Summary: Mr C complains the Council should not charge Ms M for her temporary stay at a care home, because: the Council failed to explain there would be a charge after two weeks, and the delay of moving Ms M back home was due to the Council. The Ombudsman found that it was wrong for Ms M to suffer a financial injustice, due to the time it took the Council to find a homecare agency. The Council has agreed to apologise and rectify any financial injustice Ms C has experienced.

The complaint

1. The complainant, whom I shall call Mr C, complained to us on behalf of his mother in law, whom I shall call Ms M. Mr C complained the Council failed to tell Ms M and her family, that she would be responsible for paying the costs of the nursing home after the first two weeks.
2. Furthermore, Mr C complained that the delay of moving Ms M back to her home, was due to the time it took the Council to find a homecare provider.

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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 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

5. I considered the information I received from Mr C and the Council. I shared a copy of my draft decision statement with Mr C and the Council and considered any comments I received, before I made my final decision.

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What I found

6. Mr C told me that:
• Ms M was discharged from hospital into a nursing home on 11 February 2019.
• Mr C believed it would be for 2 weeks and there would be no charge, as the first two weeks would be funded by the NHS.
• The family wanted to take Ms M home after two weeks, but the Council did not allow this. Ms M received invoices of more than £2,700 for the remaining time she was in the nursing home.
7. The Council carried out Ms M’s care needs assessment on 8 February 2019. The records state that Ms M’s daughter, whom I shall call Ms C, was supporting her mother at the assessment. Ms M understood what was discussed. Ms M said she was keen to go home and would be happy for carers to support her. Ms C said:
• Her mother has no landline. She would arrange to have this installed this weekend, or as soon as possible, to ensure the Council could install a lifeline pendant.
• She would look into getting her mother’s bed downstairs, so her mother would not have to use her stairs.
8. The social worker called Ms C later that same day. The record states that:
• Ms C was happy for her mother to go into a nursing home on a temporary basis. She felt her mother would benefit from going into a home for six to eight weeks, allowing time for her to recover from her infections and regain her strength. After this, the family would look into installing a landline, if Ms M would return home.
• The social worker advised Ms C that a decision would have to be made within the two weeks period, because her mother would have to pay for her care in the nursing home after then. Ms C said she would call on Monday once she had decided where she would like her mother to be after the two weeks.
9. Ms M went into the nursing home on 11 February 2019. Ms C told the social worker the following day, that it was too early to decide. Ms C said she would see her mother and discuss this tomorrow. The social worker advised the Council would still need to look at planning a support plan, because Ms M would be paying for her care after two weeks.
10. The social worker called Ms C again on 15 February. The record states that Ms C said:
• She was still unsure if she would like her mother to continue at the home after two weeks. The cost was high, and she may have to look at other care homes or a package of homecare.
• Her mother was also keen on coming home and did not enjoy being in the home. Her mother would be self-funding.
11. The social worker said Ms M would need a homecare package of two visits per day. One visit in the morning and one in the evening to provide support with: medication, personal care, breakfast, strip wash and getting (un)dressed. Ms would support her mother during the day.
12. The case was allocated on 20 February to another social worker. The social worker met with Ms M and Mr and Ms C on 22 February 2019, at the home. The record says that Ms M would like to go home, and her family were happy for this to go ahead. The social worker would arrange a care agency.
13. However, it was difficult for the Council to find a care agency that had availability to provide Ms M’s care support package. As such, it took until 18 March 2019, before Ms M could return home.
14. Mr C told me the family did not know that Ms M would still have to pay for her subsequent stay at the home, even though her continued stay at the home was due to delays by the Council.

Assessment

15. After the initial discussion with Ms M in the hospital, in which Ms M said she was keen to go home, the subsequent discussions by the first social worker were only with the daughter, who preferred her mother going into a nursing home first. The subsequent records only record her daughter’s views. As Ms M had capacity to make her own decisions about her care and discharge destination, the social worker should have assured herself that Ms M agreed with what her daughter was saying. In the end, it would be Ms M who would receive any care and pay for it. Instead, the first social worker was led by the wishes of Ms M’s daughter. This was fault. The second social worker rectified this by organising a meeting with Ms M and Mr and Ms C.
16. The records clearly state, on several occasions, that if Ms M would decide to remain at the home for longer than two weeks, she would have to pay for this. Ms C was aware of this. However, Ms M decided before the end of the two-week period, that she wanted to go home. It would not be fair for Ms M to suffer a financial injustice, for the Council taking 24 days to put the required care package in place.
17. The financial injustice is that Ms M had to pay the full cost of the nursing home fees for 24 days, because she could not return home yet, because the Council had not found a care agency yet. However, if Ms M would have been able to immediately go home after two weeks, she also would have had to pay for care support, namely: the full cost of her homecare support package of two visits per day.

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Agreed Action

18. I recommended that, within four weeks of my decision, the Council should:
• Provide an apology to Ms M and her family for the fault above
• Pay for Ms M’s nursing home fees, minus the amount it would have cost Ms M to pay for 24 days of homecare support.
• Share the lessons learned with relevant staff
• Put measures in place to ensure that clients will not be financially disadvantaged in future under these kinds of circumstances.

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Final decision

19. For reasons explained above, I have upheld Mr C’s complaint. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case

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Investigator's decision on behalf of the Ombudsman