Summary: There was fault by the Council in its financial assessment process and a delay in responding to the complaint. This caused Ms X avoidable confusion and time and trouble. The Council has already apologised and refunded an invoice Ms X had already paid. This Council will issue a further written apology, make a symbolic payment and deliver training for staff in the adult social care team on the charging rules and guidance.

The complaint

1. Ms X complained the Council:
1. Gave conflicting advice and issued an invoice for a period of care she had already paid the care home for directly
2. Issued a duplicate invoice for top-up fees
3. Sent threatening letters after her father had died in January 2025 with no condolences.
2. Ms X said this caused avoidable distress and she had spent countless hours trying to navigate confusing and incorrect information. She said she had felt overwhelmed at times.

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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 Ms X and the Council as well as relevant law, policy and guidance.
6. Ms 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

7. Discharge to Assess (D2A) placements are short-term care home placements which are free of charge, usually for around four to six weeks. They allow councils to carry out social care assessments to decide on longer-term care arrangements for an adult with eligible social care and support needs.
8. Most adult social care is chargeable, apart from reablement care or D2A placements which are free for up to six weeks. Councils have the legal power to charge for care otherwise. If they do so, they must carry out a financial assessment to determine how much the person should pay (called the ‘client contribution’). For residential care, people pay most of their income towards the charge. They must be left with a personal expenses allowance which is about £25.
9. Councils must be transparent so people know what they will be charged for their care. There should be enough information available so they can understand any charge. (Care and Support Statutory Guidance, paragraphs 8.2 and 8.3)
10. Councils should provide or signpost to advice and information when people come into contact with them. They should provide information to help people understand what they may have to pay, including an explanation of the charging framework (Care and Support Statutory Guidance, paragraph 3.43)
11. Local areas (councils and the NHS) should ensure clear information is available for people who may need to self-fund ongoing care so they can make informed choices about any ongoing care needs that do not fall within publicly funded care. (Hospital discharge and community support guidance)
12. The financial limit, called the upper capital limit sets out what point a person can access local authority funding for care. The upper limit is £23,250. If a person has savings (capital) over the upper capital limit, a council may charge them the full cost of their care. When their capital falls below the upper limit, they are entitled to seek means-tested support from the authority. This means the council will do a financial assessment of the person’s assets and will charge based on these rules. (Care and Support Statutory Guidance Paragraphs 8.11 and 12)
13. A self-funder is a person who has capital (including property, savings and other assets) above the upper capital limit and who has arranged their care directly with a care home. The contract for the person’s care is between the person and the care home. The council has no involvement with commissioning the placement.
14. A full-cost payer also has savings above the upper capital limit. The difference between a full-cost payer and a self-funder is that in the former case, the contract for the person’s care is between the council and the care home. The council pays the fees to the care home and then the council invoices the person (or their representative).
15. When a council arranges a care home placement, it must follow regulations which say it must ensure:
• the person has a genuine choice of accommodation;
• at least one accommodation option is available and affordable within the person’s personal budget; and,
• there is more than one of those options.

(The Care and Support and Aftercare (Choice of Accommodation) Regulations 2014}

16. Councils must disregard the value of a person’s home for the first 12 weeks of a permanent admission into a care home. (Schedule 2, The Care and Support (Charging and Assessment of Resources) Regulations 2014). This is a called a ’12- week property disregard’ and allows the person to get council funding for a period while they sell their home.

What happened

17. Ms X’s father, Mr Y was in hospital and then went into a care home in the last week of December 2023. Ms X manages Mr Y’s finances as his attorney. He cannot do so himself because of dementia.
18. The Council told Ms X in an email in December 2023 that:
• Mr Y went into a care home as a D2A placement from hospital and that his care there was funded by the NHS (hospital) for four weeks. Usually, the social care assessment is done towards the end of the four weeks.
• Mr Y was above the threshold for local authority funded so he was either a self- funder or a full-cost payer if the Council commissioned the placement.

The Council also gave Ms X a list of dementia care homes in its area.

19. Internal emails between council officers indicate officers were treating Mr Y’s placement as self-funded. Then in February 2024, the finance team completed a financial assessment and decided he was a full-cost payer.
20. At the end of March, a council officer visited Ms X and Mr Y and noted Mr Y had been ‘self-funding’, he had a home to be sold and his savings were running low.
21. Ms X said in her complaint to the Council that she only received notification of Mr Y’s financial assessment in April.
22. In April, an officer spoke to Ms X who had called in response to an invoice she had received from the Council for Mr Y’s client contribution. She asked the officer why she was paying both the care home and the Council. The notes indicate the officer told Ms X to go back to the care home and ask for a refund for anything she had paid directly to the care home since the Council started funding Mr Y’s care on 22 December 2023.
23. A further note in May said that Mr Y had been self-funding his care and Ms X had made contact with the Council to say his savings were below the threshold. The Council told me Mr Y’s savings fell to the threshold on 6 May and Ms X informed it on 16 May. The Council also said Mr Y’s placement was made permanent on 16 May and it applied the 12-week property disregard between 16 May and 31 July.
24. In August, Ms X told the Council Mr Y’s property had been sold and so he was now over the threshold. She asked about the financial support he should have had during the 12-week property disregard period.
25. In September, the Council noted it had received bank statements from Ms X which confirmed Mr Y’s capital was at the threshold on 17 May until the funds from the house sale came into his account on 1 August.
26. In October, an officer and Ms X spoke. Ms X said she understood that apart from the 12-week disregard, Mr Y would be a self-funder. Ms X said she wanted a refund of the money owed from the care home.
27. Also in October, a note on the file said Mr Y’s care was not D2A, it was short-term care. The care home also contacted the Council about money it was owed for Mr Y’s placement.
28. At the end of October, officers met to discuss Mr Y’s funding. A manager noted:
• The Council would provide financial assistance by backdating long-term care funding for 3 months to include the 12-week property disregard period. It would pay its rate of £825 a week. Mr Y would pay a contribution based on his income. If the care home charged more than this, he would need to pay the difference (this is called a first-party top-up)
• It would also pay Mr Y’s care fees on a long-term basis and charge him as a full-cost payer. If the weekly cost was above £825, his family would need to pay a top-up. Or, the family could arrange and pay for his care privately as an alternative.
29. The Council issued a first-party top up agreement which Ms X signed in November 2024. It was for the 12-week property disregard period.

Ms X’s complaint to the Council and its response

30. Ms X complained to the Council in October 2024 about matters she has raised with us.
31. The Council said in its response in April 2025 that:
• It provided incorrect information about financing residential care for the period December 2023 to February 2024. She should not have been advised to fund care privately and pay the home directly because the Council was also funding Mr Y’s care and paying the care home. This meant the Council also raised an invoice for her to pay Mr Y’s client contribution. All invoices for this period have been cancelled
• She had paid an invoice for Mr X’s top-up fee. He was also required to pay his client contribution as well. This was £607.97 a week. This invoice was valid
• Delays in assessing Mr Y and providing inaccurate information caused unnecessary distress
32. The Council provided evidence it had refunded Ms X for the double payment she had made for Mr Y’s care between December 2023 and February 2024.

Findings

Gave conflicting advice and issued an invoice for a period of care she had already paid the care home for directly

33. The charging rules are complex, especially when a person has a property to sell which means they may move between periods of self-funding and council-funding. The information given to Ms X about charging was not in line with the guidance I have set out in paragraphs 9 to 11. This was fault which has caused Ms X avoidable confusion, distress and time and trouble. The Council:
• Took six months to respond to Ms X’s complaint
• Delayed completing financial assessment(s) and notifying Ms X of Mr Y’s client contribution
• Created internal confusion about whether the placement from hospital was D2A or not

• Did not decide clearly whether Mr Y was a self-funder or full-cost payer when D2A funding ended and told Ms X he was both at different times.
• Did not offer a choice of placement
• Told Ms X she should get a refund from the care home
• Delayed applying the 12-week property disregard.

Issued a duplicate invoice for top-up fees

34. This was fault. It caused avoidable confusion. The Council has apologised and refunded the double-paid period between December 2023 and February 2024. This is a partial remedy for the injustice.

Sent threatening letters

35. There is no fault in sending (correct) invoices for client contributions and in sending standard letters for unpaid invoices. I appreciate this is upsetting for a family member when their relative has just died, but this does not mean it is fault by the Council.

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Agreed Action

36. Within one month of my final decision, the Council will complete the following:
• Issue a further apology in writing. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended in my findings.
• Make a payment of £500 to Ms X to reflect the avoidable confusion, distress and time and trouble.
37. By the end of March 2026, the Council will devise and deliver a short training session including a written briefing for adult social care staff about the law and guidance on charging, using Ms X’s complaint as an anonymous case study.
38. The Council should provide us with evidence it has complied with the above actions.

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Decision

39. I find fault causing injustice. The Council has agreed actions to remedy the injustice.

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Investigator's decision on behalf of the Ombudsman