North Yorkshire County Council stopped paying for an elderly woman’s care home after it decided she gave away money to avoid paying the fees, the Local Government and Social Care Ombudsman has found.
Following an investigation, the Ombudsman is now asking the council to reassess the woman’s finances and repay her any money she should have been entitled to had it made the correct decision about her status when it first assessed her.
The woman was 80 when she entered the care home after she was hospitalised with a stroke in 2007. She sold her home to pay for her care, but carried on making regular gifts to relatives, as she had done before she suffered the stroke.
The family paid the full cost of the woman’s care home placement from her assets until January 2015 when her capital fell below the financial threshold.
The council assessed the woman and said it was appropriate for her to stay in her care home, and agreed to pay the full care costs.
However, when it carried out a review of the woman’s finances, the council decided she had deliberately reduced her money - called ‘deprivation of assets’. It terminated the contract with the care home and stopped making payments.
The woman remains in the home and pays all her monthly income towards the fees, but this does not cover the full cost. The home has recently written to her as she owes £30,000. It has said it will take ‘further action’ if the debt is not paid.
Local Government Ombudsman, Michael King, said:
“While I appreciate councils need to make difficult, nuanced decisions about whether people have deliberately reduced their assets, the guidance does state people with care needs are free to spend their money as they see fit.
“Just because someone might be living in a care home, it does not mean they should not be able to spend their money on things other than their care, and this includes continuing to give gifts to friends and family.
“Given the woman’s prognosis when she entered the home, and after paying for her care for nine years, it is hard to see how the council concluded every penny she gave away was done with poor intentions.”
The Ombudsman’s investigation found the council did not complete a full financial assessment and instead decided all the money the woman had gifted had been capital.
The council did not provide any evidence to show how it considered the gifts were made with the intention of avoiding care charges. The woman paid the full amount of her care for nine years and more than 70 per cent of her money has been spent on care home fees.
The Local Government and Social Care Ombudsman’s role is to remedy injustice and share learning from investigations to improve local public, and adult social care, services.
In this case, the council should apologise to the woman’s daughter for its failure to complete a financial assessment and failure to evidence why it considered the gifted money was done with the intention of avoiding care charges. It should also pay the daughter £250 to recognise the distress caused.
It should also complete a financial assessment of the mother based on her circumstances in January 2015, including whether any deprivation of capital occurred and repay any money resulting from this reconsideration. It should also review the mother’s current financial situation and look at how her debt to the care home can be reduced or settled to avoid her placement being put at risk.
The Ombudsman has the power to make recommendations to improve a council’s processes for the wider public. In this case the council has agreed to now review its procedures and guidance for staff on how to deal with cases where deprivation of assets may have occurred.
Article date: 01 February 2018