Summary: Miss X complained on behalf of her uncle, Mr B. Miss X said the Council failed to consider Mr B’s care and support needs and failed to properly explain care costs and contributions. Miss X also said it took too long to respond to her complaint. We find the Council was at fault for failing to properly explain the costs of care. It was also at fault for failing to complete a timely financial assessment with Mr B and for taking too long to deal with the complaint. This caused Mr B distress and uncertainty. It also caused Miss X, distress, uncertainty, and inconvenience. We do not find fault with the Council for how it considered Mr B’s support and care needs. The Council has agreed to our recommendations to remedy the injustice.

The complaint

1. Miss X complains on behalf of her uncle, Mr B. Miss X says the Council failed to

• Properly consider Mr B’s care and support needs.
• Properly communicate or explain Mr B’s costs and contribution to his care.
• Properly explain or complete a financial assessment.
• Communicate in a timely manner when she complained.

2. Miss X said this caused Mr B distress and uncertainty. She says it also impacted on the family, causing her distress, uncertainty, and inconvenienced her.

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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. 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)
5. 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)

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How I considered this complaint

6. I have considered all the evidence supplied by Miss X in support of the complaint. I have also made enquiries of the Council and have considered all the information it has provided.
7. Miss X and the Council had an opportunity to comment on my draft decision. I have considered the comments received before making this final decision.

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What I found

Law, guidance, and policies

8. The Care Act 2014, the Care and Support Statutory Guidance 2014 (updated 2017) and the Care and Support (Charging and Assessment of Resources) Regulations 2014 set out the Council’s powers to charge. The Council also has its own policies.

Charging for social care services: the power to charge

9. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
10. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.

The Council’s Charging and Financial Assessment Policy 2015

11. The Council has an Adult Social Care Charging Policy (the Policy). This states the Council has a duty to arrange care and support for those with eligible needs. In most cases it is expected that the Council will choose to charge under section 14 of the Care Act 2014, following a person’s needs assessment for all the services that it is entitled to charge. It is underpinned with the following principles:

• Ensure that people are not charged more than is reasonably practicable for them to pay.
• Be clear and transparent, so people know what they will be charged.

12. How much a person will be charged will depend on the outcome of a financial assessment and is means tested taking into account a person’s capital and income.

Care and Support Statutory Guidance

13. The Government has issued ‘Care and Support Statutory Guidance’ (CSSG). CSSG says that councils should:

• ensure information supplied is clear. This means it is understood and able to be acted upon by the people receiving it.
• take all reasonable efforts to provide comprehensive information and advice at an early stage.
• provide an information and advice service which is more than just leaflets and web-based materials; and
• signpost people to independent financial information and advice.

Council’s Complaint Policy

14. The Council has a two stage complaints procedure. The Council’s policy says it will respond to both Stage One and if escalated to Stage Two within 15 days.

What happened

15. Below is a chronology of key events. It is not meant to show everything that happened.
16. Mr B lives alone in his own home. He has learning difficulties, cerebral palsy, a hearing impairment, visual impairment, mobility issues and suffers from anxiety. Mr B struggles to communicate his needs and uses a mixture of lip reading, simple British Sign Language (BSL) and phone texting to communicate with others.
17. Mr B relied on his brother, Mr C and latterly his niece Miss X to provide emotional and active support to help him continue to live in the community. Towards the end of 2020, Mr C became ill and was no longer able to offer the same amount of support to his brother, Mr B.
18. Following a GP referral to social services, Miss X requested an assessment asking for increased support for Mr B in October 2020.
19. Social Services visited Mr B in mid-March 2021 and completed a needs assessment. Also present were Mr C and Miss X. This document noted Mr B had agreed to a financial assessment. It also noted there would be charges for care and said Mr B had the capacity to make choices around his care and finances.
20. Mr B’s social worker revisited him in April 2021, with a BSL support worker to help communication. It said it provided Mr B with a copy of his care assessment, detailing the support he would receive. The Council said it contacted Mr C a few days later and updated him with details of Mr B’s care plan.
21. After this meeting, Mr B’s social worker asked the Council to complete a financial assessment to determine what Mr B should pay for his care and support.
22. Mr B’s support started in early May 2021. The care plan said Mr B would receive support from a carer for eight hours a week, this was split over Wednesdays and Fridays. This care assessment document showed there would be a cost for the care and support Mr B received.
23. The Council supported Mr B in-line with his care plan throughout 2021.
24. Miss X contacted the Council in December 2021. She said Mr B had been in contact with Mr C and appeared anxious. She queried the support the Council was providing for Mr B and asked the Council if there was a cost for his package of care.
25. The Council reviewed Mr B’s finances in February 2022.
26. The Council contacted Miss X in late February 2022. It apologised for the time it had taken to respond to her concerns. It said Mr B’s social worker was on long term sick and it did not have permission to share information with Miss X. The Council confirmed Mr B did pay a contribution to his care and said social care was not free. It explained it would consider Mr B’s benefits when calculating care charges.
27. Mr B received an invoice for £4113.51 in March 2022 for the care and support he had received between 10 May until 13 June 2021.
28. Mr B became distressed on receiving the invoice and contacted Mr C. He said the invoice was unexpected. Mr B was extremely anxious and said he had no idea how he would pay the debt.
29. Miss X contacted the Council a few days later and formally complained in early April 2022. She said the unexpected invoice had frightened Mr B, causing a great deal of stress not only to him but for the whole family. She said the Council had not told Mr B of the cost of care before the package commenced and he could not afford to pay the invoice. Miss X said that if the Council had made Mr B aware of the charges before the package of care started, he would not have agreed to it. Miss X asked the Council:

• Why had it taken over a year to tell Mr B there would be a charge for his care?

• How had it calculated what Mr B could afford?
• Who had consented to the care package and how had it satisfied itself this was suitable to meet Mr B’s needs?

30. Miss X asked the Council to waive any charges for care for Mr B. She said the Council had failed to complete a financial assessment with Mr B. She said it had also failed to check if Mr B understood there would be a cost for care, failed to provide any information on charging or checked whether Mr B could afford the care package or repay the debt.
31. Miss X said she also telephoned and emailed the Council’s finance department but failed to receive a satisfactory response to her questions and concerns.
32. The Council responded to Miss X and said it had received her complaint, it told her it was awaiting information from several departments involved with Mr B. Miss X said she chased the Council for a response, believing it had twenty-five days to respond, she also said Mr B had received more invoices for care, causing him further distress.
33. The Council emailed Miss X in May 2022; it explained invoices should not have been sent while there was a current investigation.
34. Miss X expressed concern for Mr B’s mental health. A meeting was set up in June 2022 with his social worker, support workers, and medical staff.
35. The Council carried out a mental capacity assessment (MCA) with Mr B who was aided by a BSL support worker in late July 2022. It noted Mr B had mild learning difficulties but decided he did have capacity to understand care contributions.
36. Miss X said the Council continued to send invoices to Mr B.
37. The Council completed a further review meeting of Mr B’s needs. Also present was Miss X and Mr C. Miss X said Mr B did not understand why he had to pay for care when he believed this had been free for the previous nine months.
38. Mr B became unwell and was admitted to hospital in September 2022.
39. The Council responded to Miss X’s complaint in September 2022. Its Stage Two response said it was sorry for the significant delay in responding. It recognised there had been several errors that had led to Mr B not being financially assessed. It cancelled Mr B’s care charges from May 2021 until February 2022 and said it would reassess Mr B. It also said:

• Mr B had consented to a financial assessment and was aware he was receiving a chargeable service.
• A financial assessment would be completed.
• Mr B had not been assessed within the standard time frame due to an error.
• Mr B was not properly told of his contribution in a timely manner.
• There was no evidence to support it had explained the cost of care to Mr B.
• It had failed to share the Council’s charging booklet.

40. Miss X complained to the Ombudsman in October 2022.

Council’s response to my enquiries

41. The Council responded to my enquiries and said:

• Mr B’s financial assessment had now been corrected. It had now considered Mr B’s disability related expenditure (DRE). It said Mr B would now be charged a reduced amount from April 2022.
• It accepted it had taken too long to complete Miss X’s complaint, although it said it had kept her informed of the reasons for the delay.
• It had apologised to Miss X and Mr B for the distress caused and had cancelled the care charges between May 2021 and February 2022.
• It has now undertaken an internal review of its Adult Social Care Charging Policy and has drafted two new charging policy documents.
• It runs a weekly report highlighting any outstanding financial assessments, reviews, and staff now need to document when a charging booklet is given.

Analysis

42. The Council accepts there were errors when handling Mr B’s case which it has recognised has led to an injustice for both Mr B and Miss X.

Care Charges

43. The Council upheld the complaint and accepted it failed to clearly explain the costs of care or provide Mr B with an information booklet to help him understand care charges. The Council issued an invoice for retrospective care charges dating back to June 2021 which Mr B was not expecting. The Council failed to explain how it had calculated the charge and offered no support or advice on how Mr B could repay the debt. The Council provided no evidence it considered Mr B’s financial position or whether the retrospective debt was affordable. This was fault, the Council has apologised to Mr B and Miss X for the faults identified and the distress this caused. I have made further recommendations below to remedy the injustice.

Financial Assessment

44. The Council accepts due to an internal error it did not complete a financial assessment with Mr B in a timely manner. The Council assessed Mr B by reviewing internal records in February 2022. The Council accepts it should have invited Mr B to complete an online financial assessment. It did not do this. The Council did not correct Mr B’s financial assessment until October 2022. This was too long and was fault. On reassessment, the Council has now considered Mr B’s disability related expenditure and finances.
45. In failing to complete the financial assessment properly and in a timely manner, Mr B was caused distress, and uncertainty. Miss X was also caused distress and uncertainty and was inconvenienced chasing the complaint. The Council has cancelled the retrospective care charges from May 2021 until February 2022. It has also amended the invoices it sent Mr B from April 2022, reducing the amount he must pay. The Council has also undertaken a review of its charging policy and has completed several service improvements.
46. If the Council had completed the process correctly, Mr B would have always been liable to pay something for the care received. I am satisfied the Council has acted appropriately by completing a financial assessment and by cancelling and reviewing some of the care charges Mr B was expected to pay. It has also reviewed its policies and made service improvements. This goes a long way towards remedying the injustice caused to Mr B. However, I consider the Council should make a symbolic payment to both Mr B and Miss X to recognise the distress and uncertainty to both of them.

Mr B’s Care Assessment

47. The Council completed a care assessment in March 2021. It also completed several further reviews. On many occasions, Mr B was supported by his family and a BSL support worker. The Council’s notes show it left a copy of the assessment from March 2021 with Mr B and contacted his brother Mr C to make him aware of the support that it would put in place. The Council assessed Mr B’s needs and decided on the level of care it believed was appropriate. This was a decision it was entitled to make. Therefore, I do not find any fault with how the Council assessed Mr B’s care needs or how it decided what care and support was appropriate.

Complaint Handling

48. The Council accepts there was a significant delay in completing its investigation into the complaint within its stated time frame. This was fault. I acknowledge the Council updated Miss X on the reasons for the delay. However, the investigation took too long to complete, causing Miss X uncertainty and put her to the inconvenience of chasing the Council for a final response. This caused further loss of confidence in the Council. I have made recommendations to remedy the injustice.

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Agreed action

49. The Council will by 27 July 2023:

• Pay Mr B £300 for distress and uncertainty.
• Pay Miss X £200 for distress, uncertainty, and inconvenience.
• Remind staff dealing with complaints to adhere to timescales set out in the Council’s complaints procedure.

50. The Council should provide us with evidence it has complied with the above actions.

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Final decision

51. I have completed my investigation by finding the Council was at fault causing an injustice to Mr B and Miss X. The Council has agreed to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman