Birmingham City Council (19 004 245)

Category : Adult care services > Charging

Decision : Upheld

Decision date : 02 Jan 2020

The Ombudsman's final decision:

Summary: Mr X complained the Council has charged his mother for a temporary stay in a care home, even though it initially said the placement would be free of charge. The Ombudsman decided to uphold the complaint. The Council has agreed to provide an apology and pay for Mrs M’s stay at the first care home. It has also agreed to review if there have been similar cases in the last 12 months that may require a similar remedy.

The complaint

  1. The complainant, whom I shall call Mr X, complained to us on behalf of his mother, whom I shall call Mrs M. Mr X complained the Council told him that his mother would be discharged into a bed, for which there would not be a charge. However, it subsequently discharged his mother into a bed that was not free and failed to tell him in advance there would be a charge for this bed.

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The Ombudsman’s role and powers

  1. 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)
  2. 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

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

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What I found

What should have happened

  1. Enhanced Assessment Beds (EAB) are for all people who have recovered from illness, but cannot be discharged from hospital straightaway and require further social care assessment or period of enablement within a residential setting. It allows for a period of further recovery and enablement so that the assessment for long term social care is undertaken at the best time possible for the client. Furthermore, it is also a mechanism to avoid delayed discharges, which is in everyone's best interests.
  2. EAB is only a short stay for no more than four weeks. It is free of charge for the time deemed necessary to complete a full assessment for ongoing support. However, if a person’s stay in an EAB bed exceeds the expected discharge date, charges may apply.

What happened

  1. Mrs M went into hospital in January 2019, with feeling generally unwell and increasingly confused. Mr X told me that, since his mother’s admission, the hospital social worker advised him that his mother would be placed into an EAB, which would be free of charge for his mother. He received a leaflet that confirmed this. It was explained to him that after this period, there would be a charge for the placement. As such, the social worker provided a financial assessment form to him to complete for his mother.
  2. Mrs M met with a social worker in hospital on 29 January 2019. The Council’s record states that:
    • We have a conversation about discharge options: care package on return home and short term stay at the EAB.
    • Family meeting with son: Mr X did not think that a return home was good. The social worker explained about EAB and said this would be free of charge. The social worker provided Mr X with a leaflet. The leaflet contained information summaries above in paragraph 5 and 6.
  3. After an initial needs assessment of Mrs M on 31 January 2019, the social worker referred Mrs M for EAB the following day. This meant that Mrs M was eligible (met the criteria) for a free temporary stay in an EAB.
  4. The social worker called Mr X on 4 February 2019 to explain that there were currently no EAB beds available. The social worker said she would therefore offer his mother an “Interim bed”. The record states the social worker explained to Mr X that this bed would be chargeable and she therefore needed Mr X to complete a financial assessment. The record states that Mr X agreed to the referral, and the social worker provided him with a financial assessment form to complete.
  5. Mrs M moved into the interim bed on 13 February 2019. The Council told Mr X that it would soon allocate a new social worker to start the assessment process.
  6. Mrs M’s financial assessment concluded she would have to contribute £138.10 per week towards the cost of the interim bed.
  7. Following the assessment at the care home, Mrs M moved permanently into another home on 9 April 2019.


  1. Mr X was aware the Council would charge his mother for the placement in the first care home.
  2. However, based on Mrs M’s circumstances, the Council clearly concluded that she met the criteria for being placed in a free EAB bed. This was to enable a quick discharge and carry out an assessment of her needs, which is why the EAB scheme was created. As such, it is clear that Mrs M should not have been charged under these circumstances. The only reason she ended up having to pay a contribution, was because there were no available EAB beds at the time. However, this is not Mrs M’s fault. As such, it was fault by the Council to charge her for the bed it subsequently provided to her.

Agreed action

  1. I recommended the Council should:
    • Within four weeks of my decision:
        1. Provide an apology to Mr X and his mother for the fault above and the distress this has caused them.
        2. Pay for Mrs M’s stay at the first care home, in line with the EAB criteria.
    • Within three months of my decision:
        1. Review if there have been any similar cases in the last twelve months, and provide a remedy to those affected, where required, in line with the one applied in this case.
  2. The Council has told me it has accepted my recommendations.

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Final decision

  1. For reasons explained above, I have upheld Mr X’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

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