Summary: Mrs X complains on behalf of her late mother-in-law, Mrs Y, the council failed to take into account her rent and bills when calculating charges for her care home. Mrs X says Mrs Y does not have enough funds to cover the fees being requested by the Council. Mrs X says this has caused the family distress. We have found fault in the actions of the Council for delay in confirming what information it needed to complete the financial assessment. The Council has agreed to issue an apology, discuss the information it needs to complete the assessment and completes service improvements.

The complaint

1. Mrs X complains on behalf of her late mother-in-law, Mrs Y, the council failed to take into account her rent and bills when calculating charges for her care home. Mrs X says Mrs Y does not have enough funds to cover the fees being requested by the Council.
2. Mrs X says this has caused the family distress.

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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 may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

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(1), as amended)

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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 were invited to comment on my draft decision. I have considered any comments before making a final decision.

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What I found

8. 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.
9. 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.
10. 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.
11. The Care and Support Statutory Guidance issued under the Care Act 2014 at Annex C says there may be circumstances where it would not be appropriate to leave a person with only the personal expenses allowance (PEA) after charges. It says allowances should be made for fixed payments such as rent and for utility costs.

What happened

12. Mrs Y was placed in a care home in May 2023 following a stay in hospital after a fall.
13. The Council sent Mrs Y’s son (Mr Z) forms to fill in to allow it to complete a financial assessment in June 2023. Mr Z completed these and sent them back in June 2023. The Council issued a letter in July 2023 and said it had not received the forms it sent to Mr Z.
14. Mr Z complained to the Council in early August 2023 and said he had completed the forms the Council sent and returned them straight away. He also said he had tried to contact the Council, but the Council did not respond to his emails or calls.
15. The Council replied to Mr Z’s complaint in mid-September 2023 and said it had received the financial forms he had completed and apologised for the incorrect letter being sent to him. The Council also said it had completed a financial assessment and sent this to Mr Z in August 2023.
16. The Council wrote to Mr Z in November 2023 and said it had completed the financial assessment and sent him a direct debit form. He said he did not have Power of Attorney for his mother and as such could not set up a direct debit.
17. The Council issued a bill to Mr Z in December 2023 for £7,517.71.
18. Mr Z wrote to the Council in late December 2023 to complain again, saying he had told the Council he did not have Power of Attorney and as such could not give up the tenancy on her property or deal with any financial matters such as with utility companies. Mr Z said Mrs Y did not have funds to pay both her rent and utilities costs and care home fees out of her state benefits.
19. Mr Z said the Council told him to give notice on Mrs Y’s property in mid-January 2024.
20. The Council issued a stage two response to Mr Z in late January 2024. This apologised for the delays in completing the assessment and attached a copy of how it reached the calculations of Mrs Y’s contribution towards her care home fees.
21. Mr Z contacted the Council in late January 2024 and said he now had Power of Attorney. He told the Council again it had not taken into account Mrs Y’s rent, utilities and bills in the financial assessment. He said he had not been told to end Mrs Y’s tenancy until January 2024, and she did not have enough money in her account to pay the bill the Council had sent.
22. Mr Z told the Council Mrs Y had passed away in mid-April 2024. He emailed the Council four days later to say he had received a further bill, sent with no accompanying letter just after he had informed the Council Mrs Y had passed away.
23. The Council wrote to Mr Z in mid-May 2024 and apologised for incorrectly stating it had not received the financial information he had provided. It also said it had provided information about the maximum costs Mrs Y would be responsible for.
24. Mr Z replied to say he was unhappy with the Councils response.
25. The Council sent a stage two complaint response in late July 2024 and apologised for the delay in confirming the placement for Mrs Y was permanent. It said this was due to trying to source a more cost-effective placement. The Council also said Mrs Y’s housing costs were covered by housing benefit. The Council told Mr Z to provide evidence of costs Mrs Y was paying and it would consider those.
26. Mrs X sent the Council copies of Mrs Y’s bank statements and tenancy agreement in mid-September 2024. The bank statements provided highlighted costs such as utilities.
27. The Council wrote to Mr Z in late October 2024 and said it had incorrectly said it was trying to source a more cost-effective placement. The Council also confirmed it had reassessed Mrs Y’s contribution and confirmed the new figures to Mr Z.
28. In response to our enquiries the Council has said it believes there is an outstanding balance of £4749.77. It has also said if a breakdown of utilities and insurance costs can be provided it will consider this within the financial assessment. The Council has further clarified copies of all utility bills will need to be provided.

Analysis

29. Mr Z told the Council in December 2023 that she had a property she was responsible for. He also said he did not have Power of Attorney at that point and could not give up the property or deal with any of the utility payments.
30. Mr Z told the Council in January 2024 its assessment had not taken into account the costs Mrs Y was having to pay towards rent and bills.
31. I have not been able to see that the Council asked for information concerning the costs Mrs Y was paying towards her property until around July 2024 when the Council explained it would reconsider the financial assessment if these were provided. This is fault.
32. Mrs X provided bank statements and a copy of Mrs Y’s tenancy agreement in September 2024. This included details of the rent Mrs Y had been paying and utility costs. The Council reconsidered the financial assessment in October 2024. However, this only mentioned reconsideration in relation to the rent Mrs Y was paying and did not mention the other costs Mrs X had provided.
33. The Council has said it would need copies of utility bills to consider these which showed the period covered and evidence these had been paid. The bank statements she provided show the payments being made but I cannot see the Council has told Mrs X it needed further information to consider the utility bills. This is fault and has caused Mrs X and her family distress.

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Action

34. Within one month of a final decision the Council should:

• Write to Mrs X and apologise for the distress caused by the faults identified.
• Write to Mrs X to discuss the information it needs to complete the financial assessment bearing in mind Mrs X no longer has access to many invoices but has provided bank statements.
• In writing, remind staff to confirm what evidence is required to allow costs to be considered in financial assessments.

35. The Council should provide us with evidence it has complied with the above actions.

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Decision

36. I find fault causing injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman