Summary: Ms C complained about the way in which the Council dealt with her sister’s financial assessment for her temporary care home placement. Ms C says this resulted in distress to her. We have upheld Ms C’s complaint. The Council has agreed to apologise for any distress Ms C experienced and pay her £300 as a financial remedy.

The complaint

1. The complainant, whom I shall call Ms C, complained to us on behalf of her sister, whom I shall call Ms D. Ms C complains that:
• The Council has still not confirmed to her, in writing, that it has written off her sister’s outstanding care contributions for the period May 2019 to February 2020, as per email from the Council to the Ombudsman on 8 October 2020.
• According to information she has received from her sister’s social worker(s), her sister should not have had to pay any contribution towards her temporary residential stay because: “she is on benefits, has no savings, and was placed in temporary accommodation”.
• Her sister is unable to pay for her rent as well as the contribution she has been told to pay towards her care home fees.
• There has been a lack of timely and sufficiently clear / comprehensive information provided to her by adult social care, finance, housing and the benefits team, with regards to what would happen, if/how the Council would charge for temporary care, if/when housing benefits would stop, how her sister would have to pay for her rent as well as the assessed care home contribution etc. This has caused her a lot of time, trouble, and uncertainty resulting in distress.

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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’. 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)
3. 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

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

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What I found

Relevant Legislation and Guidance

5. The Statutory Care Act Guidance says that:
• The approach to charging for care and support needs should, amongst others, be clear and transparent so people know what they will be charged. Councils should ensure there is sufficient information and advice available to ensure that a person or their representative are able to understand any contributions they will be asked to make.
• Legislation and guidance says a financial assessment should be complete before arranging care services (or at the same time). Where this is not possible (for instance in urgent cases, we expect a council to at least give people a reasonable estimate of likely charges before the support starts and complete the formal financial assessment as quickly as possible after that.
• Where a person is a short-term or temporary resident, there is a degree of discretion or modified charging rules to take account of this. Because a temporary resident is expected to return home, certain housing-related costs are disregarded in the financial assessment. For example, allowances should be made for fixed payments (like mortgages, rent and Council Tax), building insurance, utility costs (gas, electricity and water, including basic heating during the winter) and reasonable property maintenance costs.

What happened

6. Ms D used to live with her adult son in a flat she rented from the Council. She had a fall down the stairs and went into hospital in February 2019. Ms D stayed in hospital for three months. The options discussed were:
• Discharge home with a care support package and assistive technology.
• Discharge to step-down extra sheltered flat, whilst waiting on an assessment for permanent sheltered flat
• Extra care accommodation
7. An Occupational Therapist said at the end of March 2019 that, even though Ms D was at high risk of falls, she could be set up in her home in a way that she could live downstairs. However, the hospital discharge coordinator said in early April 2019 that a discharge home would not be safe for Ms D, and she recommended a 24-hours support environment instead. The Dementia Navigator officer supported this, by saying Ms D would not be safe between care calls. Ms C told me it would not have been possible for Ms D to have lived downstairs.
8. Furthermore, at a discharge meeting, Ms D said she did not want to return home. Ms C said her sister was scared of her son and a safeguarding concern was raised with regards to potential abuse. Ms C also said there were stairs in the property, and her sister would not be able to access the bathroom and the community.
9. The Council said it decided to discharge Ms D into a care home for six weeks, during which it would review her needs and decide what should happen next. The social worker sent a copy of the financial assessment form to Ms C to complete.
10. Ms C says she asked her sister’s social worker who would pay for Ms D to go into the care home. She says the social worker explained that she had to “go to Panel”, and she later said the Panel agreed to pick up the cost. Ms C says that, at the time, she thought it was plausible that her sister would not have to pay anything, as her sister was only on benefits. Ms C completed and returned the financial assessment forms in May 2019. She says she kept on asking the social worker to confirm who would pay for the temporary placement. However, she did not hear anything further about this until February 2020.
11. According to an email from a social worker to Homes for Haringy (HfH) in June 2019, it was clear that Ms D would not be able to go back to her own home in the future. It said: “The request is for a permanent sheltered placement. Ms D is currently in a step-down placement, as unable to return back to her home due to raised safeguarding alert against those in the property. Also deemed to no longer be suitable, as she is unable to negotiate the stairs”. This meant the Council should have told HfH to start the procedure to transfer Ms D’s tenancy in June 2019. However, this only started in 2021.
12. It took until August 2019 (three months) before HfH assessed Ms D. It concluded that Ms D’s needs were extremely high and were higher than what supported accommodation could meet. As such, it recommended Ms D would need extra care housing.
13. The Council has acknowledged it should not have cancelled Ms D’s Housing Benefit and Council Tax Reduction in September 2019. This happened because it incorrectly believed her placement in the home was permanent. It was Ms C who brought this issue to the Council’s attention, who subsequently corrected this in December 2019. This error resulted in Ms C receiving incorrect invoices, which caused her distress at a time she had a range of issues to already deal with.
14. It took until the end of February 2020 (nine months) before the Council told Ms C what her sister would have to pay towards the cost of her care. This resulted in an invoice of more than £4,000 for the period May 2019 to February 2020. The Council initially told Ms C the delay was because Ms C failed to return the financial assessment form on time. However, it later acknowledged in October 2020 that it had failed to process the forms Ms C had submitted in May 2019. It apologised for the delay. More recently it agreed not to charge Ms D at all for that period. However, Ms C complained to the Ombudsman that the Council had still not confirmed to her, in writing, that it had actually written off this amount. In response, the Council has apologised for the delay and confirmed this to her.
15. Ms D had been receiving Housing Benefits. These benefits were enough to almost cover all her rent. However, Housing Benefits usually stop if a person has not lived at the property for more than 12 months. As such, the Council told Ms C in March 2020 that Ms D’s claim for Housing Benefit had now been cancelled. This meant Ms D would now have to pay for her rent. However, she was unable to do this, because she already had to use her income and benefits to pay the assessed contribution for her temporary residential care. This resulted in Ms D’s rent not being paid anymore, and rent arrears increasing.
16. The Council acknowledged it failed to carry out Ms D’s annual financial reassessment / review around March/April 2020. This would have picked up that Ms D would no longer have to contribute to her care, because she would not have sufficient money left after paying her rent. However, the Council also says that Ms C knew she was responsible for telling the Council’s finance department of any changes in Ms D’s financial circumstances. It said if she had done this, this would have resulted in a financial reassessment and Ms D no longer having to pay a contribution towards her care. However, the Council did not provide me with evidence it had told this to Ms C.
17. Ms C called the social worker in May 2020 to ask to proceed with Ms D’s care review. However, the review could not take place due to the care home’s visitor restrictions. The review eventually took place in October 2020 and concluded that extra care accommodation was no longer suitable due to Ms D’s increased needs. As such, the social worker concluded it would be in Ms D’s best interests to stay at the home. The Council has since said that it should have recommended, at this point in time, that Ms D’s care home placement should become permanent.
18. As part of my enquiries, I asked the Council to organise a meeting between all relevant departments, to discuss Ms D’s case and agree what should be done to rectify any outstanding issues. Following the meeting, the Council wrote to Ms C to tell her that:
• It would start the necessary procedures to transfer Ms D’s flat, and she would therefore no longer have to pay any rent. It would also pay for her rent for the period October 2020 and May 2021.
• Ms D will not have to pay any contribution towards the cost of her temporary residential care, for the period May 2019 (when she went into the home) and April 2021 (when her placement became permanent).
• It would like to apologies for the faults that happened and the problems she has experienced in dealing with her sister’s affairs.
19. The Council said it will develop a protocol between Adults Social Care and HfH to ensure there is clarity over the procedure to follow when a tenant goes into care, with particular reference for when the tenant may not have mental capacity, and also when there are remaining occupants of the property.

Analysis

20. In response to my enquiries, the Council confirmed to Ms C in writing, that it has written off her sister’s outstanding care contributions for the period May 2019 to February 2020. It has apologised for the delay.
21. I found the Council has been at fault for not sufficiently explaining to Ms C, in a timely manner, how the Council would charge Ms D for her temporary care placement. Ms C initially believed it would be free, which means this was not sufficiently explained to her.
22. The Council was also at fault for failing to process the completed financial form when it received this in May 2019. This resulted in a ten-month delay before Ms C was told that her sister would have to pay a contribution, and how much that would be. It also resulted in Ms C being told there would be a large debt to Ms D. This added to Ms C’s distress.
23. The Council has acknowledged it wrongly cancelled Ms D’s Housing Benefit and Council Tax Reduction in September 2019, because it incorrectly believed her placement in the home was permanent. It was Ms C who brought this issue to the Council’s attention, who subsequently corrected this in December 2019. This error resulted in Ms C receiving incorrect invoices, which caused her distress at a time she had a range of issues to already deal with.
24. I also found the Council failed to carry out a financial reassessment in March / April 2020, which would have identified that Ms D should no longer contribute towards the cost of her care. This resulted in an increased in Ms D’s rent arrears, and therefore further distress to Ms C who has trying to manage this.
25. Overall, I found there was an unreasonable delay by the Council in coming to a clear view / decision that Ms D would not be able to return to her flat. It could have arrived at this as early as June 2019 (see paragraph 11), which meant the Council could have immediately started the process to ensure Ms D would no longer have to pay anything towards the monthly cost of the property.
26. I find that the Council’s remedy in paragraph 18, sufficiently remedies any injustice Ms D has suffered. However, it does not address the injustice Ms C experienced as a result of the Council’s fault.

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Agreed action

27. The Council has told me it has already decided to carry out the actions mentioned in paragraph 18 and 19.
28. In addition to those, I recommend that, within four weeks of my decision, the Council should:
• Provide an apology to Ms C and pay her £300 for the distress it caused her.
• Share the lessons learned with its adult social care and finance teams.
29. The Council has told me it has accepted my recommendations.

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Final decision

30. For reasons explained above, I found there was fault in the Council’s actions.
31. 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