Cheshire East Council

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Centenarian nursing home resident forced to move because of funding mistakes, Ombudsman investigation finds

A number of errors by a council and a care provider led to a centenarian facing eviction from her nursing home because of unpaid fees, despite both her family and the council paying for her care, an investigation from The Local Government and Social Care Ombudsman has found.

Devon County Council and the nursing home, Swimbridge House Nursing, were both criticised by the Ombudsman following the investigation.

The investigation found the woman, who had dementia, had been living at the Swimbridge House Nursing home near Barnstaple and had been paying for her care privately. But when her funding ran low, the council stepped in to help pay for her care. At the same time, the woman's family had paid in advance for her care, and for more than a month the nursing home received double payments.

An assessment of the woman's needs found she required a 24-hour placement, and should remain at the home. The council started paying for the woman's care, but at a lower rate than the woman had been paying. The care provider was not happy with this reduction and wanted the council to agree a top-up.

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As this was happening, the family decided the nursing home was no longer affordable and subsequently asked the council to find a less expensive option. The council provided details of other homes which were affordable and had vacancies, but the council did not carry out a risk assessment of moving the woman to another home.

Because the council was not paying the home as much as the placement had cost the woman privately, the nursing home gave the family notice to quit claiming her account was in deficit.

The woman then moved to a new care home. It was six months later before a final invoice showed the woman's account had been in credit. A cheque was then sent to the family from the care provider in October 2019. Sadly, the woman died in the same month.

The Ombudsman's investigation found the council did not reach an agreement with the home on the amount paid for the woman's placement or consider paying more than it would normally to keep the placement because of the potential impact on her wellbeing of moving her.

The investigation also found fault with how the council failed to discuss a third-party top-up payment with the family and did not tell the family what they needed to do once the council took over responsibility for the care and payments.

The watchdog criticised the care home for continuing to enforce the private contract after it started accepting payments from the council and for serving a notice of eviction to the woman without trying to do more to resolve the payment issues.

Michael King, the Local Government and Social Care Ombudsman, said: "Because of the failings I have found by both the council and care home, a woman – who was more than 100 years old – had to find a new home without anyone assessing what impact this might have on her.

"This case is a stark reminder of what can go wrong when councils do not have robust policies in place for when people move from self-funded to council-funded care. Had the council focused on a person-centred approach, rather than look simply at its balance sheet, this woman may not have had to move.

"I am pleased both the council and care home have accepted my recommendations to improve their processes and procedures, and note the council has already developed an action plan to put things right."

In light of the findings, the council has agreed to complete a new financial assessment for the woman, taking into account she had paid in advance for the care home. If it finds her savings fell below the threshold and she was eligible for financial assistance, it should refund any money owing to her estate, the Ombudsman has recommended.

In addition, the council has agreed to review its procedures around the transition from self-funded to council-funded care to ensure similar problems do not happen again. It will also ensure all staff are aware of the requirements to carry out a risk assessment where there are funding issues and a service user may need to move to a new placement.

The care home has agreed to apologise to the woman's daughter and pay her £250 for the avoidable distress caused as a result of having to find her mother a new care home. The Ombudsman has recommended that it also review the terms and conditions in its contracts to cover the circumstances where a resident becomes eligible for council funding to prevent similar problems from recurring.

A spokesman for Devon County Council said: "Our sympathies are with the lady's family, to whom we have also offered an apology for our shortcomings. We always endeavour to work to our fullest in the best interest of the people who we help to support."

The spokesperson added: "In this case, sadly our best at the time was not good enough and we accept the judgement of the Local Government Ombudsman. We have already reviewed our practice and rigorous steps have been taken to ensure that this does not happen again."

Dr Joost van Delft of Swimbridge House Nursing Home said: "The report of the Ombudsman describes an accumulation of miscommunications by all involved parties, such:

  1. Unclarities in our contract about procedures when a resident can’t pay anymore for the care fees,
  2. Lack of communication by resident’s family about not being able anymore to pay for the care fees,
  3. Lack of communication by Devon County Council towards care home and residents’ family.

"After four months of still no clarity about who was going to pay what part of the care fees, an eviction notice was issued, which finally triggered a response. It is and has always been our firm believe that care fees should depend on the resident’s needs, and do not depend on whether fees are paid by local authorities or by the resident."

Adam Carey

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