The Ombudsman's final decision
Summary: Mr X complained about the Council’s decision to charge support at home care charges for his father three years after his father passed away. We do not find fault with the Council charging for the care Mr X’s father received. But Mr X has provided evidence of a decision by the NHS Local Decision Panel providing funding which the Council was unaware of. We found fault with delays by the Council. The Council agreed to remove charges covered by the NHS Local Decision Panel funding time period, apologise to Mr X and reduce the balance owed by £150 to reflect the distress and inconvenience caused.
The complaint
Mr X complained about the Council applying support at home care charges for his late father.
Mr X also complained the Council only billed for the support at home care charges in May 2021 despite his father passing away in August 2018.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended) If we are satisfied with an organisation’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 considered all the information Mr X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
Mr X and the Council provided comments on my draft decision which I considered before making my final decision.
What I found
Assessment of needs Councils must assess anybody in their area who appears in need of care services. Following an assessment, the Council must decide which needs are eligible for their support. If the Council provides support, it must produce a written Care Plan.
Where a council assesses a person’s needs and agrees to provide care, it should set a personal budget in a care and support plan. A personal budget is a statement which specifies the cost to the local authority of meeting eligible needs, the amount a person must contribute and the amount the council must contribute. (Care Act 2014, section 26) A financial assessment decides who will pay for the eligible care needs. Councils can charge for care services. The Council should provide clear information about charges and how it assesses them at the time it finds out care needs. If a person refuses a financial assessment they must self-fund their care.
Persons who have over £23,250 of eligible capital will be expected to pay for the full cost of their care home fees. However, once their capital has reduced to less than £23,250, they only have to pay an assessed contribution towards their fees. (The Care and Support (Charging and Assessment of Resources) Regulations 2014; Care and Support Statutory Guidance 2014 (CSSG)) What happened On 29 June 2018, the Council completed a care needs assessment of Mr X’s father, Mr Z. The Council started to provide Mr Z with support at home on 2 July 2018 and told Mr Z it would need to complete a financial assessment to decide his care charges.
The Council wrote to Mr Z on 9 July 2018 to advise of a £2.50 per week charge for Assistive Technology Services starting from 2 July 2018.
Mr Z contacted the Council on 11 July 2018 to query the £2.50 per week charge. The Council discussed this cost with Mr Z and his finances. The Council wrote to Mr Z on 23 July 2018 to confirm it had arranged a financial assessment visit for 30 July 2018. The Council explained this visit would help Mr Z complete a financial assessment to decide the full cost of care provided from 2 July 2018.
Mr Z asked to rearrange the financial assessment visit. The Council agreed to complete this on 14 August 2018.
On 14 August 2018, the Council completed the financial assessment visit with Mr Z. The Council confirmed with Mr Z in writing it would charge £120.90 a week, inclusive of the £2.50 Assistive Technology charge, for Mr Z’s care and support backdated to 2 July 2018.
The Council billed Mr Z £7.50 for the Assistive Technology Service from 2 July 2018 to 22 July 2018 on 15 August 2018.
Mr Z passed away on 25 August 2018.
The Council sent a revised bill to Mr Z on 11 September 2018 for the full cost of his care from 2 July 2018 to 19 August 2018 totalling £711.21.
A member of Mr Z’s family contacted the Council on 18 September 2018 to query the bill. The Council explained the bill was for support provided by the Council.
On 6 November 2018, the Council sent a final bill to the executors of Mr Z’s estate for charges up to 25 August 2018 detailing further charges of £105.74.
The Council sent a letter to the executors of Mr Z’s estate to Mr Z’s address on 13 November 2018. This letter confirmed the outstanding balance owed to the Council by the estate was £824.45.
On 8 July 2019, the NHS Local Decision Panel wrote to Mr X’s sister to confirm that it had decided Mr Z was eligible for fully funded NHS Continuing Healthcare from 1 August 2018 to 26 August 2018. Mr X’s sister did not provide this letter to the Council.
The Council did not receive payment or take further action until August 2019. In August 2019, the Council got Mr X’s details from Adult Social Services. The Council wrote to Mr X at his address on 12 August 2019. The Council provided a copy of the letter dated 13 November 2018 detailing the balance owed of £824.45 and asked if Mr X could advise it of the executor for Mr Z’s estate.
Mr X did not contact the Council and the Council did not make further contact with Mr X about the outstanding balance for Mr Z’ care charges. On 17 May 2021, the Council sent a letter to Mr X chasing payment of outstanding care charges for Mr X’s mother-in-law. When Mr X contacted to discuss these care charges, the Council also entered into discussions with Mr X about the outstanding balance owed for Mr Z’s care charges.
Mr X raised a formal complaint with the Council on 3 June 2021. The Council provided its complaint response to Mr X on 5 October 2021. The Council said: It apologised for the delayed response to Mr X’s complaint.
It could not investigate Mr X’s complaint about Mr Z’s care charges because the issues were outside the last 12 months.
The outstanding balance of £824.45 is due for payment and provided contact details for Mr X to discuss repayment options.
Mr X complained to the Council about its decision not to investigate his complaint about his father’s care charges.
The Council did not provide a further response to the Mr X’s complaint.
Analysis Care charges Mr X complained about the Council raising support at home care charges for his late father.
A council must assess a person in their area who appears in need of care services. If the Council decides a person is eligible for support and the person agrees to receive support, the Council should complete a financial assessment. The financial assessment will decide what contribution the person needs to make towards their support.
The Council completed a care needs assessment of Mr Z on 29 June 2018 and decided he had care needs. The Council put in place home support for Mr Z from 2 July 2018.
Since Mr Z received home care support from the Council, it is only correct the Council charged Mr Z the correct amount for the care provided. The Ombudsman normally expects a Council to complete a financial assessment within six weeks of a care needs assessment. This would be 10 August 2018 for Mr Z.
The Council only completed the financial assessment on 14 August 2018. However, Mr Z asked the Council to complete the financial assessment on 14 August 2018 rather than 30 July 2018. The Council acted in accordance with Mr Z’s wishes and this is not fault.
When the Council completed Mr Z’s financial assessment it determined Mr Z would need to pay £120.90 per week for the cost of his care backdated to 2 July 2018. The Council has already confirmed with Mr Z that it would charge £2.50 per week for Assistive Technology Services from 2 July 2018 which was included within this cost of £120.90 per week.
The Council completed a financial assessment and confirmed this in writing to Mr Z on 14 August 2018. This financial assessment detailed Mr Z’s weekly charges for the care the Council was providing from 2 July 2018. I do not find fault with the Council.
The Council billed Mr Z following completion of the financial assessment. The Council only produced one bill for £7.50 for the Assistive Technology Services from 2 July 2018 to 22 July 2018 before Mr Z passed away.
After Mr Z passed away, the Council produced charges for the full cost of care from 2 July 2018 to 25 August 2018 over two bills resulting in a total owed of £824.45. The Council sent the latter bill to the executors of Mr Z’s estate at Mr Z’s address.
The Council has produced accurate charges based on the care provided and financial assessment for Mr Z’s contribution to this care. While the Council has only raised most these charges following Mr Z’s death, the charges are accurate and valid. I do not find fault with the charges owed.
Mr X has provided evidence to the Ombudsman of the letter dated 8 July 2019 from the NHS Local Decision panel. This letter detailed that it would refund any charges Mr Z incurred for his care charges from 1 August 2018 until 26 August 2018. Neither Mr X or his sister provided this letter to the Council. Since the NHS Local Decision Panel made this decision a year after the Council charged for Mr Z’s care and the Council was not made aware of this decision, I do not find fault with the Council.
Had Mr X paid the Council’s cares, he could have requested a refund directly from the NHS Local Decision Panel. Since Mr X has not paid the charges the Council has offered to only charge Mr Z for his care charge sup to 31 July 2018 so Mr X does not need to request the refund himself. I consider this resolution appropriate in the circumstances.
Charging delays Mr X complained the Council only billed for the support at home care charges in May 2021 despite his father passing away in August 2018.
The Council produced invoices for care charges, sent to Mr Z’s address, on 15 August 2018, 11 September 2018 and 6 November 2018. The Council then produced the final bill for Mr Z’s care charges on 13 November 2018. The Council sent the final bill to Mr Z’s address in the name of the executors.
While Mr X may not have received these invoices, the Council has shown it produced the invoices and sent these to Mr Z’s address.
The Council acted correctly to send billing to Mr Z before he passed away since he had capacity to manage his own finances. Since the Council did not receive a forwarding address following Mr Z passing away, it was suitable for the Council to continue to send correspondence to Mr Z’s address.
I do not find fault with how the Council produced invoices for the care charges up to 13 November 2018.
Since Mr Z’s family contacted the Council on 18 September 2018 to question the billing it showed the family was also aware of the charges.
After the final bill on 13 November 2018, the Council failed to attempt any further contacts to get the executors details until 12 August 2019 when it wrote to Mr X. This meant the Council took nine months to make any attempts to identify who the executor of Mr Z’s estate might be.
Following this contact, the Council failed to take any further action to follow up on the outstanding balance owed for Mr Z’s care charges. The Council only took further action after Mr X contacted the Council to complain about different care charges in May 2021.
While the charges for Mr Z’s care are valid, the Council failed to take suitable steps to follow up on this debt from 13 November 2018 until May 2021. This delay of 30 months is fault. It is also notable that it was Mr X that prompted contact from the Council in May 2021 and not because the Council took further action. If not for Mr X, the Council could have delayed longer in taking any action to follow up on the outstanding balance.
The Council’s delays have caused Mr X avoidable distress and inconvenience at having to address his late father’s outstanding balance three years after he passed away and after disbursement of the estate.
The Council’s delays have caused Mr X distress and inconvenience.
But, this is partially mitigated by the fact that Mr Z’s family have confirmed they were aware of the care charges through contact with the Council on 18 September 2018 and the Council wrote to Mr X at his address in August 2019. Mr X has therefore partly contributed towards the overall delays.
Complaint handling delays The Council took from 3 June 2021 until 23 September 2021 to handle Mr X’s complaint through its complaints process.
The Council’s complaints procedure for adult social care complaints says it will take a maximum of six months to resolve complaints of a “more complex nature” but will look to handle complaints expediently. The Council responded to Mr X’s complaint in three and a half months so fell within the timescale set out in its complaint’s procedure.
While the Council met maximum complaints procedure timescale, the Council told Mr X it would not investigate Mr X’s complaint because of the timescale. Given the Council's response was to advise it would not investigate the complaint, this was not a complex case and did not need the full time set out in the Council’s complaint timescale. The Council should have handled Mr X’s complaint “expediently”, failing to do so is fault. This fault caused Mr X further avoidable distress and inconvenience.
Agreed action
Within one month of the Ombudsman’s final decision the Council should: Apologise to Mr X and reduce the outstanding balance owed for Mr Z’s care charges by £150. This is to reflect the avoidable inconvenience and distress caused by the Council’s delays in chasing for payment and handling of Mr X’s complaint.
Amend the Council’s charges for Mr Z’s care to only charge up to 31 July 2018 and write to Mr Z to confirm the balance owed.
Final decision
There was fault by the Council as the Council has agreed to my recommendations, I have completed my investigation.
Investigator's decision on behalf of the Ombudsman