Summary: The investigation into this complaint will be discontinued. The Council has now agreed to fund the full cost of Ms Y’s residential care placement.

The complaint

1. Ms X complains the Council refused to fund the full cost of her mother, Ms Y’s residential care placement, and failed to properly consider the risks of moving her to a different care home.

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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 the complaint and discussed it with Ms X;
• considered the correspondence between Ms X and the Council, including the Council’s response to the complaint, and its subsequent letter of 3 July 2020
• offered Ms X and the Council an opportunity to comment on a draft of this statement.

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What I found

Relevant legislation

5. The Care Act 2014 sets out the Council’s duty to assess the care needs and financial resources of the person needing care, and also allows the Council to charge for the cost of care.
6. The government issued the Care and Support Statutory Guidance 2014 which sets out how councils meet these duties. This says “The personal budget is defined as the cost to the Council of meeting the person’s needs which the Council chooses or is required to meet. However, the Council should take into consideration cases or circumstances where this ‘cost to the Council’ may need to be adjusted to ensure that needs are met.

What happened

7. Ms X complains on behalf of her mother Ms Y. Ms Y has advanced Alzheimer’s disease. She has lived in a residential care home since 2017 and funded her care privately.
8. In 2019, Ms Y’s funds were nearing the threshold for assistance with funding from the Council, so Ms X contacted the Council.
9. The Council assessed Ms Y’s care needs and concluded she met the eligibility criteria. I have seen a copy of the assessment. It records Ms Y to have advanced Alzheimer’s and that she lacked capacity to make decisions about her care and accommodation needs. Ms Y’s behaviour was reported to challenging and sometimes difficult to manage.
10. The cost of Ms Y’s placement at the home was more expensive, (£1050 per week) than the usual rate the Council would pay. It told Ms X it would fund £750 per week towards the placement, and the remining £300 would need to come from a third-party top-up. It said if the family were not agreeable to a top-up fee it would move Ms Y to a care home that charged the Council’s usual rates
11. Ms X says her mother is settled in the home and moving her to a different home would be detrimental to her health. She obtained evidence from the Community Mental Health Team involved with Ms Y. The team advised that moving Ms Y may lead to increased behavioural difficulties.
12. The Council sought advice from a Consultant Psychiatrist involved in Ms Y’s care. The Consultant said there may be a risk of Ms Y’s behaviour deteriorating if she was moved. The Council says the Consultant did not say the behaviour could not be managed elsewhere in a specialist facility.
13. The Council reiterated its position, that should a top-up fee not be available Ms Y would be moved to an affordable placement.
14. I have seen no evidence the Council completed a formal risk assessment to establish the risks of moving Ms Y to a different care home.
15. Ms X complained to the Council. The Council responded and initially held its position, that it would not fund the full cost of the placement. It later wrote to Ms X on 3 July 2020 agreeing to fund the full cost of the placement until a review of Ms Y’s care was held in January 2021.
16. As the Council has agreed to fund the full cost of the placement, no further investigation is required.

Final decision

17. The investigation into this complaint will be discontinued. The Council has now agreed to fund the full cost of Ms Y’s residential care placement.
18. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman