Date of decision: 13 May 2025
Summary
The Council failed to provide clear advice about adult social care charges when assessing a person’s needs whilst still at home, when he was known to be above threshold – and his overall financial situation, after he entered a care home. The family only learned much later that he could have been entitled to Council support with care costs, resulting in significant financial loss and distress, even after backdating to the date when financial assessment was sought.
What happened
In May 2021, the Council assessed Mr Y’s care needs, noting he had significant needs and that his family was providing care, with his daughter-in-law, Mrs X, being his main carer in the younger couple’s own home.
It was known that Mr and Mrs Y had a property to sell.
The Council discussed day centre options and said a financial assessment would be needed for Council-arranged services, but the family chose to arrange care privately at that point. The Council said it would send information by post.
After Mr Y moved to a care home in July 2022, Mrs X had contacted the Council but was not advised about capital limits or support for care costs. The Council had no record of this contact but accepted that it was made.
In September 2023, after being advised to do so by Mr Y’s care home because his capital was depleting, Mrs X asked for a financial assessment. In October 2023, Mrs X spoke to a manager who said that if Mr Y had overpaid, they would receive a refund from the care provider.
After completing a financial assessment, Mrs X was advised of the outcome in November 2023. At this point, Mr Y’s capital had fallen to around £11,000. He was still chargeable, based on income, but to a lesser extent – the question was for how long, retrospectively, should he have been subsidised through the Care Act charging system?
The Council said it would support Mr Y with his care home fees from September 2023, when the request for a financial assessment was made.
The Council asked the care home to refund any overpayment from 29 September to the date of its funding decision. The Council later confirmed it could not back-date the funding further because it had had no notice of Mr Y’s change of circumstances until September 2023.
What was found
The Ombudsman thought it was probable that the Council had failed to keep proper records of advice given about charging for adult social care in May 2021, could not demonstrate it provided written information to the family, and that it had potentially misled Mrs X about refunds in October 2023. These failings caused uncertainty and frustration, but the Investigator said it was impossible to conclude whether the outcome would have been different, due to poor record-keeping and the time elapsed. [The investigation was being done despite lateness, given that Mrs X had extensive caring responsibilities.]
The Council agreed to apologise, make a symbolic payment of £250 to Mrs X for the uncertainty and distress, and remind staff to provide and record clear written advice about adult social care charging. This would be with a view to enabling families to make an informed choice about care and support, to ensure the advice given is properly recorded and to provide written advice about charging for adult social care.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
We think that this is an example of a Council making a considerable effort to persuade people that having the Council meet one’s needs is not necessarily the best thing to do, if one has considerable savings, because there’s a trade-off between choice and control and all councils have to maximise use of people’s assets and strengths (this does not mean their financial assets!).
This can of course deter some people from having a proper Care Act assessment, if it doesn’t seem important, and it’s a moot point whether or not that is the intention.
It is important councils give sufficient information about paying for care at an early stage to enable informed decision making. Where the council is not able to complete a prompt financial assessment it should still give appropriate written general information about the likelihood of needing to make a contribution towards care costs.
Individuals with capital in excess of the upper capital threshold of £23,250 must pay the full costs of their residential care home fees. However, if the capital is below this sum or has reduced to less than the upper capital limit, the individual will only pay an assessed contribution towards their fees.
At £14,250 of savings, the lower threshold, not mentioned by the investigator, an individual does not pay from capital at all, so the fact that this man’s assets went down to £11,000 should have been avoidable. We can’t understand why the investigator felt unable to say what would have been different had the information been provided much earlier on, because he would have had his care needs contracted for much earlier, at a likely lower rate, once the Council was the commissioner.
Mrs X said Mr Y has paid significantly more towards his care than he should have done, by paying the private rate, and she wanted a refund of at least £15,500, but the report does not say how that calculation had been arrived at, unfortunately.
Please use the following link to read the original Local Government and Social Care Ombudsman’s Durham County Council (24 017 370) report.
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