Decision Date: 16 July 2024
Summary
Mrs X complained on behalf of her husband, Mr X, that the Council delayed completing a financial assessment. The Council mistakenly allowed the financial assessment to drift, delaying the final outcome. It offered an affordable repayment plan for backdated charges in light of the confusion, uncertainty and backdated charges it had caused.
What happened
Mr X lived at home with his wife, Mrs X, while receiving care and support. In January 2023, Mrs X told the Council she was struggling with Mr X’s needs and that he needed to go into a care home. The Council sent her an email linking an online financial assessment for Mr X and other information about charging, completing the assessment and a care contribution estimator.
The Council completed a care and support assessment on 23 January 2023, concluding Mr X would receive short-term respite care and long-term respite care subject to his financial assessment.
Mrs X told the Council she completed the financial assessment on 30 January 2023, but the Council did not receive it for reasons unknown. When asked for a reference number, Mrs X said she did not receive one or any email confirmation of the assessment’s submission. The Council emailed her the link for the assessment and sent it by post.
In mid-July 2023, the Council asked Mrs X to complete the financial assessment, but she said she already completed it and had been advised Mr X’s care would be fully funded. She said she could not pay for his care. The Council did not receive the assessment by August 2023 and sent Mrs X another one, a care home funding booklet and its charging policy.
Mrs X acknowledged that she received the assessment and booklet but said she would not have agreed to Mr X’s placement if she had known that he had to pay for it. She also did not want a backdated bill.
The Council received the assessment in October 2023, reviewed it and set out the amount Mr X had to pay, which it had already been paying for to a level above the out of area Council’s (not Leicestershire CC’s own) banded rate for the cost of Mr X’s care and support. Mrs X complained.
What was found
The LGSCO accepted that there is no set timescale for the completion of a financial assessment, although the statutory guidance implies it should be done alongside a care needs assessment. The Council should have completed a financial assessment within a month of a care needs assessment, the LGSCO suggested.
Although Mrs X claimed the Council failed to inform her about Mr X financially contributing to his care at all, the evidence showed, as part of her own position that she had submitted a financial assessment to the Council, early on, that she could only have been aware that the assessment was being done to determine the contribution.
While the Council knew it had not received a completed financial assessment, it did nothing to address this between February and July 2023. This caused a delay in advising Mr and Mrs X of the contributions, which was fault. The Council’s communication with Mrs X did not confirm the amounts Mr X would be charged. She also did not realise the charges would be backdated, which would have been a shock to hear in September 2023.
There was no evidence to suggest that the Council told Mrs X that Mr X’s care since January 2023 would ever be fully funded. She was aware that the assessment may have been due, but the delay in the Council’s confirmation caused Mrs X an injustice, the LGSCO concluded, as she was made uncertain and frustrated about what the costs would be and given the shock of backdated charges.
The Council agreed to apologise to Mrs X, pay her £200, offer Mr X an affordable repayment plan, and remind staff to complete financial assessments in a timely manner.
Points to note for councils, professionals, people using services and their carers, advocacy groups andmembers of the public
It is quite odd to read an LGSCO report reciting that Mr and Mrs X had to pay charges, when the charges would have been for Mr X only, albeit Mrs X might have been administering them out of a joint account informally or through having a power of attorney: no clarification is given.
It is also difficult to tell whether the amount the Council was paying above the local out of area Council’s rate was a top up which the family had decided Mr X should pay for wants as opposed to needs.
The care and support statutory guidance is the most detailed source of the rules. The relevant parts of paragraph 3.19-3.20 of the guidance say—
3.19 Local authorities should ensure that information supplied is clear. Information and advice should only be judged as clear if it is understood and able to be acted upon by the individual receiving it. Local authorities will need to take steps to evaluate and ensure that information and advice is understood and able to be acted upon.
3.20 Information and advice provided within the service should be accurate, up-to-date and consistent with other sources of information and advice. Staff providing information and advice within a local authority and other frontline staff should be aware of accessibility issues and be appropriately trained.
The local authority service should include the following aspects of financial information and advice:
- understanding care charges
- ways to pay
- money management
- making informed financial decisions
- facilitating access to independent financial information and advice
Councils will not fail to comply with these paragraphs just because someone mistakenly thinks that that they would not have to contribute to care costs. This will only be the case where they were not given enough information to help them reasonably reach the conclusion that they might have to contribute financially. This may be, for example, by Councils supplying them with information about their charging policies and ways to estimate care contributions online. It is best for councils to have records of someone’s understanding they might have to contribute to care otherwise the LGSCO might be inclined to think the information was insufficiently clear, understandable, accurate, up-to-date and consistent.
The relevant parts of paragraphs 8.16 and 8.20 of the guidance say—
8.16 Where a local authority has decided to charge, . . . it must carry out a financial assessment of what the person can afford to pay and, once complete, it must give a written record of that assessment to the person. This could be provided alongside a person’s care and support plan or separately, including via online means. It should explain how the assessment has been carried out, what the charge will be and how often it will be made, and if there is any fluctuation in charges, the reason. The local authority should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.
8.20 In the financial assessment, the person’s capital is taken into account unless it is subject to one of the disregards set out in Schedule 2 to the regulations and described in Annex B.
The Council’s fault is more obvious when viewed considering the above paragraphs, as it took around five months to effectively respond to Mrs X’s delayed financial assessment and provide a breakdown of costs.
Given that the Council contacted Mrs X several times after not receiving the assessment, the report does not explicitly state what the Council should have done. If it was paying a top up for wants and not needs, and a top up over the out of area council’s rate, that is correct practice, because it must contract at the full admission rate and take the risk on the top up. Rather, the report focuses on the need for the Council to have been clear and transparent about charging. Yet the report seemingly found that the Council was clear and transparent just prior, when discussing whether the Council failed to inform Mrs X about a financial contribution. It could be argued that the Council was unable to give Mrs X a detailed breakdown of costs until she gave it the completed financial assessment, which took her months to complete in full. She could not produce a reference for the assessment when she claimed she completed it initially, nor could she show an email receipt. In contrast, the Council sent her multiple links to the assessment online and posted a copy to her. A more proportionate conclusion may have been that neither Mrs X nor the Council were proactive enough in attending to the financial assessment and breakdown of costs; the report seems quite harsh towards the Council without providing a substantive explanation about what it could have done, other than chase sooner!
We think that sooner or later the LGSCO will start saying that people should take some responsibility for informing themselves as to the cost implications from the Guidance, with a steer if needs be.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Leicestershire County Council (23 014 360) report.
If you are affected by the issues in this report, please consider asking a free, one-off question, anonymously, at a level of principle, here. Our experts’ response will give you an opinion which may then help you and the broader community when posted.
Did you enjoy this analysis? Want to stay informed with our weekly Alert Service?
Then do click here to find out how you can receive the latest insights from our experts and commentators and stay updated on key judicial decisions, ombudsmen’s reports, and critical law and policy changes, all for just £50 per YEAR and sent straight to your inbox or WhatsApp!