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Ombudsman criticises council after telling family of woman with dementia to change care home when her money ran out

Brighton and Hove City Council told a woman's family she would have to move to a cheaper care home when her money ran out, without assessing whether moving would harm her, the Local Government and Social Care Ombudsman has found.

In response to the report, the council said it would pay the complainant's care home fees in full between January and May 2018, at a weekly cost of £1,365 minus her assessed client contribution.

The woman had been paying for her care at a residential home near to her daughter. When her money neared the £23,250 threshold at which the council would have to step in to help fund her care, the council told the family she might have to move to a cheaper home, because it could not pay the costs of the home she was in.

Brighton and Hove provided details of other homes that would accept the woman within the personal budget the council had set, and where she would not have to pay a 'top-up' for her care. However, the woman's daughter said none were suitable and were too far from where she lived.

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The woman's GP told the council a move would be detrimental to the woman's mental and physical wellbeing. However, the council did not consider the risk of moving the woman, investigate why the daughter thought the homes would be unsuitable or explain this properly to the daughter, the LGO said.

The daughter engaged a solicitor and told the council her mother's care needs had increased. Upon reassessment, the council increased the woman's personal budget. At the same time, the care home agreed to drop its costs, and the family agreed to pay the difference, which enabled the woman to remain in the home.

Upon investigation, the Ombudsman found the council did not leave enough time to complete the process of moving the woman once her daughter alerted it to her dwindling funds. Had the daughter agreed to a move, there would have still been a delay between the woman's funds falling below the threshold and her leaving the more expensive home. This would have meant the woman would have had to continue to pay £1,300 for her placement for a number of weeks, instead of her assessed weekly contribution of just £180.

Michael King, Local Government and Social Care Ombudsman, said: "Funding arrangements for care can be incredibly complex, so it is vitally important councils keep communication channels open with families – particularly during stressful times when finances are running low.

"While the council in this case followed good practice by alerting the family early on to the possibility of having to move, it did not do enough to establish whether such a move might have a serious consequences for the woman – something both her daughter and medical professionals warned it about.

"I welcome the council's ready agreement to my recommendations and hope this means other families are not left in the same distressing circumstances when a relative's funds run low."

The council has apologised and will pay the woman's care home fee in full from 1 January to 1 May 2018. The authority also agreed to pay her £200.

Brighton and Hove said it would also reimburse the daughter's solicitor costs amounting to £804.

As a result of the Ombudsman's investigation, the council has agreed to share the lessons learned with all staff in its adult social care and finance teams.

New staff guidance is in the works as well to ensure that when the authority needs to consider moving a vulnerable resident to a more affordable home, it carries out the necessary checks and consults with the family where necessary, and in a timely manner.

Councillor Sue Shanks, Chair of the council's Health & Wellbeing Board, said the local authority was committed to learning from mistakes made.

In a statement, she said: "The council fell below expected standards in this particular case and welcomes the report and has acted upon the findings. Arrangements for paying for care and support can be difficult to understand and we try to make sure people have access to the information and advice they need to make decisions about their care arrangements. I'm pleased that the Ombudsman has recognised our good practice in this area.

"I look forward to a report coming to the Health & Wellbeing Board in January which will provide further assurance on the actions taken in support of the recommendations and improve future practice."

Adam Carey

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