Summary: Mr X complains the Council failed to correctly inform him about his mother’s care home fees. This inconvenienced Mr X and caused him distress during an already stressful and upsetting situation. The Council was at fault which caused Mr X an injustice. The Council have agreed to apologise and to pay Mr X a financial remedy.

The complaint

1. Mr X complained on behalf of his mother, Mrs X. He said the Council did not correctly inform him about his mother’s care home fees. He said the Council:
• sent him the wrong information leaflet;
• failed to tell him that he would need to pay the care home directly;
• failed to tell the care home that his mother would be self-funding.
2. Mr X said this miscommunication caused him added distress during an already stressful and upsetting situation.
3. Mr X also complained that his mother is paying higher fees for the same room she had before she became self-funded.

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What I have investigated

4. I have investigated Mr X’s complaint about the Council’s failure to properly inform him about Mrs X’s fees.
5. Paragraphs 34 and 35 explain what part of the complaint I have not investigated and why.

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The Ombudsman’s role and powers

6. 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)
7. 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

8. I have considered Mr X’s complaint and have spoken to him about it.
9. I have also considered the Council’s response to Mr X and to my enquiries.
10. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Law

11. In April each year, the government sets out the levels that determine whether an individual may qualify for financial help from their council. At the time of Mrs X’s transfer into the care home, the threshold was £23,250.

‘Charging for residential care’ (2018 and updated 2019)

12. The Council leaflet contains information about how the Council works out charges for care provided in residential and nursing homes. It explains the Councils charging rules and about the help available, including financial help.
13. It covers needs assessments and financial assessments, and what is taken into account when considering a person’s capital.

‘Guide for people funding themselves in residential and nursing homes’ (2019)

14. This Council leaflet provides advice for people on some points to consider regarding finances before choosing a care home. It also provides advice for people already living in a care home on what they might be able to do if their savings drop below the limit for local authority support.

Lasting Power of Attorney (LPA)

15. This is a legal document that lets a person (Mrs X) appoint one or more people (her sons; Mr X and his brother) to help make decisions or to make decisions on her behalf. There are two types of LPA: ‘health and welfare’ and ‘property and financial affairs’. Mr X and his brother hold both types of LPA for Mrs X.

What happened

Background

16. In early 2019, Mrs X was living at home with her husband. The Council drew up a care and support plan and organised a care agency that Mrs X paid for. Mrs X was charged the full costs as her capital was over the £23,250 threshold. The Council paid the agency directly and then invoiced Mr X who has Legal Power of Attorney for Mrs X’s finances.
17. In February of that year, Mrs X transferred to a care home for a week’s respite whilst her husband was in hospital. Due to the urgent nature of this stay, the care agency paid for it. Sadly, Mrs X’s husband died in hospital and she required a permanent placement in the care home.

Care Needs Assessment

18. The Council carried out a care needs assessment for Mrs X in late February 2019. This showed that Mrs X’s capital remained above the threshold and she would need to self-fund her care home fees. Mr X confirmed this was correct. The Council gave Mr X a leaflet called ‘Charging for Residential Care’ and said it advised Mr X to contact the Council when Mrs X’s capital fell below the threshold.

Council’s communication with Mr X and the Care Home

19. I have seen evidence which shows the Council wrote to Mr X in March to confirm Mrs X would need to pay for the full cost of her care from 27 February 2019. However, it did not confirm how this payment should be made. This correspondence also included the same ‘Charging for Residential Care’ leaflet.
20. The Council now acknowledges it did not inform Mr X that he would need to pay the care home directly. It also admits the leaflet it sent to Mr X contained misleading information.
21. The Council informed the care home that Mrs X would be self-funding but did not specify the means of payment. During an email exchange from March 2019, the care home asked the Council to confirm a date when the funding would change. I have seen no further evidence the Council provided a date.

Mr X raises concerns

22. In May 2019, Mr X raised concerns about his mother’s funding. At this stage, the Council realised it had given Mr X the wrong leaflet on two occasions and had not explained the process for self-funded clients. The Council sent Mr X the correct leaflet ‘Guide for people funding themselves in residential and nursing care homes’.
23. At this stage, Mr X queried why the Council would not continue the same payment method as before. This was where the Council managed the payment and then invoiced Mr X.
24. The Council explained it did not offer a managed service for self-funding clients unless there were exceptional circumstances. It said because Mr X holds LPA for his mother, he would be able to manage the relationship directly with the care home.
25. The Council added that if Mrs X’s capital were made up of the equity in her property, and there was no immediate access to this, the Council would have offered a deferred payment scheme. In this situation, the Council would have maintained the management of the financial relationship with the care home until equity was released. This was not the case with Mrs X.
26. The Council said if it had felt it needed to keep the Council’s involvement open with Mrs X due to her vulnerability and she did not have a suitable financial agent of LPA in place, it would have requested the appointment of a panel deputy to take responsibility for Mrs X’s finance and property.

Analysis

27. The evidence I have seen shows the Council miscommunicated with Mr X and the care home. This led Mr X to believe the Council was still managing his mother’s care home fees.
28. The miscommunication included:
• Sending Mr X a misleading leaflet;
• Failing to inform him that he would need to pay the care home directly; and
• Failing to inform the care home of the date when the funding changes would take place.
29. In its response to Mr X’s complaint, the Council acknowledged and apologised for the miscommunication. It recognised the lack of clarity about how a self-funded client pays for care left Mr X presuming the arrangements would stay the same as when his mother was receiving care at home. It said, Mr X continued to receive the invoices (March-June) from the care agency which compounded his assumptions.
30. I have found fault with the Council for its poor communication.

Agreed action

31. Within 4 weeks of my final decision, the Council has agreed to:
• Apologise to Mr X for the avoidable distress and inconvenience caused by its miscommunication; and
• Pay Mr X £300 as an acknowledgement of the avoidable distress caused by the uncertainty and inconvenience.

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Final decision

32. I have completed my investigation. The Council was at fault for its failure to communicate the process of self-funding to Mr X. This caused him inconvenience and distress.
33. The Council has agreed to apologise and pay Mr X £300 for the distress caused.

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Parts of the complaint that I did not investigate

34. I have not investigated Mr X’s complaint that his mother is being charged a higher rate for the same room she had before she was self-funding.
35. This is because, the care home sets out the fees for the rooms, not the Council. Mr X could make a new complaint to us about Mrs X’s care home fees.

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Investigator's decision on behalf of the Ombudsman