Summary: The Council acknowledged failings in the way it dealt with the financial assessment for Mrs Y’s care, before the complaint came to this office. It apologised and offered a repayment plan. We consider this a satisfactory remedy.

The complaint

1. Mr X complains about the way the Council dealt with a financial assessment for his late grandmother’s domiciliary care. Mr X also complains about the quality of care provided.

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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 significant injustice, or that could cause injustice to others in future 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 have:
• considered the complaint and supporting information submitted by Mr X;
• considered the correspondence between Mr X and the Council, including the Council’s response to his complaint;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. 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 duties towards adults who require care and support and its powers to charge. 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)
6. The financial limit, known as the ‘upper capital limit’, exists for the purposes of the financial assessment. This sets out at what point a person can get council support to meet their eligible needs. People who have over the upper capital limit must pay the full cost of their care fees.
7. Once a council completes the financial assessment, it must give a written record of the assessment to the person. It should explain how the assessment has been carried out, what the charge will be, how often it will be made and if there is any fluctuation in charges, the reason. Councils should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.

Key facts

8. Mrs Y, a senior citizen, initially, she received a period of free care to aid rehabilitation. This ended in September 2022, and the care became chargeable. The Council commissioned a care agency to commence care visits from 2 September 2022.
9. The Council’s records show Mrs Y was informed long-term may be chargeable, subject to a financial assessment.
10. In 2023, Mr X raised concerns about the quality-of-care Mrs Y was receiving. He says 15-minute visits were agreed, but at some point, this was increased to 30 minutes. Mr X also complained about short visits and issues relating to medication management. The Council told Mr X it would investigate his concerns.
11. Information provided to this office shows that officers from the Council’s quality/ contracts team met with the care provider to address the concerns raised by Mr X, following which, some shortcomings were identified. The Council offered Mrs Y a change in care provider. The offer was initially declined.
12. Following further concerns, and a review of Mrs Y’s needs, the Council arranged a change in provider from the end of October 2023.
13. The Council sent Mr X a financial form in August 2023. Following completion, the Council wrote to Mr X saying Mrs Y was nil charge.
14. In January 2024, the Council realised it had erred in the calculation of Mrs Y’s finances because it had failed to take account of housing benefit, she received. Following a recalculation, charges were backdated to August 2022. Mrs Y received a backdated bill.
15. Mr X complained to the Council in April 2024. He said the delay in informing Mrs Y about the charge had denied her the opportunity to make an informed decision about the cost of the care. He also reiterated previously raised concerns relating to the quality of care provided by the care provider. He said the duration of care visits were increased from fifteen minutes to thirty minutes without consultation, and visits were cut short.
16. The Council provide Mr X with a complaint response in June 2024. In its letter, the Council acknowledged delay in the error and completion of the financial assessment and apologised. It said both he and Mrs Y had been aware care may be chargeable. It offered a repayment plan for the backdated charges. It reiterated the action officers took in response to concerns about the quality of care from the care provider.
17. Mr X contacted the Council to express his dissatisfaction with the complaint response. The complaint was received by a different officer and a final complaint response issued to Mr X in August 2024. The Council upheld the original decision.
18. In response to enquiries from this office, the Council says care visits were not increased, that the care provider had been commissioned to provide 30-minute visits from the outset, and Mr X was informed about this on 5 September 2022. The Council explained the action it has taken to monitor the quality of care provided by the Care Provider. Regular monitoring visits / meetings have taken place throughout 2024.

Analysis

19. The law and guidance do not specify a timescale for completing financial assessments, however, councils are expected to complete such assessments in a timely manner.
20. In this case, there was a significant delay in the completion of the financial assessment, and in Mrs Y receiving notification of the charges, which is fault by the Council. This resulted in an unexpected, backdated bill, which caused Mrs Y injustice. During this investigation Mrs Y sadly passed away so are unable to provide a remedy for the injustice caused to her.
21. Although the delay was unacceptable, the Council did inform both Mrs Y and Mr X that care may be chargeable, subject to assessment. I appreciate Mr X’s dissatisfaction with the Council’s actions, but I have no grounds to direct the Council to write off the outstanding care charges. This is because it is within the Council’s right to charge for the care services provided to service users.
22. I see from the Council’s complaint response; it has apologised to Mr X for its actions. This is adequate.
23. The actions taken by the Council to address issues relating to the quality of care provided by the care provider were adequate. The Ombudsman cannot add to this.

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Final Decision

24. The Council acknowledged fault in the way it dealt with the financial assessment for Mrs Y’s care, before the complaint came to this office. It apologised to Mrs Y and Mr X and offered a repayment plan. We consider this a satisfactory remedy.
25. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman