Summary: Mr X complains the Council failed to arrange a package of care for him when he returned home in December 2023 and unreasonably increased the charges for his care. The Council failed to give Mr X copies of his assessment and care and support plan in 2023. It failed to provide timely information about the cost of and charges for his care. It also failed to take account of the fact it had been told Mr X’s stay in a care home would be for two weeks. These failings caused avoidable distress and prevented Mr X from making informed decisions about his care. The Council needs to apologise and make a symbolic payment for the distress. It also needs to improve its working practices.

The complaint

1. The complainant, Mr X, complains the Council failed arrange a package of care for him when he returned home in December 2023 and unreasonably increased the charges for his care.

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The Ombudsman’s role and powers

2. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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)

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What I have and have not investigated

4. I have investigated events relating to Mr X’s discharge from hospital in 2023. I have not investigated more recent events, as Mr X first needs to complain to the Council before we can investigate them.

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How I considered this complaint

5. I have:
• considered the complaint and the documents provided by Mr X;
• discussed the complaint with Mr X’s advocate, Mr Y;
• considered the comments and documents the Council has provided in response to my enquiries;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Mr X, his advocate and the Council, for me to consider before making my final decision.

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What I found

What happened

6. Mr X lives in his own home with his partner. In 2023 the Council was providing one hour of support each morning to meet his eligible needs under the Care Act 2014. This cost £146.86 a week. Mr X had to pay this, as his financial assessment said he could afford to pay up to £293.36 a week.
7. Mr X went into hospital in October 2023. When ready to leave hospital, Mr X said he did not want to return home as his partner would be away and he did not want to be on his own. The Council told him he could not stay in hospital until his partner returned, as his needs could be met in his own home. Mr X said he would stay in a care home, but did not want to pay for it himself. The Council said it would not pay for a care home when it could meet his needs at home.
8. During a telephone call with Mr Y on 29 November, the Council said Mr X would not have to pay more than he was already paying (£146.86 a week) towards the cost of his package of care when he returned home.
9. On 4 December the Council told Mr X his package of care was due to start on 6 December. Mr X said he would self-fund a placement in a care home. The Council told him he could not keep changing his mind. Mr Y told the Council Mr X had the money to fund a placement in a care home. He noted Mr X often changed his mind.
10. The Council arranged for a care provider to meet Mr X’s needs at home (four calls a day) from lunchtime on 6 December, but Mr X did not return home.
11. Mr X decided to stay in a care home when he left hospital on 7 December and paid for this himself. Mr Y said Mr X would fund the placement for two weeks.
12. Mr X returned home on 22 December. Mr Y contacted the Council on 23 December. He said Mr X had expected to receive four calls a day when he returned home but the care provider had not turned up. He said there was not enough space for Mr X to live downstairs (he was sleeping on a sofa in the lounge with a commode in the hallway). The Council spoke to Mr X who initially said he knew there would be no care when he returned home but then said he had expected it to be in place. Mr X agreed the property was cluttered so there was no room for a bed downstairs. He agreed to return to the care home, if that was needed. The Council said it would have to secure funding for a placement. It said returning to the care home would allow time for an occupational therapist to assess his home environment.
13. However, the care home said Mr X could not return as they had struggled to meet his needs while there. It confirmed Mr X had needed two care workers to support him when moving. A social worker based at the hospital agreed to continue dealing with Mr X.
14. The care provider said it could not take on Mr X’s care package at such short notice, but could start in the new year. The Council told Mr X no care was available (neither at home nor in a care home), so he needed to call an ambulance and be readmitted to hospital for his safety.
15. The Council visited Mr X in hospital on 3 January 2024, but he did not want to discuss plans for his discharge. He said he was having problems with his memory. He asked officers to speak to Mr Y.
16. The Council spoke to Mr Y. It said Mr X would need four calls a day from two care workers when he returned home. Mr Y raised concerns about a potential increase in Mr X’s weekly charge because of the increased package of care.
17. The care provider agreed to provide two care workers to visit Mr X for:
• 30 minutes in the morning
• 30 minutes at lunchtime
• 30 minutes at teatime
• 30 minutes at bedtime
18. The Council arranged for the carer provider to start visiting Mr X at home on 15 January. Mr Y said they would not agree to the package of care until they knew how much Mr X would have to contribute towards its cost. Mr X refused to leave the hospital, saying he needed two weeks’ notice.
19. On 15 January the Council told Mr Y Mr X would have to pay £293.36 a week towards the cost of his care (£635.32). Mr X refused to leave hospital, saying he needed three weeks’ notice. He also complained to the Council about providing misleading information about the charges and failing to provide care and support when he returned home on 23 December.
20. Mr X returned home on 19 January. On 23 January, Mr X and Mr Y told the care provider he only wanted care workers to visit in the morning and at lunchtime, but he needed one hour in the mornings. He would not let the care workers visit. Mr X says he was readmitted to hospital on 23 January for urgent treatment and discharged again the next day.
21. When the Council replied to Mr X’s complaint on 30 January, it said:
• It had assessed his needs under the Care Act and provided a package of care based on four calls when he returned home.
• It had written to him about the charges for his care in April 2022, March 2023 and January 2024.
• It apologised for the inaccurate information about care charges provided in the telephone call on 29 November 2023.
• There was no evidence they had made the Council aware that Mr X had arranged a short-term self-funded stay in the care home. It was therefore unaware of the arrangement to return home on 22 December
• It had tried to arrange urgent care on 23 December, but no care provider had the capacity to support Mr X.
22. Mr X was not satisfied with the Council’s response. He said:
• It had not provided him with a copy of his assessment and care and support plan.
• It was now charging him more than it had charged in the past.
• It had not provided support after he returned home on 22 December.
23. When the Council replied in March, it said:
• It would send Mr X copies of his assessment and care and support plan;
• Mr X could provide up-to-date information about his finances, if the information provided for his financial assessment was now out-of-date.
• There was no evidence of anyone telling the Council Mr X had left hospital for a care home or asking for care to restart on a particular date. Nor did anyone tell the Council Mr X was leaving the care home to return home.

Is there evidence of fault by the Council which caused injustice?

24. The Council was also at fault for:
• Denying it had been told Mr X’s stay in the care home would be short-term. Its own records show Mr Y told the Council Mr X would stay in the care home for two weeks. The Council failed to act on that information.
• Failing to send Mr X copies of his Care Act assessment and care and support plan in December 2023.
• Providing inaccurate information about the charges for Mr X’s care and failing to provide timely information about the cost and charges for that care. It only did this on 15 January, when it planned to start care for the second time.
25. Under the Care and Support Statutory Guidance councils should provide people with copies of their assessment and care and support plans. The latter should contain information about their personal budget. The failure to provide information in a timely fashion prevented Mr X from making informed decisions about his care. It is clear that Mr X and Mr Y had concerns about the cost of any care the Council provided. As they did not know the overall costs of the care until 15 January 2024, they accepted what Mr Y had been told, that the charge would remain £146.86 a week.
26. The Council knew the stay in the care home was only temporary (while Mr X’s partner was away) and had even been told it would be for two weeks. The Council should either have told Mr X it would arrange his package of care to start after two weeks, or advised him how much notice he needed to give to ensure the package would start when he returned home. If the Council had done this, it could have avoided the need for Mr X to spend another three weeks in hospital.

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Agreed action

27. I recommended the Council:
• Within four weeks, pays Mr X £500 and apologises to him for the failure to provide him with the information he needed to make informed decisions about his care, and the distress this caused, including having to return to hospital in December 2023.
• Within eight weeks, reminds officers of the need to send people copies of their assessments and care and support plans, so they can make informed decisions about their care.
28. The Council has agreed to do this. It should provide us with evidence it has complied with the above actions.

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Final decision

29. I have completed my investigation on the basis there has been fault by the Council causing injustice which requires a remedy.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman