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Ombudsman warns councils over care home top-up fees

Councils have been warned by the Local Government and Social Care Ombudsman over the administration of ‘top-up fees’ under the Care Act for people contributing towards relatives’ care.

This came after Dudley Metropolitan Borough Council and Lincolnshire County Council disputed some Ombudsman recommendations.

The fees are usually paid by family members and cover the difference between the cost of care and what the local authority is willing to pay.

Dudley was found to have asked relatives to enter an agreement with the care home to pay the amount, rather than administer the funding itself and claim the money from the relatives.

The council declined an Ombudsman recommendation to end this practice, and argued that administering the fees would be too costly.

Lincolnshire did not give people the option to pay the top-up fee to the council and rejected a recommendation to allow this on cost grounds. It also argued it was permitted to use agents - in this case care homes - to collect the fees.

Ombudsman Michael King said the Care Act required that someone could pay a top-up fee direct to the care home only with the consent of those involved and of the care home. It also said this method is not recommended.

He said that leaving top-up fees to negotiations between homes and residents or their families “can potentially leave people vulnerable to the risk of fee increases”.

Mr King said: “The reasons both councils have given for departing from the guidance – the financial cost of doing things properly – is irrelevant.

“At the heart of the matter, we have two councils absolving themselves of their responsibilities to offer the public its basic protections set out in law.”

He said guidance issued in 2015 was “quite clear that leaving the administration of top-up fees to care homes was wrong”.

Dudley though remained unmoved by the Ombudsman’s criticism.

Nicholas Barlow, cabinet member for adult social care, said: “While we take the recommendations of the Ombudsman seriously and have adhered to almost all of them, having taken legal advice we are confident our processes are appropriate and are in the best interests of all parties.

“If we were to change the way we administer top-up fees, it could have a real detrimental impact on the council’s finances.”

He said measures had been taken to protect third-party users from price increases which had not been agreed with the authority and the council would develop standardised mechanisms for applying the third-party contributions, including how and when increases were applied.

Glen Garrod, executive director for adult care and community wellbeing at Lincolnshire, said: “The council has made great strides over the last year in developing its systems and processes to improve our customer's experience around financial assessments.

“We continue to implement a programme of improvements and, as part of an already planned review, over the next four months we will consider the position of third party top-up fees in accordance with the Ombudsman's recommendations."

Mark Smulian

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