Summary: We will not investigate Mrs X complaint the Council failed to give her sufficient information about top up fees for her mother’s residential care placement. This is because there is insufficient evidence of fault. In addition, the accepted fault has not caused any significant injustice.

The complaint

1. Mrs X complains the Council failed to give her sufficient information about top up fees for her mother’s residential care placement. She says this means the top up fees she agreed to was not made with informed consent.

Back to top

The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any injustice is not significant enough to justify our involvement.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

Back to top

How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.

Back to top

My assessment

5. In November 2023, Mrs X’s mother, Mrs Z, went into respite care in a residential care home, Care Home 1. Following an assessment, it was agreed Mrs Z needed long term care and that her needs were best met in a residential care home.
6. Mrs X considered the Care Home 1 was the best placement for Mrs Z due to the facilities and the proximity of the home to family. However, the Council identified another care home (Care Home 2) that could meet Mrs Z’s needs, but at a lower cost than Care Home 1. The Council told Mrs X that if she wanted Mrs Z to remain in Care Home 1, she would need to pay a top up fee to cover the difference between the cost of Care Home 1 and Care Home 2.
7. The Council sent Mrs X an email which contained a factsheet which set out information about paying for permanent residential care. This factsheet clearly set out that a financial assessment would be completed to calculate the individual’s contribution towards the cost of meeting eligible needs in a care home. It also provided in depth information about how the financial assessment would be completed.
8. The Council also provided Mrs X with a link to its website and directed Mrs X to review the information about third party top ups. I have reviewed the information and can see it provided information about what a third party top up was and who needed to pay it.
9. Mrs X signed a third party top up agreement in December 2023. This agreement detailed Mrs X’s responsibility to pay the top up fee and the weekly amount payable.
10. Mrs X says the Council failed to tell her that it would complete a financial assessment for Mrs Z to determine how much she would need to contribute towards the cost of the placement. Mrs X said because of this, she thought the Council was going to pay the fees in full. Therefore, she felt obligated to agree to the top up agreement. Mrs X says if she had known her mother would need to contribute, she would not have signed the top up agreement.
11. In its complaint response, the Council accepted it did not specifically tell her that a financial assessment would be completed. The Council apologised for this oversight.
12. While the Council may not have explicitly told Mrs X it would complete a financial assessment, I am satisfied the Council provided sufficient information to Mrs X about the financial assessment process. There was enough information for Mrs X to infer her mother would need to contribute towards the cost of her residential placement. If Mrs X had been confused about why the information had been sent to her, it would have been reasonable for her to have raised this with the Council.
13. Further, an investigation is not justified as we are not likely to find fault. This is because the Council provided sufficient information to Mrs X about the third party top up fees to allow her to make an informed decision about whether to agree to it or not.
14. I am not persuaded by Mrs X’s position that had she known about the financial assessment, she would not have agreed to the third party top up. This is because the information that a financial assessment would be completed, and Mrs Z would need to contribute towards the cost of her placement, is not relevant to whether Mrs X is willing and able to fund the third party top up fees. As above, Mrs X had sufficient information to understand what the third party top up fee was and her responsibility for paying it if she agreed.
15. In any case, even if Mrs X had challenged the third party top up before signing the agreement, it is not likely the Council’s position would have changed. This is because the Council appropriately carried out a search for the best value placement and was satisfied Care Home 2 could meet Mrs Z’s care needs at a lower cost. Therefore, the outcome would likely have been the same in that Mrs X would still have needed to decide between agreeing the third party top up agreement or for her mother to move to Care Home 2.
16. I understand Mrs X may be having difficulty funding the third party top up fees. It is open to her to discuss this with the Council so appropriate action can be taken with regards to Mrs Z’s care placement.

Back to top

Final decision

17. We will not investigate MRs X’s complaint because there is insufficient evidence of fault. In addition, the accepted fault has not caused any significant injustice.

Back to top

Investigator's decision on behalf of the Ombudsman