Failure to provide a fully funded care package

What happened

Before late winter 2013, R's care package was provided by the local authority. R was living in a bungalow. He had previously been nominated for a local authority flat, which professionals involved in his care felt met his needs.

In late winter 2013, R was found eligible for NHS continuing healthcare funding. At the transition meeting, Mr H was told that the offer of the local authority flat had been withdrawn.

A NHS continuing healthcare care plan was put together with contributions from Mr H, R's psychiatrist and his clinical psychologist. Within the care plan, it was stated that one of the outcomes was for 'R to have increased opportunities for meaningful therapeutic and social activities everyday'. A list of specific activities was included. Mr H was told that these activities would not be funded by the NHS.

What we found

We partly upheld this complaint. The withdrawal of the offer of the local authority flat was outside the Clinical Commissioning Group's (CCG's) control so we did not uphold this part of the complaint.

The care plan was too specific. It should have broadly set out what R's care needs were and what interventions were needed to meet these. The care plan, which had been agreed by the multidisciplinary team, indicated that R had therapeutic needs that needed to be met by the care package. In accordance with the National Framework, the CCG was responsible for meeting these needs. We said that this did not necessarily mean that the CCG had to fund the specific activities in the care plan. However, if the CCG did not consider that these particular activities were appropriate to meet R's needs, it should still have made sure that suitable alternatives were provided.

Putting it right

The CCG wrote to Mr H apologising for the failings we identified and for the injustice these failings caused. It also agreed to arrange to fund appropriate interventions to make sure R's therapeutic needs were met in line with his care plan.