Summary: Mr X complains the Council was at fault in the way it moved his father Mr Y, from residential care to supported living which was not in his best interest as Mr Y’s health declined and he passed away. Mr X also complains the Council depleted Mr Y’s finances and failed to help him apply for benefits leaving him with little money when he died causing distress to the family. We have found no evidence of fault in the way the Council considered these matters. So, we have completed our investigation.

The complaint

1. I have called the complainant Mr X. He complains for his father Mr Y the Council moved Mr Y from residential care to supported living which was not in his best interest. Mr Y’s health declined, and he passed away. Mr X believes the move was financially motivated and the Council depleted Mr Y’s funds leaving him with £900 in his bank account at the time of his death causing distress. Mr X says the Council failed to help Mr Y apply for benefits to help with his costs.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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 provided by Mr X and discussed the complaint with him. I made enquiries of the Council and considered its response along with the relevant law and guidance.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Legal background

Charging for permanent residential care

6. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
7. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.
8. The financial limit, known as the ‘upper capital limit’, exists for the purposes of the financial assessment. This sets out at what point a person can get council support to meet their eligible needs. People who have over the upper capital limit must pay the full cost of their residential care home fees. Once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees. Where a person’s resources are below the lower capital limit they will not need to contribute to the cost of their care and support from their capital.
9. Where a council has decided to charge for care, 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.
10. A person will have to pay the full cost of their care if they:
• Do not meet the national eligibility for care and support and decide to arrange it privately.
• Choose not to have a financial assessment.
• Have savings or income of more than £23,250.

Community care assessment

11. 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. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.

Events leading up to the complaint

12. What follows is a brief chronology of key events. It does not contain all the information I reviewed during my investigation.
13. Mr Y lived alone in a ground floor flat. Mr X visited him regularly and provided support. Mr Y did not receive any care or support from the Council. In April 2020 Mr Y was admitted to hospital following a fall and reported to be frail, malnourished and with swelling in his legs.
14. The Council carried out an Adult Social Care (ASC) assessment and drew up a support plan for Mr Y in May 2020. Mr Y was considered medically fit to be discharged but did not want to return to his flat. With Mr Y’s agreement the Council looked at a care home for him to stay in temporarily.
15. A care home offered Mr Y a placement which Mr X did not agree to. Mr X wanted Mr Y to return home. The Council advised that due to the Covid 19 pandemic it was not suitable for Mr Y to return home as it was not accessible for him and his needs. Mr X was discharged to an interim placement. The Council considered Mr Y had capacity to decide where he wanted to go to. Mr Y said he felt safe in a 24-hour care setting and wanted to move to a nursing home. It was agreed Mr Y would be moved to a different nursing home.
16. Mr Y moved to the nursing home in May 2020. A social worker carried out a telephone review of the support plan to identify if Mr Y’s placement was to be long term. The Council sought Mr X and Mr Y’s views with Mr Y wanting to stay at the nursing home. The social worker discussed funding Mr Y’s care currently being covered by Covid Funding, but this was to end soon. Mr Y would then be financially assessed by the Council to see if he needed to make a client contribution towards the costs of the placement.
17. The Council considered Mr Y had mental capacity to decide on his accommodation and he wanted to stay at the nursing home. Mr Y became a permanent resident at the nursing home in June 2020. Mr X and Mr Y were advised the Council would carry out a financial assessment on Mr Y. The assessment in December 2020 noted Mr Y had capital of £16,500. The Council assessed Mr Y’s total weekly income as £377.14. It calculated Mr Y’s capital using a tariff as he had capital of less than £23,250 and calculated it as £10.00. It said Mr Y’s contribution towards his care charges was £356.49 a week based on his income. The Council sent a letter to Mr Y to advise of the charges and explain how it was calculated.
18. The Council reviewed Mr Y’s finances in 2021 as Mr Y’s capital increased to £21,000 due to changes in his capital and private pensions. Mr X’s contributions also changed to £388.42 based on his assessed income and tariff income on his capital. The Council wrote to Mr Y after each change in contribution to advise of the costs.
19. In February 2022 Mr Y contacted ASC for support to maximise his independence as he could use a wheelchair to access the community. The Council allocated an occupational therapist (OT) to assess Mr Y.
20. The OT found Mr Y had made remarkable rehabilitation progress and could self-propel a wheelchair. It was noted Mr Y had full capacity and was almost independent in his own care and support needs. Mr Y advised of his trips out into the wider community, and said he no longer needed a nursing placement.
21. The Council carried out an annual review of Mr Y’s financial assessment in May 2022. It was noted Mr Y had capital of £9,000 and calculated his weekly contribution as £374.42 based on his assessed income and tariff income now regarded as £0. Mr Y was advised of the changes by letter.
22. The Council carried out an ASC assessment on Mr Y in May 2022 and drew up a support plan. It noted Mr Y had improved while at the nursing home for two years and had capacity to decide where he wanted to live. Mr Y wanted to move into more independent living and decided to move to extra care housing with 24/7 support. The Council gave Mr Y information on extra care housing and to arrange viewings of schemes with Mr X to see where he wished to live.
23. Mr Y advised he had been contributing towards his care and his savings now depleted. The Council said it would carry out a new financial assessment.
24. In June 2022 Mr Y contacted the Council about an extra care housing scheme. The Council advised Mr Y to go and view it. The Council contacted Mr Y in October 2022 to confirm whether he still wished to move from the nursing home. Mr Y confirmed his interest.
25. The Council carried out an ASC assessment and drew up a support plan on Mr Y in November 2022. It was agreed Mr Y would move to extra care housing. But would need a domiciliary care package to help with personal care and support. The Council referred Mr Y to the Extra Care Housing panel who agreed to the referral. The Council updated the support plan for Mr Y to move to independent living in the community.
26. The Council allocated Mr Y a flat at an extra care housing scheme. Mr Y viewed the accommodation with an OT, was happy with the property and accepted it. Officers discussed the weekly cost with Mr Y, advised his finances will be assessed and discussed a moving-in date. Council records noted Mr Y understood the costs of moving to the extra care home. Officers booked a visit to see Mr Y once moved in to help him apply for benefits.
27. Mr Y signed the tenancy on 1 March 2023, completed the paperwork, paid one month’s rent in advance, and set up a direct debit to pay each month. Mr Y asked for his care package to start on 7 March 2023. Mr X helped Mr Y to move to the property.
28. The Council carried out a financial assessment on Mr Y for the extra care housing scheme. Mr Y’s capital was now £3,000. The Council assessed Mr Y’s contribution as £53.71 a week based on a weekly income of £404.24 and a tariff income of £0. The Council advised Mr Y of the charge.
29. A social worker visited Mr Y who said things were going well and wanted to stop some care calls. A week later Mr Y had a fall in his home and was admitted to hospital with a head injury. Sadly, Mr Y passed away.

Mr X’s complaints to the Council

30. Mr X complained to the Council he was struggling to pay for Mr Y’s funeral as he found Mr Y had little money left in his bank accounts. Mr X held the Council responsible for depleting Mr Y’s bank account due to the care charges and failing to help Mr Y apply for benefits to help with costs. Mr Y believed Mr Y was entitled to Attendance Allowance while staying at the nursing home which would have covered his costs.
31. Mr X expressed concern about the suitability of Mr X’s accommodation at the extra care housing and it had not been in Mr Y’s interest to move there due to his needs. Mr X considered the Council had moved Mr Y as he had no money, and he could not afford to remain in the nursing home.
32. The Council responded to Mr X’s complaints. It confirmed it had financially assessed Mr Y in March 2023. Mr X had a weekly income of £443.45, and capital of £3000. It calculated Mr Y had a weekly charge of £53 to stay at the extra care housing. Mr Y had an outstanding charge of £535.55 for care charges.
33. The Council said it was not an appointee for Mr Y so did not manage his finances and had no further information about Mr Y’s finances and bank accounts. The Council confirmed Mr Y was not entitled to Attendance Allowance while he stayed in residential care as his charges were mainly funded by the Council. Once Mr Y moved to the extra care scheme, he would have met the criteria for Attendance Allowance and able to make a claim.
34. The Council confirmed its Finance and Benefits team had contacted Mr Y when he moved to the extra care scheme about claiming attendance allowance. The Council asked the Department for Welfare and Pensions to send Mr Y a claim form. It asked Mr Y to contact it when received so officers could help fill in the form. Sadly, Mr Y passed away shortly afterwards without contacting the Council about the form.

My assessment

35. The evidence provided shows Mr Y had an input into where he wanted to live. Mr Y moved to a temporary care home after his fall and stay in hospital. Mr Y then moved to a nursing home where he chose to become a permanent resident and was aware of the costs of doing so. After two years Mr Y decided he wanted to move into more independent living at an extra care housing scheme.
36. The documents show Mr Y had mental capacity to choose where he wanted to live, and the Council’s evidence clearly shows how the decisions were made. The Council carried out ASC assessments on Mr Y as the law requires and drew up support plans to ensure Mr Y had appropriate support. There is no evidence of fault in the way the Council dealt with Mr Y’s care needs and his choices of accommodation.
37. It is unfortunate that Mr Y had a fall and passed away after being reported to be in good health following his move. But I cannot say this was due to any fault by the Council.
38. The documents provided also show Mr Y was clearly advised of the costs involved in each of his moves. The Council carried out financial assessments on Mr Y as required by law and explained how it calculated the charges. As Mr Y’s savings were under the threshold of £23,250 the Council used a tariff income on capital to assess any contributions. The Council’s calculations show it took minimal account of his capital with the weekly charges being assessed out of Mr Y’s income and not his capital. This is according to the regulations and guidance. There is no evidence of fault in the way the Council carried out a financial assessment on Mr Y and charged him a contribution toward his care charges. So, I cannot say the Council was responsible for the depletion of Mr Y’s capital. It will have been for Mr Y to choose how he spent his capital.
39. The evidence I have seen shows Mr Y’s move from the nursing home was not due to finances but Mr Y’s request to move to more independent living. The decision was documented in the ASC assessment and support plans.
40. The Council’s documents also show officers were advising Mr Y on applying for benefits as he may be entitled to Attendance Allowance following his move to extra care. Sadly, Mr Y passed away before this could be applied for. There is no evidence of fault by the Council in the way it was assisting Mr Y to apply for benefits.

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Final decision

41. I have completed my investigation. There is no evidence of fault by the Council in the way it dealt with Mr Y’s move to supported living, financially assessed him for contributions to care charges and helped him apply for benefits.

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Investigator's decision on behalf of the Ombudsman