Summary: There was fault by the Council. The Council sent contradictory letters which caused confusion on whether the Council would fund a care home placement. This meant the transition from Council funded to self-funded care was not well managed and the complainants were not given the option of the Council managing the care, with the complainants paying the full cost. Reviewing the procedures to ensure they comply with the Care Act 2014 and paying the care home fees owed once the upper capital threshold would have been reached remedies the injustice caused.

The complaint

1. The complainant, who I shall refer to as Mrs D, complains on behalf of her father, the late Mr X. Mrs D complains about the Council’s financial assessment when calculating whether it would contribute towards Mr X’s care home fees. Mrs D says the Council did not properly manage the change when Mr X’s capital increased to above the upper capital limit.
2. Mrs D says the Council delayed carrying out a valuation of a property to determine its value. And, the Council has not completed a financial assessment to decide when capital dropped below the upper financial limit and made a contribution towards care home fees. Mrs D says they are uncertain how much they need to contribute towards the care fees and the delay has increased this uncertainty.

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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. 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

5. I considered evidence provided by Mrs D and the Council as well as relevant law, policy and guidance.
6. Mrs D 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

7. 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)
8. 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.
9. 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.
10. 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.
11. 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.

Key facts

12. Mr and Mrs X jointly owned a commercial property which was leased out. This was in addition to their home that they owned. The Council funded Mr X’s place in a care home, with him making a financial contribution of £193 per week.
13. When the lease ended on the commercial property, a new financial assessment was carried out. This included the value of the commercial property.
14. The Council wrote to Mr X twice on 25 October 2023. The first letter said that Mr X needed to pay a financial contribution of £290 per week from April 2023. The second letter said the commercial property was a capital asset and so Mr X had to pay the full costs of his care from 1 September 2023.
15. The Council has said that it accepts that receiving the two letters was potentially confusing as it did not say the £290 client contribution only applied until 31 August 2023. The Council said it acknowledged the second letter did not state the Council would stop paying the care home and Mr X was now responsible for making his own arrangements with the care home. However, the Council officer had emailed the family separately to say that Mr X needed to make his own arrangements from 1 September 2023.
16. The Council’s contract with the care home stopped on 31 August 2023. But, the care home continued to invoice the family for £193 per week, not the full cost of Mr X’s care.
17. Mrs D rang the Council in November 2023. There are no notes of this conversation. Mrs D says she asked to appeal against the decision that the commercial property had a capital value. This was because the property was in poor condition and jointly owned.
18. Mrs D made a written appeal in May 2024 disputing the value of Mr X’s share of the commercial property. The Council said it would arrange an independent valuation of the property. The result of the valuation was received on 29 November 2024, which valued the property share at £35,000.
19. Mr X died in January 2025. A financial assessment was carried out in July 2025, as the family needed time after Mr X’s death to send in information. The assessment was based on the figures Mrs D supplied with Mr X paying £193 per week towards the cost of his care. But, Mrs D should have put on the form the full cost of the care fees so the calculation was incorrect.
20. The Council has now repeated the financial assessment, with the full cost of the care fees. The Council has calculated the family owe the care home £30,141 from Mr X’s estate. Once this has been paid and Mr X’s capital reduced below the capital threshold the Council has said it will pay the balance of the care home charges from 27 February 2024 until January 2025. The Council has said the family owe an additional £18.67 per week financial contribution from 27 February 2024 until 27 January 2025, which it will invoice Mr X’s estate for.

My analysis

21. There has been fault by the Council. When it wrote to Mr X in October 2023 the two letters sent caused confusion. However, the injustice to the family was minimal as they had been told by email and letter they would need to fund Mr X’s care from September 2025. Reviewing the standard letters is a reasonable remedy to this fault, to ensure the process is clearer in future.
22. It is clear the transition to self-funding could have been managed better by the Council and the family were not offered the option of the Council managing the care with the family paying the full costs. But the Council did tell the family clearly in an email that Mr X would need to fund his own care from September 2023 and the Council was not aware the family had not paid the care home fully. The care home continued to care for Mr X, so no injustice was caused to him. But, there is a large outstanding debt that has built up as the care home has not been fully paid for over a year. So, the main injustice in this complaint has been caused to the care home rather than Mr X’s family. The Council has proposed to put the care home and family in the situation they should have been to remedy the complaint. It will also review its standard letters and review its procedures to ensure that when service users transition to self funding the Council follows the Care Act 2014 guidance. This should consider whether the Council has a duty to arrange and manage the care and whether a deferred payment agreement is appropriate.
23. There is no written evidence that Mrs D appealed in November 2023, so I consider the Council’s response to her appeal in May 2024, to arrange a valuation was correct. It took 6 months to get the valuation report. The Council asked for the valuation on 30 July and it was carried on 2 October 2024. The process was slow but I cannot say that the Council caused any significant delay. It seems that each stage of the process was slow and simply took time. I can appreciate this was frustrating for the family but I do not consider there was fault on this point.
24. Mrs D has explained that during this period they were waiting for the valuation to be carried out the family carried out work to the property and so she considers the cost of the works have not been taken into account. I can see from the valuation that the valuer considered the information sent by the family about the cost of the works. So, I find no fault on this point. The family was aware that the valuation was to be carried out so if they were concerned about the works affecting the valuation they could have postponed them.
25. The Council asked for the valuation to be on the date of inspection rather than the date Mr X went into care. In this case, given the low valuation I do not consider the valuation date was likely to have changed the valuation. The property is a three storey property including a food retail area and seating but was in poor repair in a city centre location. The valuation was for a 50% share and took account of the fact the other owners did not want to sell or buy Mr X’s share. The valuation was £35,000 and the valuer said in the report that the value of the property would be significantly higher if the other owners were willing to co-operate in a sale. This indicates to me that the date of the valuation would have had much less impact on the value than the issues with the shared ownership. So, I do not consider that the date of the valuation (and so the time it took to arrange the valuation) caused significant injustice to the family as it was very unlikely to have significantly altered the valuation.

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Action

26. Within two months of the date of the decision on this complaint the Council should:
• Review its procedures to ensure that when service users transition to self funding the Council follows the Care Act 2014 guidance. This should consider whether the Council has a duty to arrange and manage the care and whether a deferred payment agreement is appropriate.
• Review its relevant standard letters to ensure they are clear and comply with the Care Act 2014 guidance.
• Invoice Mr X’s estate for the additional financial contribution from 27 February 2024 until 27 January 2025.
• Pay the balance of the care home charges for the period of 27 February 2024 until 27 January 2025 after the family have paid the fees of £30,141 to the care home.
27. The Council should provide us with evidence it has complied with the above actions. If the family do not pay the £30,141 care home fees then the late Mr X’s capital would not have dropped below the threshold and so the Council will not be required to pay the balance of the care home charges for 27 February 2024 until 27 January 2025.

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Decision

28. I have completed my investigation and I find fault causing injustice. The Council has agreed actions to remedy injustice.

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Investigator's decision on behalf of the Ombudsman