Date of decision: 06 March 2025
Summary
A care home, commissioned by the Council, wrongly charged a family for a relative’s respite stay, the full private client rate, causing significant financial strain and distress. The Home and the Council delayed refunding the overpayment and failed to ensure clear communication, resulting in avoidable uncertainty and frustration for the family.
What happened
In January 2024, Mrs Y enquired about respite care costs at Priors Hall care home and was directed as to how to seek council funding.
The Council subsequently agreed to fund a three-week respite placement for Mrs X at Mrs Y’s chosen care home, covering £742 per week with a family top-up of £58 per week. That was ALL the family was due to be paying: the top-up for a respite care home of their relative’s preference.
The total cost of the stay at the Council rate was £2400 at the council rate. £174 of that was the 3-week top up.
Upon admission in late March, the care home demanded the full private rate of £2,616 up front, promising a refund once the Council paid.
Despite receiving Council funding confirmation three days later, the care home delayed a partial refund for a month and failed to return multiple calls from Mrs Y.
By late July, the care home informed Mrs Y that any further refund would be paid to the Council, not her, and to date, she had not received the full amount owed.
What was found
The investigator pointed out that in the case of a short-term resident in a care home, the Council has discretion to assess and charge as if the person were having their needs met other than by providing accommodation in a care home [in other words, they do not have to follow the rules for capital and income for people in care homes, and can use a different approach or an ‘as if’ non-residential approach]. Respite is usually treated as temporary residential care and it is either provided free or charged for on the non-residential basis, meaning based on peoples’ assessable income only.
Once a council has decided to charge a person, and it has been agreed they are a temporary resident, it must complete the financial assessment in line with the Care and Support (Charging and Assessment of Resources) Regulations 2014 and the Care and Support Statutory Guidance.
The Ombudsman found the Council at fault for failing to ensure the care home refunded Mrs Y promptly and for poor communication. The care home’s actions, as a commissioned provider, were treated as actions of the Council. The delay in refunding and lack of response caused Mrs Y avoidable distress, uncertainty, and ongoing financial strain.
The Ombudsman ordered the Council to pay Mrs Y £752 [we think it should have been £758] to refund the money owed [she had got back £1684, from the £2616, and had always agreed to pay £174, so the difference should have been £758], £500 for distress and uncertainty, and £200 for the time and trouble spent resolving the complaint—a total of £1,452.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
The Care Act 2014 and the Care and Support (Charging and Assessment of Resources) Regulations 2014 set out clear duties for councils arranging care, including transparent financial assessment, clear communication, and timely handling of payments and refunds. Councils must ensure that any provider they commission acts lawfully and promptly, as their actions are legally attributable to the council itself.
Failure to refund promptly after a council’s funding decision, or to communicate clearly about financial arrangements, and charge a council client a private client fee, constitutes very poor practice, and a breach of statutory duty to provide that which had been planned for, on the part of the Council. Such failures are not remedied solely by apology; they require financial redress for distress and inconvenience caused.
Delays in remedying financial injustice, especially where the person is vulnerable or at risk of deprivation, may also engage human rights considerations (Article 8 ECHR) but this has been avoided by recourse to the Ombudsman, here.
Councils must ensure robust oversight of commissioned providers, with clear protocols for handling payments and complaints. Where families are left out of pocket due to council or provider error, prompt, full reimbursement and compensation for distress and time lost are essential. The sector should note that statutory breaches in care funding and communication are actionable and must be addressed without delay, regardless of resource pressures.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s North Northamptonshire Council (24 007 645) 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.
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