Summary: Mr X complained the Council failed to meet his mother Mrs Y’s care needs due to delays in completing a financial assessment. The Council was not at fault. Mr X and Mrs Y chose not to receive care while the financial assessment process was ongoing. The financial assessment is yet to be completed but that is not due to Council fault.

The complaint

1. Mr X complained the Council has:
1. mishandled his request for an ‘in principle’ decision on whether it would apply a discretionary disregard to his mother, Mrs Y’s property should she move into a care home.
2. failed to meet his mother’s care and support needs due to delays in completing a financial assessment of her contribution to her care costs. This has caused him frustration and uncertainty and is affecting his mother’s health and well-being

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What I have investigated

2. I have investigated the complaint at 1b) above. I have explained at the end of this statement why I have not investigated part 1a).

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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. 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

5. I have considered the information provided by Mr X and have discussed the complaint with him on the telephone. I have considered the Council’s response to my enquiries and the relevant law and guidance.
6. I gave Mr X and the Council the opportunity to comment on a draft of this decision. I considered any comments I received in reaching the final decision.

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What I found

The relevant law and guidance

Assessment of needs

7. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. Where the council identifies “eligible” care needs it will prepare a care and support plan that sets out how those needs will be met. The council can meet the person’s eligible needs by arranging for a care provider to provide care.

Reablement services

8. Reablement support services are for people after they have left hospital or when they are at risk of having to go into hospital. They are time limited and aim to help a person to preserve or regain the ability to live independently. Regulations say local authorities must not charge for reablement services. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)

Charging for adult social care

9. The Care Act 2014 sets out the legal framework for charging. Councils can make charges for care and support services they provide or arrange. They must do so in line with the Care and Support (Charging and Assessment of Resources) Regulations 2014. Charges may only cover the cost the council incurs.
10. Where the person has capital above the upper capital limit of £23,250, the person will need to pay the costs of their care in full. Otherwise, the council will carry out a financial assessment to determine how much they should contribute to the cost of their care.
11. The regulations set out that where an individual refuses a financial assessment the council can treat it as if one has been completed and the individual has financial resources which exceed the financial limit. In other words, the individual will be charged the full cost of their care package. The council can also charge the full cost if it decides to meet some or all of an adult‘s needs for care and support where it has been unable to complete a full financial assessment because of the adult’s refusal to cooperate with the assessment. (s.10(1)(a) and (b) The Care and Support (charging and assessment of resources) Regulations 2014)
12. Where a council believes a person may have deliberately deprived themselves of assets to avoid paying for care and support costs it may charge the person as if they possess the asset. If the asset has been transferred to someone else, it can seek to recover the care and support costs from that person.

The Council’s charging policy

13. The Council’s charging policy sets out that charges for packages of care and support are based on the amount of the personal budget and an individual’s ability to pay. It sets out that it will not stop providing services if a service user refuses to pay or appeals against their assessed charge.
14. It sets out that all capital and assets are included in the financial assessment calculation. This includes property (not the main residence), land, savings, bonds and shares and notes the list is not exhaustive. It sets out that if a service user chooses not to provide details of their finances, they will be charged fully for the services they receive up to the actual cost of the service.

What happened

15. The following is a summary of the main events relevant to this complaint. It does not refer to every event, email or exchange between Mr X and the Council.
16. Mrs Y lives at home with her adult son, Mr X. Mrs Y has physical health conditions which affect her mobility. Mr X has lasting power of attorney for Mrs Y’s finances and health and welfare.
17. In June 2020 the Council reassessed Mrs Y’s needs. It assessed Mrs Y as requiring 30 minutes of care each morning to assist with personal care and dressing plus one hour per week for support with domestic tasks. This was the same care package she had received previously. However, it noted Mrs Y had cancelled the care package with a care company due to the cost of the care package, which she was paying for herself. The Council noted Mrs Y had eligible needs but Mr X said he was going to assist her with all her care needs.
18. In February 2021 Mr X contacted the Council to seek a reassessment of Mrs Y’s care needs. He said he was providing increasing support to Mrs Y. Mr X said they had stopped the previous care as it cost too much. The officer explained Mrs Y would need to pay a financial contribution to her care package and so a financial assessment would be needed. Mr X stated Mrs Y had no urgent care needs at that time and they did not want care until after Mrs Y received her second COVID vaccination. The officer arranged to send Mr X a financial assessment form which he completed and returned.
19. A social worker spoke to Mr X and completed a needs assessment in March 2021. On the case record the social worker noted Mrs Y had previously paid for carers privately but had stopped this as they felt this was safer to reduce the transmission of COVID-19. Mr X considered he and Mrs Y would benefit from more support once Mrs Y had her second COVID vaccine. The officer noted Mrs Y did not want to go into residential care and Mr X was happy to maintain the current arrangement. However, some support would also benefit Mr X as it would give him time to himself. They noted Mrs Y was awaiting a financial assessment to determine her contribution towards her care costs. The social worker recommended a package of care would be appropriate to meet Mrs Y’s needs.
20. In March 2021 the Council advised Mr X it needed to complete the financial assessment as part of Mr X’s request for home care support for Mrs Y. It advised if he chose not to disclose her financial information Mrs Y would be treated as full cost. It set out that if Mrs Y had capital over £23,250 she would be a full cost payer. This would also apply if she gifted money over to this value as this would be considered a deprivation of assets.
21. A council officer contacted Mr X in March 2021 to work through the financial assessment form, to discuss relevant transactions and to seek evidence of Mrs Y’s financial position. The officer asked about specific expenditure and transactions. Mr X was not willing to provide the requested information. The officer asked to speak with Mrs Y to check she was okay with the officer not completing the financial assessment. The officer noted Mrs Y said she was fine and did not require extra support right now as they were managing okay and she would pay herself for any care.
22. The officer emailed Mr X in April to confirm that without the requested information the Council could not finalise the assessment and Mrs Y would be liable for the full cost of any care.
23. The social worker telephoned Mr X in early May 2021. They noted they explained if Mr X would not complete the financial assessment Mrs Y would need to pay for the full cost of the care package. They noted they could implement a care package but Mr X would not agree to care as he disputed Mrs Y should pay the full cost. They advised Mr X the cost of a package similar to that they had received before would be around £85 a week. They noted Mr X said Mrs Y did not need urgent care at this time and Mr X did not wish them to pursue any care arrangements at that time.
24. Mr X emailed the Council’s finance team. He said Mrs Y’s need for assistance was not being met and her money was below the threshold. He said the Council’s inaction was preventing access to the support Mrs Y needed.
25. In May 2021 Mrs Y received some short term reablement care of two visits per day following a hospital admission while she recovered from a urine infection. The social worker spoke with Mrs Y about whether she required long term support at the end of the reablement period. Mrs Y said she would think about it and discuss it with Mr X. The social worker spoke to Mr X who would not agree to support without knowing what Mrs Y would be required to pay. Mr X said he would support Mrs Y until the financial query was dealt with. The notes record the social worker said they would provide services but they were chargeable. Mr X said he had discussed it with Mrs Y and she was not willing to accept support when they did not know how much it would cost.
26. Mr X complained to the Council in May 2021 as he was unhappy with the lack of progress. The Council responded to Mr X’s complaint In June 2021. It set out that it was unable to finalise the financial assessment as it needed further information from Mr X, so Mrs Y would be a full cost payer. It said Mr X had advised they would not accept care until financial matters were sorted.
27. Mr X remained unhappy. He considered he had provided sufficient information for the Council to complete the financial assessment. The Council responded to Mr X at the next stage of its complaints’ process. It said it had tried to work with Mr X to progress the financial assessment and had offered to provide further clarification about what additional information it required. It said it understood Mr X and Mrs Y had decided to wait until the outcome of the financial assessment before accessing care and support. If Mr X needed support before then he should contact the social worker who could arrange a package of home care.
28. Mr X contacted the Council in July 2021 asking for details of the relevant law which allowed the Council to request additional financial information. The Council explained its charging policy was based on the Care Act. The Council explained that where it was apparent that there were additional considerations such as transactions unidentified, potential deprivation or additional accounts, further information was required. It said ‘Until we have adequately identified all relevant transactions, accounts etc, we are unable to finalise the assessment for your mother’.
29. The Council emailed Mr X in late July 2021. It set out the further information it required to move the assessment forward. It explained that until it received this, Mrs Y would be liable for the full cost of any care. The information it requested included full bank statements, statements for any other accounts (as it said transfers of money indicated another account existed), information about a potential safety deposit box (as payments were being made to a safety deposit company) and information regarding what had happened to a compensation payment paid to Mrs Y following an accident.
30. Mr X objected to this. He considered the Council had not explained the regulations and law under which this level of financial data could be requested and he considered it had sufficient financial information for the purposes of care provision. Mr X said Mrs Y had full mental capacity but the requests were intrusive which was putting her off dealing with the Council. He submitted a further complaint to the Council.
31. In July 2021 Mr X requested a carer’s assessment. The social worker sent a form which Mr X completed and returned. The social worker considered this but decided Mr X’s needs could be met via provision of care for Mrs Y which had been declined. The social worker reiterated to Mr X they were happy to arrange care to support Mr X in his caring role and to meet Mrs Y’s needs however they had both declined for the social worker to put this in place until financial matters were dealt with.
32. In late July 2021 the social worker emailed Mr X and suggested a joint visit with the finance team to carry out a new financial assessment so they could consider Mrs Y’s views. They also wanted to be satisfied Mrs Y had capacity to decline the assessment and understood the impact of having no care and support in place. Mr X responded that the financial assessment was stuck in limbo. He wanted proof the Council was entitled to see the information it requested. He suggested a phone conference rather than having people in the house.
33. The social worker responded that they would like to meet Mrs Y to gather her wishes and feelings and to discuss her care plan. They offered the option of a meeting in a council building or a video call.
34. Mr X responded that the social worker had initially planned to visit to discuss the financial assessment and now wanted to discuss the care plan and asked for the actual reason for the visit. He said at present they had no interaction with social services because while the care needs were assessed, the services were being blocked because of the financial assessment. He said there was no requirement to meet at present as there was no interaction between council services and the household.
35. The social worker called Mrs Y. In the notes they recorded Mrs Y said Mr X dealt with the financial assessment. They noted Mrs Y said they did not need a financial assessment yet as any support they needed they arranged privately. They noted Mrs Y was happy for Mr X to deal with her finances. Mrs Y asked the social worker not to write down what she said as Mr X ‘did not like people like you ringing and interrogating me’. The social worker asked Mrs Y if she felt like the social worker was interrogating her and Mrs Y said yes. The social worker apologised and said they were just ensuring Mrs Y was happy for Mr X to manage her finances and to ensure her care needs were being met. Mrs Y asked that in future the social worker ring and speak with Mr X.
36. The social worker emailed Mr X following this. They advised they had spoken to Mrs Y. They said they needed to ensure Mrs Y understood the consequences of her decision, and that her lack of engagement with the financial assessment was leading to the Council being unable to arrange care and support for her.
37. Mr X responded by email the next day. He was unhappy the social worker had called Mrs Y. He said Mrs Y was upset that she had been interrogated. He told the Council not to call Mrs Y and speak to her in isolation from him again and that it should discuss matters arising in relation to Mrs Y with him in future.
38. The Council responded to Mr X’s complaint in August 2021. It confirmed it required full financial disclosure. It said the original financial assessment document was not fully completed and there were missing documents regarding capital, income and expenditure. It set out there were missing bank statement periods, Mr X was not willing to clarify certain transactions debiting and crediting the account in Mrs Y’s name. It had also not been able to clarify what happened to Mrs Y’s personal injury settlement. It said all these aspects were relevant in arriving at an accurate financial assessment.
39. It said the same level of information was required for all similar cases and Mrs Y was not being treated differently to other service users. It referred Mr X to the Care and Support Statutory Guidance as the relevant legislation the Council’s charging policy was derived from. It said there was no intention to cause Mrs Y distress and aside from a short phone conversation all dealings had been with Mr X. It had suggested a face to face meeting to allow for a more personal experience but this was declined.
40. Mr X remained unhappy about the phone call to Mrs Y. The Council reviewed Mrs Y’s care needs in September 2021. It noted Mrs Y requested formal carer input in the mornings for support with personal care and dressing. Having declined a financial assessment Mrs Y was deemed a full cost payer and had therefore refused care. It noted Mrs Y’s needs were minimal and she had capacity to make a decision to decline a financial assessment and care package. The Council had tried to meet with Mrs Y to assess her needs but Mrs Y and Mr X declined this. It was satisfied Mrs Y did not need urgent care. It noted it would complete a needs assessment in future if Mrs Y consented to it and that Mrs Y’s care needs were being met by Mr X.

Findings

41. The Council properly assessed Mrs Y and identified she and Mr X would benefit if Mrs Y received some daily support. Mr X initially declined a care package until Mrs Y received her second COVID vaccination and until he knew the outcome of the financial assessment.
42. The Council is entitled to charge people for care and to do so it needs information on all their capital and income. This is to ensure any charges are fair and consistent. The Council has explained to Mr X the basis on which it can charge and has referred him to the correct law and guidance. The Council is not at fault.
43. The Council has yet to finalise a financial assessment for Mrs Y because Mr X has not provided the Council with the information it requested. The Council has explained what information it needs and why it needs it and I have seen no evidence of fault in the way it has reached this view. The Council needs to be satisfied it has properly assessed Mrs Y’s finances and has taken into account all her assets. Mr X has chosen not to provide the information requested. In line with the regulations the Council is therefore entitled to charge Mrs Y the full cost of any care she receives. The Council is not at fault.
44. The evidence shows the Council has offered to provide Mrs Y with care but Mrs Y and Mr X will not accept care while the financial assessment is outstanding. That is their choice and not fault by the Council. Mr X has continued to provide care to support Mrs Y so in any case Mrs Y was not caused an injustice. If Mr X or Mrs Y want the Council to implement a care package it is open to them to request this from the Council.
45. Mr X was unhappy the social worker called Mrs Y and says Mrs Y was upset by the call. Although Mr X has lasting power of attorney for Mrs Y, there is no evidence to doubt Mrs Y has capacity to make decisions about her care and support needs and financial assessments. It was appropriate for the Council to check with Mrs Y that she was happy for Mr X to manage her finances and that she understood the implications of not cooperating with a financial assessment. The Council was not at fault.

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Final decision

46. I have completed my investigation. The Council was not at fault.

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Parts of the complaint that I did not investigate

47. I have not investigated part 1a) that the Council mishandled Mr X’s application for a discretionary disregard.
48. The Council has made an ‘in principle’ decision not to apply a discretionary disregard. Mrs Y is not looking to enter a care home at present so Mr X’s housing situation is not currently at risk. Any injustice to Mr X is therefore, at this stage, speculative.
49. The Council set out in its complaint response to Mr X of April 2021 on this issue that if Mrs Y ‘does require admission to a residential care home, then you make a further application for a discretionary property disregard at that time, on the basis of the circumstances as they are then found to be. It will be considered against the findings made by [a Council officer] in determining [Mrs Y’s] application for a decision in principle but you will be able to reply upon and refer to any new or intervening events and evidence’.
50. If in future Mrs Y requires a care home placement, we would expect the Council to consider again whether to apply a discretionary disregard to her property based on the circumstances at that time, as it said it would in the complaint response.

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Investigator's decision on behalf of the Ombudsman