Summary: We will not investigate this complaint about the Council’s financial assessment for residential care. This is because there is not enough evidence of fault in the Council’s decision-making. Any delay or lack of clarity did not cause significant enough injustice to justify an investigation.

The complaint

1. Mr X complains on behalf of his relative, Mrs Y.
2. Mr X says the Council first agreed to contribute to the cost of Mrs Y’s residential care. Following a financial assessment, the Council decided that Mrs Y must pay for her care costs in full. Mr X disagrees with the Council’s decision and says it has caused significant stress and hardship.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating,
• any injustice is not significant enough to justify our involvement, or
• we cannot achieve the outcome someone wants (Local Government Act 1974, section 24A(6), as amended, section 34(B)).

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How I considered this complaint

4. I considered information provided by Mr X and the Council.
5. I also considered the Ombudsman’s Assessment Code, and relevant law and policy.

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My assessment

6. In July 2024, Mrs Y moved into residential care. Mr X says the Council first agreed to contribute to the cost of her care, with the rest paid by Mrs Y and a top-up paid by Mr X and other relatives.
7. In October 2024, the Council completed Mrs Y’s financial assessment and decided Mrs Y was above the financial threshold and she needed to pay the full cost of her care. This is because the Council assessed the value of an asset Mrs Y gifted in 2019 as it considered this to be a deliberate deprivation of assets.
8. Mr X is unhappy the Council changed its position and is no longer contributing to Mrs Y’s care home fees. Mr X also disagrees with the Council’s asset deprivation decision.
9. The evidence I have seen shows:
• In early August 2024, Mr X received the Council’s resident agreement, which provided information about the financial assessment and an estimate of care costs. Clause 10 of the resident agreement states that: “should the outcome of a Financial Assessment indicate that the Resident’s savings and other assets are above a threshold of £23,250 at any time during the duration of this Agreement, then the Resident must pay the full cost of their accommodation and support.”
• Between August 2024 and October 2024, the Council asked Mr X for further information about Mrs Y’s assets, including information about the asset Mrs Y gifted in 2019.
• In late October 2024, the Council determined the asset Mrs Y gifted in 2019 was a deliberate deprivation of assets and treated the value as notional capital. This took Mrs Y’s capital above the £23,250 threshold. The Council then decided Mrs Y must pay the full cost of her care. The Council has apologised for not completing the financial assessment sooner.
10. I accept that Mr X, and other relatives of Mrs Y, have experienced confusion about the care fees payable. I also accept there was some delay in the Council completing the financial assessment.
11. I do not consider any fault by the Council has caused significant enough injustice warranting us investigating. This is because I am satisfied the resident agreement made clear that:
• any estimated costs might change following the financial assessment;
• the financial assessment was still ongoing; and
• if Mrs Y’s assets were above the threshold, she may need to pay the full costs of her care.
12. Mr X knew of the possibility of a change in fees soon after Mrs Y moved into the care home. Therefore any surprise or upset when this in fact happened is not significant enough to warrant us investigating. The Council’s apology for the delay in reaching the final position is enough remedy for any injustice caused.
13. I understand Mr X disagrees with the financial assessment’s conclusion that a deprivation of an asset had occurred.
14. The Ombudsman is not an appeal body. We cannot decide if the Council’s decision was right or wrong. We can only look at the Council’s process for making its decision.
15. The evidence I have seen shows the Council followed the correct steps in carrying out the financial assessment and that, in considering whether deprivation of an asset had occurred, it considered relevant information and evidence in line with the law and government guidance on charging. Therefore, I am satisfied the Council reached its decision properly. While Mr X may disagree with the decision, we cannot question it because it was reached properly.

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Final decision

16. We will not investigate this complaint. This is because the delayed financial assessment and the Council changing its position did not cause significant enough injustice to warrant us investigating. Further, I am satisfied the Council properly reached its decision in the financial assessment.

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Investigator's decision on behalf of the Ombudsman