The Ombudsman's final decision
Summary: Ms X complains the Council was at fault as it did not communicate her mother, Mrs Y would be required to contribute towards a domiciliary care service. The Council has accepted it was at fault. It has apologised and offered to withdraw the invoice for the charges incurred. This is a suitable remedy in this case, so we have completed our investigation.
The complaint
I have called the complainant Ms X . She complains the Council failed to communicate that a contribution was required for the domiciliary care service it commissioned for her mother, Mrs Y. Ms X says she received invoices for the care four months after the care began. Ms X says this has caused her and Mrs Y anxiety, stress and placed her mother in financial hardship.
The Ombudsman’s role and powers
The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide: we could not add to any previous investigation by the organisation, or further investigation would not lead to a different outcome.
(Local Government Act 1974, section 24A(6)) If we are satisfied with a council’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 read the papers submitted by Ms X and we have spoken to her about her complaint. I considered the Council’s comments about the complaint and the supporting documents it provided.
Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.
What I found
Charging Charging for social care services: the power to charge Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14) How to assess and thresholds Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The scheme must comply with the principles in law and guidance, including that charges should not reduce a person’s income below Income Support plus 25%. The Council can take a person’s capital and savings into account subject to certain conditions. If a person incurs expenses directly related to any disability he or she has, the Council should take that into account when assessing his or her finances. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010) What happened in this case Mrs Y needed a stay in hospital in June 2020. A Key Worker carried out a care assessment on Mrs Y for the Council when she was due to be discharged. The Key Worker spoke to Ms X. It was agreed Mrs Y would return home with a domiciliary care package in place from a care provider. On Mrs Y’s return home, she received three visits a day from a care provider.
The Council started a financial assessment on Mrs Y in August 2020 to see what her contribution should be towards the care she was receiving. It sent Ms X a financial assessment form to complete. Ms X returned the form in September 2020, but the Council asked her to provide more information.
In September 2020 the Council changed Mrs Y’s care provider. The new provider made two visits a day to help Mrs Y. The Council completed the financial assessment at the end of October 2020. It sent Ms X an invoice for Mrs Y’s contribution towards her care costs totalling £1446. 56 in November 2020.
Mrs Y was distressed to receive the invoice as the cost would cause her financial difficulties. Ms X contacted the Council and an officer agreed for Mrs Y’s case to be considered at the Waiver Panel in March 2021 to see if the Council should waive the charges. The Waiver panel declined to agree to waiver the costs. It considered there was not enough information to enable it to decide and limited proof of financial hardship to Mrs Y. The panel said it could reconsider the case in the future if Ms X provided more detailed financial information.
Ms X complained to the Council in April 2021. Ms X said Mrs Y was discharged back home following a care assessment and she had answered the Key Worker’s questions but did not receive a written record of the discussions. Ms X said she told the Key Worker Mrs Y had no finances to pay for a care package and reassured there would be no costs. If they had been aware of costs Ms X says they would have cancelled the care package, but they were not given the opportunity to do so.
Ms X confirmed they had not been given a contract or invoice for either care provider. And the Council did not invoice them until November 2020. Ms X complained the Council recently sent a letter threatening legal action if they did not pay the invoice and it was causing them both distress. Ms X asked the Council to waiver the invoice as it had not properly told them of the charges.
The Councils response to Ms X’s complaint The Council responded to Ms X’s complaint. It told her Mrs Y’s case records showed the Key Worker discussed finances and Mrs Y’s discharge plan with her during the care assessment in June 2020. Ms X confirmed Mrs Y was below the current financial threshold and receiving pension credit. The Key Worker advised Ms X the care would be free for two weeks under COVID-19 funding and then Mrs X’s contribution would be subject to a financial assessment if care continued. The Council said there was no record it told Ms X there would be no charge for the care.
The Key Worker noted Ms X said she would ask a charity to help with the financial assessment forms. Ms X also contacted the Council’s Customer Service Centre to ensure Mrs Y received support to maximise her entitlement to benefits in response to financial concerns. The Key Worker also noted Ms X advised her that she was using the service to check Mrs Y’s benefits. Ms X was applying for a lifeline service for Mrs Y and hoped her contribution to any costs for help were low as it would worry her.
The Council carried out a financial assessment in August 2020 and completed it in October 2020. The Council advised Ms X Mrs Y needed to pay £98.321 a week from 20 July 2020 towards her care. The Council considers its case notes entries show it gave information, advice and support to Ms X and Mrs Y about paying for care and benefit entitlement to help doing so.
In responding to our enquiries on the complaint the Council accepts it delayed actioning Mrs Y’s financial assessment until 17 August 2020. This was unfortunately due to officers becoming familiar with changes to the referral procedure. It also notes a delay in Mrs X receiving the financial assessment form until 2 September 2020. Ms X returned the form, but the Council needed further information. Ms X returned it on 19 September 2020 and the Council completed the assessment on 27 October 2020.
The Council reports it was implementing new arrangements when Mrs Y was being discharged from hospital. The Council recognised that people being discharged with Adult Care from hospitals should be provided with information explaining how COVID-19 funding would initially pay for their care. The Council set up a letter explaining the funding in June 2020, but it has no evidence to show it sent the letter to Mrs Y. The Council says Mrs Y’s hospital discharge and implementing the letter happened when the health and social care system faced severe pressure from the pandemic. The Council says because of this it did not send a letter to Mrs Y. The Council apologised for the omission.
The Council confirms it charged Mrs Y for a contribution towards her care from 20 July 2020. It says it has no evidence to show it communicated this to Ms X or Mrs Y. So, they were unaware of the charges until they received the invoice in November 2020. The Council fully accepts it should have told Mrs Y by letter when the charging dates were planned to start.
The Council has offered to withdraw the invoice for £1446.56 for the whole period Mrs Y was receiving care to resolve Ms X’s complaint. It says its findings in response to our enquiries would have prompted an earlier offer to withdraw the invoice and helped resolve matters sooner. And lessened the impact of the complaint onto Ms X and Mrs Y. The Council apologised it did not produce the findings as part of its earlier responses to Ms X and Mrs Y’s complaints.
My assessment
The Council’s case notes do show that Ms X was given some information that Mrs Y may be required to contribute towards her care. Ms X contacted the Customer Service Centre for information in response to ensure Mrs Y was receiving all the benefits she was entitled to for help towards costs.
However, the Council accepts it was at fault as it failed to send Mrs Y a letter explaining about COVID-19 funding when she was discharged from hospital. It also failed to tell Ms X and Mrs Y when her charges for care would start from. I consider the fault caused an injustice to Ms X and Mrs Y as they were unclear whether Mrs Y would be charged after the two weeks. And so unable to decide whether to incur costs and continue with the care package.
The Council also accepts there were delays carrying out a financial assessment on Mrs Y. This meant Ms X and Mrs Y did not receive the invoice for Mrs Y’s contribution towards charges for four months until November 2020, so the charges were then £1446.56. I consider this has also caused an injustice to Ms X and Mrs Y. This is because they were again unable to decide whether to continue with the care package and incur charges as they were unaware of the costs.
The Council also accepts that its earlier complaint responses to Ms X’s concerns did not pick up its findings sooner. I consider this has caused an injustice to Ms X and Mrs Y as the Council could have resolved the distress they were suffering much sooner.
In view of the Council’s fault when dealing with Ms X and Mrs Y it has apologised and offered to withdraw the invoice for £1446.56. I consider this is suitable action and it is the outcome Ms X was seeking when making her complaint. So, I do not consider that any further investigation will add anything to the Council’s investigation or achieve anything more for her.
Final decision
I am completing my investigation.
The Council was at fault as it delayed carrying out a financial assessment on Mrs Y. The Council also failed to send letter to Mrs Y explaining COVID-19 Charges and when her charges would start. This caused an injustice to Ms X and Mrs Y as they were again unable to decide whether to continue with the care package and incur charges as they were unaware of the costs. The Council has offered suitable remedy in this case.
Investigator's decision on behalf of the Ombudsman