Summary: Mrs X complained that the Council provided misleading information about how it would treat a property her mother owned abroad when deciding whether she would need to contribute to the cost of her home care. We found delay and poor communication in completing the financial assessment which caused distress and the Council agreed to apologise and make a symbolic payment.

The complaint

1. The complainant, Mrs X, complains the Council provided misleading information about how it would treat a property her mother, Ms Y, owned abroad when deciding whether she would need to contribute to the cost of her home care. Mrs X says the Council took almost a year to complete a financial assessment which found her mother was required to pay for her home care.
2. Mrs X says because of the Council’s fault, her mother faced a large and unexpected bill for care costs which caused the family significant distress. Mrs X further says her mother would not have accepted the care if the Council had properly informed her about the cost.

Back to top

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 may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
5. 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)

Back to top

How I considered this complaint

6. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
7. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

Back to top

What I found

Background and legislation

8. 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)
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. Councils have no power to assess couples according to their joint financial resources. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
10. A financial assessment should be carried out over an appropriate and reasonable timescale. Local authorities should inform the individual of an indicative timescale over which their assessment will be conducted and keep the person informed throughout the assessment process. (Care and Support Statutory Guidance, Paragraph 6.29)

What happened

11. The following is a summary of key events. It does not include everything that happened.
12. The Council completed a Care Act assessment for Ms Y towards the end of 2022 following her discharge from hospital after a fall at home. This identified Ms Y had eligible needs and a long-term care package was to be put in place to allow her to safely continue to live at home with Mrs X and her family. It was recorded that Ms Y received a pension from abroad and had savings below the threshold and there was a discussion about long-term care being chargeable and a financial assessment was needed to determine if Ms Y would need to make a contribution towards the cost of her care. The care package of three calls a day started in November with the weekly cost shown as £612.50.
13. The Council has provided a case note dated 30 September which included the following statement under the heading ‘Finances’ – “Under £23,250. Only benefits she is not eligible for is state pension but she is in receipt of state pension from [named country]. Does not own a property.”
14. The Council wrote to Ms Y on 2 November to confirm the weekly cost of £612.50 and that following a financial assessment she may be required to pay a part of this cost. The Council would inform her separately about this.

15. Ms Y completed and signed an ‘Agreement to pay a charge’ form on 9 November 2022. This confirmed receipt of the relevant booklet ‘Your life, your choice’ about how the financial assessment would be completed and how any charges would be decided.
16. The Council made a request for a financial assessment to be completed at the end of November.
17. The Council issued a Financial Assessment Pre-Assessment Letter on 19 July 2023. The Council subsequently issued a ‘Statement of Financial Circumstances’ form to Ms Y by post.
18. The Council received the completed form dated 21 August and some supporting evidence on 24 August. This noted that Ms Y owned 100% of a property abroad with an estimated value of £25,000.
19. The Council sought further financial evidence in September which was returned on 10 October. The Council wrote to Ms Y on 11 October with the outcome of the financial assessment. This set out that the property Ms Y owned abroad was classed as extra capital. Mrs X cancelled the care package.
20. Ms Y received an invoice in November for £34, 637.86 for the period 2 November 2022 to 18 November 2023.
21. Mrs X complained to the Council. In responding to Mrs X’s complaint, the Council accepted the invoice did not take into account the fact that Mrs X had cancelled the care package from 13 October. The Council also reconsidered the contribution to take into account if Ms Y paid the charge the value of her assets would have dropped below the upper funding threshold in June 2023 and from that point would have no contribution to make as her income was so low. The Council subsequently applied a credit note of £15, 212.86 to the amount. This left an outstanding balance of £19,425. The Council offered a payment plan to Ms Y. Mrs X paid the outstanding balance of £19,425 in full at the end of June 2024.
22. Sadly, Ms Y died at the end of 2024.

Analysis

23. It took the Council over eight months to contact Ms Y to start her financial assessment. The statutory guidance says councils should carry out a financial assessment over an ‘appropriate and reasonable’ timeframe. Eight months is a significant delay and was fault by the Council. The Council has explained the delay was due to the unprecedented demands it was receiving for financial assessments.
24. I have seen no evidence of fault in the financial assessment itself that the Council subsequently completed.
25. The Council has provided evidence of the information it provided at the time which sets out the indicative cost of the care and the possibility Ms Y may be required to pay a contribution towards this depending on the outcome of the financial assessment.
26. While the Council’s information about how it treated property that was owned but not lived in could have been clearer, I do not consider the information suggested the care would be free of charge. The Council was entitled to charge Ms Y and she received the care. In these circumstances, I cannot recommend the Council waive the charges.
27. However, by the time the Council completed Ms Y’s financial assessment, her care package had been in place for nearly a year. It was therefore particularly distressing for Mrs X and Ms Y to receive a large bill for backdated charges.
28. The Council has provided details of the action it took to clear the backlog of financial assessments and so I have not made an additional service recommendation.
29. The Council also confirmed in its complaint correspondence with Mrs X that it would amend its finance booklets to make clear that other property and land (not the property lived in) is classed as a capital asset when conducting a financial assessment. The Council has provided details of the amended information which sets out in the capital (savings and assets) section that although any property a person owns and continues to live in will be disregarded and so not included in the financial assessment it will need to know about the value of any other property or land that a person owns and does not live in.

Back to top

Action

30. Within four weeks of my final decision, the Council will take the following action to provide a suitable remedy to Mrs X:
1. write to Mrs X to apologise for not providing clear written information about charging at the outset and its delay starting Ms Y’s financial assessment and for the distress Mrs X and Ms Y suffered when they received a large bill for backdated care charges; and
2. make a payment of £400 to Mrs X to acknowledge her distress.
31. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
32. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

33. I find fault causing injustice. The Council has agreed actions to remedy injustice.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman