Summary: Ms X complained on behalf of Mrs Y about the way the Council dealt with care charges for her mother, Mrs Z. The Council was at fault for delaying in offering a financial assessment, which caused uncertainty. The Council has agreed to apologise for this.

The complaint

1. Ms X, a legal advisor complains on behalf of Mrs Y, about the way the Council dealt with care charges for her mother, Mrs Z. She says the Council:
1. wrongly charged for care despite saying that Mrs Z’s liability for charges would only begin after her surgery;
2. failed to provide copies of previous financial assessments; and
3. wrongly advised about the status of Mrs Y’s co-owned properties.
2. Ms X says this caused Mrs Y significant distress and the Council treating Mrs Z as a permanent resident from an early stage and before it was appropriate meant the family lost the opportunity to consider moving her back home with a care package.

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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. 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.
5. 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.
6. 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

7. I considered evidence provided by Ms X and Mrs Y and the Council as well as relevant law, policy and guidance.
8. 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

Legislation and guidance

Providing information about charging

9. Section 4 of the Care Act 2014 says councils must maintain a service which provides information and advice about adult social care. The care and support statutory guidance (the Guidance) explains the information and advice should cover:
10. the charging arrangements for care and support;
11. how a person can plan for needing to pay for care in the future; and
12. how they can obtain independent financial advice.   
13. The Guidance says the information councils give should be sufficiently thorough, shared early on, meet the person’s requirements at the time and be accessible to them.

Income

14. In a financial assessment, capital generally covers buildings, land and savings including stocks and shares and money held in banks or in cash.
15. Someone with over £23,250 in capital will be classed as able to afford the full cost of their care. Any capital below the lower capital limit of £14,250 is disregarded and not considered in a financial assessment.
16. Those with an amount between these two figures will have to pay a ‘tariff income’ from their capital. If someone has less than £14,250 in capital, they do not contribute from their capital but still have to pay an assessed contribution from their income, such as their pension.

Intermediate Care and Reablement

17. Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently.
18. Regulations require intermediate care and reablement to be provided without charge for up to six weeks. Councils may charge where services are provided beyond the first six weeks but should consider continuing providing them without charge because of the preventive benefits. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)

Charging for permanent residential care

19. 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.
20. 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.
21. 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.

Charging for temporary residential care

22. 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. 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.
23. 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.

Top-up payment

24. If a person chooses to go into a home that costs more than the personal budget, and the council can show that it can meet the person’s needs in a less expensive home within the personal budget, it can still arrange a place at the home if:

• the person can find someone else (a ‘third party’) to pay the top-up; or
• the resident has entered a deferred payment scheme with the council and is willing to pay the top-up fee themself.

What happened?

25. Mrs X was admitted to hospital at the end of June 2024 and discharged a few days later. She was discharged to an assessment unit while she waited for surgery. At this time, the Council and Mrs Z’s family considered it unsafe for her to return home independently before her operation, and it would consider this again after the operation.
26. At the end of September, the Council contacted Mrs Y to see if Mrs Z had a date for her surgery. It explained that because of the delay in surgery, Mrs Z would need to move to a short-term residential home because she could not stay at the assessment unit long term.
27. A few days later, Mrs Y identified a potential short-term residential home for Mrs Z. Mrs Y and the Council also decided that Mrs Z should not return home after her surgery due to her high level of care and support needs.
28. The Council met with Mrs Y in early October. At this meeting, the Council noted that Mrs Z could not stay at the assessment until her surgery because it was a provision meant for very short stays.
29. Mrs Y says the Council told her, at this meeting, that a manager had given ‘special dispensation’ for Mrs Z to move to another short-term placement until she had her operation, post operative rehabilitation, then she would be assessed for returning home. She says that the Council told her that Mrs Z would only need to pay a top-up fee towards the cost of care until she was ready to return home.
30. The following day, the Council told Mrs Y that it would need to complete a financial assessment with Mrs Z to decide if/what she would need to contribute to her care. The Council also sent Mrs Y a copy of the financial assessment factsheet and agreement.
31. The same day a social worker told Mrs Y:

• If the financial assessment was completed after Mrs Z went to the short-term residential care home, any contribution she would need to make would be backdated to the date she was admitted.
• Mrs Z would only need to pay the third party top up until her operation, and then the post operation assessment would decide whether Mrs Z could go home. If she could not live independently, she would only have to start paying for her care when her house was sold.
• A third party top up fee is different to a contribution.
• Mrs Y could contact the finance department directly for further advice.

32. Mrs Y noted a valuation of Mrs Z’s house would take her assets over £23,000. She clarified if this meant Mrs Z would have to pay all the care costs if the placement became permanant. The social worker responded that this would only be the case if Mrs Z’s stay became permanent and not short term.
33. In mid-October, Mrs Z moved from the assessment unit to the identified short term residential home, where the Council recorded, she would stay until her surgery which would likely be in early 2025. A social worker told Mrs Y to contact the finance department for any questions she had about charging.
34. In early November, the Council contacted Mrs Y to complete a financial assessment. Mrs Y declined the financial assessment explaining she had been told that while Mrs Z remained in short term care, this would be funded by the Council, and they would only need to pay a third party top up.
35. A few days later, the Council contacted Mrs Y explaining it would charge full care fees if she was unwilling to complete a financial assessment. It completed an internal financial assessment form, leaving out the details of Mrs Z’s finances, noting only that she accepted full charge of care costs.
36. The Council told Mrs Y that assessment unit was funded, but the short stay residential home would require a financial assessment. It also noted that Mrs Z’s property would be disregarded, because it was just a short-term arrangement, but it would still need to complete a financial assessment to assess Mrs Z’s capital and income. Mrs Y again declined to complete the financial assessment.
37. Unhappy with the Council’s handling of Mrs Z’s charging, Mrs Y complained to the Council in early December. She complained the Council had told her that Mrs Z could go to a fully funded short term placement up until her operation, which would include post-surgery rehabilitation and then a reassessment. She also said the Council told the family she would only have to pay a third party top up.
38. Mrs Y also complained that a social worker asked to complete a home assessment in late August but did not complete this. This meant there were no options to make home adaptations for Mrs Z to return home, forcing her to stay in residential care, which the Council now wanted her to pay for.
39. The Council responded to Mrs Y’s complaint in mid-December. It did not uphold any of her complaints.
40. The Council noted in March 2025, that the family had not made any payments towards Mrs Z’s care. It sent an invoice for outstanding care charges to the family the following month.
41. Shortly after this, Ms X contacted the Council on behalf of Mrs X and Mrs Z disputing the care charged from October to present, on the basis of the information the Council gave them in October 2024 was that Mrs Z would not be liable for the costs of her stay until an assessment after surgery, apart from the third party top up.
42. Ms X also complained that the Council indicated in a letter in April 2025, that it had already completed a financial assessment, which was incorrect.
43. In mid-May, the Council and Mrs Y discussed a financial assessment.
44. Mrs Y told the Council Mrs Z had shared ownership of nine other properties. The Council explained it would treat these as second properties, meaning her total capital and assets would be above the limit of £23,250 and so Mrs Z would be liable for full care costs.
45. The Council responded to Ms X’s stage two complaint at the end of May. It did not uphold any of her complaints. It noted the claim that Mrs Z would not be liable for care costs until after her surgery was not supported by any documents. It explained it had now completed the financial assessment and Mrs Z was liable for care costs since 11 October 2024.
46. As of October 2025, Mrs Z had not had the planned surgery, as she had not been well enough.

Findings

The Council wrongly charged for care despite saying that Mrs Z’s liability for charges would only begin after her surgery

47. We expect a council to give sufficient information to a person about paying for care.
48. Here, the Council provided free reablement care for longer than the recommended six weeks, then in October 2024, both the Council and Mrs Y decided that Mrs Z needed further care and could not return home. The Council told Mrs Y at the time that it needed to complete a financial assessment to decide if/what Mrs Z needed to contribute towards her care. It also provided a financial assessment factsheet with comprehensive charging information.
49. I accept that when Mrs Y asked a social worker some specific questions about Mrs Z’s financial situation in early October 2024, their responses were confusing. But we do not expect social workers to provide definitive answers to questions about a resident's individual circumstances, especially where their financial affairs are not straightforward, as was the case here.  The social worker's primary focus is to ensure the wellbeing of resident’s wellbeing, often in times of crisis.  It is role of the financial assessor to determine what, if anything, they are liable to pay.
50. It is also not for me to reconsider Mrs Z’s finances and make any decisions on charges. However, I consider that, on the balance of probabilities, the Council did give Mrs Y sufficient information in telling her that it needed to complete a financial assessment and giving her a copy of the financial assessment factsheet. So, I find no fault in the Council’s sharing of financial information with Mrs Y.
51. I appreciate that Mrs Y was upset by the receipt of invoices for care after Mrs Z moved and that she considered Mrs Z should not pay for care until after her surgery. But, the care was delivered to Mrs Z, and the Council was entitled to charge her for it, and there was no fault in asking her to do so. Mrs Y had an opportunity to gain charging information specific to Mrs Z, but she decided not to engage with the financial assessment process.
52. However, I also acknowledge that despite the Council being aware that Mrs Z would likely need to contribute towards her care in October 2024, and arranging for her to move into short-term residential care at the same time, it took until November 2024 for the Council to ask Mrs Y to complete Mrs Z’s financial assessment. By this time, Mrs Z had already been receiving this care for over a month.
53. We expect a council to carry out a financial assessment before care services begin. The Council did not do this here, and this was fault.
54. This meant Mrs Z’s family did not know the specific cost of her care before she moved. But, the injustice caused to Mrs Z and the family is limited to uncertainty, because when the Council did offer the financial assessment, Mrs Y declined to complete it. I also note that Mrs Y sourced the short-term residential home herself, and noted twice in early October that it would not be possible for Mrs Z to return home and so it is unlikely the family would have chosen home care as an alternative had they known the cost of care.

The Council failed to provide copies of previous financial assessments

55. Ms X complained that the Council failed to provide copies of previous financial assessments. There is no evidence that the Council completed any financial assessments prior to that the one completed in November 2024, and so it could not have provided any copies. There was no fault in the actions of the Council related to this.

The Council wrongly advised about the status of Mrs Y’s co-owned properties

56. I understand that Mrs Y remains unhappy with advice the Council gave about several properties that Mrs Z co-owned.
57. It is not for me to complete a retrospective financial assessment now, based on Mrs Z’s financial situation and decide whether the Council should have disregarded certain parts of Mrs Z's finances.
58. Any advice that the Council gave, outside of the financial assessment process, would have been hypothetical. This is because, to decide on a person’s charging, a council would need to complete a full financial assessment which is a complex and specialist process.
59. The Council asked to complete a financial assessment to consider Mrs Z’s finances twice in November 2024, but Mrs Y declined to complete this. For this reason, the Council could not provide definitive advice about Mrs Z’s financial situation and any property disregards and so there was no fault in the actions of the Council. Y had already been receiving

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Action

60. Within four weeks of our final decision, the Council will:
• apologise to Mrs Y and Mrs Z for delaying in offering a financial assessment. 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 its apology.
61. The Council should provide us with evidence it has complied with the above actions.

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Investigator's decision on behalf of the Ombudsman