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East Sussex County Council (21 006 531)

Category : Adult care services > Residential care

Decision : Upheld

Decision date : 28 Mar 2022

The Ombudsman's final decision:

Summary: Mrs X complained the Council placed her in unsuitable care homes in 2017. She also complained it failed to support her in her payment dispute with a care home in 2021. We found the Council at fault for its failure to properly consider and support her with her payment dispute with the care home it placed her in. The Council has agreed to apologise to Mrs X. We have not considered Mrs X’s 2017 concerns. This part of her complaint was late.

The complaint

  1. The complainant, whom I shall refer to as Mrs X, complained about the Council’s handling of her care arrangement. She said it placed her in unsuitable care homes in late 2017 and failed to take action to move her to a suitable care home until summer 2019.
  2. Mrs X also says the Council failed to take any action when a care home (the Care Home) asked her for payments more than a year after she had moved out.
  3. As a result, Mrs X said she experienced distress and uncertainty.

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What I have investigated

  1. I have investigated Mrs X’s complaint about how the Council handled her concerns about the Care Home charges in 2021.
  2. The final paragraph of this decision explains why I have not considered Mrs X’s complaint about the Council’s handling of her care arrangements between 2017 to 2019.

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The Ombudsman’s role and powers

  1. 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)
  2. Part 3 and Part 3A of the Local Government Act 1974 give us our powers to investigate adult social care complaints. Part 3 is for complaints where local councils provide services themselves. It also applies where a council arranges or commissions care services from a provider, even if the council charges the person receiving the care. In these cases, we treat the provider’s actions as if they were council actions. Part 3A is for complaints about care bought directly from a care provider by the person who needs it or their representative, and includes care funded privately or with direct payments using a personal budget. (Part 3 and Part 3A Local Government Act 1974; section 25(6) & (7) of the Act)
  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

  1. As part of my investigation, I have:
    • considered Mrs X’s complaints and the Council’s responses;
    • considered the Care Home’s response to Mrs X’s complaint and its correspondence with her;
    • discussed the complaint with Mrs X and her advocate; and
    • considered the relevant law and Council Policy.
  2. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

Care arrangements

  1. The Care Act 2014 require councils to assess a person’s care needs and how identified needs should be met. If it is found a person needs residential care, councils have a duty to arrange for the care. A council may arrange residential care in private care homes, but it remains responsible for the care arrangement, and ensuring the persons needs are met.
  2. The Care and Support (Charging and Assessment of Resources Regulations 2014 requires councils to complete a financial assessment of a person’s circumstances when it is found a person has eligible care needs. This may mean the person cared for has to make payments towards their care.

Council Policy

  1. The Council’s ‘How to pay our invoices when we arrange your support’ and its leaflet ‘what you will need to pay towards your care and support’ explains how the Council arranges payments for care support which it has arranged. It says it will normally send invoices every four weeks and payments should be made to the Council.

What happened

  1. In 2017 Mrs X lived in her own home. She had some support needs and used a wheelchair.
  2. In late 2017, the Council assessed Mrs X social care needs. It found her needs were best met in a care home.
  3. The Council placed Mrs X temporarily in a care home, which she did not find suitable.
  4. Shortly after, the Council move Mrs X to another care home (the Care Home) where she stayed until summer 2019. It told her to pay her contribution towards her care directly to her Care Home.
  5. In 2018 Mrs X complained to the Council about its handling of her care. She said it had placed her in unsuitable care homes and it had not given her the opportunity to view the homes beforehand. She also raised concerns about her financial assessment and charges for the Care Home.
  6. In response the Council told Mrs X it had placed her in her first care home temporarily as it had not been possible to assess her needs fully beforehand. It then moved her to the Care Home where it assessed her needs. It did not find she had needs the Care Home could not provide. It also said it offered her viewings within the Care Home for more suitable accommodations, but Mrs X had declined the viewings due to her health.
  7. The Council also sent Mrs X a response regarding her concerns about its financial assessment and care charges. This set out how it had calculated the costs and her contribution.
  8. In summer 2019 Mrs X went into hospital. When she was ready to be discharged, she decided not to return to the Care Home, and moved to a new care home. She said she paid the final invoice she received to the Care Home.
  9. In Autumn 2020 the Care Home sent Mrs X a letter asking her for payments for some of the care charges she had incurred from 2018 to 2019 totalling almost £4,000.
  10. The Care Home continued to ask Mrs X for payment. Although, she disputed the payment to the Care Home with the help of her advocate, she made payments to reduce the debt, which included a payment from a charity.
  11. In 2021 Mrs X told the Council about her payment dispute with the Care Home. However, the Council told her, as it did not have an open complaint, it could not look into the matter any further.
  12. In early 2022, the Care Home and Mrs X agreed the remainder of her debt should be written off as full settlement of any claim or dispute she may have had about its service.

Analysis

  1. Since making her complaint to the Ombudsman, Mrs X has made and agreement with the Care Home for the remaining debt to be written off. I am therefore not considering the Care Home’s handling of Mrs X’s concerns or its charges.

The Council’s role

  1. The Council assessed and placed Mrs X in the Care Home in 2018. The Council’s Policy says Mrs X would normally pay her care home fees to the Council. However, in this case the Council told Mrs X she should pay directly to the Care Home.
  2. Mrs X paid the Care Home regularly when she received her invoices from it. It is therefore clear Mrs X was aware she had to pay the Care Home directly.
  3. However, when Mrs X told the Council in 2021 about her payment dispute with the Care Home, the Council said it could not look into the matter any further. This was fault. While Mrs X was responsible for the payments to the Care Home, the Council arranged for the placement. It therefore remained responsible for properly considering and supporting her with any care and payment issues that arose as a result of its placement.
  4. I cannot say if the Council’s involvement would have led to any different outcome in Mrs X’s dispute with the Care Home. However, I found the Council’s failure to provide advice or support to Mrs X caused her some limited distress.

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Agreed action

  1. To remedy the injustice the Council caused to Mrs X, the Council should, within one month of the final decision:
      1. apologise in writing to Mrs X to acknowledge the limited distress she experienced as a result of the Council’s failure to properly consider and support her with the payment dispute with the Care Home.
  2. Within three months of the final decision the Council should also:
      1.  
      2. remind its staff when the Council has assessed a person as eligible for support and it has arranged the provision of care, the Council remains responsible for care placements. This includes disputes about charges and payments for care provision delivered by third party care providers.

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Final decision

  1. There was fault leading to an injustice. The Council agreed to my recommendations, it is on this basis I have completed my investigation.

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Parts of the complaint that I did not investigate

  1. Mrs X complaint includes the Council’s handling of her care home arrangements between 2017 to 2019. This part of her complaint is more than 12 months ago and is therefore late.
  2. I have seen no good reason to exercise my discretion to consider this part of her complaint. This is because Mrs X and her advocate brought her complaints to the Council’s attention in 2018. If Mrs X remained unhappy, she should have brought her concerns to us at the time.

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Investigator's decision on behalf of the Ombudsman

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