Summary: Miss Z on behalf of her mother, Mrs X, complained the Council failed to provide information about the cost of a care home, delayed in completing the financial assessment and sending an invoice and then wrongly assessed Ms X’s savings. There is no fault in the Council’s calculations but it did delay completing this. The apology already provided by the Council is a suitable remedy.

The complaint

1. Miss Z, on behalf of her mother Mrs X, complains the Council failed to provide information about the cost of a care home, delayed in completing the financial assessment and sending an invoice and then wrongly assessed Ms X’s savings.
2. Miss Z says this caused distress to herself and her mother and significantly impacted their finances.

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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 Miss Z and the Council as well as relevant law, policy and guidance.
6. Miss Z 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

Charging for temporary residential care

7. A temporary resident is someone admitted to a care or nursing home where the agreed plan is for it to last for a limited period, such as respite care, or there is doubt a permanent admission is required. The person’s stay should be unlikely to exceed 52 weeks, or in exceptional circumstances, unlikely to substantially exceed 52 weeks. A decision to treat a person as a temporary resident must be agreed with the person and/or their representative and written into their care plan.
8. A council can choose whether to charge a person where it is arranging to meet their needs. In the case of a short-term resident in a care home, the council has discretion to assess and charge as if the person were having their needs met other than by providing accommodation in a care home. Once a council has decided to charge a person, and it has been agreed they are a temporary resident, it must complete the financial assessment in line with the Care and Support (Charging and Assessment of Resources) Regulations 2014 and the Care and Support Statutory Guidance.

Charging for permanent residential care

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. This section sets out the key events in this case and is not intended to be a detailed chronology.
13. Mrs X was assessed as needing a nursing home placement in January 2024. This move was arranged to ease the pressure on hospital beds and was intended to be an interim placement. Mrs X moved to the care home at the beginning of February.
14. An interim financial assessment was notified to Mrs X on 14 February which indicated a provisional weekly contribution of £172.50. The letter set out the weekly cost of the care home and clearly stated this could change once a full financial assessment had been completed. Miss X says this was the first time she was aware of the full cost of the placement. Mrs X began making the interim payments as requested.
15. In March, Miss Z was in correspondence with the Council about the money in an account held jointly between her and Mrs X. The Council asked specifically about a transaction out of the account of £30,000. Miss Z explained to the Council this account had been operating for many years and the money was in fact her savings. The Council asked Miss Z if she was able to provide evidence to show this money was hers such as evidence of her paying money into the account. It acknowledged this could be difficult where there were informal family arrangements but that it would need to see evidence to determine ownership of the funds.
16. Miss Z did forward some evidence of payments from her personal account to the joint account amounting to £2664. She explained that she had no evidence of specific cash withdrawals and was finding this very stressful at a time when her mother was in a vulnerable situation. Miss Z said she did not agree with the total of £2664 explaining this was a quick sample to evidence money into the account. She explained this arrangement had been in place for over 25 years and so she was unable to provide evidence for the whole of that period.
17. In April, Miss Z asked the Council about the financial assessment and the move to a different care home closer to her home. The Council apologised for the slow pace in finding a closer care home acknowledging the current placement had been made as a short term placement to facilitate hospital discharge. It said there was no further update regarding a move.
18. On 23 May Miss Z contacted the Council saying Mrs X had died on 10 May. Miss Z asked the Council to indicate how much was owed to the care home. Miss Z received no response and so emailed the Council again on 11 June asking it to respond and explain what was owed.
19. On 13 June the Council emailed Miss Z apologising for the delay in bringing the account up to date saying it had a high volume of cases. It also provided a completed financial assessment. It said that because Mrs X had capital in excess of the funding threshold of £23,250, it had assessed that she was liable to pay the full cost of her care rather than the provisional assessment of £172.80. The letter set out the weekly costs, this had increased from 1 April, and the amounts already paid. However, it did not include any reference to amounts paid as FNC directly to the care home.
20. In response to a formal complaint by Miss Z, the Council accepted that it could have acted quicker than it did regarding the financial assessment. However, it said the assessed contribution was correct based on the evidence provided. It explained why it had treated all of the income as Mrs X’s income and that it had given Miss Z an opportunity to provide evidence to show it was in fact her money. It said that it would not be offering any reduction.

Analysis

21. This complaint concerns the financial assessment and the amount charged for a period of residential care provided to Miss Z’s mother. In particular it is about the amount of capital the Council considers was held by Mrs X.
22. In response to my enquiries the Council has explained how it reached the decision that the money in the joint account, including the £30,000 withdrawn by Miss Z in December 2023, should be treated as Mrs X’s capital. It says the normal rule is that both account holders have an absolute right to the funds and then it would include 50% of the balance. However, in circumstances where only one person appears to have deposited money into an account in joint names, there is a legal principle that states the other account holder does not hold the beneficial interest. It says this is known as a resulting trust.
23. The Council says the onus is on the joint account holder to evidence that either they paid money into the joint account or that it was intended to be a gift to the other party. It says it is legally obliged to include all of the funds in the account in the financial assessment until satisfactory evidence is received.
24. The Council has taken a position regarding the capital and explained it to Miss Z. It offered her the opportunity to provide further evidence and explained what would be required. While I understand Miss Z disagrees with the assessment, I cannot say there is fault in the process leading to the Council’s decision and so I cannot criticise the decision reached.
25. However, even if the Council had only included 50% of the capital in the joint account in the financial assessment, this would still have put Mrs X over the savings threshold and she would have been liable for the full cost of her care until the level of her savings fell below the threshold. The Council has provided a hypothetical calculation that shows Mrs X would still have been liable for the full cost of the care she received between 3 February and 9 May 2024.
26. In response to her complaints, the Council accepted some fault in respect of delay and providing the invoice to Mrs X’s estate. It has apologised for this which I consider is an appropriate remedy for the injustice caused and so will not recommend any further action.

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Decision

27. I am not persuaded there is a fault causing an injustice significant enough to warrant further action.

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Investigator's decision on behalf of the Ombudsman