Summary: Miss X complains on behalf of her sister, Miss Y, that the Council incorrectly charged for residential care between December 2022 and March 2023. Miss X says the Council has also failed to confirm how charges have been calculated. Miss X says this has caused her distress and confusion about the amount she has had to pay. We find fault with the Council for not providing information about the charges it intended to make to Miss Y sooner. The Council has agreed to pay a financial remedy and carry out service improvements.

The complaint

1. Miss X complains on behalf of her sister, Miss Y, that the Council incorrectly charged for residential care between December 2022 and March 2023. Miss X says the Council has also failed to confirm how charges have been calculated.

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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 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

4. I spoke with Miss X and considered the information she provided.
5. I made enquiries with the Council and considered the information it provided.
6. Miss X and the Council have had the opportunity to comment on my draft decision. I have considered any comments received before issuing a final decision.

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What I found

7. The Care Act 2014 and the Care and Support (Charging and Assessment of Resources) Regulations 2014 (Regulations) provide details of councils’ duties towards their residents with eligible social care needs and rules for charging for the services provided.
8. When exercising their social care functions councils must follow the Care and Support Statutory guidance (Statutory Guidance) issued by the Department of Health and Social Care, which is based on the Care Act 2014, unless they have very good reasons not to. They should also follow the Regulations.

Financial assessments

9. Where a local authority has decided to charge, it must carry out a financial assessment of what the person can afford to pay and, once complete, it must give a written record of that assessment to the person. This could be provided alongside a person’s care and support plan or separately, including via online means. (Care and Support statutory guidance paragraph 8.16)
10. Financial information and advice is fundamental to enabling people to make well-informed choices about how they pay for their care. The local authority service should include the following aspects of financial information and advice:

• understanding care charges
• ways to pay
• money management
• making informed financial decisions
• facilitating access to independent financial information and advice
• the cap on care costs, when preparing for its introduction in 2020 (Care and Support statutory guidance paragraphs 3.36 and 3.41)

11. Councils should ensure that information supplied is clear. Information and advice should only be judged as clear if it is understood and able to be acted upon by the individual receiving it. Information and advice provided within the service should be accurate, up-to-date and consistent with other sources of information and advice. (Care and Support statutory guidance paragraphs 3.19 and 3.20)

Charging

12. When the Council arranges a care home placement, it has to follow charging rules set up in the Regulations when undertaking a financial assessment to decide how much a person has to pay towards the cost of their residential care. The rules state that people who have over the upper capital limit (£23,250) have to pay for the full cost of their residential care home fees. However, once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees.
13. When making decisions on charging local authorities should be clear and transparent so people know what they will be charged. Where a local authority has decided to charge it should explain in the financial assessment how the assessment has been carried out, what the charge will be and how often it will be made. The local authority should ensure this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice. (Care and Support statutory guidance paragraph 8.2 & 8.16)

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What happened

14. Miss Y went into to hospital in March 2021. In October 2021 the Council found temporary respite accommodation for Miss Y in a care home. Miss Y remained in this accommodation until January 2022 when she moved to a permanent placement.
15. Miss X has both Property and Financial and Health and Welfare Power of Attorney for to Miss Y.
16. The Council sent Miss X an email towards the end of December 2022 which confirmed that funding was agreed for a permanent placement for Miss Y. It also reminded Miss X she would need to send through information needed by the finance department otherwise Miss Y would be liable for the full costs of her care.
17. Miss X returned the financial information in January 2023. The Council wrote to her in February 2023 to say it had assessed Miss Y needed to pay £183.64 per week towards the short break/respite services she received. The Council also said in a separate letter it had assessed Miss Y would need to pay £422.24 per week towards the residential care services she received.
18. Miss X queried the charges with the Council in June 2023. It accepted she had not been told about the permanent residential costs until 22 December 2022. The Council said it would amend its charging to reflect that respite level charges were up until 22 December 2022. The Council said after this Miss Y would be charged at the residential care services rate.
19. The Council have confirmed charges made for 6 October 2022 to 22 December 2022 amount to £2,106.58 and charges from 23 December 2022 to 12 January 2024 amount to £24,362.39. It sent Mrs X an invoice reflecting these amounts.
20. Miss X remained unhappy with the amount calculated by the Council and continued to raise complaints. The Council responded to these in October 2023. It remained of the view that Miss Y was liable for the charges. Miss X then brought her complaint to the Ombudsman.

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Analysis

21. There is no evidence to show the Council provided any information about the costs associated with Miss Y’s care until February 2023. I recognise that Miss X received an email in December 2022 which stated if she did not provide financial information Miss Y would be liable for all her care costs. However, this did not confirm the amounts which would be charged.
22. Whilst the Council completed the financial assessment in a reasonable timeframe once it received information from Miss X, I am not satisfied it provided Miss X with any information about the costs of care before this.
23. The Care and Support statutory guidance says Councils should be clear and transparent, so people know what they will have to pay. The Council did not tell Miss X about the costs this until February 2023. I have found fault in the actions of the Council for not telling Miss X what the charges would be sooner.
24. Miss X has suffered an injustice as it would have been distressing worrying about the likely costs adding up and the uncertainty surrounding that. Miss X has also lost the opportunity to budget Miss Y’s finances due to not being provided with the amounts which would be due.
25. I accept from December 2022 onwards Miss X knew that some costs would be due for the permanent care Miss Y was receiving. I have considered this when deciding the recommendations I have made.
26. I have not been able to find any reference to the Council telling Miss X that permanent residential costs would not start until March 2023 as she has said.
27. Miss X asked the Council about the charges in June 2023. The Council said that due to Miss X not being told about the costs of the care for Miss Y, it would amend its charges. However, Miss X was still unclear how the amounts were calculated following the amended invoice.
28. Following my draft decision, the Council has confirmed Miss Y was charged £422.24 per week from 1 December 2022 to 14 April 2023 and then £451.45 per week following an annual uplift. This totals £24,362.39. We agree with the Council’s calculations and final total.
29. I understand that Miss Y is not aware of any issues with the funding of her care and Miss X has dealt with the matter. I cannot see that Miss Y has suffered any injustice herself as her care has been consistent.

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Agreed action

30. Within one month of our final decision the Council should:

• Remind staff in writing of the importance of confirming costs of care with service users or their representatives in line with the statutory guidance;
• Apologise to Miss X for the injustice caused by the faults identified;
• Pay Miss X £200 to recognise the distress caused to her.

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

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Final decision

32. I have found fault in the actions of the Council for not telling Miss X about the charges associated with Miss Y’s care sooner.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman