Summary: Ms X complained about how the Council decided to meet Mrs Y’s care and support needs and how it assessed her finances. Ms X said this caused her real stress and frustration. We do not find the Council at fault. We are satisfied the Council has already apologised where there was evidence of fault or delay with the Council’s communication with Ms X.

The complaint

1. Ms X complains about how the Council handled Mrs Y’s care and support needs. Specifically, Ms X says the Council:
• Failed to properly consider Mrs Y’s care and support needs from September 2022 and did not provide her with a copy of the relevant care and support plans;
• Delayed completing a financial assessment for Mrs Y and did not provide her with clear information about the assessment process;
• Did not properly process her request for a personal budget for Mrs Y’s care or arrange a suitable direct payment consistent with her care needs; and
• Failed to communicate effectively with her about Mrs Y’s care.
2. Ms X says this has caused her real stress and frustration.

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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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. 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)
5. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
6. 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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What I have and have not investigated

7. We cannot usually investigate complaints about events that took place more than 12 months before they were brought to our service. We can only exercise discretion to look back further if there are good reasons to do so.
8. Ms X first brought her complaint to the Ombudsman in January 2024. This means anything that took place prior to January 2023 has been raised late, and I have seen no good reason to exercise discretion to look back any further than this.
9. For this reason, I have limited the scope of my investigation to between January 2023 and January 2024. Any reference below to events that took place before or after this time, are for reference only.

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How I considered this complaint

10. I considered information Ms X provided. I also considered information received from the Council.
11. Ms 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

Relevant law and guidance

12. 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.
13. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.
14. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
15. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.
16. There are three main ways a personal budget can be administered:
• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.
  (Care and Support Statutory Guidance 2014)
17. 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 places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the 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)

What happened

18. I have summarised below some key events leading to Ms X’s complaint. While I have considered everything submitted, this is not intended to be a detailed account of what took place.
19. Ms X and Ms Z jointly and severally hold power of attorney to deal with Mrs Y’s financial affairs, however they do not hold power of attorney in relation to decisions on her health and welfare.
20. Mrs Y was a self-funding resident in a care home until she was admitted to hospital following a fall. As Ms X and Ms Z disagreed on where Mrs Y’s care should be delivered following her discharge and the Council had concerns about Mrs Y’s capacity to decide for herself, it arranged a best interest meeting. The result of this was that Mrs Y would return to the home she owned rather than the care home and receive privately funded 2:1 care 24-hours a day.
21. The Council asked Ms X to provide it with information to complete a financial assessment in December 2022 in respect of possible proceedings at the court of protection regarding property.
22. In January 2023, a social worker from the Council visited Mrs Y’s home with an occupational therapist to meet Ms X and one of Mrs Y’s carers to ensure relevant equipment was in place. Mrs Y returned home later that month.
23. The social worker visited Mrs Y several times in January 2023 and February 2023. They noted she appeared to be settled and they were satisfied her needs were being met.
24. The Council emailed Ms X in January to say, based on the information that had already been shared, it would not need to carry out a full financial assessment at that point. Mrs Y was above the capital threshold for assistance. The capital limits, specified in regulations made under the Care Act 2014, set the levels of capital (excluding any capital that has been disregarded) that a person can have while qualifying for financial support from a council for care costs.
25. In March 2023, the social worker carried out further visits to Mrs Y, one of which was with an independent advocate for her. They completed a review of Mrs Y’s care and support needs and noted no concerns around how her care needs were being met.
26. In June 2023 a social worker visited Mrs Y again. Again, they noted her needs were being met at home as she had two carers present at all times. During this month, Ms X explained Mrs Y would also need financial support to remain at home as her savings would soon fall below the funding threshold. The Council sent Ms X a link to complete an online financial assessment.
27. In July 2023, Ms X provided the Council with information to assess Mrs Y’s finances but did not include a completed finance form. The Council called Ms X to chase this and explained, based on the information provided, Mrs Y was still above the funding threshold.
28. The social worker then asked the Council’s funding panel to assess whether it would fund the current level of care Mrs Y received once she fell below the funding threshold so they could assess if this was sustainable in the long term.
29. In August 2023, Ms X provided the outstanding financial information to the Council. The Council considered this and let her know Mrs Y would fall below the funding threshold on 11 November. It provided its calculations and explained that from then Mrs Y’s weekly contribution would be £326.90.
30. In October 2023, the Council’s brokerage team began exploring options for delivering Mrs Y’s care and consulted with several care homes.
31. The Council emailed Ms X at the beginning of November 2023 to explain it had identified two care home placements for Mrs Y that could meet her needs. It initially proposed a personal budget of £1,050 per week to cover these. The Council explained if Mrs Y were to remain at home, she would have to fund the additional costs herself.
32. Ms X disagreed with the Council and said she felt Mrs Y needed constant 1:1 care which would not be provided at a care home. Ms X said she felt the Council ought to have completed its financial assessment much earlier than it had done and asked for an urgent referral to the Court of Protection for a best interest decision to determine where Mrs Y should live and what care she needed. The Council made a referral for an advocate to ascertain Mrs Y’s views.
33. Ms X asked the Council to provide her with a copy of Mrs Y’s support plan. The Council’s records note it explained this should be in her home, as outlined by her care provider. The Council explained it would only provide a support plan itself at the point it became responsible for commissioning care.
34. Ms X then entered discussions with Mrs Y’s current care providers to see if they could minimise costs while still meeting her support needs. They agreed a number of measures that would reduce costs and Ms X informed the Council that now she would likely be able to pay the difference.
35. On 8 December, the Council wrote to Ms X to confirm it had now approved a weekly personal budget of £1,000 towards the cost of Mrs Y’s care, with her contribution of £326.90 deducted from this. The Council explained if Mrs Y were to remain at home, any additional cost would need to be paid by Ms X or Ms Z. The Council said the top up fee would currently be £2,632.15. Ms X said she had told the Council she would not be willing to pay this amount from her own funds.
36. Ms X complained to the Council that same day. Ms X said the Council had been aware since February 2023 that Mrs Y would soon need financial assistance but had delayed completing an assessment. Ms X said the Council’s calculations were based on a very basic level of care, and she had needed to reduce Mrs Y’s care to the minimum safe level. Ms X also asked the Council to explain how it had calculated the top up fee.
37. The Council responded to Ms X later that month. It explained it had calculated the top up fee based on a care invoice she had provided. However, it agreed it had not accounted for the agreed reduction in the care and had now amended its calculation to show the top up fee was £1,104.90 per week. The Council said it aimed to issue legal proceedings in January 2024 relating to an urgent welfare decision around deprivation of liberty for Mrs Y.
38. In January 2024, the Council provided Ms X and Ms Z with a copy of a support plan for Mrs Y. This confirmed Mrs Y needed support across all areas of eligible personal care needs, and these were currently being met with the assistance of two carers. This set out a weekly personal budget of £1,000 to cover the assessed needs. Ms X was unhappy with errors in the Council’s support plan. The social worker apologised and amended the support plan.

Analysis

39. When Mrs Y returned home in January 2023, the Council had already asked Ms X to provide information to enable it to carry out a financial assessment. Ms X did not provide all the information the Council required. The Council chased Ms X for this but let her know, based on the information it did have, it was satisfied Mrs Y was above the threshold for assistance. I do not find fault with the process the Council followed to assess Mrs Y’s finances at this point.
40. Ms X then asked the Council to complete a financial assessment in June 2023. At this point, she provided most of the information the Council needed. The Council considered Mrs Y’s assessed needs, how these could be met, what it knew about her finances and eventually, in November, set a final personal budget of £1,000 per week. I do not find fault with the process the Council followed to reach this decision. I appreciate Ms X feels this took too long, but this is because the Council explored options for efficiently delivering Mrs Y’s care and I cannot see it was responsible for any avoidable delays.
41. The Council appears to have been contactable throughout the financial assessment process and provided Ms X with information and updates as necessary. At times the Council took longer to respond than Ms X would have liked. I am satisfied the delays were not so great that it caused her a significant injustice. The Council also apologised for any miscommunication regarding the earlier financial assessment. I have not seen evidence of the Council failing to provide Ms X with information about the process and it answered questions that were put to it. I do not find it at fault here. We would not investigate further because if there was any fault with its communication causing significant injustice, the Council’s apologies were a suitable remedy for any injustice caused.
42. Mrs Y’s needs were assessed prior to her being discharged from hospital. The available records show the Council’s social worker visited Mrs Y multiple times and had discussions with her care providers to ensure her needs were met throughout the timeline I have investigated. I do not find fault with how the Council ensured Mrs Y’s needs were met.
43. Once the Council was due to make contributions to the cost of Mrs Y’s care, it explored how it could fulfil its duties most efficiently. It identified two care homes that could provide the services Mrs Y required for £1,000 per week and set a final personal budget to meet this. I appreciate Ms X feels 1:1 would be better for Mrs Y, but the Council is not obliged to cover the cost of this if it is satisfied adequate care can be delivered in a different way. The care homes the Council consulted with said they would be able to meet Mrs Y’s assessed needs and gave the cost of this. I do not find fault with the actions the Council took to decide what was a suitable personal budget for Mrs Y.
44. The Council initially miscalculated the amount of the top-up fee as it did not take account of the reduction in care costs Ms X had negotiated. While the Council was at fault here, it quickly corrected the error once it was pointed out which I find is a suitable remedy to any injustice caused.
45. Ms X complained the Council did not provide her with copies of all needs assessments and support plans that were completed for Mrs Y. The Council has explained it did not provide copies of all assessments as Ms X does not hold power of attorney for matters relating to Mrs Y’s health and welfare and she could not consent to their disclosure. However, it provided copies of care and support plans needed in relation to her holding power of attorney for financial and property affairs and is managing Mrs Y’s direct payments. I do not find the Council at fault here as I would not expect it to disclose information where it was not satisfied Ms X was entitled to this.
46. Ms X also raised concerns about the level of communication she received from the Council. From the records I have been provided, the Council kept an open dialogue with Ms X throughout and I cannot see any unnecessary delays in responding to her. Where there were short periods of delay, for example a five-week delay in sending forms to its brokerage team for cost comparisons, the Council has already apologised. The communication the Council has provided was clear and it responded to communications it has received from Ms X. I do not find significant fault with the way the Council has communicated with Ms X.

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Final decision

47. I do not find fault with the way the Council considered Mrs Y’s care and support needs, or the process it followed for her financial assessment. While the Council was at fault for providing incorrect top-up fee figures, it quickly corrected this, and I find that is suitable to recognise the injustice caused. Where there were errors or delays in communication with Ms X that may have caused her some injustice, the Council has already apologised. I have now completed my investigation.
     

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman