Summary: We did not find fault with the Council for how it considered Mrs X’s mother’s access to care from December 2024 to April 2025, including completion of care assessments. We found fault with the Council taking three and a half months to complete the financial assessment for Mrs X’s mother’s care home costs following it agreeing to the placement; this was a delay. The Council agreed to apologise for the uncertainty and distress caused by its fault.

The complaint

1. Mrs X complained the Council delayed completion of a care assessment of her mother for her to have a permanent placement at a care home. Mrs X says because of this delay, they had to pay privately for the care home placement meanwhile.
2. Mrs X complained the Council delayed confirming what contribution her mother would need to make towards her care home costs following its decision that her placement should be permanent.
3. Mrs X says the Council has caused her and the family distress and frustration.

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The Ombudsman’s role and powers

4. 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)
5. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
6. 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(1), as amended)

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How I considered this complaint

7. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
8. Mrs X and the Council had an opportunity to comment on my draft decision before I made a final decision.

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What I found

Rules and Regulations

Assessment

9. 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. The National eligibility criteria is set out in Section 13 of the Care Act 2014 and includes consideration about whether a person is able to manage safely in their own home.
10. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Charging for permanent residential care

11. 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.
12. 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.
13. 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.

Mental Capacity Act

14. The Mental Capacity Act 2005 is the framework for acting and deciding for people who lack the mental capacity to make particular decisions for themselves. The Act (and the Code of Practice 2007) describes the steps a person should take when dealing with someone who may lack capacity to make decisions for themselves. It describes when to assess a person’s capacity to make a decision, how to do this, and how to make a decision on behalf of somebody who cannot do so.

Best interest decision making

15. A key principle of the Mental Capacity Act 2005 is that any act done for, or any decision made on behalf of a person who lacks capacity must be in that person’s best interests. The decision-maker also has to consider if there is a less restrictive choice available that can achieve the same outcome. Section 4 of the Act provides a checklist of steps decision-makers must follow to determine what is in a person’s best interests.
16. If there is a conflict about what is in a person’s best interests, and all efforts to resolve the dispute have failed, the Court of Protection might need to decide what is in the person’s best interests.

What happened

17. Mrs X’s mother, Mrs Z, previously lived abroad before selling her property and moving into an annexe built on the side of one of her daughter’s, Mrs Y’s, house.
18. In December 2024, the Council completed a care assessment of Mrs Z. The Council confirmed during this care assessment that Mrs Z was an independent person and liked her current living situation in the annexe. The Council also confirmed Mrs Y was struggling with her caring role when Mrs Z would go out in the community on her own. The Council confirmed Mrs Z had eligible care needs and agreed for two days per week at a day service on the two free days each week Mrs Z had. The Council confirmed Mrs Z did not have an eligible care need for “Being able to make use of the home safely”. The Council also confirmed a consequence of Mrs Z’s eligible needs was not the “Suitability of accommodation and living arrangements”.
19. In January 2025, Mrs Y continued discussions with the Council about Mrs Z’s care needs. Mrs Y wanted Mrs Z to move into a care home. The Council outlined the extra support it could provide for Mrs Z and offered a carers' assessment for Mrs Y.
20. At the end of January 2025, Mrs Y reiterated the strain of caring for Mrs Z was having on her. The Council agreed for two weeks respite care for Mrs Z with her to return home to the annexe afterwards. The Council advised Mrs Y needs a formal carers assessment to decide long-term options. Mrs Y agreed to the care home suggested by the Council for the respite care.
21. Following the respite care in February 2025, Mrs Y asked the Council for information about care homes for Mrs Z as she could not cope as her carer any longer. The Council explained Mrs Z does not meet the criteria for long term care in a care home at present. The Council provided information to Mrs Y about planned breaks and offered further support for Mrs Z at home. The Council continued to discuss different options with Mrs Y into March 2025.
22. In March 2025, Mrs Y asked the Council if Mrs Z could go into a care home for respite for two weeks in April 2025. The Council provided details of costs and the NHS carers break funds for respite Mrs Y could use. The Council also confirmed it had agreed to increase Mrs Z’s home care further. Mrs Y told the Council she had already booked Mrs Z into the care home for two weeks costing about £1,400 each week. The Council contacted the care home and agreed for them to use the local authority rates to reduce the cost by almost half.
23. Mrs Z entered the care home in April 2025 for her two weeks of respite care. Two days before Mrs Z’s respite care was due to end Mrs Y told the Council Mrs Z would remain in the care home. Mrs Y told the Council she has spoken with the care home staff who said Mrs Z needs full-time care. The Council spoke with the care home staff who told it they had not advised Mrs Z needs full-time care. The Council told Mrs Y it did not consider Mrs Z needed full-time care in a care home and Mrs Z does not meet the local authority’s criteria for funded care placements. The Council said it intended to continue the current package of care at home following end of the respite placement.
24. On the day before Mrs Z was due to leave the care home, Mrs Y disputed the Council’s position and said she considered Mrs Z needed a care home placement. Mrs Y said the Council had not assessed Mrs Z since December 2024 and she had deteriorated significantly since then. The Council told Mrs Y that Mrs Z needed to return home as she was in a funded bed. The Council said it could then complete a care assessment but if she remained in the care home then Mrs Y would need to pay for her stay. The Council contacted Mrs X at Mrs Y’s request and confirmed if Mrs Z stays in the care home then this would not be funded by the Council and they would need to pay privately. The Council confirmed it needed to complete a reassessment of Mrs Z to decide her eligibility for the care home stay.
25. The Council told the care home Mrs Z could not return home but it would not be agreeing to fund the placement so any invoices would need to be sent to the family.
26. Mrs X made a formal complaint to the Council. Mrs X said:
• Mrs Y had no legal obligation to continue to care for Mrs Z and had formally withdrawn her role as her informal carer.
• The care provision provided by the Council did not mitigate Mrs Y’s psychological distress in her caring role.
• The Council did not formally assess Mrs Y through a carers' assessment.
• She wanted a full care act reassessment of Mrs Z and an immediate plan for her care which does not involve Mrs Y’s input.
• She wanted to know the legal basis for holding Mrs Y responsible for Mrs Z’s care home charges.
27. At the end of April 2025, the Council completed a reassessment of Mrs Z’s care needs. As part of this assessment the Council confirmed its thinking that Mrs Z’s care needs could be met in the community with care and support. The Council also confirmed within this assessment that Mrs Y wanted Mrs Z to stay in the care home.
28. The Council held internal discussions about Mrs Z’s right to residence in the annexe and the best options for her long-term placement. The Council updated Mrs Z’s care plan in May 2025 to reflect a recommendation for care home placement as the best option given the full circumstances and situation. The Council noted this was despite its consideration Mrs Z could live in the community. The Council told Mrs X it needed to complete a new financial assessment of Mrs Z.
29. The Council provided its stage one complaint response. The Council said it had now completed a care assessment of Mrs Z and agreed to fund her placement since the date of its care assessment.
30. Mrs X responded to the Council to complain they had been asking for a reassessment of Mrs Z but the Council relied on the December 2024 assessment. Mrs X said her mother was below the threshold to self-fund so disputed having to pay any care costs. Mrs X also disputed the chosen date for the Council to start funding from when this was five days after the respite care ended. Mrs X also said the care home had directly billed Mrs Y beyond the date the Council said it would charge from. Mrs X said she does not understand why Mrs Y is being held responsible for this.
31. The Council provided a stage two complaint response and advised it had agreed to fund the placement from the date it completed the assessment. The Council said it had updated the care home who should amend their bills to not bill beyond this point. The Council explained any charges before it agreed to fund the placement was for the family to resolve.
32. In September 2025, the Council completed a financial assessment of Mrs Z and outlined the care fees she would need to pay. The Council sent a letter to Mrs Y confirming this. The Council issued a backdated invoice followed by monthly invoices for the care home costs.

Analysis

Care assessment

33. Mrs X complained the Council delayed completion of a care assessment of Mrs Z for her permanent placement at a care home.
34. When the Council assessed Mrs Z in December 2024 it determined she did not meet the eligibility criteria for a place at a care home. There was no dispute in December 2024, and the Council has reached a decision it was entitled to make on the assessment it completed.
35. From January 2025 to March 2025, the Council discussed Mrs Z’s care options with Mrs Y. While Mrs Y told the Council she wanted Mrs Z to move into a care home, Mrs Y did not make a formal request for reassessment. The Council was clear that based on a recent assessment that Mrs Z did not meet the threshold. The focus of the Council’s discussions was about what extra it support it could arrange for Mrs Z and promoting Mrs Y to arrange a carers' assessment with it. The Council took the correct approach based on an assessment it completed within the last three months and offered the correct support options to Mrs Y. I do not find fault with the Council.
36. The Council also supported Mrs Y in arranging respite stays for Mrs Z in February 2025 and April 2025. The Council ensured both spells of respite were charged at the local authority rates. The Council provided suitable support and I do not find fault.
37. When Mrs Y told the Council Mrs Z could not return home to the annexe, the Council reiterated its decision Mrs Z did not meet the criteria for a care home placement. The Council told Mrs X and Mrs Y they would incur the costs of a private placement if Mrs Z remained in the care home. The Council reached a decision it was entitled to and provide the relevant information to Mrs X and Mrs Y. I do not find fault.
38. It took the Council four working days from Mrs X’s request to complete an assessment of Mrs Z in the care home. This is not a significant amount of time, and I do not find fault.
39. As part of the Council’s assessment it decided that Mrs Z’s needs could still be met in the community; this decision supported its previous offers of support from January to March 2025. However, because of the situation, with Mrs Y struggling and the refusal to allow Mrs Z to return to the annexe, the Council agreed to make Mrs Z a permanent care home placement. This was a suitable best interests decisions for Mrs Z based on the circumstances and I do not find fault with the Council.
40. The Council had no duty to backdate its decision any earlier than the assessment date. Mrs X and Mrs Y knew they would incur charges for Mrs Z’s residence beyond the respite period and were given opportunity for Mrs Z to return home. Since Mrs X and Mrs Y decided Mrs Z should remain in the care home, responsibility for payment in the interim is a private matter between the care home and Mrs Z and her family. It is not for the Council to dictate who the care home bills in such circumstances.

Financial assessment

41. Mrs X complained the Council delayed completion of a financial assessment for Mrs Z which delayed confirmation of contributions towards the cost of care.
42. Under normal circumstances, a council should complete a financial assessment of a person before a person moves into a care home so there is confirmation of the care costs. The Council had no opportunity to complete the financial assessment before Mrs Z moved into the care home. This is because Mrs X and Mrs Y had effectively already placed Mrs Z at the care home before confirming their intention that Mrs Z would remain there. This denied the Council opportunity to complete a financial assessment before placement meaning it was not at fault.
43. I would expect to see the Council complete a financial assessment of Mrs Z as soon as possible following its decision, in mid-May 2025, Mrs Z would remain a permanent resident in the care home.
44. The Council took until the start of September 2025 to complete its financial assessment, this was three and a half months. This is an extended time period and is not without delay; the Council was at fault.
45. The Council’s delay caused distress and uncertainty to Mrs X and Mrs Y. However, Mrs X and Mrs Y already knew the potential maximum charge for the care home stay through the private charges issued by the care home and information provided by the Council. The Council’s assessed contribution costs fell well below the private charges meaning there was no financial injustice through the Council’s delays.
46. Responsibility for payment of invoices issued by the Council rests with Mrs Z, and anyone with a Lasting Power of Attorney for Property and Financial Affairs acting on her behalf, which includes both Mrs X and Mrs Y.

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Action

47. Within one month of the Ombudsman’s final decision the Council will:
• Provide an apology to Mrs X for the distress and uncertainty caused by the delays in completing the financial assessment of Mrs Z’s care home placement. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended in my findings.
48. The Council should provide us with evidence it has complied with the above actions.

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Decision

49. There was fault leading to injustice. As the Council has agreed to my recommendations, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman