Summary: Mrs X complained that the Council took too long to make funding arrangements to support her mother’s place in a care home. We found the Council to at fault because it took over a year to resolve. This caused Mrs X significant distress and frustration. To remedy this injustice, the Council has agreed to apologise and make a symbolic payment to Mrs X. It will also take action to improve its service.

The complaint

1. Mrs X complains the Council took too long to carry out a financial assessment and take over responsibility for her mother’s place in a care home. She says the delay caused significant distress and frustration.

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The Ombudsman’s role and powers

2. 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)
3. 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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How I considered this complaint

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

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What I found

Relevant law and guidance

Charging for permanent residential care

6. 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.
7. 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.
8. 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.

What happened

9. Mrs X’s mother, Mrs D, has dementia. In 2022, Mrs D went to live at a care home on a privately funded basis. In August 2023, when Mrs D’s savings approached the upper capital limit, Mrs X asked the Council to take over responsibility for the placement. A social worker (Officer P) was assigned to Mrs D’s case in November 2023. but he did not contact Mrs X until January 2024. Officer P completed his assessment the following month. Officer P subsequently left his employment. Mrs X contacted Officer P on several occasions without receiving a response during this time.
10. After several months new social worker was appointed to progress the case. In October 2024, the Council confirmed it accepted responsibility for the placement, backdated to July 2023. Mrs X was reimbursed for the costs she had incurred in the meantime.
11. Mrs X complained to the Council about its handling of the matter.
12. In response, the Council:

• accepted it took too long to complete the financial assessment;
• explained this was, in part, due to Officer P’s poor performance; and
• apologised and offered Mrs X £200 as a gesture to goodwill.

13. Disappointed with this outcome, Mrs X brought her complaint to the Ombudsman. She did so because she wanted action to be taken to ensure a similar situation did not reoccur.
14. In response to our preliminary enquiries, the Council reaffirmed its position that Officer P’s actions were primarily responsible for the delay. It also confirmed it would conduct a briefing session with relevant social work practitioners to remind them of the importance of keeping families aware of the steps involved to when requesting funding from the Council.

Analysis

15. The law expects councils to process funding requests in a timely fashion. This did not happen in this case. It took five months for the Council to complete its financial assessment and a further eight months to make contractual arrangements with the care home. While the case records show that during this time enquiries were made about the ownership of Mrs X’s previous home, this did not account for the time taken to finalise the matter. I am satisfied the delay in this case amounted to fault.
16. I welcome the Council’s acceptance of fault and proposed remedial action. Mrs X has made it clear to the Ombudsman she was not seeking financial compensation. Instead, her reason for making her complaint was to ensure other families do not experience similar frustration. For this reason, I consider the goodwill payment of £200 to be a reasonable sum to a symbolic payment to acknowledge Mrs X’s time, trouble and frustration.
17. However, I do not consider the Council’s proposal to improve its service provision is adequate. While I accept Officer P’s failure to process the assessment was a significant cause of the delay, the Council should have processes in place to ensure cases are not allowed to drift for such a long period of time and financial assessments are allocated and completed in a timely fashion. The Ombudsman expects Council’s to have management oversight of social worker caseloads. This should ensure when a member of staff leaves their employment, cases are transferred to another officer without excessive delay. Mr recommendations below reflect this.

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Agreed action

18. Within four weeks from the date of my final decision, the Council has agreed to take the following action.
1. Apologise to Mrs X.
2. Remind Mrs X of its previous offer to pay her £200 to acknowledge her time, trouble and frustration.
3. Carry out a review, at management level, about what went wrong in this case and provide the Ombudsman with a short report setting out the action it proposes to take to ensure financial assessments are completed in a timely fashion and there is sufficient management oversight of outstanding financial assessments.
4. Brief relevant staff of the importance of keeping family members informed of progress when carrying out financial assessments.
19. The Council should provide us with evidence it has complied with the above actions.

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Final decision

20. I find fault causing injustice. The Council has agreed to take action to remedy the injustice to Mrs X and improve its service.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman