Summary: The Council is not at fault for refusing to halve charges for community based social care services. Even though the NHS funds half the care package the Council is not charging more than the cost of its half of the care package.

The complaint

1. The complainant, whom I refer to as Mr X, complains on behalf of his daughter, who I refer to as Miss D. Mr X complains the Council should halve Miss D’s assessed contribution for social care as the NHS fund half of her care package.

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The Ombudsman’s role and powers

2. 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)
3. 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)
4. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)

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How I considered this complaint

5. I spoke with Mr X and made written enquiries of the Council. I considered the Council’s response and applied the relevant law, guidance and local policy; detailed where relevant below, before reaching a draft decision.
6. I have written to Mr X and the Council with my draft decision and given them an opportunity to comment.

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What I found

Background information

7. Miss D has learning difficulties. She lives at home with her parents and receives day care and respite care from the Council. Since August 2018, the NHS has funded half of Miss D’s care package.

What should have happened

8. The Care and Support Statutory Guidance says that councils must not charge more than the cost that it incurs in meeting the assessed needs of the person. The Council is unable to charge for services provided by the NHS.
9. Where disability-related benefits are considered, the local authority should make an assessment and allow the person to keep enough benefit to pay for necessary Disability Related Expenditure (DRE) to meet any needs which are not being met by the local authority.
10. The Council’s Policy on Charging for Adult Social Care Services dated September 2019 says: -
11. “Any costs covered by the NHS (either under Continuing Health Care or Funded Nursing Care) are not subject to this policy. However, where it has been agreed that a care package will be jointly funded between the Council and the NHS, the Council will determine a person’s charge based on 100% of the cost to the Council of providing that support.”

What happened

12. On 2 April 2019 the Council assessed Miss D’s charge as £31.34 per week this included a disregard of £50 for DRE. Miss D also contributes towards respite care and associated transport costs.
13. On 23 April 2019 Mr X complained to the Council asking it to halve the charges as the NHS funded half of Miss D’s care package. The Council refused saying it based the charges on its charging policy and was therefore entitled to charge up to the cost it incurred in providing services. In this case £677.80 per week; half the total package costs.

Is there fault causing injustice?

14. I find no fault in the Council’s decision not to reduce Miss D’s care costs by half. It has calculated Miss D’s charge according to its charging policy; and is not charging more than its cost of providing Miss D’s care package.

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Final decision

15. I have completed my investigation and closed the complaint as I have found no fault in the Council’s actions.

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Investigator's decision on behalf of the Ombudsman