Summary: Mr X complained that due to poor wording in the Council’s annual financial review letters, he did not know his relative was being undercharged for her care between 2015 and 2020. He says the Council has since unfairly made a backdated claim on his relative’s estate for an increased contribution to her care costs. The Council is not at fault.

The complaint

1. Mr X complained:
1. The Council has lost the financial assessment completed for his relative in 2014.
2. About unclear wording in the Council’s annual financial review letters which meant he was unaware his relative was being undercharged for her care between 2015 and 2020. He says since his relative passed away in 2020, the Council has confirmed the value of her estate and made a retrospective claim of over £25,000 towards her care costs.

He says this has caused him distress, and, if he had known she should have been paying more, he may have reviewed her care arrangements. He wants the Council to write off the outstanding care bill.

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What I have investigated

2. I have investigated part b) of Mr X ‘s complaint. I have explained why I have not investigated part a) at the end of this statement.

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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 read Mr X’s complaint and spoke with him about it on the phone.
6. I considered the Council’s responses to his complaint.
7. Mr X and the Council had the opportunity to comment on the draft decision. I considered their comments before making a final decision.

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What I found

Charging for care

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. The rules related to charging for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and statutory guidance.
10. When a Council decides to charge for care, it must carry out a financial assessment of what the person can afford to pay. When a person has financial assets above £23,250, they are assessed as being self-funded and are required to pay all their care costs. When a person’s assets fall below this level, they may be assessed as needing to pay a contribution towards their care.
11. A council must regularly re-assess a person’s ability to meet the cost of any charges to take account of any changes to their resources. Statutory guidance says this is likely to be on an annual basis.

What happened

12. In 2014, Mr X’s relative, Mrs Y, moved into residential care. The Council arranged the care and completed a financial assessment with Mrs Y’s daughter, who was acting on Mrs Y’s behalf at that time. It assessed Mrs Y’s contribution and Mrs Y’s daughter signed an agreement to say she agreed with the calculations and Mrs Y’s assessed contribution.
13. In 2015, Mr X took on responsibility for managing Mrs Y’s finances. The Council sent him an annual financial review letter each April between 2015 and 2020. These letters:
1. Set out the details of its annual financial assessment of Mrs Y’s finances and its revised calculation of her assessed weekly contribution, which accounted for annual increases in state benefits. The details included figures related to Mrs Y’s pension and her bank current account. It said her Bank current account balance was £23,250 (threshold).
2. Asked him to check the revised financial assessment carefully and contact the Council if Mrs Y’s income or capital was different from the amount the Council has assumed it to be.
3. Told him if he failed to notify the Council of any changes which affected Mrs Y’s financial assessment and charges (e.g. an increase to savings or benefits), he would be charged at a later date.
14. After Mrs Y passed away in 2020, the Council confirmed the value of Mrs Y’s estate. The assessment showed Mrs Y had savings significantly above the £23,250 threshold, which the Council previous did not know about. It sent Mr X a retrospective bill for additional contributions towards her care.
15. Mr X was unhappy and complained to the Council. He said:
1. The Council had lost the initial financial assessment completed in 2014, so he did not know why Mrs Y’s savings were not initially included.
2. The wording in the annual financial review letters was unclear. Because of this, he had not understood that all Mrs Y’s capital needed to be included in the assessment including savings and not just that in current accounts.
3. He wanted the Council to write off the bill.
16. The Council responded and apologised to him for the loss of the financial assessment from 2014. It provided other documents which showed Mrs Y received a financial assessment and that Mrs Y’s daughter had agreed with the Council’s calculations at the time and signed an agreement on Mrs Y’s behalf to pay the assessed contributions.
17. It said it had reviewed his comments about the wording in the annual financial review letters. It said it had since made changes to list each bank account and its balance, based on information given, to reduce any potential confusion with the words “current account”. However, it said the annual letters asked him to contact the Council each year since 2014 if he thought any of the information was incorrect. Mr X had not done this, and the Council had had no contact from him until October 2020. It said it could not cancel the invoice.
18. Mr X remained unhappy and brought his complaint to us.

Analysis

19. The Council has lost the original financial assessment from 2014 but provided evidence it did assess Mrs Y’s finances and that Mrs Y’s daughter agreed with its calculations at the time. It appears Mrs Y’s savings were not included in the 2014 assessment, but we cannot now know the reasons for this.
20. Between 2015 and 2020, the Council acted in line with its duty and sent Mr X, acting on Mrs Y’s behalf, an annual financial review letter. Each year, the letters asked him to contact the Council if he did not agree with the calculations. Mr X did not do this.
21. Although the Council has since reviewed the wording of these letters to make it even clearer, I am satisfied the wording of the letters was clear enough at the time. The letters did not refer to Mrs Y’s savings, but the Council did not know about them. The letters asked Mr X to check the revised financial assessment carefully and told him that if he failed to notify the Council of any changes (e.g. a change to or an increase in savings or benefits) he would be charged at a later date. Mr X did not do this, but this is not Council fault.
22. Had Mr X contacted the Council earlier, the Council would have revised its calculations to account for Mrs Y’s savings, and Mrs Y’s assessed contributions would have increased. Mrs Y received care between 2015 and 2020 and the retrospective bill is correcting the fact that, as the Council did not know about her savings, Mrs Y had been undercharged for her care. The annual letters are clear that if a person does not notify the Council of changes to a person’s finances in addition to what has already been declared, a person will be charged at a later date. The Council is not at fault for recalculating Mrs Y’s assessed contribution once it became aware of her savings in 2020, and so I cannot ask it to write off the bill.

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Final decision

23. I have completed my investigation. The Council is not at fault.

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Parts of the complaint that I did not investigate

24. I did not investigate Mr X’s complaint that the Council has lost the financial assessment from 2014. This is because it is too long ago and further investigation would achieve nothing more.

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Investigator's decision on behalf of the Ombudsman