Summary: Miss X complained the Council wrongly decided to consider the funds raised by her property sale in its financial assessment. Miss X also complained the Council provided her with poor quality care. She said this caused significantly impacted her health and caused her financial strain. We find no fault with the Council’s decision making regarding the financial assessment. We do find fault with the care provided by the Council which caused Miss X some injustice. The Council has agreed to take service improvement action to remedy the injustice caused.

The complaint

1. Miss X complains about the Council’s handling of her care. Specifically, she complains the Council:

1. wrongly decided to consider funds raised by her house sale in its financial assessment to calculate her care contributions; and
2. wrongly charged her for poor quality care.

2. Miss X says this significantly impacted her physical and mental health and caused her financial strain.

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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. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A), and 25 (7) as amended)
6. When considering complaints, we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
7. 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)
8. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
9. 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

10. Miss X brought her complaint to us in August 2025. She complains about matters which began in early 2022. As I explained above, we cannot investigate late complaints unless we decide there are good reasons. I have considered Miss X’s personal circumstances, and I consider there is good reason to exercise discretion and investigate matters from October 2022.
11. I will investigate both parts of Miss X’s complaint from October 2022.

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How I considered this complaint

12. I considered evidence provided by Miss X and the Council as well as relevant law, policy and guidance.
13. Miss 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

Financial assessment (part a of the complaint)

14. 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)
15. Statutory guidance says where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. The financial assessment needs to look across all the person’s assets which includes both the person’s capital assets, for example a property owned by a person they are not living in, and the person’s income.
16. In assessing what a person can afford to contribute a local authority must apply the upper and lower capital limits. The upper capital limit is currently set at £23,250 and the lower capital limit at £14,250. A person with assets above the upper capital limit will be deemed to be able to afford the full cost of their care.
17. Statutory guidance explains the term deprivation of assets means where a person has intentionally deprived or decreased their overall assets in order to reduce the amount they are charged towards their care. This means that they must have known that they needed care and support and have reduced their assets to reduce the contribution they are asked to make towards the cost of that care.
18. A local authority should consider the following before deciding whether deprivation for the purpose of avoiding care and support charges has occurred:
1. whether avoiding the care and support charge was a significant motivation in the timing of the disposal of the asset; at the point the capital was disposed of could the person have a reasonable expectation of the need for care and support?
2. did the person have a reasonable expectation of needing to contribute to the cost of their eligible care needs?

Care provision (part b of the complaint)

19. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. 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.
20. NHS Continuing Healthcare (CHC) is a package of ongoing care that is arranged and funded by the NHS where a person has been assessed as having 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. CHC funding can be provided in any setting.
21. A person’s local Integrated Care Board (ICB) is responsible for assessing their eligibility for CHC and providing the funding. ICB’s sometimes commission other NHS organisations to carry out the assessments on their behalf.
22. For most people who may be eligible for CHC, the first step in assessment is for a health or social care professional to complete a CHC checklist. If the completed CHC checklist indicates the person may be eligible for CHC, councils must notify the relevant ICB who will complete a full multidisciplinary assessment.

What happened

23. Miss X has care needs. She lived in a home she owned in another area.
24. Prior to October 2022, Miss X’s family member offered to build an annexe to meet her needs in their property. The annexe is in the Council’s area. Miss X listed her own property for sale. The Council received notice Miss X was moving to its area.
25. In October, the Council completed a home visit to Miss X prior to her moving to the annexe. It took details of the care package she was receiving. It issued a support plan for Miss X which detailed she required support from care workers to complete personal care tasks including toileting, washing, getting dressed and undressed. The Council did not consider whether Miss X may be eligible for CHC funding in its assessment.
26. Miss X moved to the annexe.
27. The Council commissioned Care Provider A and arranged the following care visits with two carers:
• Daily morning visits at 09:30 lasting 90 minutes
• Afternoon visits four days per week lasting 30 minutes
• Daily evening visits at 18:00 lasting 60 minutes
28. In December, the Council changed the timings of Miss X’s care visits to:
• Daily morning visits at 09:30 lasting 90 minutes
• Afternoon visits four days per week lasting 30 minutes
• Daily teatime visits at 17:00 lasting 30 minutes
• Daily evening visits at 21:00 lasting 30 minutes
29. In early February 2023, the Council contacted Miss X to discuss her financial assessment. Miss X told the Council she was planning to use the money raised from selling her home to pay back her family member for the costs they incurred building the annexe. Miss X told the Council she was not planning to be added to the deeds of her family member’s home. The Council said if she was not on the deeds as part owner of the home, the Council would consider she had deprived herself of the money and it would still consider the home she was selling as a capital asset and so include it as money she has in her financial assessment.
30. Miss X appealed the Council’s decision.
31. In late February, the Council wrote to Miss X and explained it could disregard the money Miss X made from selling her property from the financial assessment if she used the money to buy another home. It told Miss X it had decided not to disregard the money because she previously said she would not use the money raised from the sale of her property to purchase another home.
32. In March, Miss X told the Council she had decided to be named on the property ownership deeds for the annexe.
33. The Council told Miss X to send proof once she was named on the property ownership deeds. It said once it received this proof, it would complete another financial assessment and disregard the amount paid towards the annexe.
34. In May, Miss X asked the Council to consider whether she was eligible for CHC funding for her care. She told the Council she did not want Care Provider A because the care workers did not attend on time. The Council asked Miss X’s GP to complete the CHC funding checklist.
35. In June, the Council changed Miss X’s care providers to Care Provider B. The Council arranged the following care visits with two carers:
• Daily morning visits at 08:00 lasting 60 minutes
• Daily afternoon visits at 13:00 lasting 30 minutes
• Daily teatime visits at 17:00 lasting 30 minutes
• Daily evening visits at 21:00 lasting 30 minutes
36. After its start date, Care Provider B provided 30 minutes in the morning. Miss X contacted Care Provider B and complained. It arranged 60-minute visits to start two days later.
37. Miss X contacted the Council and asked for an update regarding her request for CHC funding consideration. The Council completed a home visit and completed the CHC assessment checklist. It assessed Miss X met the threshold for a CHC assessment and submitted this to the ICB.
38. In January 2024, Miss X made a formal complaint to the Council about the care she had received. She complained the care workers provided did not attend on time, spoke poor English and did not properly understand her care plan. She also complained about the Council’s decision to not disregard her property asset in her financial assessment.
39. In its complaint response, the Council explained it had completed an investigation of Miss X’s experience with the two care providers. It upheld her complaint about Care Provider A and Care Provider B not attending visits on time. It told Care Provider A it must attend visits on time and have a mechanism in place to inform clients if a care worker is delayed. It informed the Council it had a new system which alerted the office if a care worker is running late and office staff contact the client and reroute other care workers to complete visits where necessary. It told Miss X it would complete service improvement action with Care Provider B to address the timeliness and communication issues.
40. The Council also investigated Miss X’s complaint about the language barrier with care workers employed by Care Provider B. The Council confirmed all care workers employed by Care Provider B completed the language exam required by the government to work in the country.
41. The Council told Miss X it decided to consider the money Miss X made from the sale of her home in her financial assessment because she did not add herself to the deeds of her family member’s property and therefore did not sell her property to buy a new one.
42. To date, Miss X has not been added to the property ownership deeds.
43. Miss X now receives CHC funded care.

Analysis

Financial assessment (part a of the complaint)

44. I am satisfied the Council considered all relevant information in its decision to include the money Miss X raised from her property sale in its financial assessment. I am satisfied it made its decision in line with statutory guidance. I find no fault with the Council’s decision making and so I cannot criticise the outcome.

Care provision (part b of the complaint)

45. Miss X complains when she first moved to the Council’s area the time between her evening visit and morning visit was too long. The Council implemented the same personal care package she had in her previous council and so provided continuity of care. This was discussed and agreed with Miss X prior to the package starting. When Miss X raised her concerns, the Council amended the package of care and redistributed the care hours to add a later evening visit to shorten the length of time between evening and morning visits. I find no fault.
46. Although Care Provider A only attended one third of Miss X’s visits on time, I am satisfied the workers still completed the required personal care tasks during visits. Care Provider B also attended visits late and did not provide evidence it had communicated with Miss X. I consider the regular delays and poor communication by both care providers to be fault which caused Miss X avoidable uncertainty which is injustice.
47. There was also a short time at the beginning of Care Provider B’s tenure when Miss X received 30-minute visits rather than 60-minute visits. The Council did not charge Miss X for these visits. I consider that, on balance, Miss X did receive the care set out in her care plan.
48. I consider the Council treated Miss X’s concerns regarding a language barrier with due seriousness. The Council investigated and satisfied itself the care workers met the required language ability. I find no fault.
49. I consider it was reasonable for the Council to consider whether Miss X was eligible for CHC funding in her care and support assessment. I consider the Council should have completed the CHC funding checklist once Miss X requested it. Evidence shows there was uncertainty by the Council about its role in completing the CHC checklist which caused delay. I cannot say what the outcome of an assessment would have been if it had been completed without delay. I consider this delay caused some uncertainty to Miss X, which is injustice.
50. I am satisfied the Council took appropriate service improvement action to address the timeliness and communication issue with Care Provider A. The Council told Miss X it would address the poor timeliness and communication with Care Provider B to ensure it improved its service for clients. The Council has not yet provided evidence it has done so.
51. The service improvement actions will benefit its future clients; however, as Miss X had left both services by the time the Council took action, it does not remedy the injustice to her. I consider an apology to be appropriate and proportionate for the level of injustice in this case. Miss X tells me she does wish to seek an apology, and so I have not recommended a personal remedy in this case.

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Action

52. Within four weeks of the final decision statement, the Council will:
1. provide us with evidence of the action it has taken to address the identified timeliness and communication issues with Care Provider B.
2. tell us what action it will take to ensure its relevant officers have the necessary understanding of their role in identifying clients who may be eligible for CHC funding and their role in completing the CHC checklist.
53. The Council should provide us with evidence it has complied with the above actions.

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Decision

54. 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