Summary: Mr X complained about the Council’s decision to claim back its contribution towards his mother’s care. The Ombudsman will not investigate this complaint. This is because it is unlikely our involvement would lead to a different outcome. The Council has apologised and proposed an appropriate remedy for not providing clear information about contributions it offered Mr X’s mother.

The complaint

1. Mr X complains about the Council’s decision to claim back its contribution towards his mother’s care. He says it failed to explain to him that he will have to repay any contributions paid toward his mother’s care because they were a loan.

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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. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe it is unlikely further investigation will lead to a different outcome or we are satisfied with the actions a council has taken or proposes to take. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

3. I considered the information provided by Mr X. This included his correspondence with the Council. Mr X had an opportunity to comment on my draft decision.

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What I found

Background

4. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The scheme must comply with the principles in law and guidance, including that charges should not reduce a person’s income below Income Support plus 25%. The Council can take a person’s capital and savings into account subject to certain conditions. If a person incurs expenses directly related to their disability, the Council should take that into account when assessing his or her finances. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)
5. Sometimes councils can pay the care provider before completing the financial assessment to ensure the provider is not left without payment for the service they are providing.
6. Mr X’s mother was in a care home since 2016. When she went into care it was fully self-funded because she had assets over the statutory threshold of £23,250.
7. Mr X contacted the Council in September 2019 and asked it to assess his mother’s circumstances again.
8. The Council decided to contribute to the care costs for the time that it would take to carry out another financial assessment. It paid contributions on a “non-prejudiced” basis to ensure the care home was not left without payment for its service.
9. The Council sent a financial assessment form to Mr X and asked him to return it completed. He completed the form, and he disclosed the income from the property he and his mother co-owned and inherited from his late father.
10. In March 2020 the Council asked Mr X for proof of the rent the inherited property was bringing. He provided the evidence and expressed his surprise that this was not requested before. Additionally, he had already provided the information in September 2019.
11. In April 2020 the Council contacted Mr X after his mother died and told him that it intended to reclaim the contributions it made to his mother’s care. This was because the income from the rental property his mother co-owned meant that her assets were still above the statutory threshold.
12. Mr X complained to the Council and said he sent the assessment form back and the Council confirmed it would contribute to his mother’s care costs. He said that the Social Services department never explained to him that he would ever have to repay the contributions.
13. The Council confirmed that contributions made to his mother’s care were on a non-prejudiced basis. Therefore, if the financial assessment showed that his mother was not eligible for financial contributions, Mr X would have to repay the money to the Council.

Assessment

14. The Council must make a financial assessment before deciding if it will contribute to a person’s care costs. This assessment needs to be carried out efficiently to ensure clarity in who is contributing to the costs of the care.
15. The Council has admitted the financial assessment took longer than it should, and the terms of the contributions it made in the meantime were not clear enough. For that reason, it agreed to pay £150 to Mr X for his injustice.
16. The Council has provided an appropriate remedy to Mr X which recognises the confusion he was caused. However, an investigation is unlikely to find the Council was at fault for reclaiming its contributions towards the care costs.
17. I understand that Mr X feels that he should not have to return the money to the Council, however the financial assessment concluded that his mother was not entitled to the contributions.

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Final decision

18. The Ombudsman will not investigate this complaint. This is because it is unlikely our involvement would lead to a different outcome. The Council has apologised and proposed an appropriate remedy for not providing clear information about contributions it offered Mr X’s mother.

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Investigator's decision on behalf of the Ombudsman