Summary: Mr C complained about the way in which the Council assessed his mother’s needs and finances, as part of her permanent placement at a care home. He said this resulted in a debt accruing for his mother and distress to him. We did not uphold Mr C’s complaint.

The complaint

1. The complainant, whom I shall call Mr C, complained to us on behalf of his mother, whom I shall call Mrs X. Mr C complained:
• There was an unreasonable delay of six months before the Council completed his mother’s financial assessment and said how much she would have to pay for her weekly care. This resulted in a debt for his mother.
• The Council failed to involve his mother, him (as his mother’s advocate and PoA) and his brother (his mother’s other PoA) in discussions about whether his mother’s placement should become permanent, or if she could return home.
• Once the Council eventually decided in October 2021 that the placement should become permanent, it failed to tell him and his mother until January 2022 that it had made this decision and when it made this. As a result, there was a delay in him being able to stop one of his mother’s direct debits of £80 a month, until January 2022.

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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 an organisation’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 Mr C and the Council. I shared a copy of my draft decision statement with Mr C and the Council and considered any comments I received, before I made my final decision.

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What I found

5. Mr C complains there was an unreasonable delay of six months before the Council completed his mother’s financial assessment and said how much she would have to pay for her weekly care. This resulted in a debt to her mother.
6. Mrs X went into the nursing home as a temporary resident. She was also renting a property at the same time, which she continued to pay for by direct debit.
7. Records state the Council emailed a “Costs of Care letter” to Mr C on 27 April 2021. It asked Mr C to explain the letter to his mother, ask her to sign it, and then return it to the Council. The letter provides a general explanation about the financial assessment and charging process. It also says a client in a care home should pay a standard charge for the first four weeks, after which the Council will assess how much the client will have to contribute to the cost of their care home placement according to their income and assets.
8. The Council allocated Mrs X’s case to a social worker in May 2021 to carry out a social care assessment. She subsequently had discussions with Mr C as to whether his mother should stay in her current care home (with the need to pay a top up fee), move to a cheaper home without a top up fee or move back home (something Mr C was considering). She explained the care home was expensive and, as such, if Mrs X would stay in her current home the family would have to pay a weekly ‘top up’. A top up is the difference between the cost of a care home and what the Council would usually pay for such care.
9. However, a top up was no longer needed shortly later, as the Council’s support panel eventually approved to cover the higher fees of Mrs X’s current care home. This meant that Mrs X could remain in the home, as per her wish. The Council informed Mr C by email in June 2021. The record states Mrs X had still not returned a signed Cost of Care letter.
10. The Council started to charge for Mrs X’s stay at the nursing home from June 2021 onwards. As explained in the Cost of Care Letter, she would initially have to pay a standard contribution charge for the first four weeks. Mr C received a letter dated 17 June 2021 that said there would be an initial charge of £152.20 per week and he would receive further notification about any revised charges.
11. To calculate how much Mrs X would have to pay after four weeks, the Council chased Mr C for a copy of the signed Cost of Care letter and asked him to complete the financial forms. It explained to him that, if he did not return this, the Council would have to charge his mother for the full cost of her care.
12. After that:
• The Council spoke to Mr C on 27 July 2021. He indicated he had received the forms by email but said he could not complete them because he did not have a printer. The officer immediately posted the forms to him.
• Mr C said he returned the forms and bank statements on 16 August 2021, but the Council lost them.
• The Council said it called Mr C on 14 September 2021 to explain there would be a 28-day review to confirm the placement as permanent. It said it told Mr C the Council had not yet received the finance pack back from him. Mr C said he had completed it and sent it back in June/July but could not confirm when.
13. Mr C said on 14 September that he returned the financial assessment forms in June or July 2021. This is different to what Mr C has also said, which was that he returned the forms in mid-August 2021.
14. The Council:
• Spoke to Mr C again on 21 September 2021 to say it had not received his forms. The officer posted another copy of the forms the same day.
• Chased Mr C by phone and text on 28 September but did not receive a response.
• Emailed a copy of the Cost of Care letter to Mr C on 4 October to be completed and returned as he claimed he did not receive it.
• Emailed Mr C on 7 October 2021 and said his mother’s placement had become permanent as of today. It asked him to complete the financial form and return the signed copy of the cost of care letter, to determine his mother’s contribution.
• Chased Mr C gain on 13 and 26 October 2021 by text, but it did not get a response. It also sent a reminder letter on 1 November 2021.
15. The Council received the completed assessment form on 8 November 2021; it took four weeks until it issued a “Notification of revised charges” to Mr C on 6 December. The Council apologised for the four weeks delay due to leave.
16. The Council says it only became aware of Mrs X’s home commitments (Council Tax, Water, Electric and water) when it received her financial information in November 2021. It said it has allowed for the cost of these utilities while she was a temporary resident. However, she would of course not be liable for any ongoing housing costs once she became a permanent resident in a care home. Although Mrs X’s placement became permanent on 8 November 2021, the Council agreed to take her home commitments into account until 6 December 2021.

Analysis

17. The delay in completing the financial assessment was not due to the Council which continuously reminded Mr C to complete and return the Cost of Care letter and financial forms. There is no evidence to conclude the Council received (and therefore lost) the financial forms in August 2021.
18. The Council told Mr C on 7 October 2021 that the placement had become permanent. As such, Mr C had the information needed that day to immediately stop all ongoing direct debits related to his mother’s tenancy etc.

The process through which the Council decided to make the place permanent

19. Mr C said:
• The Council failed to involve his mother, him (as his mother’s advocate and PoA) and his brother (his mother’s other PoA) in any discussions about whether his mother’s placement should become permanent or if there would be any other options (a return home).
• He and his mother would have wanted to have been part of the discussions in September / October 2021, when it was decided what should happen with his mother going forward. He said his mother was unhappy in the home and he had spoken to a couple of homecare providers who indicated his mother may return home with the correct support package and equipment.
20. The social worker spoke to Mr C in April 2021 to discuss his mother’s care. The record states his mother had said she wanted to stay at the home. However, the cost of the home was more than the Council would usually pay for a care home placement. As such, the social worker explained to Mr C there would be a need for a weekly top up by the family.
21. A record from 21 April 2021 states that Mr C told the Council that he and his brother felt their mother was receiving appropriate care at her current care home. However, he was concerned about the family having to pay a top up fee and asked the allocated social worker if his mother could return home with support from a live in carer instead.
22. The case was allocated to a new social worker to carry out a needs assessment. She called Mr C on 6 May 2021 and discussed his views about his mother’s care needs. The record states that:
• Mr C said that doctors, the lead nurse, discharge team all said, at the time of the hospital discharge, that his mother could not return home because she needed two care workers.
• He said his mother had initially told him she was unhappy in the home. However, she seems to have settled during the last month and gets on well with staff.
• Mr C said the previous social worker told him that, due to the high cost of his mother’s current care home, the Council would need to look for another care home for her.
• Mr C said he felt a move to another home would have a negative impact on his mother. However, the family could not afford a top up. He said he would accept his mother could not return home, if the outcome of the assessment would be that she would need 24-hour care.
• The social worker said she would look into other possible care homes and update him when needed.
23. Following the conversation, the social worker approached various care homes.
24. Mr C asked the social worker on 8 May 2021 to provide information about how the Council would fund a possible return to her home.
25. Mr C’s brother told the social worker on 14 May 2021 that he heard their mother would be moved to care home X in a few days. However, the social worker confirmed this was not the case.
26. The social worker completed a visit to Mrs X on 13 May 2021. Mr C was present too. The record states that:
• Mrs X was very clear that she wanted to remain in the home.
• The social worker explained that, due to the cost of the home, she was looking into finding another cheaper home and had approached care home X. However, she would inform the panel of Mrs X’s wish to stay.
27. Following this visit, the records state the panel turned down the request for additional funding to enable Mrs X to stay at her current home, on 19 May 2021. The social worker discussed this with Mr C who said he would view care home X.
28. Mr C said he asked the social worker in May 2021 to ask an Occupational Therapist to assess if his mother could return home, to which the social worker agreed.
29. However, this was no longer needed as of June 2021 when the Council’s support panel eventually approved to cover the higher fees of Mrs X’s current care home. This meant Mrs X could remain in the home as per her wish.
30. The Council’s support panel approved Mrs X’s placement for permanent funding on 14 June 2021. A document with this date says that:
• Mrs X told a social worker during a face-to-face assessment in April 2021 that she wanted to remain at the care home. She is self-aware of some of her care needs and can communicate well when she is not anxious.
• Staying at the home is the family’s preference. They said Mrs X is fragile and a move could have a negative physical and mental impact on her.
31. The Council carried out a 28-days care review in September 2021. It explained that the purpose of the 28-day review is to discuss with the client (if this is deemed suitable), the family and the care home if they wish for the placement to become permanent and if there are any concerns to consider. The placement is not considered permanent until the 28-day review.
32. The records show an officer:
• Spoke to Mr C’s brother (who has joint PoA) on 9 September 2021, who said his mother was very settled at the care home and the family was happy with the care and support there.
• Spoke to the home manager, who said Mrs X was settled and happy. She said it would not be in her best interest to participate in the care review due to the risk of her becoming very anxious and upset. Both agreed that both sons were in a good position to advocate on her behalf.
33. Mr C told me he only had a conversation with the officer about the financial assessment and not about his mother’s care at this time. He said the officer did not discuss his mother’s care needs with him. He said that, at that time, the family was hoping she could return as his mother was not happy at the home.
34. The placement became permanent on 7 October 2021. The Council said that it should have sent a copy of Mrs X’s needs assessment from May 2021 to the family at the time.
35. The Council told me that, at no point did Mrs X’s sons suggest there were any issues or concerns with their mother’s placement or that their mother was unhappy there. If they had, the 28-day review would have taken a different pathway such as: discussing alternative provisions / placements / further discussions with the placement manager etc.

Analysis

36. The Council involved Mrs X and her sons in the care assessment in May 2021, which resulted in a decision that Mrs X should remain at the home. The Council has acknowledged it should have shared a copy of this assessment with Mrs X’s sons
37. It would have been good practice if:
• The Council had asked Mrs X, as part of the 28-day review, if she was happy at the home and would like to stay. I have not seen evidence to conclude those two questions would have resulted in Mrs X becoming overly anxious. However, there is no indication this would have made a difference to the outcome, as Mrs X had always been very clear she wanted to stay at the home.
• The Council had also spoken to Mr C about his other’s care. There is no evidence in the records to show it did as part of the 28 days review. However, there is no indication this would have made a difference to the outcome (the decision the placement should become permanent then).
38. All concerned parties consulted, indicated during the 28-day review that they did not have concerns with the care at the home and that they would like the placement to become permanent. As such, the review was a ‘light-touch review’ and did not have to go into any further detail. I have not seen any evidence to the contrary in relation to this review in September 2021.

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Final decision

39. For reasons explained above, I did not find fault with regards to the way the Council carried out the assessments. As such, I have not upheld Mr C’s complaint.

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Investigator's decision on behalf of the Ombudsman