Summary: Mr X complained about the Council’s handling of his mother, Mrs Y’s, financial assessment during 2021 and early 2022. There was no fault in how the Council financially assessed Mrs Y during 2021 and it was entitled to ask for the further evidence it required. However, since early 2022 the Council has let the matter drift which was fault. It agreed to make a decision and issue Mrs X’s financial assessment within one month of this decision.

The complaint

1. Mr X complains about the Council’s handling of his mother, Mrs Y’s, financial assessment for non-residential care. Mr X says the outcome of the assessment is wrong and Mrs Y should not need to make a contribution towards her care. He says the Council has given him conflicting and confusing information about what evidence it required.
2. Mr X says the matter is causing Mrs Y distress and uncertainty and causing him time and trouble.

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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 Mr X about the complaint and considered information he provided.
7. I considered the Council’s response to my enquiry letter and the information it provided.
8. Mr X and the Council had an opportunity to comment on this draft decision. I considered comments before I made a final decision.

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What I found

Charging for non-residential care

9. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in settings other than care homes. A council has discretion to charge for non-residential care following a person’s needs assessment. Where it decides to charge a council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
10. Where a council has decided to charge, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. The upper capital limit is currently set at £23,250 and the lower at £14,250. A person with assets above the upper capital limit is required to pay for their own care. Even if the capital is below the threshold of £23,250, residents may have to pay a contribution from their income towards their care.

The Council’s policy

11. The Council has a policy which sets out how it calculates a person’s contribution towards their care and support in a non-residential setting.
12. The policy says if the person requiring care pays a mortgage or rent then the Council will take these from the person’s income before it works out the contribution. It says if the person owns or part owns a property other than the home in which they live then the value of that property will be included in the financial assessment.
13. The policy says the Council will ignore the value of a person’s property when taking account of capital and investments. However, if the person has an interest in a second property, then it will take this into account and the person will then have to pay the full cost of the care they receive.
14. If a person thinks the Council’s financial assessment is wrong, they can request an appeal form within 28 days from a member of the financial assessment team.
15. If a person wishes to make a complaint about how the Council has dealt with them, they should first speak to the member of staff or their manager to try and settle the matter. If the member of staff or manager cannot resolve the problem the person can contact the Council’s complaints department.

What happened

16. Mrs Y is elderly and lives with her son, Mr X. In April 2021 Mr X contacted the Council requesting a package of non-residential care for Mrs Y. The Council informed Mr X that all care packages are subject to a financial assessment (FA) and as such sent him a finance and correspondent form so he could deal with the FA on Mrs Y’s behalf.
17. In May 2021 a non-residential package of care commenced for Mrs Y for visits of one hour per day.
18. Mr X completed the finance form for the FA over the telephone. He sent the Council information and attachments relating to Mrs Y’s benefits, and receipts and information relating to Mrs Y’s disability related expenditure (DRE).
19. In July 2021 the FA team wrote to Mr X and asked for bank statements showing evidence of Mrs Y’s income and capital. Mr X contacted the Council and said Mrs Y did not have an account solely in her name. Officer 1 from the Council who was dealing with the case told Mr X he could redact any transactions which were unrelated to Mrs Y. Mr X sent the Council bank statements in which the account holder name, all withdrawals and account balances were redacted.
20. In early August the Council’s FA team sent Mr X the outcome of Mrs Y’s FA which it completed based on the information it held at the time. The outcome was that Mrs Y was liable to contribute £47.19 per week towards the cost of her care package.
21. Mr X contacted the Council, unhappy with the outcome. Records show Officer 1 left their employment with the Council, so the case was passed to Officer 2. Officer 2 carried out verification checks on Mrs Y’s FA and decided they needed further information. The checks found Mrs Y was associated with a property (property A) which was not declared on the finance form and they also had concerns about the amount of redaction on the bank statements. Officer 2 wrote to Mr X explaining they required detailed bank statements including all transactions and the balance. They also asked for an explanation around Mrs Y’s relationship and status with property A.
22. Mr X was unhappy with how Officer 2 was dealing with the case and raised a complaint. He said Officer 1 told him to redact everything from the bank statements. He asked why the Council finalised the assessment if it was unhappy with the bank statements. Mr X said Mrs Y was lodging with them and had been since April 2021 and the Council had not accounted for the rent which she paid. With regards to property A, Mr X said the property was owned by another family member and Mrs Y had previously stayed there. However, she did not own it and was not associated with it in any other way. Mr X also said he was denied his right of appeal against the outcome of the FA.
23. The Council responded to Mr X at the end of August 2021. It said it required full bank statements, including opening and closing balances because without them it was not satisfied that Mrs Y’s capital was under the threshold. The Council said Officer A did not give permission for Mr X to redact account holder names and balances. With regards to property A it said additional checks had found Mrs Y was associated with it and as it was not disclosed on the finance form it required additional clarification around that association. It said there was no mention of Mrs Y’s rental liability and there was no record of any tenancy agreement. The Council said it had no record of Mr X requesting any appeal forms. It said without this information it could not carry out a means tested FA assessment. It said it was satisfied it had carried out the assessment correctly based on the information provided.
24. Mr X remained unhappy and complained to us.
25. The Council continued sending Mr X invoices for Mrs Y’s contribution. Records show Mr X contacted the Council in January 2022. He said the Council was not accounting for the rent Mrs Y paid as part an agreement to live with Mr X. Mr X sent the Council a copy of a lodger’s agreement signed by Mrs Y in April 2021. This agreement said she paid Mr X £600 per month rent to live with him and his wife. The Council acknowledged the lodger’s agreement in February 2022 but said it still required unredacted bank statements. It also said it required supporting evidence to establish the association between Mrs Y and property A.
26. In February 2022 Mr X sent the Council unredacted bank statements. These showed the account was a joint one in the names of Mr X and Mrs Y. The incoming transactions were all related to Mrs Y’s benefits. The balance showed the account was consistently below the lower threshold. Mr X also provided a letter from his solicitor confirming Mrs Y did not have any ownership or other association with property A.
27. In April Mr X sent a further email to the Council asking why the evidence he provided had not resulted in a revised FA. The Council responded and said it was unhappy with the lodger’s agreement which it said appeared to show a different signature to the one Mrs Y provided on the finance consent form in July 2021. It also asked for an explanation of why the rental amount was not disclosed on the finance form he completed in 2021. The Council has also asked Mr X to confirm whether any third party held an interest in the capital/balance of the bank account.
28. At the time of writing the matter remains unresolved and the Council continues to review the information Mr X has provided.

My findings

29. The Ombudsman is not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider it followed those processes correctly, we cannot question whether the decision was right or wrong, regardless of how much a complainant disagrees with the decision.
30. There are no records of exactly what Officer A told Mr X he could redact from the bank statements. However, without evidence of balances the Council was unable to properly assess Mrs Y’s capital. Therefore, in line with relevant guidance it was entitled to ask Mr X for unredacted statements. Doing so was not fault and it explained the reasons why they were required at the time.
31. Mr X expressed dissatisfaction with the outcome of the FA although I have seen no specific evidence he asked for an appeal form. In any case, Mr X made a formal complaint. The Council’s complaint response was to all intents and purposes a review of the FA which concluded the Council required further information and evidence to review the outcome of the FA. It dealt with this in a timely manner, so I find no fault.
32. There is no evidence Mr X provided the Council with the required information until the start of 2022 so there was no fault between September and January 2022. However, since January 2022 the Council has let the matter drift. Mr X provided the Council with a lodger’s agreement in January 2022 however it was not until April 2022 when it raised concerns with it. Mr X provided unredacted bank statements in February 2022 which showed the balance was consistently below the lower threshold. It is unclear why the Council is still requesting further clarification on third party interest in the capital when it is at such a low amount.
33. It is not for us to tell the Council whether to accept the lodger’s agreement or bank statements. However, there has been delay and drift in concluding the review of Mrs Y’s FA which is fault and is causing Mr X and Mrs Y frustration and uncertainty. I therefore made a recommendation to bring the matter to a conclusion and prevent further drift.

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Agreed action

34. Within one month of the final decision the Council agreed to:
• write to Mr X and apologise for frustration caused by the delay in making a decision about Mrs Y’s financial assessment.
• complete Mrs Y’s financial assessment based on the information it holds to bring the matter to conclusion.
35. Following my draft decision, the Council had already written to Mr X and apologised for the inconvenience and frustration caused by the length of time it took to issue Mrs X’s financial assessment and said it had now sent Mrs X’s completed financial assessment. It should however provide us with evidence of this action. If Mr X is unhappy with the outcome of the financial assessment, he has a right to ask for a review of the decision.

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Final decision

36. I completed my investigation. I found fault and the Council agreed to my recommendations to remedy the injustice caused by that fault.

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Investigator's decision on behalf of the Ombudsman