Summary: Mr X complains about misleading information the Council gave him over funding to meet the care needs of his elderly mother when she moved to Norfolk in 2019. There was fault by the Council because it did not correctly follow the continuity of care process under the Care Act 2014. The Council agreed to remedy the injustice it caused by paying £300 to Mr X’s mother for the distress she was caused by its action as well as a time and trouble payment of £100 to Mr X.

The complaint

1. Mr X complains about misleading information the Council gave him over funding to meet his elderly mother’s care needs when she moved to Norfolk in 2019.
2. Mr X is also unhappy about the actions of the Council as well as what he considers to be its poor communication.
3. Mr X wants the Council to explain why things went wrong. He wants clarity on funding arrangements for his mother. He also wants an apology from the Council.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. 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

6. I reviewed the complaint and background information from Mr X and the Council. I discussed matters with Mr X by telephone. I sent a draft decision statement to Mr X and the Council and invited their comments on it.

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What I found

The Care Act 2014 continuity of care process

7. Continuity of Care arrangements apply when;
1. A person with eligible care and support needs (receiving care and support arranged by the Local Authority) chooses to move from one Local Authority area to another Local Authority area, resulting in a change to their ordinary residence status and the Local Authority that is responsible for meeting their care and support needs;
2. A person with eligible care and support needs (receiving care and support arranged by the Local Authority), who lacks capacity to make a decision about where to live is moved or placed into another Local Authority area by someone other than the first Local Authority (for example by a family member);
8. Continuity of care arrangements involve the 2 local authorities working with the person to ensure that their care and support (and any carer’s Support) is in place before, during and after their move so as to provide an undisrupted service and smooth transition from one area to another. 
9. The key to good continuity of care arrangements is effective and timely co-operation between the local authorities.
10. On occasion the 2nd Local Authority may not have completed the required assessment or Care and Support Plan in order to ensure that care and support to meet eligible needs is in place from the day of the move. This does not affect their responsibility to arrange and fund the services required and in this situation the Care Act requires them to either;
1. Liaise with the current care and support provider and the person to ensure that the same provision remains in place and at the same level until the assessment has been completed; or
2. Arrange for a local care and support provider to provide care and support at the same level as the person had been receiving in the 1st Authority until the assessment has been completed.
11. The Care Act statutory guidance does not stipulate what to do should the 2nd Authority fail in their duty to do either of the above, potentially leaving the person without the care and support they need after the move. If the 1st Local Authority is aware of this then it can be reasonably assumed that, in the spirit of the Act, it should continue to provide the care and support that the person needs, and to liaise with the 2nd Authority to monitor progress and agree terms of reimbursement. Where there is a dispute about Ordinary Residence the procedures to resolve disputes between 2 or more local authorities should be followed.

Background

12. Mr X’s mother lived in a care home in the Harrow areas, originally as a self-funder but then funded by the Council from 2015.
13. Mr X moved to Norfolk in July 2019. His mother had capacity at the time and expressed a wish to be closer to him.
14. Mr X contacted the adult care team by telephone. He explained his mother’s wish to move to a care home in Norfolk. Mr X reports the officer whom he spoke with told him he could find a care home in Norfolk and the Council would fund the placement for six weeks. Thereafter, the officer told Mr X to ask Norfolk to fund the placement.
15. Mr X moved his mother to a care home in Norfolk.
16. But there then ensued a dispute over ordinary residence between the Council and Norfolk County Council. During this period, Mr X’s mother acquired pressure sores at the care home. Mr X says this was because the home did not have the right equipment to meet his mother’s needs.
17. Mr X wanted to move his mother to a different care home that would be suitable to meet her needs. Mr X says the Council did not provide him with any assistance over the move. He points out the Council would not agree to the move until the funding issue was resolved.
18. Mr X says his mother had to remain in the unsuitable care home for three weeks before she was moved to a new home.
19. In September 2019, the Council agreed to meet the costs of the new home. Mr X asked the Council to pay the outstanding care home fees directly but it instead paid money into his account. The sum the Council deposited was incorrect as it was less than the outstanding sum.
20. Mr X says he sent several emails to the Council and telephoned several times but the Council did not respond.
21. Mr X received a response at the end of September 2019 after involving a local councillor. The Council expressed a view that his mother’s needs had changed and that accounted for the delay in acting. Mr X was unhappy with its stance because it had not assessed his mother’s needs before making the claim. Mr X wrote to the Council after receiving its email but heard nothing further from the Council. Mr X then complained to the Ombudsman.
22. The Council has since written to this service to say the funding matter has been resolved. It agreed to fund the placement from the date of admission of Mr X’s mother and to cover any outstanding payments due to the new care home.
23. The Council said Mr X was aware of the action it took to resolve the matter. Mr X told me the Council had not contacted him since September 2019.

Finding

24. It appears the Council gave misleading advice to Mr X about ordinary residence and funding for care by telling him it would fund his mother’s care in Norfolk for six weeks after which he must ask Norfolk for funding.
25. There was also fault by the Council when it blocked a transfer for Mr X’s mother to another care home because of a dispute over the funding dispute with Norfolk. It was incumbent upon the Council to ensure continuity in the care of Mr X’s mother. The Care Act is clear that disputes over funding should not affect the delivery of care.
26. It is good practice to reassess if a council believes there may have been a change in an individual’s care needs. But there was a delay in carrying out the assessment that adversely affected Mr X’s mother. The Council stated a need for an assessment of her care needs in September but the assessment was only completed in November 2019. In the meantime, the Council had accepted a need for a transfer to the new care home without completion of the assessment.

Injustice and a remedy

27. Where we find fault by a council we must go on to assess the injustice and, where possible, a remedy for the injustice.
28. I find Mr X’s mother remained in an unsuitable care home for longer than was necessary because of delay by the Council. Mr X had explained that she developed bed sores because of the lack of equipment in the care home. So, there was a risk to his mother’s health through a delay in moving her to another care home or finding the appropriate equipment for her needs.
29. I recommend the Council pays £300 to Mr X’s mother to reflect the distress she was caused and the risk to her health as a consequence of delay.
30. The problems encountered in this case could have been prevented had the Council provided the correct advice on the continuity of care process from the outset. Rather than agree to fund six weeks of Mr X’s mother’s care before telling him to contact Norfolk County Council, both councils should have worked together to ensure Mr X’s mother’s needs were assessed and funding put in place before her move to Norfolk.
31. I find Mr X was put to unnecessary time and trouble in pursuing matters with the Council. I recommend a payment of £100 to him.
32. I recommend the Council provide training on the continuity of care process to its frontline staff whether in the adult care team or the customer service team.
33. The Council should also write to Mr X to apologise for the difficulties he and his mother faced in this case. It should also clarify the funding arrangements for his mother henceforth.

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Final decision

34. There was fault by the Council which caused an injustice to Mr X and his mother. I closed the complaint because the Council agreed to remedy the injustice.

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Investigator's decision on behalf of the Ombudsman