Summary: Mr Y complained the Council failed to provide Ms X with appropriate support to manage her finances. The Council commissioned care provider, which supported Ms X to manage her finances, failed to ensure the situation was appropriately resolved and the Council allowed the situation to drift. This was fault. The Council has agreed to apologise and make a payment to Ms X to acknowledge the distress and frustration this caused. It has also agreed to meet with her to arrange a suitable repayment plan.

The complaint

1. Ms X’s representative Mr Y complained the Council failed to provide Ms X with appropriate support when undertaking financial assessments and calculating care charges. Mr Y also said the Council failed to make reasonable adjustments to enable her to engage in the assessment process or to provide advocacy. He said this caused Ms X distress and meant she has incurred an unexpected debt.

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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 the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended). Ms X’s complaint concerns her financial assessment from November 2022. Ms X has a learning disability and was not aware of our role until her advocate raised a complaint on her behalf. I have therefore exercised discretion to consider what happened since November 2022.
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A) and 25(7), 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 considered evidence provided by Ms X’s representative and the Council as well as relevant law, policy and guidance.
7. I gave Ms X and the Council an opportunity to comment on a draft of this decision. I considered any comments before making a final decision.

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What I found

Relevant Law and Guidance

8. 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)
9. 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.
10. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home. After charging, a person’s income must not reduce below a weekly amount known as the minimum income guarantee (MIG). This is set by national government and reviewed each year. A council can allow people to keep more than the MIG. (Care Act 2014)
11. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care. When doing so, a council should do an assessment to allow the person to keep enough benefit to pay for necessary disability-related expenditure (DRE) to meet any needs it is not meeting. The Care and Support Statutory Guidance sets out a list of examples of such expenditure. It says any reasonable additional costs directly related to a person's disability should be included. What counts as DRE should not be limited to what is necessary for care and support. For example, above average heating costs should be considered.

What happened

12. Ms X has a learning disability and lived in supported living accommodation (placement B). She received 25 hours of one to one care each week. Ms X previously paid £2.18 a week towards her care costs. In November 2022 the Council reassessed her contribution to her care costs. This calculated Ms X’s contribution as £60.90 per week. The Council had allowed for the minimum income guarantee and a notional £11 per week for disability related expenditure.
13. Placement B emailed the Council to say it did not agree with the assessment and attached a letter, which I have not seen. The Council responded in December 2022. It said it had applied a standard DRE disregard of £11 but asked for receipts for Ms X’s food shop, types and frequency of activities and explained that additional costs for personal care would not be allowed as Ms X’s needs assessment said she could manage this by herself.
14. In February 2023 the Council carried out a review of Ms X’s care needs. The goals in Ms X’s assessment included that Ms X would be supported to manage her finances appropriately, to budget and look at options for saving for her future. Ms X would have ongoing support with her paperwork and correspondence. The assessment noted she received help from the team to manage her finances and to ensure she does not overspend. Ms X also received support with food preparation.
15. Ms X gave notice to Placement B as she wanted to live in her own property, so the Council again reviewed her care and support needs. The review included a discussion with the manager at the placement who did not feel Ms X was ready to live independently. The social worker noted the manager said Ms X required a lot of support with her financial paperwork and they were currently sorting her care costs with the Council. Around this time the Council referred Ms X for an advocate.
16. Later in February 2023, placement B provided the Council with information and a breakdown of Ms X’s DRE. It said it had tried to gather receipts and evidence but Ms X was disorganised, and it did not want to push her too hard as it was trying to reduce her tendency to hoard. It requested £51 per week of DRE including £20 a week for personal care treatments and £10 a week for activities. It requested a further review.
17. In March 2023 the Council referred Ms X for advocacy support with moving accommodation.
18. Placement B contacted the Council for an update in late March 2023 on Ms X’s care charges. It said Ms X would be unlikely to pay until these were finalised and it wanted this resolved so Ms X did not build up too big a debt.
19. The Council recalculated Ms X’s DRE from late February 2023 to allow for £21 a week of DRE from the date the information was provided. It did not allow the requested £20 a week for personal care as it said Ms X could manage her personal care, or £10 a week for activities as it said no evidence was provided.
20. Placement B contacted the Council again in mid April. It said it was still waiting for a response around the level of care charges and in the meantime Ms X was receiving urgent reminders about overdue payments. The Council responded that it had reassessed Ms X’s finances and sent her the outcome in March 2023. Placement B asked that this be re-sent as Ms X had not received it. The Council re-sent the letter.
21. In May 2023 the Council agreed to Ms X moving to placement C, another supported living provider.
22. In late May the Council called Ms X to arrange a payment plan. The notes record there was no answer to the call. It then wrote to Ms X with a payment plan which it said was agreed and it would collect by direct debit. It is unclear who discussed and arranged this with Ms X.
23. In early June 2023 placement B asked the Council to re-look at the payment plan and resend the letter. It said the letter should include what day the direct debit would be taken and for how many payments. It said the letter had 2025 as the end date and it should be for 12 monthly payments not 10. The records note a revised letter was sent early June.
24. The following day Ms X moved to placement C. Later in June 2023 Mr Y, Ms X’s advocate who had bene supporting her with the accommodation move, contacted the Council concerned about Ms X’s charges.
25. In July 2023 the Council reviewed Ms X’s placement. Mr Y attended. The Council agreed to carry out another financial assessment. Mr Y also said Ms X had received a letter about a payment plan but had not received an explanation of what the payments were for. He said she had not received support to understand the process or about DRE when she moved to placement B and could not afford the payments. The Council sent Mr Y a financial assessment form and explained Ms X was charged £60.90 a week from November 2022 and then £50.90 a week from February 2023. This increased to £58.20 per week when Ms X’s benefit increased. The Council also said it had sent a payment plan to Ms X but had not set up a direct debit to take payments.
26. In September 2023 the Council received returned post from placement B. It had sent reminders to placement B. It noted there was no direct debit set up on its system to pay Ms X’s care charges.
27. In October 2023 Mr Y contacted the Council as Ms X had been sent invoices but had not had a reassessment and had no explanation of how the charges were calculated. The Council responded and noted Ms X had now moved to universal credit. It sent another financial review form which Mr Y completed and returned to the Council in early November.
28. In December 2023 Mr Y complained to the Council on Ms X’s behalf. Ms X complained she did not have support of an advocate and placement B ignored the invoices. She considered the Council and placement B failed to ensure she had adequate support which result in the debt. The Council reviewed Ms X’s financial assessment as she had now moved to universal credit. This resulted in a reduction in her care contributions to £7.85 a week, which the Council backdated to June 2023 (when Ms X first received universal credit).
29. The Council responded to Ms X’s complaint in May 2024. It set out a chronology of what happened. It said Ms X would need to complain to placement B if she considered it did not follow the care plan and that Ms X could have requested a review if she felt her needs were not being met.
30. Ms X remained unhappy and in late October 2024 Mr Y complained to us on her behalf.

Findings

31. The Council is entitled to charge a contribution towards care charges and was not at fault for doing so. It reviewed Ms X’s financial assessment in November 2022 and this significantly increased her contribution to her care costs. However, I have seen no evidence of fault in the way it did this.
32. Mr Y complained the Council failed to provide Ms X with advocacy support to assist with managing her finances. Ms X had an assessed need for support with managing her finances, to be provided by staff at Placement B. Due to the passage of time and staff changes, Placement B has not provided me with any evidence of the support it provided to Ms X so I cannot know exactly what it discussed with her. However, Council records show Placement B was liaising with the Council regarding Ms X’s care cost, had discussed them with her and provided additional information about her DRE. This resulted in the Council recalculating Ms X’s care charges and her contribution reducing to £51 a week from February 2023. However, the Council failed to consider backdating this to when the reassessment occurred in November 2022. This was fault and means Ms X is faced with a bigger debt than she should be.
33. Placement B contacted the Council again in April 2023 as it considered the situation unresolved. It said Ms X had not received the outcome of the reassessment the Council carried out in March 2023. The records show the Council sent this. I cannot hold the Council responsible for any issues with Ms X’s post and I note the Council re-sent the reassessment outcome when requested.
34. Ms X made no payments during this time, and I have seen no evidence Placement B sought to set up an arrangement or made any further efforts to resolve this issue. This was fault. The Council also allowed the situation to drift. It arranged a repayment plan in April 2023 but failed to set up the direct debit.
35. There is no evidence the Council followed up the lack of a direct debit until September 2023. There is no case note of any conversation with Ms X whereby she agreed to the setting up of the repayment plan and when Ms X moved placement in June 2023 the Council sent reminders to her old address. I have seen no evidence the Council proactively sought to support Ms X with arranging to pay off the debt. This was fault and meant the debt has continued to accumulate.
36. Ms X is required to pay her contribution to her care costs. However, the lack of follow up by the Council commissioned provider and the Council’s failure to set up a direct debit or to proactively assist Ms X in dealing with the debt have caused her frustration. It has also have resulted in the accumulation of a significant debt to Ms X which has caused her distress, particularly given her care plan specifically states she needs support with managing her finances.
37. This was fault. When Ms X moved placements Mr Y, her advocate, started to support Ms X with the issue regarding her care charges.

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Agreed Action

38. Within one month of the final decision the Council has agreed to:
1. backdate Ms X’s financial assessment of March 2023 to November 2022 and amend the debt accordingly;
2. meet with Ms X and an advocate or suitable representative to explain what she owes and to arrange an affordable repayment plan.
3. apologise to Ms X and pay her £300 to acknowledge the distress and frustration she was caused by the Council’s faults.
39. The Council should provide us with evidence it has complied with the above actions.

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Decision

40. The Council was at fault causing injustice which it has agreed to remedy.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman