Councils warned about lack of transparency over 'top up' fees

Councils have been reminded by the Local Government and Social Care Ombudsman that they need to provide better clarity on care home costs, following a complaint by the ‘distressed’ family of a man with dementia.

The complaint against Lincolnshire County Council was upheld after the Ombudsman ruled that there were several areas where Lincolnshire Council fell short in providing vital financial information to the family, especially with regard to 'top-up' fees.

It urged that greater transparency about care home fees needed to be provided to those who urgently require care; this was especially important for families who may not be in a strong financial position.

Michael King, Local Government and Social Care Ombudsman, said: “Councils have a duty to provide accurate information to families about care home placements. This is particularly important at times such as this where families do not have the luxury of being able to plan for their relative’s care.

“We issued a focus report on this subject in 2015 and I would encourage anyone working in the field to have a look at the good practice guidance it contains, and check their own policies and procedures to ensure they comply with the Care Act.”

Not only did the Ombudsman find that the family wasn’t provided with vital financial information when an emergency forced them to admit their father to a care home, but it also resulted in the family being forced to pay a ‘top-up fee’, which they couldn’t afford.

If the family had been warned about the fee by the council they could have potentially placed their father in another home that didn't charge the fee, said the Ombudsman.

Another failure was that the father should have been eligible for council funding as he had been assessed at the time he was placed in emergency residential accommodation, as doctors acknowledged that he had dementia and physical disabilities.

The knock-on effect of the confusion was that the family struggled to pay the fees and their father was threatened with eviction, causing even more stress to the father and his family. The daughter was especially put under a lot of pressure by demands for money from the home.

Local authorities are responsible for collecting top-up arrangements and not the care provider directly, so the family shouldn't have been chased up by the home even if they were to pay the extra fees.

The Ombudsman’s verdict was that the council should acknowledge its faults and apologise to the family.

It also stated that the council should reimburse the top up fee of £65 and pay the family £300 to reflect their distress and a further £300 for the time and trouble of bringing the complaint.

It was also advised that the council should now review its procedures and top-up fee contract to ensure people are offered the option to pay the top-up-fee directly to the council, and review its existing top-up agreements to bring them in line with the Care Act.

Councils abdicating responsibility for top-ups is cited by the Ombudsman's 2015 focus report as being one of the biggest faults of councils when informing public choices about care homes.

According to the report, “some councils fail to contract with care homes to pay the full chargeable rate, leaving the home to collect the resident’s contribution and the top-up payments, leaving placements vulnerable if either payment is not made.

“Some councils routinely leave care homes to enter into top-up agreements with residents or third parties. This is wrong. Top-up agreements must be made between the council and the person paying the top-up fee. Leaving care providers to deal with the top-up agreement can result in avoidable disputes over what has been agreed with the council”.

Focus reports from the Local Government and Social Care Ombudsman can be found here: http://www.lgo.org.uk/information-centre/reports/focus-reports