Ombudsman finds issues with care calculations made by council

The Local Government and Social Care Ombudsman has told North Yorkshire Council to re-calculate how much a woman should pay for her care after finding faults with a predecessor authority’s financial assessment.

The report acknowledges that although the findings were made against a former council, the new unitary authority will carry out the recommendations.

The Ombudsman said that Mr X complained about the council’s financial assessment for his mother, Mrs Y’s residential care charges and its decision to treat monetary gifts to her children and grandchildren as “notional capital”.

The council was satisfied the money – totalling nearly £20,000 – was not given away to avoid paying more for Mrs Y’s care home fees, the report found.

“This should have meant the council disregarded it when calculating how much she would have to pay”, said the Ombudsman.

However, the council did not do this. The Ombudsman concluded that the woman “contributed towards the cost of her care for longer than she potentially should have done” and was left with outstanding care home fees she could not pay.

To remedy the injustice caused, the Ombudsman asked the council to:

• complete a new financial assessment to calculate what Mrs Y’s contribution should have been from the point her money fell below the capital limit for paying for care.
• reimburse any overpayments the new assessment shows she has made and pay any outstanding fees it is responsible for.
• pay Mr X £350 to recognise the distress and anxiety caused by the inclusion of the notional capital in Mrs Y’s financial assessments.

The Ombudsman also recommended the council review the financial assessments for the other people affected and make reimbursements to them where appropriate.

Paul Najsarek, Local Government and Social Care Ombudsman, said: “The family said the woman’s sole reason for gifting the money was to help her children and grandchildren, and be able to see it while she was still alive.

“They told the council she had paid about 90% of her money towards her care home fees, and she had had no intention of avoiding paying her fair share, but the council still included this gifted money in its sums.

“During our investigation we found four other people have been potentially affected by the same issues, so I am pleased the council has accepted my recommendations to remedy this for both the woman whose family has complained and those others.”

North Yorkshire Council’s director of health and adult services, Richard Webb, said: “While we have raised concerns with the Local Government and Social Care Ombudsman over aspects of this case and how it has been reported, we accept that our explanation to Mrs Y and her family was not clear.

“We have apologised to both Mrs Y and her family for the distress and anxiety that was caused as a consequence.

“In line with the Ombudsman’s recommendations, we have already implemented much of what was required of us prior to publication of the report and further work is ongoing to ensure our procedures comply with current legislation.”

Lottie Winson