Summary: There was no fault on the part of the Council in the charges it applied for the late Mr B’s care. There is no evidence Mr B or his relative Mr X were told by the Council the care would be free of charge.

The complaint

1. Mr X (the complainant) says the Council told him and Mr B that the first four week of Mr B’s care in a care home would be free of charge. He says the Council later told him that it would charge for the short period of time Mr B spent in the care home before he died.

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The Ombudsman’s role and powers

2. 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)
3. 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

4. I considered evidence provided by Mr B and the Council as well as relevant law, policy and guidance.
5. Mr B and the Council had an opportunity to comment on my draft decision. I considered comments before making a final decision.

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What I found

Relevant law and guidance

6. 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 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.
7. 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.
8. NHS CHC is a package of ongoing care arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need’ as set out in the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care. Such care is provided to people aged 18 years or over, to meet needs arising from disability, accident or illness.

What happened

9. Mr B was admitted to hospital in early 2025 following a second stroke within the space of a year.
10. A social work practitioner assessed Mr B’s eligible care needs on the hospital ward on 21 February. She assessed that he required residential care. She noted that he had full capacity to make decisions about his own finances and recorded that he “asked what if he chose not to discuss, We advised him that is his right, however he would have to pay full cost of care. (Mr B) thought we would ask his children for money we reassured him we will not do that.”
11. A checklist for Continuing Health Care (CHC) Funding was also completed while Mr B was on the ward but he was not considered to be eligible.
12. Mr X says he returned from holiday to discover Mr B had been moved to another hospital and phoned the practitioner to ask why the family had not been told. She was also unaware and told Mr X the hospital should have notified both him and the Council as she had to liaise with the care homes planning an assessment.
13. Following an assessment by a care home which could accept Mr B, the social work practitioner telephoned Mr X on 11 March to notify him. She noted, “Confirmed with (Mr X) funding has been agreed for a temp placement and the financial assessment will take place to determine any financial contribution and any monies owing will be from the date of the SANA [strengths and needs assessment]”. Mr X says the social worker told him Mr B would be moved to a care home for 4 weeks respite care which would be fully funded.
14. The Council’s records show the social work practitioner spoke to Mr X again on 26 March. Mr X said he had received the costing for (Mr B)'s care and he “understood that his Dad should have 4 weeks free, I advised (Mr X) that it’s from the SANA that people are charged, and we fund until the financial assessment is completed and contributions will then be backdated.” Mr X said Mr B was now on end-of-life care.

The complaint

15. Following Mr B’s death on 29 March, Mr X spoke to the practitioner again. He said he was very unhappy with the communication. He said the hospital and the care home had both said Mr B would receive 4 weeks’ free respite care and the home understood he was discharged there on to end of life care. The social work practitioner recorded she told him Mr B was assessed as having residential care needs. He was discharged to this home as a temporary placement because he had not decided to commit to a home at that point. She said he had no nursing needs at the time of the assessment, or he would have been discharged to a nursing placement. Mr X reiterated that ‘everyone’ had told him the first four weeks’ care would be free of charge. The social work practitioner recorded that when she asked him who he meant by ‘everyone’, he said the doctor, the ward and the care home.
16. The care home confirmed to the practitioner that Mr X did not have nursing needs while in their care and said they would not have accepted him if he had.
17. Mr X said he wanted to appeal against the charges for care.
18. The Council’s files have records of Mr X’s conversation with a manager about his concerns. He was reminded that the social work practtioner had told him on 26 March that the financial assessment was determined from the time of the needs assessment. He said he had understood this was in relation to the four weeks’ free care. He said he wanted the complaint to be dealt with formally as he had been told by so many people the care would be free.
19. The Council responded to Mr X’s complaint in July. The head of service apologized for the delay. She also apologised that the start date of the care period was shown incorrectly on the care plan. She said the records showed the social work practitioner had spoken to Mr X twice in March to explain and clarify that a financial assessment would determine any contribution, which would apply from the date of the needs assessment. She said, “We apologise if any incorrect or conflicting information was given by any other professionals involved in the discharge process. However, our records indicate that the Social Worker involved provided accurate information of the charging processes within Adult Social Care.” She did not uphold the complaint.
20. Mr X complained to the Ombudsman. He said the matter had caused considerable distress and he had been unable to finalize the estate as there was an outstanding invoice for two weeks’ care. He wanted the Council to cancel the invoice and ensure future information was correct.
21. The Council says it does produce an information leaflet in connection with paying for care but has no record this was given to Mr B or his family at the time.

Analysis

22. There is no evidence the social work practitioner told Mr X that Mr B would receive free care. She told him the Council would fund the care pending the financial assessment which would be backdated to the date of the needs assessment. That was not fault.
23. It was not fault on the part of the Council if other people involved in the process, but outside the Council, told Mr X the care would be free. It was not their responsibility to do so. The Council is the body responsible for carrying out the needs and the financial assessment.
24. There is no reason to waive the care home charges which were legitimately raised by the Council. Mr B was not eligible for free care.

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Investigator's decision on behalf of the Ombudsman