Summary: Mr C complains that the Council failed to inform him that his relative, Ms B, would be required to contribute towards the cost of her nursing home fees and failed to respond to his complaint. The Ombudsman finds the Council was at fault in that it delayed in carrying out a financial assessment and failed to contact Mr C about Ms B’s contribution to the charges until after she died. This caused Mr C uncertainty and he was put to time and trouble in pursuing the matter. The Council has agreed to remedy this injustice by making a payment to Mr C.

The complaint

1. Mr C complains that the Council:
• failed to inform his sister-in-law, Ms B, or her family that she would be required to contribute towards the costs of her care; and
• failed to respond to his complaint, putting him to time and trouble.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I have considered all the information provided by Mr C, made enquiries of the Council and considered its comments and the documents it provided.
5. I have written to Mr C and the Council with my draft decision and considered their comments.

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What I found

Legal and administrative background

Charging for residential care

6. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs (Care Act 2014, section 14).
7. The charging rules for residential care are set out in the “Care and Support (Charging and Assessment of Resources) Regulations 2014” and the “Care and Support Statutory Guidance 2014”.
8. When a council arranges a care home placement, it must follow these rules when undertaking a financial assessment to decide how much a person has to pay towards the costs of their residential care. The rules state that people who have over the upper capital limit are expected to pay for the full cost of their residential care home fees. However, once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees. The Council must assess the means of people who have less than the upper capital limit, to decide how much they can contribute towards the cost of the care home fees. In doing so, it can take into account a person’s capital, savings and income subject to certain conditions (Care Act 2014; Department for Health Care and Support statutory guidance 2014).
9. Statutory guidance emphasises the importance of accurate financial advice so people can make well-informed choices about how they pay for their care.

Key facts

10. Ms B was receiving home care from 2011. Her brother-in-law, Mr C, completed a financial circumstances form on her behalf. He told the Council he was applying for Lasting Power of Attorney.
11. In January 2017 Ms B was in hospital and a discharge planning meeting was held to decide the most appropriate discharge destination for her. Hospital staff, the hospital social worker, Ms B’s sister, Mrs C, and Mr C were all present at the meeting. Everyone agreed Ms B should be discharged to a nursing home because of the high risk of harm and self-neglect if she was discharged home.
12. Mr and Mrs C visited several nursing homes and ultimately agreed Ms B should be placed in Home X. Ms B was discharged to the home in February 2017.
13. On 16 March 2017 the social worker recorded that the Council’s charging policy had been explained to the family and they were given a financial circumstances form to complete and return. The completed form was never returned.
14. The Council sent Mr C reminder notices in respect of outstanding invoices for Ms B’s contribution towards her home care charges for 2016 in January, February and March 2017. Mr B paid part of the amount due and the Council sent further reminders in September and October 2017.
15. On 6 November 2017 a finance officer carried out a search at the Office of the Public Guardian (OPG) to find out whether there was a registered Enduring Power of Attorney, Lasting Power of Attorney or court-appointed Deputy for Ms B. The OPG confirmed there was no record of any of these. So the officer sent Mr C a final reminder and a statement of account to prompt payment of the outstanding home care fees. A week later the officer met with Mr C to discuss the outstanding debt. Mr C provided copies of court documents regarding his application to become Ms B’s Deputy. He paid some of the arrears and agreed to pay the balance by 15 February 2018.
16. The Council still did not have documentation from Mr C confirming he had formal status to manage Ms B’s financial affairs or an up-to-date financial circumstances form. So the financial assessment officer contacted the Department for Work and Pensions (DWP) for details of what benefits and allowances Ms B was receiving at the time of her admission to Home X. He used this information to complete a financial assessment. The Council assessed Ms B as being required to pay £159.47 per week towards the cost of her care from February 2017 and £165.05 per week from April 2017 to December 2017.
17. On 12 December 2017 Mr C telephoned the finance officer explaining he had now been appointed Ms B’s Deputy. Ms B sadly died a few days later.
18. On 2 January 2018 the Council wrote to Mr C explaining the contribution Ms B was assessed to pay towards her residential care charges. The letter enclosed a financial breakdown showing how the contribution was calculated.
19. The Council sent an invoice to Mr C on 16 January 2018 for a total of £7152.40 in respect of Ms B’s contribution from February 2017 until December 2017.
20. Mr C contacted the Council stating he did not know Ms B would be required to contribute towards the cost of her care as Home X. He had a meeting with an officer who said the matter would be put on hold pending another meeting. This meeting did not take place until August 2018 because two arranged meetings had to be cancelled. Mr C says that, on the day of the meeting, the Council’s IT system was not working so the officer said he would look into the case when the IT systems were back online and would contact Mr C. This never happened.
21. Mr C submitted a formal complaint to the Council on 29 August 2018. The Council never responded despite him chasing a response.

Analysis

Charges

22. The guidance is clear that a council must make charging clear and transparent, provide financial information or refer the person to independent advice. The aim is that the person knows what they will be charged.
23. Mr C says the decision to place Ms B in a nursing home was made solely by the hospital without any consultation with the family. This is incorrect as Mr and Mrs C were both present at the best interests meeting at which all parties agreed Ms B should be discharged to a nursing home. Mr and Mrs C then visited several homes before deciding which they preferred.
24. Mr C says he was not informed that costs would be incurred when Ms B was placed in Home X. He also says that, for the entire duration of Ms B’s stay at the Home, he received no invoices, statements or other communications from the Council to advise him that monies were owed.
25. The Council says its case notes show the family was in communication with a hospital social worker and was aware of the Council’s charging policies.
26. I consider Mr C should have known Ms B would have to pay a contribution towards the costs of her care because she had been contributing towards her home care costs since 2011 and he had been dealing with these invoices on her behalf. In addition, the Council has provided evidence that the social worker told the family about its charging policy and gave them a financial circumstances form to complete in March 2017. The family failed to return the form. However, the Council was at fault in failing to chase this up and in failing to contact Mr C about the charges until after Ms B died nearly 10 months later.
27. The Council says the delay in carrying out a financial assessment was because it was waiting for Mr C to be appointed deputy for Ms B. It says he consistently stated he was applying for deputyship but was not appointed until December 2017 shortly before Ms B died.
28. I accept this contributed towards the delay. But the Council could have contacted the DWP for information and carried out a financial assessment sooner than it did. In the meantime, it should have given Mr C some indication of the costs that were accruing. It sent him reminders about Ms B’s outstanding domiciliary care charges but provided him with no information about the residential care costs which were accumulating during her stay in Home X.
29. Councils have a legal duty to charge people for residential care. There is no fault in the Council’s decision to seek to recover the amount owing in respect of Ms B’s contribution towards the cost of her care from her estate. This is a debt owed by the estate. Ms B was receiving benefits during her time in the nursing home. These form part of her estate and should be used towards the cost of her care.

Mr C’s complaint

30. Mr C submitted a formal complaint to the Council on 29 August 2018 but received no response. He telephoned the Council on 17 October 2018 chasing a response. Mr C chased the matter again on 17 April 2019.
31. The Council accepts no formal response was sent. This was fault.

Injustice

32. The Council’s delay in completing the financial assessment did not cause a significant injustice to Ms B. She received care and was required to pay for it.
33. The delay in completing the financial assessment and the Council’s failure to issue invoices/updates during Ms B’s stay in Home X caused Mr C uncertainty and he was put to time and trouble in trying to resolve the matter. The Council’s failure to respond to his complaint exacerbated the situation because Mr C could not finalise Ms B’s estate due to the uncertainty about the amount of care fees owing. Mr C was also put to time and trouble in attending meetings with the Council which failed to resolve the matter, chasing up a response to his complaint and, ultimately, complaining to the Ombudsman.

Agreed action

34. The Council has agreed that, within one month of the Ombudsman’s final decision, it will pay Mr C £1,000 in recognition of the uncertainty and time and trouble he was put to as a result of its failings.

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Final decision

35. I find the Council was at fault in that it: failed to chase up the completed financial circumstances form; delayed in completing a financial assessment; and failed to issue invoices/updates during Ms B’s stay in Home X. However, Mr C should have been aware that Ms B would need to pay a contribution towards the costs of her care.

36. I have completed my investigation on the basis that the Council has agreed to implement the recommended remedy.

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Investigator's decision on behalf of the Ombudsman