Summary: Mrs X complains about the Council’s decision to charge Mr Y for his care home place following his admission to hospital. There is no evidence of fault in the Council’s decision to charge Mr Y for his place in residential care following his hospital admission. The Council delayed in dealing with Mrs X’s complaint which caused avoidable time and trouble to her. The Council has agreed to apologise to Mrs X for this injustice.

The complaint

1. Mrs X complains that the Council’s decision to charge Mr Y for his care at a care home while he was in hospital on an end of life pathway was unfair as Mrs X informed the nursing home Mr Y would not be returning. Mrs X considers that as a result the Council is wrongly seeking to recover approximately £1800 in care fees which Mr Y did not owe.

Back to top

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)

Back to top

How I considered this complaint

4. I have:

• Considered the complaint and the information provided by Mrs X;
• Discussed the issues with Mrs X;
• Made enquiries of the Council and considered the information provided;
• Invited Mrs X and the Council to comment on the draft decision. I considered any comments received before making a final decision.

Back to top

What I found

What happened

5. Mrs X complains on behalf of her late father Mr Y. In 2018 the Council commissioned a place at a nursing home for Mr Y as he required 24 hour care. Following a financial assessment, it concluded Mr Y should pay the full cost of his care.
6. In 2020 Mr Y was admitted to hospital. Mrs X has said she notified the care home that Mr Y was at the end of his life and would not be returning to the home. She says the person she spoke to said they would inform the relevant team. There are no records of the calls.
7. Mr Y sadly passed away just under four weeks later. The Council sent an invoice to Mrs X for Mr Y’s outstanding care charges up to the day he passed away. Mrs X contacted the Council to ask why Mr Y had been charged for the 26 days he was in hospital. Officer 1, finance officer, advised he had passed Mrs X’s email to the complaints team to establish when the care package should have been closed. He also said he would respond after a period of leave.
8. Mrs X told officer 2, complaints officer, she would await officer 1’s response. Officer 1 did not respond.
9. The Council sent a debt recovery letter to Mrs X for the outstanding fees. Mrs X contacted officer 3, finance officer, to explain why she was querying the outstanding charges. As she did not receive a substantive response Mrs X chased the matter again.
10. Officer 2 wrote to Mrs X to explain the Council had charged Mr Y for the period he was in hospital as it did not receive any notification Mr Y would not be returning to the nursing home. Officer 2 also said would have kept his room in case he returned to the home. In response Mrs X said she notified the Council and care home that Mr Y would not be returning shortly after his admission to hospital.
11. Mrs X made a complaint to the Council about its decision to charge Mr Y following his admission to hospital. The Council did not uphold Mrs X’s complaint.
12. In response to my enquiries the Council has said:

• It does not have a record of Mrs X advising Mr Y would not be returning to the care home;
• The care home recalls Mrs X contacting it but considers it was a general conversation about Mr Y’s condition and not to terminate his placement;
• It acknowledges the delay in dealing with Mrs X’s complaint due to confusion as Mrs X said she was waiting for officer 1 to respond and due to officers seeking information on when Mr Y’s placement ended.
• The Council has also said that it will not terminate a care home place in the event a resident is admitted to hospital and at relatives request. A social worker would carry out an assessment to ensure medical professionals had identified the person could not return to the care home. To terminate a care home place without an assessment could cause a person to become homeless. It is also not unusual for hospitals to discharge patients to their care home for end of life care.

Analysis

13. I cannot know, on balance, if Mrs X notified the care home and Council that Mr Y would not be returning to the care home. Mrs X undoubtedly contacted the care home shortly after Mr Y had been admitted to hospital. But the care home and Mrs X’s account of the call are different and there are no records of the call. The Council also has no records of Mrs X’s contact to say Mr Y would not be returning. So, I cannot know if Mrs X notified the care home and Council that Mr Y would not be returning to the care home.
14. But even, if I could establish Mrs X had told the care home and Council that Mr Y could not return, I could not conclude the outcome would have been any different. In the event it receives a request to terminate a care home placement, the Council will carry out an assessment of the care home resident to determine if it should agree the request. This is not fault. The Council has a duty to safeguard the interests of the care home resident such as ensuring they are not made homeless. I cannot know what the outcome of any assessment of Mr Y would have been or if the Council would have been able to carry it out before he passed away.
15. I therefore find the Council is not at fault for charging Mr Y for the cost of his care home place while he was in hospital.
16. I have not seen any evidence to show the Council notifies residents of care home places it commissions of the process for terminating the placement and that charges will apply in the event of hospital admission. The Council should ensure it informs residents on their admission to the care home, for example, in the individual placement agreement.
17. Mrs X has said Mr Y did not have an individual placement agreement with the Council when it commissioned his care home place. This could be fault but it is not proportionate to pursue the matter further as I am satisfied there is no fault in the Council’s decision to charge Mr Y for the cost of his care home place. But the Council should ensure residents have individual placement agreements for the places it commissions.
18. The Council has acknowledged there was some confusion and delay in dealing with Mrs X’s complaint as she was waiting for information from officer 1. However, the Council should have treated her concern as a complaint when he failed to respond. Mrs X also had to chase for a response to her enquiries following the sending of the debt recovery notice to her. The Council should apologise to Mrs X for the avoidable time and trouble caused to her.

Back to top

Agreed action

19. The Council will:
1. Send a written apology to Mrs X for the avoidable time and trouble caused to her by officers failing to respond to her enquiries and the delay in dealing with her complaint. The Council should take this action within one month of my final decision.
2. Ensure residents of care home places commissioned by the Council are provided with information about the process for terminating a care home place and that charges will apply in the event of hospital admission. This information should be provided when a resident is admitted to a care home and could be included in the individual placement agreement. The Council should take this action within two months of my final decision.

Back to top

Final decision

20. There is no evidence of fault in the Council’s decision to charge Mr Y for his place in residential care following his hospital admission. The Council delayed in dealing with Mrs X’s complaint which caused avoidable time and trouble which it should apologise for.

Back to top

Investigator's decision on behalf of the Ombudsman