Summary: The Council was at fault for delaying Mrs Y’s financial assessment and for failing to establish appropriate support and communication arrangements for Mrs Y when it shared her care plan and financial assessment letters to ensure she received and understood the information sent to her. This caused avoidable distress and uncertainty for Mrs Y about the amount she would be required to contribute towards her care. The Council was not at fault for arranging a care package to meet Mrs Y’s assessed eligible needs, and there is no evidence to conclude the care package was unnecessary. The Council agreed to apologise and make a payment to Mrs Y to remedy the injustice caused. The Council agreed to further make a service improvement.

The complaint

1. Mrs X complained the Council unnecessarily arranged a care package for her mother, Mrs Y. She said the Council completed a care assessment without informing the family of the outcome, sent carers to Mrs Y’s home without the knowledge or consent of either Mrs Y or her family, and later sought payment for care services that were not needed.
2. Mrs X said the unannounced care visits caused Mrs Y avoidable distress, and receiving unnecessary care caused her frustration. Mrs X wants the Council to apologise for these failings and cancel the outstanding care charges.

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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 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)
4. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
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(1), as amended)
6. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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How I considered this complaint

7. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
8. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and guidance

Assessment

9. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.

Care Plan

10. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Charging for social care services: the power to charge

11. 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)
12. 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 not charge more than the cost it incurs to meet a person’s assessed eligible needs.
13. The Ombudsman expects, based on the wording of the statutory guidance supporting the Care Act, that councils complete financial assessments before care services start. This would enable people to know how much they must pay, if anything, before the care starts. However, in practice this rarely happens.

Mental Capacity Act

14. The Mental Capacity Act 2005 is the framework for acting and deciding for people who lack the mental capacity to make particular decisions for themselves. The Act (and the Code of Practice 2007) describes the steps a person should take when dealing with someone who may lack capacity to make decisions for themselves. It describes when to assess a person’s capacity to make a decision, how to do this, and how to make a decision on behalf of somebody who cannot do so.

Mental capacity assessment

15. A person aged 16 or over must be presumed to have capacity to make a decision unless it is established they lack capacity. A person should not be treated as unable to make a decision:

• because they make an unwise decision;
• based simply on: their age; their appearance; assumptions about their condition, or any aspect of their behaviour; or
• before all practicable steps to help the person to do so have been taken without success.

16. The council must assess someone’s ability to make a decision when that person’s capacity is in doubt. How it assesses capacity may vary depending on the complexity of the decision.
17. An assessment of someone’s capacity is specific to the decision to be made at a particular time. When assessing somebody’s capacity, the assessor needs to find out the following:

• Does the person have a general understanding of what decision they need to make and why they need to make it?
• Does the person have a general understanding of the likely effects of making, or not making, this decision?
• Is the person able to understand, retain, use, and weigh up the information relevant to this decision?
• Can the person communicate their decision?

What happened

Background

18. Mrs Y, who has dementia, was cared for by her daughter, Mrs X, who supported her with finances, appointments, managing paperwork and medication. As Mrs X was due to have surgery, a dementia care organisation who was regularly in touch with Mrs Y since she was diagnosed, contacted the Council to request a Care Act needs assessment for Mrs Y in June 2024. The referral stated that Mrs X managed Mrs Y's finances and was put down as contact. The Council carried out Mrs Y’s care needs assessment by telephone in late June 2024. The Council said that, during the assessment, it discussed its charging policy and client contribution arrangements with Mrs Y and Mrs X, who were both present during the call contributing to the assessment.

Matters subject to investigation

19. In early July following the telephone assessment of Mrs Y’s care needs, the Council sent Mrs Y a letter informing her that she was eligible for support from the Council. The letter said it was likely Mrs Y would need to pay towards the cost of that support and the amount would depend on her financial circumstances. It referred Mrs Y for a financial assessment.
20. Within days the Council issued Mrs Y’s support plan which stated Mrs Y needed support in managing her finances, paperwork, appointments and she needed support in complex financial decision making. The plan also noted the Council had assessed Mrs Y to have mental capacity to make her own care and support decisions.
21. In mid-July Mrs X had surgery and was no longer available to support Mrs Y in the immediate future while she was recovering. The same day, a care agency – commissioned by the Council - carried out an assessment of Mrs Y in her home.
22. Shortly after the assessment, Mrs Y began receiving a care package consisting of two 45-minute visits each week to support her in accessing the community and the management of her paperwork. There is no evidence the Council informed Mrs Y it had secured this agency and when the visits would take place.
23. In September the Council visited Mrs Y at home. She said she was well and Mrs X who was present at the meeting said she had asked the care agency to check on Mrs Y’s medication as well. She also stated Mrs Y would hide her letters in her bedroom and tell carers there wasn’t any mail she needed help with.
24. The same day when the care agency visited, Mrs X told the carer that Mrs Y required support with monitoring her medication and managing her mail, despite it being likely that Mrs Y would say she did not need this assistance.
25. In early October, the Council wrote to Mrs Y to confirm it had completed a provisional financial assessment and requested further financial documents by mid-October. The letter summarised the financial information already held by the Council and concluded Mrs Y had to make contributions towards her care. Unhappy about this letter, Mrs X contacted the Council's financial assessment team, but her email was neither acknowledged nor did she receive a response.
26. In mid-October, the Council contacted Mrs X in response to her earlier email. Mrs X said that she did not understand why Mrs Y was required to make a financial contribution towards the cost of her care, as this had not previously been explained to them. She also said that Mrs Y could not afford the assessed contribution. Mrs X further raised concerns that the Council’s delay in completing the financial assessment had resulted in significant backdated charges.
27. The Council subsequently apologised, acknowledging that its Finance Team had failed to acknowledge Mrs X’s earlier email or pass it to Mrs Y’s case worker. The Council said that it had explained the financial assessment process again and that the process had previously been discussed with both Mrs Y and Mrs X during the initial care needs assessment.
28. In late October the Council completed Mrs Y’s financial assessment, it sent her a letter outlining the weekly contribution she had to make. The Council sent the outcome letter of the financial assessment to Mrs Y only, not to Mrs X.
29. In December Mrs X’s Lasting Power of Attorney (LPA) formally registered her as Mrs Y’s sole attorney on all matters relating to Mrs Y’s finances as well as her health and welfare.
30. In February 2025, the Council responded to Mrs X’s complaint and said Mrs Y had capacity to agree to her care package, that it had therefore corresponded directly with her until Mrs X's LPA was registered, and that Mrs Y remained liable for the outstanding care charges.
31. In August 2025 Mrs X complained to us.

My findings

32. Following the referral from the dementia care organisation, the Council assessed Mrs Y’s care and support needs, established how it could best support her with these needs, found her eligible for support, and explained during the assessment that she was likely required to contribute towards the cost of her care. It referred Mrs Y for a financial assessment and arranged a care package through a commissioned care agency. There was no fault how the Council assessed Mrs Y’s care and support needs or its decision to arrange the care package.
33. The Council was satisfied Mrs Y had capacity at the time of the care needs assessment and, and in line with paragraphs 15 to 17, there was no requirement for it to undertake a formal capacity assessment. However, the Council was aware that Mrs Y required support with managing paperwork and with making complex financial decisions. It was also aware that Mrs X had historically provided that support and had, in mid-October, specifically requested that Mrs Y’s correspondence be sent to her rather than directly to Mrs Y.
34. In those circumstances, it was reasonable for the Council to consider how Mrs Y would deal with its letters and whether she fully understood the financial information these included. This included considering whether Mrs X could have appropriately supported her, provided Mrs Y consented to her doing so. Not considering establishing an appropriate support and communication arrangement for Mrs Y was fault which caused avoidable distress to Mrs Y when she was later informed of the exact amount she had to contribute towards her care.
35. Once the Council decided to charge for Mrs Y’s care, it was required to complete a financial assessment to determine what she could afford to contribute. The Council arranged care in July 2024 but did not complete the financial assessment until late October 2024, meaning Mrs Y received care for over three months without confirmation of her assessed contribution.
36. Although the Council had explained during the initial assessment that Mrs Y may need to contribute towards her care costs, neither Mrs Y nor Mrs X knew the amount she would be required to pay until the provisional assessment was issued in October and the final assessment was completed later that month. This delay was fault and meant that Mrs Y was receiving care without clear information about the amount she would have to pay and resulted in an accumulation of charges before the amount of her contribution was known. This caused Mrs Y uncertainty and avoidable distress.
37. We have not seen evidence the Council arranged the care package unnecessarily. The assessment identified care and support needs, and Mrs X requested additional assistance from the carers with matters including diary management, Mrs Y’s mail and medication, as outlined in paragraphs 23 and 24. Although Mrs Y often declined assistance during the twice-weekly visits, the evidence shows that the carers did provide support during those visits and that Mrs X also actively used the service to assist Mrs Y.

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Actions

38. Within one month of the final decision the Council agreed to take the following actions:
1. Apologise and make a payment of £100 to Mrs Y in recognition of the uncertainty and avoidable distress it caused by:
1. delays in carrying out the financial assessment and in informing her of the contributions she had to pay; and
2. failing to establish appropriate support and communication arrangements for Mrs Y when it shared her care plan and financial assessment letters, to ensure she was able to understand and respond appropriately to the correspondence.
2. Inform its staff through training that it should complete financial assessments before care services start. This would ensure, whenever possible, that people have the necessary information about the contribution they will be expected to pay towards their care before they need to make decisions about the care they want.

We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended.

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

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Decision

40. I have found fault and the Council agreed to remedy the injustice caused by the fault.

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Investigator's decision on behalf of the Ombudsman