Woman left with unexpected £2,000 bill after council gave insufficient information on care costs

A woman was left with an unexpected £2,000 bill after a council failed to provide her attorneys with sufficient information about her care home costs, the Local Government and Social Care Ombudsman has found.

Devon council failed to provide Mrs Y’s attorneys for property and affairs, Mrs X and Mrs Z, with written information about her care costs before her move into a care home following a hospital admission

As a result, the attorneys were unaware they had to pay a contribution towards Mrs Y’s care, as well as a top-up fee, during her first 12 weeks in the home.

The ombudsman also found that a “lack of clarity” from the council in Mrs Y’s hospital discharge letter, which was sent to Mrs X after  Mrs Y was admitted to the home, had made it more difficult for the attorneys to fully understand what the required financial contribution would be.

In addition, the ombudsman found fault with the council for taking more than three months to complete Mrs Y’s financial assessment after she had moved into the care home.

More ombudsman reports:

• Service user’s wife caused ‘frustration, distress and anxiety’ after safeguarding referral left open for 15 months
• ‘Distress and confusion’ for service user whom council failed to properly inform of increased care charges

Liability for care charges

At the time of her admission to the care home, Mrs Y owned her home but otherwise had less than £14,250, the lower capital threshold, in assets. This meant that during the first 12 weeks of her stay in the home, during which her property was disregarded for the purposes of care charges, she was not liable to make any financial contribution from her capital. She would only have had to make a contribution to the costs of care from her income during that time.

Officer A, a social worker, met with Mrs X and Mrs Z to discuss Mrs Y’s move to residential care and advised that the care home they had chosen for Mrs Y was more expensive than the council would usually pay. The officer’s notes also advised that Mrs Y would need a financial assessment to ascertain how much she needed to contribute towards the cost of her stay.

Mrs X and Mrs Z said they did not want to look at other options and advised the council that they would pay a top-up fee to enable Mrs Y to move to the care home. There is no record to show the council provided any information in writing to the attorneys about paying for Mrs Y’s residential care.

Attorney’s claims

Mrs X claims that Officer A told her and Mrs Z that the council would pay £485 per week towards Mrs Y’s care home fees during the 12-week property disregard period, after which she would be liable for the full cost of care.

Mrs X said she contacted Devon council on two occasions, asking whether it would pay £485 per week in full, to which she said it agreed, though the council has no record of these calls.

The day after Mrs Y moved into the home, Officer A sent a discharge letter to Mrs X, saying the council had calculated a personal budget of £485 per week and Mrs Y needed a financial assessment to see how much she should contribute towards her funding.

The letter also said a top-up fee was needed to pay the difference between the funding provided of £485 and the fee at the care home, which was £975 per week. Mrs X signed the letter in agreement on Mrs Y’s behalf to the top up fee of £490 per week.

On the same day, Mrs X contacted the council for advice on funding residential care, to which it provided advice on deferred payment arrangements. But records do not show if the council advised Mrs Y needed to make a contribution to her fees during the 12-week period disregard period.

Devon council completed Mrs Y’s financial assessment three and a half months after she had moved into the care home, requiring that she pay a contribution of £178.75 in addition to the top up fee already being paid, during the 12-week disregard period, totalling £2145.

Mrs X made a complaint to the council saying it should not be charging a contribution for care as she thought the council had agreed to pay £485 per week in full towards Mrs Y’s care during the disregard period. But the council said its records did not show it had advised this, and so did not uphold the complaint.

Lack of sufficient information

The ombudsman found Devon council was entitled to require a financial contribution from Mrs Y during the 12-week disregard period, but  failed to provide Mrs X and Mrs Z with “sufficient information and advice” to “fully understand” this.

Specifically, it was at fault for not providing written information about the potential costs of residential care before Mrs Y moved into the care home. Though Officer A’s notes recorded that she had told Mrs X and Mrs Z that Mrs Y would need to make a financial contribution, the notes showed that the attorneys understood this to mean the top-up. Emphasising the importance of providing written information, the ombudsman added: “Charging for residential care is complex and people have to make decisions about care in a short time period. So they cannot be expected to understand or remember what they are told at meetings or by telephone at what is usually a stressful time.”

Though the discharge letter stated that Mrs Y would need to pay a contribution in addition to the top-up, it then referred to £485 per week being the funding that would be provided so it was understandable that Mrs X thought this was what the council would contribute, the ombudsman concluded.

It was also a fault that Devon council took three months to carry out the financial assessment for Mrs Y, having overlooked Mrs Y’s referral for that assessment. This meant Mrs X and Mrs Y were unaware of the true costs of Mrs Y’s care for longer than necessary.

Review of procedures recommended

Devon council agreed to send a written apology to Mrs X and Mrs Y for the distress caused to them by failing to provide sufficient information making them aware of the potential costs of residential care before Mrs Y was admitted.

It also agreed to make a total payment of £250 to acknowledge the distress caused by the council’s errors.

The ombudsman recommended that the council reviews its procedures to ensure service users and their families are provided with factsheets in charging to ensure they are “fully aware of the potential costs of residential care” when looking for a care home and before accepting a place.