Summary: Mr X complains the Council failed to provide him and Ms Y with information about possible charges for her residential care leading to a debt causing distress. We have found no evidence of fault in the way the Council considered these matters. So, we have completed our investigation.

The complaint

1. Mr X complains for Ms Y the Council did not provide any information to her and the family about possible charges for her residential care placement. Mr X says once the family were aware of the charges, they brought Ms X home as she could not afford the costs. Ms X has now accrued a debt for the care she received causing distress.

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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 spoke to Mr X and considered the information he provided with his complaint. I considered information from the Council and the supporting documents it provided 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

Law and guidance

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.

The Council’s charging Policy

9. The Council produces a booklet on information for service users, relatives, and carers. The one relevant to this complaint was dated April 2023 to March 2024. It explains that if moving into a residential or nursing care home the Council will need to carry out a financial assessment to establish the person’s liability towards the care fees. The booklet explains about care home rates and top up payments. It says the Council will apply charging for residential or nursing care services from the date of admission. There is no period during which the individual would be exempt from charges. And everyone would be liable to make, at least, a contribution towards the cost of their care.
10. The booklet explains the Council will establish the contribution via a means tested financial assessment and it will pay the remaining fees, up to the Council’s maximum rate. Therefore, the Council does not pay a set amount. The Council’s contribution will be dependent on the person’s ability to pay and will be subject to change whenever their financial circumstances change. The Council says it will work out the contribution according to the Care Act.

What happened in this case

11. What follows is a brief chronology of key events. It does not contain all the information I reviewed during my investigation.
12. Ms Y lived at a property with Mr X and other family members. In October 2022 Ms Y was admitted to hospital. In April 2023 Ms Y was discharged to a care home as her home address was not suitable for her to return to. Ms Y received NHS funding to pay for her care home fees.
13. The Council was involved in discussions about Ms Y’s situation as she wanted to return home. It was noted Ms Y’s family members were willing to provide support, but the property needed adaptations. The Council arranged for an OT assessment on Ms Y, looked the possibility of a DFG proposal and accepted Mr X onto the housing register. Mr X said the family did not wish to pursue adaptations as they did not resolve the family’s housing situation.
14. The Council’s case notes show it was aware in June 2023 Ms Y’s NHS funding was to end on 30 June 2023 and so her care costs needed funding from 1 July 2023. The NHS said Ms Y qualified for funded nursing contributions towards her care costs. The care home confirmed the cost for Ms Y’s care would be £850 a week. It was agreed Ms Y would remain at the care home until alternative accommodation was identified for her.
15. The Council held a meeting with Mr X and Ms Y to discuss options for Ms Y including moving to supported living accommodation. But the family did not agree to this option. Mr X says at this meeting they were told the Council would take over funding Ms Y’s care home fees, and she would not be charged.
16. The Council’s financial charging form dated July 2023 notes a council officer told Mr X and Ms Y that everyone who received care was required to pay a contribution towards their care. Mr Y confirmed to the officer he had been asked to provide financial information for Ms X. The form notes Ms Y was told about a financial assessment and would have one to assess her contribution. The form notes Mr X was aware Ms X would have to contribute towards her care, they were given the booklet about paying for care and referred to it for financial information.
17. The Council carried out a financial assessment on Ms Y in July 2023. It notes Mr X was told about Ms Y’s financial assessment to determine what her contribution would be. And Ms Y will have to contribute to her care costs. It notes Mr X was given the booklet on paying for care.
18. The Council wrote to Ms Y in August 2023. It said she had accommodation charges, was assessed as needing to pay from 1 July 2023 and would be required to make a contribution towards the cost of accommodation. The charges would be £232.54 a week for July and £130.79 per week from August 2023. The letter says Ms Y would have been aware of charging and financial assessments from the booklet given to her during care planning stage.
19. Ms X was discharged back to her home address on 8 August 2023. Mr X told the Council he could no longer afford Ms Y’s client contribution and taken her home. The Council noted Ms Y was a permanent resident so the family should have given notice and there would be a two-week notice payment due.
20. The Council advised Mr X he should have spoken to officers about his concerns with invoices and explored how the family could be supported before discharging Ms Y. Mr X said he was overwhelmed by the cost and had no choice. Mr X intended to be Ms X’s main carer at home but said he could not manage. The care assessment carried out in June 2023 recommended Ms Y should remain in a long-term in a care home.
21. Mr X agreed to the Council assessing for adaptations at the property now and the OT put forward proposals for adaptations which the Council agreed to. The care home chased for the two-week notice payment it was entitled to.
22. In November 2023 Mr X complained to the Council about receiving the charges for Ms Y’s care. Mr X alleged they were told she would not need to pay because the Council was taking over costs once NHS funding ended. Mr X said they had received invoices which Ms Y could not pay. Mr X said they were also being asked to pay a two-week notice period after Ms Y returned home.
23. The Council responded to the complaint in December 2023. It explained Ms Y had received a financial assessment according to the Care Act and Council policy. Mr X alleged they were told the care charges would be fully covered by the Council. But the care notes did not confirm this. So, the charges calculated by the financial assessment remained valid. The Council said it was willing to discuss a potential solution for the debt and set up an affordable payment plan for Ms Y. The Council did not uphold the complaint.

My assessment

24. The documents provided show that Mr X and Ms Y were told about the need for a financial assessment and a possible contribution towards the care home costs. This is in accordance with the requirements of the Care Act and the Council’s policy for charging. In addition, the Council provided Mr X and Ms Y with a booklet explaining its charging policy. There is no evidence of fault by the Council in advising Mr X and Ms Y of the possibility of charges.
25. While Mr X and Ms Y may be unhappy at the charges, the Council is entitled to assess and require a contribution towards Ms Y’s care costs. The additional charges from August 2023 are from the notice period the family was required to give the care home when they removed Ms Y to take her back to her home. I appreciate the distress the outstanding charges have caused Mr X and Ms Y. But the Council has offered to consider an affordable repayment plan to clear the debt which is suitable action for it to take.

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Final decision

26. I have completed my investigation. There is no evidence of fault by the Council in the way it advised Mr X and Ms Y of the need for a financial assessment and contribution towards Ms Y’s care home fees.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman