Leicestershire County Council (22 015 917)
Category : Adult care services > Charging
Decision : Closed after initial enquiries
Decision date : 27 Mar 2023
The Ombudsman's final decision:
Summary: We will not investigate this complaint about the Council’s failure to inform Mrs C the cost of paying for her care. This is because further investigation could not add to the Council’s responses or make a different finding of the kind Mrs D wants.
The complaint
- Mrs D says she and her brother attended meetings with the Council and clearly said they wanted Mrs C to move nearer to her family before she had to start paying for her care. Mrs D complained she did not receive copies of the minutes of meetings and on receipt of them none of her concerns were documented. Mrs D says Mrs C was a temporary resident and not treated as she should have been treated. Mrs D says she was shocked to receive a retrospective invoice and says the Council should cancel the invoice for the period disputed.
The Ombudsman’s role and powers
- We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
How I considered this complaint
- I considered information provided by the complainant and the Council.
- I considered the Ombudsman’s Assessment Code.
My assessment
- The Council says Mrs C was discharged from hospital to a care home in August 2022 for a period of assessment. Mrs D was advised in a telephone call on 4 August that a placement was available for Mrs C which would be free of charge under NHS Discharge to Assess (D2A) funding for 7 days which may be extended for a further week if necessary. The Council explained it would then take over commissioning the placement and would assess Mrs D’s finances to establish whether she should contribute towards her care, or if she had capital over £23,250, she would pay the full cost. Record show Mrs D asked if this was the only option and was advised at the time it was. Mrs D said she wanted to visit the home first. the Council received a call from Mrs D later that day accepting the placement and Mrs C moved in.
- The Council arranged to meet with Mrs C on 25 August to undertake a Care Act Assessment. The Council says Mrs C said she was unsure how she would cope at home and wanted to wait to see how she could manage transferring from her bed independently. The Council arranged a further meeting for 12 September which Mrs D attended. Mrs C said she felt she was not ready to return home. Mrs D asked about extending the placement under NHS D2A and was advised the assessment bed would be available for a further week, but the Council says its records show Mrs D was advised any further extension would be under respite care and would be chargeable. The Council says its records show assessed charges, banded rates and top up fees were explained.
- The Council says between 16 and 22 September there were two further calls to Mrs D to discuss funding, but she said her brother was away and she was unable to provide an answer. The Council contacted Mrs D on 3 October when a new Care Officer was allocated Mrs C’s case. Mrs D confirmed they were not in a position to pay a third party top up fee and the Care Officer sent Mrs D a Financial Assessment form for completion. A meeting was arranged for 6 October. Mrs C was advised health care funding ceased on 24 September and she would have to pay for her placement from that date. Mrs C said she understood but felt she needed more time to decide what she wanted to do as she did not feel able to return home. A further visit was arranged but in the meantime Mrs C fell and was readmitted to hospital. Mrs D contacted the Council and advised it of Mrs D’s fall. Mrs D expressed concerns about Mrs D returning home and said due to commitments and the distance she had to travel, she was struggling to visit Mrs C at the home. Mrs D asked the Council to source a care home nearer to the family.
- Mrs C was discharged back to the care home on 20 October and a further 2 weeks funding under D2A was agreed. Mrs D confirmed Mrs C had capital over the threshold for Council funding and did not complete the financial assessment. Funding was discussed on 24 October and Mrs D was advised of the cost of the care home placement. Mrs C said she did not feel safe to return home and wanted to stay in her current home or move to a home nearer to her family so they could visit more easily. The Council emailed Mrs D details of care homes in the area. Mrs D arranged to take Mrs C to visit some of the homes and advised the Council Mrs C would be moving to a new home nearer to her family on 15 November.
- The Council emailed Mrs D on 21 November. It explained Mrs C would be funding her own care and advised Mrs D to contact the Council when her funds fell below the threshold for full self-funding. It also advised Mrs D of the two chargeable periods in the previous care home. They were 24 September-20 October, and 2-15 November. These periods were when Mrs C’s care was not funded by D2A. Mrs D responded advising she was unaware of the September charges and asked for an explanation. The Council responded to the queries Mrs D raised.
- Mrs C received care during this period, and we could not make a finding she should not pay. It is unfortunate the Council did not tell Mrs C or Mrs D the actual cost of her placement until 24 October. However, on the balance of probabilities, given records show Mrs C had said she did not feel safe going home and wanted to remain in the care home, she would have decided to stay there and incur the fees for her care if she had of known the cost of the placement. Both Mrs C and Mrs D knew the respite placement was chargeable and knew free NHS care had ceased. Mrs C moved to a care home nearer the family at a higher cost that her previous home, so she has not been disadvantaged financially.
Final decision
- We will not investigate Mrs D’s complaint because further investigation could not add to the Council’s responses or make a different finding of the kind Mrs D wants.
Investigator's decision on behalf of the Ombudsman