Summary: Mrs X complains about the way the Council has chased outstanding charges for care delivered to her late father. There was fault in the way the Council communicated with Mrs X about her father’s financial assessment. This caused Mrs X uncertainty and avoidable distress. The Council agreed to carry out a financial assessment based on the information Mrs X can provide and recalculate any charges based on the information in Mr Y’s support plan. The Council will also apologise to Mrs X and pay her £250 in recognition of the distress caused by the delay in contacting her about her father’s financial assessment.

The complaint

1. Mrs X complains the Council delayed in issuing a financial assessment form and invoice for domiciliary care her late father, Mr Y, received between February and April 2017. She says her father was told he would not have to pay for his care, otherwise he would not have agreed to it.
2. Mrs X says the Council has the information it needs about her father’s assets as this information was provided when her mother underwent financial assessment. Mrs X complains the Council is blaming her for the delay and asking to confirm her late father’s financial situation without access to the necessary information.
3. She says there were issues with the quality of care provided including missed calls, missed medication and a failure to deliver the agreed care plan.
4. Mrs X considers the Council’s actions have added to her distress while she was mourning the loss of both her parents within a short period of time.

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The Ombudsman’s role and powers

5. If we are satisfied with a council’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)
6. 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)
7. 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, section 25(7), as amended)

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How I considered this complaint

8. I have considered the complaint made by Mrs X.
9. I considered the Council’s comments about the complaint and the documents it provided in response to my enquiries.
10. I have given Mrs X and the Council an opportunity to comment on my draft decision and I have considered their comments.

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What I found

11. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. A council can begin charging from the date it starts to incur costs to meet a person’s care and support needs. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. Councils have no power to assess couples according to their joint resources: each person must be treated individually (Care Act 2014, sections 14 and 17)
12. In assessing what a person can afford to contribute from their assets, councils must apply the upper and lower capital limits. The upper capital limit is currently set at £23,250 and the lower capital limit at £14,250. If a person has assets below the lower capital limit, they might still be charged for their care, but their charge will be based on their income only.
13. The Council’s Fairer Contributions Policy says: “People who are assessed as needing support will be informed of an estimated amount of money required to meet their social care needs (called an “Indicative Budget”). This will be established in their care needs assessment. The actual amount of money required will be finalised after Support Planning and is called a “Personal Budget”. The contribution people will be required to make to their Personal Budget will be based on their ability to pay. Potentially, people will be required to make a financial contribution up to the whole amount of their Personal Budget. This means that people could, if they are assessed as being able to afford it, contribute the full amount of their Personal Budget and not be eligible for a LA contribution.”
14. The Council’s Financial Assessment Policy says: “When completing a financial assessment if a visiting officer feels that a person is not capable of sharing information about their finances or they request that a third party looks after their finances, they can complete a Financial Representative Agreement.”

What did happen?

Social care assessment

15. Mr Y went in to hospital in late 2016. He spent time in a reablement centre before he was well enough to go home.
16. The social care assessor met with Mr Y in early 2017 and spoke to him about needing a package of care when he went home. She assessed him as needing support with personal care, mobilising, transfers, maintaining nutrition and reminders to take his medication. She told him she would speak to his daughter, Mrs X, about a financial assessment and the package of care.
17. The assessor spoke to Mrs X about plans for her father’s discharge from hospital. Mrs X told the assessor she thought her father did not have savings above the upper capital limit. The assessor said she would refer Mr Y for a financial assessment.
18. The social work assessor completed two support plans for Mr Y in February 2017: one for his original package of care and a second for an extra 15-minute care call. At the end of each plan, the assessor has set out Mr Y’s personal budget. The first support plan says, “My total weekly personal budget is £8.85 per week” and the second says, “My total weekly personal budget is £6.19 per week”.
19. Shortly after he returned home, Mr Y’s wife died. Mr Y also had a number of hospital admissions in this period. Mr Y passed away in May 2017.

Financial assessment

20. The social care assessor referred Mr Y for a financial assessment. At the time, Mr Y had capacity and managed his own finances.
21. The Council has not provided any evidence that Mr Y completed a Financial Representative Agreement for Mrs X to act on his behalf.
22. The Council says it tried to arrange to visit on six occasions to carry out a financial assessment but was not successful. Mrs X says three of the visits had to be cancelled due to her mother passing away and her father being in hospital. She says one of the attempts the Council refers to couldn’t have happened on the date given because the social care assessor had not yet made a referral to the financial assessment team. Another appointment was cancelled as the Council had already issued an appointment for another date. Mrs X says she did not receive the final appointment letter issued in May 2017. The Council addressed all letters in this period to Mr Y.
23. The Council did not contact Mrs X again until October 2017. It asked Mrs X to complete a financial assessment form for her father. The Council told Mrs X’s daughter that Mrs X asked for the form to be sent to her. It sent Mrs X several further letters about her father’s financial assessment and charges for his care.
24. Mrs X told the Council she could not complete the financial assessment form as her father had managed his own finances and she did not have access to the information the Council needed. She said she could not sign the form to confirm the information she provided was “true and accurate”. Mrs X offered to provide her father’s bank statements and evidence of his savings for the Council to refer to.
25. Mrs X said the Council would already have information about her father’s capital and savings as it was provided when her mother had a financial assessment early in 2016. She said officers told her they would access this information to assess his contribution. In its response to me, the Council said it could not use this to assess her father’s contribution.
26. Mrs X told the Council about errors in the invoice. The Council revised the invoice to take account of Mr Y’s hospital admissions and disruption following one of the care providers going in to administration.
27. The Council has been unable to complete a financial assessment of Mr Y’s ability to contribute to the cost of his care, and the outstanding charges remain in dispute.

Quality of care

28. Mrs X says she complained about the quality of care delivered to her father. The Council says it has no record of any formal complaints about the care providers. It confirmed it did receive one complaint from Mrs X about the telecare service. Mrs X said she complained directly to the care providers.
29. The Council sent Mrs X a copy of electronic monitoring records for her father, which the charges were based on. This shows several calls where carers have not logged in at the start of the call and out at the end, suggesting the care was not delivered on these occasions. The Council has not charged for these missed calls.
30. The social care records show that Mrs X did raise concerns with the Council about the care provided. These included the front door being left open and the flap being open on Mr Y’s key safe. The social care assessor told the provider and the Council’s commissioning team about the concerns. The care provider said it would remind staff to ensure they are closing everything after their visits.
31. When the care transferred to a new provider, Mrs X contacted the Council’s out of hours team to say the new carers had not put her father’s commode out or put his pyjamas on. The team told Mrs X to call back during office hours.
32. None of the concerns raised in paragraph 30 or 31 were recorded as formal complaints by the Council.
33. A short time after Mr Y’s care package started, the care provider went into administration. The Council put alternative measures in place to try and maintain the package of care until a new care provider started. In its correspondence with Mrs X, the Council recognised the care at this time was unsatisfactory and used its discretion not to charge for it.
34. The Council has been unable to provide me with daily records of the care provided to Mr Y.

Analysis

35. There is no suggestion in the written records that the package of care was intended to provide reablement, therefore I am satisfied all the care delivered was chargeable. I am also satisfied that Mr Y and Mrs X were told before his discharge home that there may be a charge for the care delivered. Therefore, there is no fault in the Council charging for the care.
36. However, the way in which Mr Y’s personal budget is set out in his support plans is confusing. The figures given for hourly rates, weekly costs and yearly costs do not correlate with each other. As no financial assessment had been completed, these support plans were the only record of what Mr Y might have to pay towards his care. It is unclear whether these figures have been calculated automatically or entered manually by the social care assessor. In any case they are misleading. It would not be unreasonable for Mr Y to assume the figure given as his “total weekly personal budget” was the maximum he would need to pay. This lack of clarity amounts to fault and created uncertainty for Mr Y and, later Mrs X, about how much they would need to pay towards the cost of care.
37. I accept the Council wrote to Mr Y with appointments to carry out a financial assessment. However, I consider the reasons Mrs X gave for why assessments could not go ahead on these dates to be valid. The Council has been unable to provide an explanation for why it waited five months before contacting Mrs X about her father’s care fees. There is no evidence Mrs X asked for a form to be sent to her and the Council told me it identified the outstanding charges through its debt recovery process. The delay in carrying out the financial assessment is fault and has caused Mrs X distress coming several months after the death of her parents.
38. The Council is correct to say it could not use information provided for Mrs Y’s financial assessment to decide on Mr Y’s contribution to the cost of his care. It needed to know exactly what income and capital Mr Y had to prepare an accurate financial assessment. There is no fault in its decision not to access Mrs Y’s financial information to carry out the financial assessment of Mr Y.
39. The Council says if Mrs X provided details for Mr Y, it would be able to do an accurate financial assessment and adjust the charge. I accept Mrs X’s view that she cannot provide all the information the Council asked for and cannot sign the financial assessment form to confirm the information is accurate. Mrs X has offered to provide the information she has access to but the Council has not accepted this offer. Had it done so, it may have been able to begin the financial assessment of Mr Y and give Mrs X further advice on what other information it needed to complete it. I consider this further delay and insistence on Mrs X completing the financial assessment form to be fault which has caused unnecessary stress to Mrs X.
40. The Council documented Mrs X’s concerns about the care delivered to her father but did not record these as formal complaints. It followed up on some, though not all, directly with the providers. The Council has reduced the outstanding charges to account for missed calls, periods of hospitalisation and in recognition of poor care. While there was some fault in the way care was delivered, I am satisfied the Council has taken steps to remedy this.

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Agreed actions

41. To remedy the injustice caused by the faults I have identified, within four weeks of this decision the Council will:
• consider the bank statements and evidence of savings Mrs X can provide and begin a financial assessment.
• apologise to Mrs X and pay £250 for the distress caused by the delay in carrying out the financial assessment.
• issue interim guidance to staff completing short-term support plans on how to check the figures provided in the personal budget section are correct.
42. If the Council finds Mr Y should have contributed to the cost of his care, it will calculate any contribution using the amounts set out in the personal budget sections of his support plans. That is, a maximum charge of £8.85 per week and then a further £6.19 a week from when the extra 15-minute call started. The Council should consider any further evidence Mrs X has about missed calls when calculating the final invoice.
43. Within eight weeks of this decision, the Council will:
• review all current short-term support plans to ensure the figure provided for the personal budget is correct.
• update the Ombudsman on its progress with correcting the system error.

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Final decision

44. I have completed my investigation and uphold Mrs X’s complaint. There was fault by the Council which caused injustice to Mrs X.

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Investigator's decision on behalf of the Ombudsman