Summary: We will not investigate this about how the Council has carried out a financial assessment to determine the complainant’s contribution charges for care. This is there is insufficient evidence of fault by the Council to warrant investigation.

The complaint

1. The complainant (Ms Q) complains about how the Council has carried out a financial assessment to determine her contribution charges for care. She says there is a possible miscalculation of her care fees between May 2023 and May 2024. Ms Q notes that a small was previously identified after sharing a few months of bank statements with the Council. The complainant believes that if the council had reviewed her bank statements for the entire period in question, it might have uncovered a larger overpayment.
2. In summary, Ms Q says the alledged fault may be causing her to be overpaying for her social care. As a desired outcome, she wants a review into how her contribution has been calculated and that she be reimbursed any overpayment.

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The Ombudsman’s role and powers

3. 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 or continue an investigation if we decide there is not enough evidence of fault to justify this. (Local Government Act 1974, section 24A(6), as amended, section 34(B)).

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How I considered this complaint

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

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My assessment

5. In England, local authorities conduct a financial assessment (means test) to determine how much a person must contribute towards the cost of their care, whether at home or in a care home. The process and calculation are governed by national rules, though some details may vary by local authority:

• Income: All regular income is considered, including pensions and most benefits. Some types of income, such as the mobility component of Disability Living Allowance or Personal Independence Payment, are disregarded.
• Capital: This includes savings, investments, and property (with exceptions). For care at home, the value of your main residence is not counted. For permanent care in a care home, the property may be included unless certain relatives continue to live there.
• Disregards: Certain disability-related expenses, housing costs (rent or mortgage), and a minimum income amount (personal expenses) are disregarded from your income

6. If a person’s capital is below £14,250, it is disregarded, and only their income is assessed. Ms Q says she is concerned about the alleged miscalculation of her care home fees (personal contribution) between May 2023 and May 2024. She says had the Council looked at her bank statements, this may have resulted in a finding that she had been overpaying for her care.
7. In response to Ms Q’s complaint, the Council arranged two meetings with her to explain how her contribution had been calculated. The Council explained to her that as her capital remained consistently below £14,250, her bank statements have no relevance to the financial assessment. In accordance with the Care Support (Charging and Assessment of Resources) Regulations 2014 (the Regulations), in assessing the Ms Q’s contribution towards her residential care placement, the Council confirmed the contribution was assessed by taking Ms Q’s income and making deductions for personal expenses.
8. If Ms Q’s capital has always been below £14,250 and her income has been correctly assessed, her bank statements would not reveal any additional information relevant to the calculation of her care home contribution. The council’s approach is in line with the Care Support (Charging and Assessment of Resources) Regulations 2014, and unless there is evidence of undeclared income or missed allowable expenses, there is no further relevance to her bank statements in the financial assessment. I have seen no evidence of fault in the way the Council has assessed Ms Q’s income, as well as the disregards made.
9. The Council arranged two meetings with Ms Q to go through how her financial assessment had been completed and that this did not reveal any inaccuracy. In my view, there is insufficient evidence of there being any fault. After going through how the contribution had been calculated, the Ms Q told the Council in these meetings that she now intended to pay the care home debt accrued since she stopped paying invoices due to the concerns she had. Ms Q has since paid an amount, set up a payment plan to clear any other arrears and reinstated her direct debit for payment of future invoices. I am not persuaded further investigation of this matter is warranted.

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Final decision

10. We will not investigate this complaint. This is because the restrictions I outline at paragraph three (above) applies.

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Investigator's decision on behalf of the Ombudsman