019 and July 2019. The care home also directed Mr X to the Council in July 2019 about a deferred payment agreement.
33. The Council provided further information to Mr X about a deferred payment agreement in September 2019 following completion of the financial assessment. This information contained an application form Mr X could complete for a deferred payment agreement for his mother.
34. The Council provided Mr X with suitable information about deferred payment agreements and he had opportunity to apply for one for his mother. Mr X chose to agree to a payment arrangement with the care home instead. This was Mr X’s choice and I do not find fault with the Council.
35. Any issues about debt collection for a the payment arrangement between the care home and Mr X is a private matter which does not involve the Council.

Financial assessment in 2020

36. The Council needed to complete a financial assessment of Mr X’s mother when he contacted it to advise his mother’s savings had reduced below the threshold in November 2020.
37. The Council took suitable action to complete a financial assessment following Mr X’s contact. This financial assessment determined that Mr X’s mother was eligible for care contributions. The Council put these care contributions into place and backdated this to the date of Mr X’s contact in November 2020.
38. A council only provides funding from the date of contact for a person. Since Mr X only contacted the Council in November 2020, the Council was only required to go back to this date with the funding.
39. The Council completed a reassessment of Mr X’s mother in June 2021 and confirmed the funding for her care should continue.
40. The Council has completed the financial assessments correctly and provided funding for the correct time periods. I do not find fault with the Council.

Back to top

Final decision

41. I have completed my investigation as there was no fault by the Council.

Back to top

Investigator's decision on behalf of the Ombudsman