The complainant’s wife was admitted to a care home suffering from Alzheimer’s disease. At the time she had sufficient savings to fund her own stay there but it was expected that she would eventually need state funding. Wiltshire Social Services explained to the complainant of the financial help which might be available when her savings dropped to the appropriate level. The complainant took independent financial advice and identified a financial care plan which could be purchased from his wife’s remaining savings and which would have paid for one half of the nursing home fees for the remainder of her life but which would have brought her savings below the level at which she would qualify for state funding. The complainant enquired whether the council would consider that his wife had deprived herself of an asset by purchasing the financial care plan. Wiltshire told him that it would not take this view and that Social Services would contribute to the cost of his wife’s care when the plan was in place. However, the complainant was not given any figures to indicate how much that contribution might be. The nursing home chosen charged fees which were above the local limit set by Social Services and the complainant found that he was expected to meet this excess from his own personal funds. He complained that he and his son had never been advised of this and that had they understood this to be the case from the outset, they would probably have chosen a different investment plan which would have paid the whole of his wife’s nursing home fees for life.
Where a service user is expected to contribute to the costs of their care and in particular where the fees payable to the home exceed the local authority limit a Social Services authority is expected to give a clear explanation of what funding is available from public funds. The service user may not use his savings to pay fees in excess of the local limit and still claim public funding. In this case Wiltshire provided advice to the complainant in the form of an advice leaflet which was sent to him. The complainant also spoke to two employees of the local mental health partnership who outlined the procedure for funding assistance should his wife’s savings drop below a certain level.
The Ombudsman found that Wiltshire could have been more helpful by giving worked examples to show the breakdown of contributions. It was also critical that the council’s response had not been in writing. It also appeared that the complainant and those to whom he had been speaking were at cross purposes in relation to the amount required by the complainant to ‘top-up’ the council’s contribution. Had adequate clear and written information been passed to the complainant showing an approximation of public funding contribution and a warning that he would be responsible for unmet ‘top-ups,’ the error would certainly have been discovered before it was too late. The complainant should have been told that the council would meet the balance between the local limit (less funded nursing care) and his wife’s income and that the council was able and willing to meet the remaining fees in excess of the local limit. The council failed to do this. However, the Ombudsman did not find that the advice from Wiltshire was inaccurate or misleading and the complainant had done no more than ask whether the council would treat the purchase of the care plan as deprivation of capital, which it answered in the negative. Due to the involvement of an Independent Financial Adviser whose actions he was unable to consider, the Ombudsman did not find that any financial loss that the complainant had suffered from purchasing an inappropriate product, was wholly or mainly the fault of the council. The council agreed to pay £1,150 for the delay in dealing with his complaint and by way of an apology for failing to tell him clearly and in writing at the time he needed it, the likely level at which the council would be able to contribute to his wife’s nursing home fees.