Summary: Mrs X complained the Council failed to consider her mother, Mrs F’s best interests when it moved her to a new care home in 2021 after her capital dropped below the threshold and Mrs X could not afford the top-up fee. The Council was not at fault. It carried out relevant assessments in line with statutory guidance when it decided it was appropriate to move Mrs F to a cheaper alternative care home.

The complaint

1. Mrs X complained the Council failed to consider her mother’s Mrs F’s best interest when it moved her to another care home in 2021. Mrs X said the Council failed to consider the impact the move would have on Mrs F’s health and psychological wellbeing.
2. Mrs X said the matter caused her distress and uncertainty.

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The Ombudsman’s role and powers

3. 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)
4. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), 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 spoke to Mrs X about her complaint and considered information she provided.
7. I considered the Council’s response to my enquiry letter.
8. I considered the Care and Support statutory guidance.
9. Mrs X and the Council had an opportunity to comment on my draft decision. I considered comments before I made a final decision.

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What I found

The Care Act 2014 and charging

10. In 2014, the Government introduced the Care Act. This legislation replaced all previous guidance about how councils assess and provide care for adults in need. It includes guidance on charging for care.
11. The Care Act states councils have discretion to charge people for the care they receive. If a council decides to charge for care, it must complete a financial assessment.

Financial assessment

12. Following a needs assessment the Council must offer a financial assessment to decide who will pay for the eligible care needs. Councils can charge for care services. Those who have over £23,250 of eligible capital will be expected to pay for the full cost of their care home fees. However, once their capital has reduced to less than £23,250, they only have to pay an assessed contribution towards their fees.

Care home top-up fees

13. If the council funds a person’s care home place it will allocate an amount of money, known as the personal budget, to meet the person’s needs following the financial assessment. If the person chooses a care home that costs more than the persona budget, someone else, such as a family member can pay the difference. This is known as a third-party top-up fee.

What happened

14. Mrs F has dementia and other health issues. In 2019 she moved into Ashfields Care Home (the care home) following a short stay in hospital and following concerns she was neglecting herself living at home alone. As Mrs F had capital above £23,500 then she moved into the care home as a full cost payer.
15. In 2020 Mrs X asked the Council to carry out a financial assessment for Mrs F because she was concerned that Mrs F’s finances would soon drop below the self-funding threshold. The Council carried out a financial assessment which showed Mrs F’s capital would drop below the threshold in November 2020. The assessment found that Mrs F would require a weekly top-up fee to be able to stay at the care home. The Council told Mrs X that Mrs F would need to move to a more affordable care home if nobody could pay the top-up fee at the care home. Records show the Council had approached the care home about the possibility of reducing the top-up fee however this was unsuccessful.
16. Records show Mrs X was upset about the thought of moving Mrs F to another care home and decided she should remain at the care home while she considered the options available in moving her.
17. Mrs X contacted the Council again in Mid 2020 regarding the plan for Mrs F’s care fees. Records show the Council gave conflicting information about when Mrs F’s capital would run out. It originally said May 2021 but then changed this to May 2020. It then acknowledged it had miscalculated Mrs F’s capital and confirmed it would start funding her fees at the end of 2020. The Council told Mrs X there would be a £360 per week shortfall which it could not pay. It said therefore if Mrs X could not pay the £360 top-up, then the Council would explore an alternative care home for Mrs F.
18. The Council arranged to carry out a placement assessment for Mrs F so ensure her needs could be met in an alternative care home. The assessment found Mrs F’s cognition had improved since living at the care home and no longer had anxiety issues which she had upon moving in. It shows Mrs F was aware she needed to move care homes for financial reasons. It found Mrs F was able to communicate and express her wishes and there were no significant health concerns.
19. Mrs X complained to the Council about the prospect of moving Mrs F to another care home. Mrs X said the Council have not properly considered the impact it would have on Mrs F’s health and physical wellbeing. Mrs X was unhappy with some of the suggestions of alternative care homes from the Council. Mrs X also complained that the Council officer she spoke to was rude. Mrs X said the officer told her ‘some people can afford the Savoy and some cannot’
20. The Council responded to Mrs X in November 2020 with a final response. The Council acknowledged the matter was upsetting for Mrs X. It said it raised fees with Mrs X during 2019 and had explained at the time that the care home would require a large top-up fee when Mrs F’s capital ran out. It reiterated that Mrs F would need to move to a more affordable care home if nobody could pay the top-up fee. It said the care home was not willing to negotiate the top-up fee and the Council was also not in a position to pay it. The Council said a social worker would support Mrs F and Mrs X through the process and would carry out a new Care Act needs assessment to accurately reflect Mrs F’s needs for the new care home. The Council apologised for any confusion caused around the dates given about Mrs F’s capital. The complaint response was signed by the officer Mrs X had complained was rude to her.
21. Mrs X responded to the Council. She said the care home had done so much for Mrs F to improve her health and wellbeing and was worried that moving her to a new care home would cause her health to decline. Mrs X said she had looked at alternative care homes but decided most were unsuitable. Mrs X asked the Council to reconsider its decision to move Mrs F to a new care home. Mrs X also complained that the same Council officer whom she complained about being rude responded to the earlier response. Mrs X said therefore the Council’s response was biased.
22. The Council wrote back to Mrs X. It apologised for an administrative error where the incorrect signature of the officer Mrs X complained was rude was on its initial complaint response. The Council clarified that its response was completed by a different officer. The Council said it would write to Mrs F again to follow up on her ongoing concerns about Mrs F.
23. Mrs X remained unhappy and complained to us.
24. Following her complaint to us records show the Council found Mrs F a placement at care home B. Records show the social worker negotiated a small top-up fee which Mrs X agreed to pay. Records show Mrs X visited care home B and was happy with the choice.
25. The social worker carried out a new needs assessment with Mrs F in February 2020. The assessment captured Mrs F’s views and wishes to remain at the care home but was aware of how it expensive it was. The assessment recognised Mrs F may be unsettled moving to a new care home and that she required lots of reassurance. Mrs F’s care and support plan showed the Council had agreed additional funding for 1:1 support when she moved into care home B to allow staff to provide her with extra support and reassurance. Mrs F has settled well into care home B and did not need the additional 1:1 support.

My findings

The decision to move Mrs F to another care home

26. Records show the Council made Mrs X aware when Mrs F moved into the care home that there would be a significant top-up fee required once her capital dropped below the threshold. When this happened, the Council acted as we would expect. It tried to negotiate the fee with the care home but was unsuccessful. The Council carried out a placement assessment and a new needs assessment and decided based on those that it was appropriate to move Mrs F to another care home. The Council had considered Mrs F’s health and wellbeing, and her views. Its actions were in line with statutory guidance. The Council was not at fault.
27. Records show the Council assisted with moving Mrs F to care home B by tailoring the care and support plan and putting in additional funding for 1:1 support. Mrs F moved into care home B before the end of our investigation. She has not required the 1:1 support and records show she has settled into care home B well. Mrs X has raised no further concerns and is happy with the care that care home B is providing to Mrs F.

Complaint handling

28. In her complaint to the Council Mrs X specifically complained about an officer who she said was rude to her. The Council’s complaint response was signed by the same officer that Mrs X complained about. The Council has already apologised to Mrs X for what it called an administrative error. Mrs X was also unhappy that the Council provided her with incorrect and conflicting information about when Mrs F’s capital would drop below the threshold which she said caused her stress. Records show the Council have already apologised for what it called ‘human error’. Further investigation by me into these matters would unlikely achieve anything further.
29. The Council did not address Mrs X’s concerns about the officer. In its response to us the Council said the officer’s comment about the ‘Savoy’ was used to explain a comparison, that care home fees widely vary just as hotel costs do and people should consider whether the fees are sustainable in the long-term.
30. I am satisfied the Council provided an adequate response to Mrs X’s substantive complaint and I do not deem the concerns above serious enough to warrant a finding of fault.

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Final decision

31. I have completed my investigation as I have found no fault in the Council’s actions.

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Investigator's decision on behalf of the Ombudsman