Summary: There was no fault in the Council charging Mr E for home care after he left hospital as he was not receiving enablement care and Mrs E received appropriate information about charging.

The complaint

1. Mrs E complains for her husband Mr E that London Borough of Wandsworth (the Council) charged Mr E for six weeks care after he left hospital despite saying there would be no charge.

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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. If we are satisfied with a council’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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How I considered this complaint

3. I considered Mrs E’s complaint to us, the Council’s responses to her complaint and documents described later in this statement. I considered comments and further documents in response to a draft of this statement.

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What I found

4. A council must carry out an assessment for any adult with an appearance of need for care and support. (Care Act 2014, section 9)
5. If a council decides a person needs support, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether they meet any eligibility criteria and sets out how the council is going to meet them. It should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
6. Intermediate care is a structured programme of care provided for a limited time to help a person maintain or regain the ability to live independently. Reablement is a type of intermediate care which has a focus on helping the person regain skills and reducing their needs through providing services in the home. (Care and Support Statutory Guidance Paragraphs 2.9 and 2.10)
7. Intermediate care, including reablement, must be provided free for up to 6 weeks. (Care and Support Statutory Guidance, paragraph 8.14)
8. The Council has an enablement service called KITE (‘Keeping Independence Through Enablement’). This is a service providing short-term support for adults who have lost the ability to do tasks for themselves but have the ability and motivation to work towards specific goals.
9. Councils may charge for non-residential services they arrange or provide. This Council’s policy is that people who have saving of more than £25,000 must pay the full cost of their care.

What happened

10. Mr E was in hospital in October 2017 recovering from a stroke.
11. A social worker visited Mr E in hospital on 20 November to carry out a social care assessment. Mr E’s son was present. Their son told the social worker Mrs E could not cope with caring for Mr E at home. The social worker noted she explained that care at home could be arranged or respite care in a care home. The son agreed to discuss matter with Mrs E. The social worker noted she a gave them a financial assessment form and a leaflet on charging for social care.
12. The social care assessment concluded Mr E was eligible for social care. His personal budget was £263. At the assessment, Mr E agreed to support in the home from carers three times a day with personal care.
13. The care and support plan for Mr E said he needed support with personal hygiene, dressing and toileting as well as transfers and mobility. The plan set out three calls a day and said there would need to be a financial assessment to calculate Mr E’s charge.
14. A social worker visited Mr E in hospital the following day to talk about Mr E’s care when he left hospital. Mrs E was present and said she could not cope with caring for Mr E at home. The social worker noted he advised them that a step-down bed (temporary care in a care or nursing home, funded by the NHS) would be free for the first two weeks and chargeable thereafter.
15. Mr and Mrs E’s daughter spoke to the social worker and asked for respite care for Mr E as Mrs E could not cope. The social worker noted she told their daughter that Mr E’s care was chargeable and Mr E would need a full financial assessment. The social worker also noted she said the minimum charge would be around £134 a week and the maximum charge would be the full cost which was £550 to £650.
16. Mr E went into a step-down bed in a nursing home for two weeks. There was no charge for this.
17. Mrs E told us the social worker said the Council would provide the first six weeks of care free of charge. But there is no record of the social worker saying the first six weeks would be free. Mrs E told us she expected Mr E to get six weeks of free home care after he had left the nursing home. She also told us Mr E had physiotherapy for two weeks upon leaving hospital which suggested his mobility would improve.
18. Mrs E complained to the Council about the issues she raises with us. The Council’s final complaint response said:
• Mr E was not suitable for reablement. The social worker should have explained the criteria for the KITE service at the time and the Council was sorry for this
• There were no grounds to waive the charge as home care was a chargeable service.
19. Mr E returned the Council’s financial assessment form in March 2018 declaring capital of over £25,000. The Council’s charging policy is that people with assets of above £25,000 pay the full cost of home care.
20. The Council told us Mr E had physiotherapy and this was provided by the NHS but it was not part of a reablement plan. The Council also told us the social worker discussed Mr E’s case with the KITE team when Mr E was in hospital and he was not suitable for the service because he had difficulty following instructions and was unable to retain information between sessions with the carer.

Was there fault?

21. I do not uphold this complaint. I am satisfied the Council acted in line with the law and guidance described in paragraphs four to nine by assessing Mr E’s needs and drawing up a care and support plan to meet those needs. The Council was entitled to charge Mr E for home care from the date he left the nursing home, unless it was providing reablement care. The care and support plan completed before Mr E left hospital set out a need for long term care and support at home. I am satisfied Mr E’s care was therefore not reablement care. The Council explained in its complaint response why Mr E was not a suitable candidate for reablement.
22. There is no evidence other than Mrs E’s assertion, that the social worker told her Mr E’s home care would be free. The case notes and documents indicate the opposite: the social worker told the family on two occasions that care was chargeable and made a note saying she had provided a financial assessment form and leaflet about charging. The care and support plan also said there would need to be a financial assessment to determine the charge for Mr E’s care. All the written documentation indicates Mrs E received appropriate information at the time about the charge.

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Final decision

23. There was no fault in the Council applying a charge for Mr E’s home care after he left hospital as he was not receiving enablement care and Mrs E received appropriate information about charging at the time.
24. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman