Summary: Ms X complains for Mrs Y about the way the Council dealt with her care and support needs when she was discharged from hospital, so she stayed in a care home for longer than needed causing distress and financial loss. We found fault because the Council delayed in assessing Mrs Y’s care and support needs and submitting a budget application for a home care package. The Council has accepted it was at fault. It has already apologised to Mrs Y for the distress caused which was suitable action for it to take. So, we have completed our investigation.

The complaint

1. Ms X complains for Mrs Y about the way the Council dealt with her care and support needs when she was discharged from hospital. Ms X complains the Council:
• Placed Mrs Y in an unsuitable care home which affected her mental health.
• Delayed carrying out an assessment of Mrs Y’s care and support needs which would have enabled her to return home sooner causing distress and financial loss. Ms X wants the Council to refund Mrs Y’s care fees for the extra time she spent in the care home.
• Failed to include Mrs Y’s wishes for support in the support plan causing distress.

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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 recommend a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended). 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)
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(1), as amended)

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How I considered this complaint

4. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
5. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Legislation and statutory guidance

Community care assessment

6. 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.
7. 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.

Care and Support plan

8. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

What happened in this case

9. The following is a summary of key events. It does not include all the information I considered as part of my investigation.
10. Mrs Y lived at her home on her own. She was admitted to hospital in December 2024 after a stroke. Mrs Y was discharged to a rehabilitation unit in January 2025. This was because she no longer needed hospital care but could not return home. Unfortunately, Mrs Y had a second stroke affecting her mobility, so she was bedbound needing hoists to lift and move her. Mrs Y’s family could not decide on her care and noted issues with her returning home. Mrs Y had capacity to decide, and she said she wished to go into a 24-hour nursing home as she did not want to return home. Mrs Y and her family considered a nursing home would best meet her needs.
11. A hospital social worker arranged for offers of care from care homes for Mrs Y. Her son Mr Y asked the Council for a particular care home near to his home which the Council agreed to pursue. The care home assessed Mrs Y and agreed a placement for her. Mrs Y moved into the care home on 17 February 2025 as a permanent resident. The social worker did a review on 18 February 2025 which noted Mrs Y was settled, family had visited and no concerns raised.
12. A few days later Mr Y advised Mrs Y had her strength back and wanted to go home. Mr Y raised a few concerns about the care Mrs Y was receiving.
13. The hospital social worker contacted the care home. The care home staff advised the family said they did not want Mrs Y to remain in the care home and would look after her at home. The care home staff did not consider Mrs Y could manage at home because of her high care needs.
14. Mrs Y’s case was transferred to Council social workers. The care home contacted the Council as Mrs Y wanted to leave, was complaining, declining care and upsetting the carers. The care home said Mrs Y’s family were causing disruption at the care home and saying she should be at her own home.
15. Ms X contacted the Council on Mrs Y’s behalf in March 2025. Ms X asked the Council to move Mrs Y from the care home. This was because the family considered it unsuitable as it was for residents diagnosed with dementia which Mrs Y did not have. Ms X said the family had made a safeguarding concern about the care Mrs Y was receiving.
16. The Council’s duty social work team dealt with the case. The team told Ms X the Council would explore the option of Mrs Y returning home with a package of care. The care notes recorded Ms X saying she was unsure Mrs Y could manage at home even with care. But considered Mrs Y should move from the care home as soon as possible. The care home said it intended to serve a notice on Mrs Y to leave the care home because of the disruption she and her family were causing.
17. The Council allocated the case to a social worker, Officer B, in March 2025 to review Mrs Y’s care and support plan. This was to look to move Mrs Y to sheltered accommodation or consider a package of care at her home. The care home served notice on Mrs Y to leave the care home. Officer B and an occupational therapist (OT) visited Mrs Y’s home to assess it for her discharge. They noted the property was wheelchair accessible and the OT ordered equipment for Mrs Y to use when she returned. The OT said they would visit again to review the equipment once Mrs Y was home. The OT and Officer B also visited Mrs Y at the care home to help her return home.
18. In April 2025 Officer B considered the safeguarding concern and felt the issues were to do with a difference of opinion between the care home and family. Officer B considered the main issue was that Mrs Y was unhappy at the care home, so the Council was now facilitating a move. It was reported Mrs Y, and her family were happier now they knew she was to be moved. Officer B told the care home and Ms X the Council would be closing the safeguarding concern and not continuing with it.
19. Ms X spoke to Officer B in April 2025 about Mrs Y’s care and support plan. Ms X also emailed a weekly package of care she wished Mrs Y to have which included shopping, cleaning, social calls and attendance at a coffee morning Mrs Y liked to go to.
20. The Council carried out a financial assessment on Mrs Y to see how much she needed to contribute towards the cost of her care in the care home. The financial assessment established Mrs Y needed to contribute £270 a week from 17 February 2025 to 6 April 2025 and then £277 a week from 6 April 2025.
21. Officer B visited Mrs Y at the care home on 29 May 2025. Ms X also attended. Ms X asked the Council to discharge Mrs Y home on 12 June 2025 and outlined the support package she considered Mr Y needed. Officer B advised Ms X the Council needed to follow a process to confirm a start date. So, could only confirm a discharge date once the Council agreed the budget and identified a care agency. The agency would then have to do a risk assessment before confirming a start date.
22. Officer B contacted Ms X on 10 June 2025 apologising for the delay but had recently needed to prioritise other clients. Ms X raised concerns about the delay in discharging Mrs Y who was refusing to eat and drink and considered she was in an unsuitable home.
23. Officer B made a referral to the NHS for incontinence care for Mrs Y as she would need this when at home. A senior social worker scrutinised the package of care on 18 June 2025 and sent it to a manager on 1 July 2025. The manager approved the funding for Mrs Y on 8 July 2025. The funding was for 7 days a week with four daily one-hour visits by carers, totalling 56 hours.
24. The Council sourced a care agency the same day who carried out a risk assessment. The Council agreed with Ms X the care package would start on 17 July 2025 with the lunchtime visit. The Council confirmed there was a mobile sling in place at Mrs Y’s home and so needed two carers for each call. Officer B advised Ms X the cleaning, shopping and social calls the family requested were still on the care plan. But Council managers had not agreed to these, and they would be removed from the care and support plan. This was because there were 2 carers on each call so cleaning could be done then. Mrs Y also did online shopping and her family said they could provide support with any other shopping.

The Council response to Ms X’s complaints

25. In July 2025 Ms X complained to Council Mrs Y had been in the care home since February 2025. Ms X’s complaints included concerns Officer B had assessed Mrs Y, drawn up a support plan and said in May 2025 Mrs Y would be home by 12 June 2025. This had not happened and so Mrs Y remained at the care home refusing to eat or drink as she did not want to be there. Ms X considered there had been poor communication from Officer B. And it had taken four months for the support plan to be drawn up and approved causing Mrs Y more distress.
26. The Council responded to Ms X’s complaints. It did not uphold Ms X’s allegation she had been told Mrs Y would be discharged home by 12 June 2025. It noted Ms X had requested this but been told by Officer B they would aim to support this. However, it was subject to other factors including budget agreement so there was no guarantee Mrs Y would be discharged then.
27. The Council accepted a delay in completing the support plan, but this had been due to the need for Officer B to collaborate with the OT to arrange equipment for Mrs Y’s home. And by Ms X raising concerns about parts of the plan which meant it needed to be reviewed. The Council apologised for the delay and any inconvenience caused. It considered officers had acted Mrs Y’s best interests with the aim of ensuring a safe and well supported discharge home.
28. Ms X asked the Council to review the complaint at stage 2 of the complaint procedure as she remained unhappy with the response. The Council responded in October 2025. It accepted a significant delay in completing the budget application. It apologised for the delay and impact onto Ms X and Mrs Y. It considered the case records showed officers planned a discharge date of 12 June 2025 for Mrs Y. However, the budget was not submitted until after then with no reason given. So, the Council now upheld this part of Ms X’s complaint.
29. The Council noted Ms X did not consider Mrs Y’s support plan to be centred on the person. It apologised again for the delay in completing it. It said a social worker was to review the support plan so it would ensure it considered these concerns. The Council said it now upheld this part of the complaint.

My assessment

30. The evidence provided shows that Mrs Y and her family discussed with social workers where she should be discharged to from the hospital. The Council managed to arrange a placement at the care home which was the one requested by family members. Mrs Y had capacity to make decisions and wanted to go to the care home as she did not consider she could manage at home. The Council confirms the care home was open to all who needed nursing or personal care not just those with dementia. There is therefore no evidence of fault by the Council in placing Mrs Y in the care home as it followed the wishes of Mrs Y and her family.
31. The Council has accepted it delayed carrying out an assessment of Mrs Y’s care and support needs and submitting the budget application which would have enabled her to return home sooner. This is fault by the Council, and it has apologised to Mrs Y already for the delays. While the delays were unfortunate it was inevitable in the circumstances it would take some time to arrange the home care package for Mrs Y. This was because of the need for OT involvement and the high level of care she required. I do not consider from the evidence provided Mrs Y has been impacted financially in any significant way by the delay. And she continued to receive care in the care home in the interim. Because of this I consider the Council’s apology is sufficient to remedy any injustice caused to Mrs Y.
32. The documents provided show that officers drew up Mrs Y’s care and support plan outlining provision to meet her needs. I appreciate that Ms X and Mrs Y are disappointed with the provision that has been made and consider it does not match Mrs Y’s wishes for support. But the decision about what meets Mrs Y’s care and support needs is a matter of the officers’ professional judgement. We cannot question the merits of the decision itself without evidence of fault in the way it was made. I do not consider there is fault in this case.
33. This is because the evidence shows officers visited Mrs Y and considered information from Ms X and Mrs Y when drawing up the care and support plan. So, the content of the care and support plan is a decision the Council is entitled to make and there is no evidence of fault in the way the Council has drawn up the plan.

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Decision

34. I find fault causing injustice which the Council has already remedied.

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Investigator's decision on behalf of the Ombudsman