Summary: Mr X complains the Council did not complete a review of late Mr Y’s care plan and wrongly decided Mr Y should pay for his care. Mr X says this caused avoidable distress and financial loss to him and his family. We find the Council at fault which caused injustice. The Council has agreed to complete a backdated financial assessment and provide a written apology.

The complaint

1. Mr X complains about the Council’s handling of his late family member, Mr Y’s, care. Specifically, he complains the Council:

1. Did not complete a proper assessment of Mr Y’s care needs;
2. Did not review Mr Y’s care needs and care plan;
3. Wrongly decided his Mr Y should pay for his care;
4. Communicated poorly; and
5. Handled his complaint poorly.

2. Mr X says this has caused avoidable distress and financial loss to him and his family.

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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 consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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)
6. 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)

7. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
8. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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What I have and have not investigated

9. Mr X complains about matters which began in February 2024. He brought his complaint to the Ombudsman in May 2025. As I have said above, we can only investigate matters within the last 12 months unless there are good reasons to exercise discretion. Mr X made his complaint to the Council in January 2025, and the Council responded in April 2025. Mr X did not delay bringing his complaint to the Ombudsman, and so I consider if the Council had completed its complaints process in a timely way, Mr X would have brought his complaint to us sooner. For this reason, I have investigated all parts of the complaint from February 2024.

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How I considered this complaint

10. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
11. Mr 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

What should have happened

Care assessment (part a of the complaint)

12. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
13. 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)

Care plan review (part b of the complaint)

14. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
15. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

Financial assessment (part c of the complaint)

16. A financial assessment is completed by the Council to decide what a person can afford to pay towards their care. 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.

Complaint handling (part e of the complaint)

17. The Council’s complaint procedure states stage one complaints are dealt with by the relevant service head or their representative. It says complaints will be acknowledged within 5 days, and the Council aims to respond within 10 working days of the complaint being acknowledged.
18. The Council’s complaint procedure says complaints can be complicated and may take longer to resolve. It says if it cannot give a full reply within the stated period, it will tell complainants the reason, what actions are being taken, and give an expected date for the complainant to receive a response.

What happened

19. The late Mr Y had several health needs. He lived at home with Mr Z, who was an informal carer for Mr Y.
20. In early 2024, Mr Y was admitted to hospital.
21. In February, the Council completed an initial needs assessment. It consulted hospital staff including the ward nurse, an Occupational Therapist and a Speech and Language Therapist to gain information about Mr Y’s needs. It then consulted Mr Y and Mr Z. The Council explained its proposed care plan to Mr Z, including the proposed package of home care for Mr Y. It issued the care plan and sent Mr Z the Council’s charging policy and financial assessment form.
22. Shortly afterwards, Mr Z contacted the Council and requested a review of Mr Y’s care plan. He told the Council he could not support Mr Y’s needs with the proposed package of care and requested for Mr Y to be discharged to a residential care home instead. The Council explained it had considered Mr Y’s recent medical assessment which showed his needs had not changed. It explained to Mr Z it would consider increasing the package of home care instead.
23. Mr Y was discharged from hospital to his home, and the package of care started. The next day, Mr Y had a medical episode and was readmitted to hospital.
24. A few days later, the Council discussed Mr Y’s discharge plan with Mr Z. The Council agreed to reassess Mr Y’s care needs.
25. Mr Y was medically ready for discharge. The hospital discharge team told the Council that Mr Y’s family had arranged private residential care.
26. In late March, Mr X sent the financial assessment form and supporting documents to the Council. The next day, the Council confirmed receipt of the documents. Mr X also sent a separate letter requesting the Council review Mr Y’s needs assessment.
27. In May, Mr X submitted another request for the Council to review Mr Y’s needs assessment and care plan on its website.
28. In summer, Mr Y died. Mr X contacted the Council requesting the financial assessment. It told Mr X its finance team would contact him. The Council contacted Mr Z about a safeguarding referral it had received about Mr Y’s care.
29. In early January 2025, Mr X made a formal complaint.
30. In late April, the Council responded to Mr X’s complaint.
31. To date, the Council has not completed a financial assessment for Mr Y.

Analysis

Care needs assessment (part a of the complaint)

32. The Council completed its care needs assessment prior to completing the care plan. It consulted with medical staff working with Mr Y, and Mr Y’s family member. I am satisfied the Council considered all information available in its decision making. I find no fault with the Council’s decision making and therefore I cannot criticise the outcome.

Care plan review (part b of the complaint)

33. Upon Mr Y’s readmittance to hospital, the Council agreed to complete a reassessment of Mr Y’s needs. It did not do so. Mr X made two further requests for a review of Mr Y’s care plan, and the Council did not respond. In its final complaint response, the Council told Mr X it did not review Mr Y’s care plan because of the family’s decision to arrange private residential care. The Council should have reassessed Mr Y as it identified. Its decision not to do so is fault. This fault caused avoidable and unnecessary uncertainty and frustration to Mr X.

Financial assessment (part c of the complaint)

34. The Council accepts it received the financial assessment form and supporting documents submitted by Mr X. It tells the Ombudsman it did not complete a financial assessment because the family had arranged private residential care for Mr Y on his discharge from the hospital. The Council should have completed the financial assessment when Mr X requested it. Its decision not to do so was fault. This caused Mr X avoidable and unnecessary uncertainty and frustration.

Communication (part d of the complaint)

35. Mr X complains about the social worker’s communication regarding Mr Y’s care costs. Mr X refers to a conversation between the social worker and Mr Z which he was not present for. For this reason, I cannot make a finding on this matter. In any case, the social worker sent the charging policy and financial assessment form to Mr Z, and Mr X completed it within the timescale the Council provided. For this reason, I would consider any injustice caused by any poor communication in this conversation to be limited.
36. Mr X complains a social worker contacted Mr Z about a safeguarding concern two months after Mr Y’s death. On balance, although I acknowledge the distress and uncertainty this process caused Mr X and Mr Z, I find no fault with the Council making necessary enquiries following a safeguarding referral.
37. Mr X contacted the Council multiple times regarding his request for a financial assessment. The Council told him its finance team would contact him. It did not do so. This caused Mr X avoidable and unnecessary uncertainty and frustration.

Complaint handling (part e of the complaint)

38. The Council took four months to respond to Mr X’s complaint. It did not explain to Mr X it would take longer to respond to the complaint. This is outside of the Council’s complaints procedure, which is fault. This fault caused Mr X additional avoidable and unnecessary distress and frustration.
39. The Council’s final complaint response was written by the officer who decided not to review Mr Y’s care plan. Therefore, the Council did not investigate Mr X’s complaint impartially. This is fault. This fault caused Mr X additional frustration.

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Action

40. Within four weeks of our final decision, the Council has agreed to:
1. Complete a backdated financial assessment to calculate the amount Mr Y should have contributed towards his residential care and make a payment to his estate with any owed contributions.
2. Provide a written apology to Mr X and Mr Z for the avoidable and unnecessary uncertainty and frustration it caused by not completing the agreed review of the Mr Y’s care needs, not completing a financial assessment when requested, and its poor communication and complaints handling.
41. 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.
42. The Council should provide us with evidence it has complied with the above actions.

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Decision

43. 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