Summary: Miss X complains about the Council’s decision to no longer fund her attendance at a day centre for two days a week. She also complains about the Council’s decision to increase her contributions towards her care. The Ombudsman finds fault with the Council for not completing a full financial assessment in 2017. The Ombudsman does not find fault with the Council for not funding Miss X’s attendance at the day centre for two days a week or for increasing her contributions.

The complaint

1. Miss X complains about the Council’s decision to no longer fund her attendance at a day centre two days a week. She also complains about the Council’s decision to increase her contributions towards her care which means her weekly income has been significantly reduced. Miss X says this has affected her mental health and, emotional and social wellbeing. She also complains this has reduced her access to the local community.
2. Ms A represents Miss X.

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The Ombudsman’s role and powers

3. 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)
4. 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)

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How I considered this complaint

5. I spoke with Ms A and considered the information she provided.
6. I made enquiries with the Council and considered the information it provided.
7. I sent a draft decision to Ms A and the Council and considered their comments.

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What I found

8. 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)
9. People receiving local authority arranged care and support other than in a care home need to keep a certain level of income to cover their living costs. Under the Care Act 2014, charges must not reduce people’s income below a certain amount (Income Support, but local authorities can allow people to keep more of their income if they wish. This is known as the minimum income guarantee (MIG). For the financial year 2018/19, the MIG, where the adult concerned is a single person and is aged 25 or older but less than pension credit age, is £91.40. (Department of Health and Social Care, local authority circular LAC(DHSC)(2018)1)

Background

10. Miss X has learning disabilities and lives in an adult placement scheme, known as Shared Lives. Miss X attended a day centre two days a week.
11. The Council has assessed Miss X as having eligible care needs. The Council has set out Miss X’s care and support needs, and how they will be met, in her care and support plan.
12. The relevant care and support plans for this complaint are the plans for 2017 and 2018. Miss X’s care and support plan in 2017 sets out that Shared Lives will meet her care needs and that she would receive £331.88 a week to pay for her care. This included £91.05 which is paid to Shared Lives to manage the placement. Miss X is not paid this money as it is paid directly to Shared Lives.
13. The care and support plan in 2017 did not set out any specific funding for Miss X to attend the day centre.
14. In 2018, Miss X’s care and support plan set out that her care needs would be met by Shared Lives and that she would receive £331.88 a week. Again, this was inclusive of £91.05 which is paid to Shared Lives to manage the placement. Miss X is not paid this money as the Council paid this to Shared Lives.
15. The care plan in 2018 set out the Council would pay for Miss X to attend the day centre one day a week. The Council said it would fund this from July 2018 until December 2018. This was to enable Ms A to support Miss X with gradually reducing her attendance at the day center service and to introduce alternatives.
16. Miss X pays a contribution towards the cost of her care. This was calculated by a financial assessment. Shared Lives completed Miss X’s financial assessment on behalf of the Council, but the Council is accountable for work completed by its contractors. This is because while the Council can outsource their services, they cannot outsource the responsibility for them.

What happened

17. In 2017, Shared Lives assessed Miss X as needing to contribute £19.30 towards her care costs. The Council said this was a standard charge put in place from a previous charging practice before the Care Act 2014. The Council said this was wrong as Shared Lives should have completed a full financial assessment to correctly work out Miss X’s contributions.
18. Miss X received benefits which made up her total weekly income. After deductions of her care contributions and other costs, Miss X had just over £200 as her weekly disposable income.
19. Shared Lives told Ms A in February 2018 that it would review all service user’s financial assessments and conduct a full financial assessment. Shared Lives said this meant some service users would contribute more towards their Shared Lives service than before and impact on the level of personal allowance they will have left. Shared Lives advised that anyone contributing less than £40 a week would be affected by the change.
20. In April 2018, Shared Lives completed a full financial assessment and decided Miss X’s contribution towards her care costs was just over £120 a week. This was worked out by deducting Miss X’s MIG, and other allowances, from her total income.
21. Miss X’s MIG was £156.35. Shared Lives worked out Miss X’s MIG by adding together the following figures:

• £91.40. This was the standard allowance for those aged 25 of older but less than pension credit age.
• £45.25. This was a support component premium.
• £19.70. This was an enhanced disability premium.

22. After deductions of her care contributions and other costs, Miss X had just over £100 as her weekly disposable income.
23. Ms A said the Council had previously paid for Miss X to attend the day centre two days a week. The Council said it had only agreed to pay for Miss X to attend the day centre one day a week from July 2018 until December 2018. The Council said it had not paid for Miss X’s attendance to the day centre before then.
24. Ms A provided further information in response to my draft decision. She said that from August 2018, the day centre had been sending invoices directly to the Council. She added that prior to August, invoices were sent to Miss X directly.

Analysis

Day centre funding

25. The Council said it had not previously paid for Miss X to attend the day centre. It said it only agreed to fund one day a week for four months in 2018. Ms A said the Council had funded Miss X to attend the day centre two days a week before this.
26. Ms A said the day centre had invoiced Miss X directly prior to August 2018. Therefore, on balance, I find it was more likely Miss X had been paying for her attendance at the day centre.
27. The evidence shows Miss X’s care and support plan in 2017 did not outline any separate funding for her to attend the day centre two days a week. Therefore, this was not something the Council had to provide. Therefore, I am satisfied the Council was not responsible.
28. The Council agreed in 2018 to pay for Miss X to attend the day centre one day a week for four months. I am satisfied the Council had responsibility to do this as it had set this out in Miss X’s care and support plan. I am also satisfied that after December 2018, the Council no longer had responsibility to pay for Miss X to attend the day centre for one day a week.
29. Therefore, the Council was not at fault for not providing funding for Miss X to attend the day centre two days a week in 2018.

Financial assessment

30. The Council has explained Miss X’s assessed contributions in 2017 were wrong because Shared Lives had applied a standard charge. When the Care Act 2014 was implemented in 2015, the Council should have completed a financial assessment to work out Miss X’s contributions. It did not do this. This is fault.
31. However, I do not find the fault identified caused Miss X any injustice. This is because Miss X benefited financially from the fault as she paid less towards her care than she should have.
32. It is clear from the evidence Miss X’s disposable income had declined in 2018 due to her increased contributions towards her care. Her assessed contributions increased because the Council completed a full financial assessment.
33. I do not find the Council at fault for completing a full financial assessment. This is because this action was in line with legislation and guidance and was something that should have been done in 2015.
34. I also do not find fault with the Council’s decision to increase Miss X’s contributions towards her care. This is because the Council can charge for care and support services it provides. Further, Miss X’s income has not fallen below the minimum levels.

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Final decision

35. I find the Council was at fault for not completing a full financial assessment in 2017 but that this did not cause Miss X an injustice. I also find the Council was not at fault for increasing Miss X’s contributions and for not providing funding for the day centre for two days a week. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman