Source · LGO (Local Government & Social Care Ombudsman)

Essex County Council

LGO (Local Government & Social Care Ombudsman) Not Upheld Reference 23-016-382 Sector Adult Care Services Category Direct Payments Decided 25 June 2024

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Full decision

The Ombudsman's final decision

Summary: Mr X complains the Council has failed to deal properly with the payments for his late mother’s care. He says this resulted in it failing to accept the need to refund money to her estate to reflect the fact she had to pay more for her care herself because the Council did not pay enough money into her direct payment account. The evidence shows there has been no fault by the Council.

The complaint

The complainant, Mr X, complains the Council has failed to deal properly with the payments for his late mother’s care. He says this resulted in it failing to accept the need to refund money to her estate to reflect the fact she had to pay more for her care herself because the Council did not pay enough money into her direct payment account

The Ombudsman’s role and powers

We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended) If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

How I considered this complaint

I have: considered the complaint and the documents provided by Mr X; discussed the complaint with Mr X; considered the comments the Council has provided in response to my enquiries; considered the Ombudsman’s guidance on remedies; and invited comments on a draft of this statement from Mr X and the Council, for me to consider before making my final decision.

What I found

What happened Mr X’s mother, Mrs Y, received direct payments from the Council which she used to pay for her care. After she died in January 2023, the Council said £582.06 had to be repaid from her direct payment account. This was on the basis it had paid £859.23 into the account on 28 December to cover the next four weeks, but Mrs Y died on 10 January 2023.

In January 2022 the cost of Mrs Y’s care was £183.97 a week. Based on a financial assessment from 2021, Mrs Y did not have to contribute towards the cost of her care. However, when the Council reviewed Mrs Y’s financial assessment, it decided she had to pay £83.86 a week towards the cost of her care, because of increased state benefits. The Council told Mrs Y about the charge on 17 January.

Because of this change, the Council reduced its payments into Mrs Y’s direct payment account by £84.86 to £99.51 a week. Mrs Y covered the shortfall, which was her assessed weekly charge.

In April 2022 Mrs Y’s personal budget increased to £283.50 a week and her assessed charge increased to £89.48. The Council paid £194.02 into her direct payment account, leaving her to make up the “shortfall”.

Is there evidence of fault by the Council which caused injustice?

The “shortfall” in the Council’s payments into Mrs Y’s direct payment account related to her weekly assessed charge. That was not fault by the Council. The Council’s decision to make its payment net of the assessed charge is common practice by local authorities. The evidence does not support the claim that the Council owes Mrs Y’s estate any money, but that the overpayment for the final month needs to be repaid.

Final decision

I have completed my investigation on the basis there has been no fault by the Council.

Investigator’s decision on behalf of the Ombudsman

Investigator's decision on behalf of the Ombudsman

View original on LGO (Local Governme… website

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