Summary: The Council did not carry out regular financial reassessments of a service users ability to contribute towards day centre care costs. There is evidence that it told the user of changes to a direct debit amount and that she needed to pay the cost of the day centre. The Council’s offer to backdate a financial assessment and to replay any fees charged when the user did not attend, along with a £250 payment for time and trouble remedies the injustice caused.

The complaint

1. The complainant, whom I shall refer to as Miss B, is represented by Mr C. Mr C complains about the Council’s billing of fees for the time Miss B spent at a day centre.
2. Mr C complains specifically the Council did not tell Miss B in writing of changes to the amount she paid by direct debit and due to misleading verbal information she thought that she was getting one day at a day centre free of charge.
3. Mr C also complains the Council’s refund of day centre fees for times when Miss B did not attend is inadequate.

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The Ombudsman’s role and powers

4. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
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)

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How I considered this complaint

6. I read the papers sent by Mr C and discussed the complaint with him.
7. I considered the Council’s comments about the complaint and any supporting documents it provided.
8. I gave the Council and Mr C the opportunity to comment on my draft decision.

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What I found

9. Miss B lived at home and attended one day a week at a day care service for the elderly from 2009.
10. The Council has sent me a copy of the financial assessment on 30 November 2009 which assessed Miss B as needing to contribute £5 per week towards the day care on one day.
11. The Council arranged a direct debit in January 2010 for £20 every four weeks from Miss B’s account for the cost of one day a week day care at the centre.
12. In 2011 the Council changed its policy on charging for social care services for adults living at home. The Council said that it could not continue to subsidise day care services as it had done previously, so the charge would increase from £5 to £30.75 per day. The councils leaflet said that to ease the period of transition it would cap weekly increases in costs to £30 a day in the first year. The leaflet says that an individual with savings over £23,250 would pay the maximum charges.
13. The Council said that Miss B’s direct debit increased to £123 every four weeks in June 2011 as the cost of one days attendance increased to £30.75 per day. The Council said that it told all customers who paid by direct debit of the change in amount and has sent me a copy of the general notification letter sent.
14. The Council says the direct debit from Miss B’s account has remained at £123 every four weeks so it did not send any further notifications.
15. The Council carried out a care and support needs assessment in March 2013, as Miss B asked for some equipment to help her around the house. The Council sent the support plan to Miss B in December 2013. There is a note on the social work file in March 2014 that Miss B wanted the day care to increase to 2 days a week. The social worker noted that Miss B should do this privately as she would not meet the Council’s substantial needs but as the Council put in place the services she needed to review the support plan.
16. The review was carried out in July 2014. The notes say that Miss B said she did not wish to go to day care for a second day as she did not wish to pay as she made a contribution of £125 per month towards care services. Miss B told the social worker she did not wish to have any carers and that her nephew, Mr C, took her shopping and provided support.
17. Miss B went into hospital in October 2014. There is a note on the file that the financial implications of Miss B’s discharge to reablement care were discussed with Mr C’s wife.
18. The social workers notes of December 2014 record that Miss B was able to read the instructions on ready meals with a magnifying glass but found small print difficult without. Mr C says he does not believe this was correct. The social worker recorded that Miss B would like to restart her day centre visits and would arrange carers privately if needed so the reablement carers stopped.
19. Miss B paid privately (in cash) to attend an extra day at the day care centre from July 2015.
20. A social worker carried out a care and support needs assessment in December 2016. There were no changes to the care plan, with one day at day care commissioned by Social services but funded by Miss B.

My analysis

21. There are four parts to the complaint made by Mr C, which I intend to consider in turn.

Changes to direct debit amount

22. Mr C complains the Council did not tell Miss B of the changes to the direct debit amount. The only change occurred in June 2011. The Council says that all service users who paid by direct debit were informed by letter, but due to the time that has elapsed, no individual copies of this letter are retained on the files. It has, however, sent an example copy of the letter.
23. I have looked at the direct debit guarantee and this says the Council should report if there are changes, but does not place any obligation on the Council to contact the payer yearly.
24. I can find no evidence of fault by the Council. The Council consulted on its change to policy and has provided evidence that all service users were informed of the changes in 2011. Given the time that has elapsed, it is impossible to confirm for certain that Miss B got the letter but all the evidence provided by the Council shows this would have happened on the balance of probabilities. The direct debit guarantee does not require the Council to tell Miss B there were no changes to the amount after 2011.
25. The Council’s 2011 leaflet does say the increase in charges would be capped to £30 in the first year, so I will ask the Council to check that it applied this cap in charges to Miss B’s account for the first year.

Reassessment of Miss B’s financial contribution

26. The Council carried out a financial assessment of Miss B’s contribution in 2009.
27. The Council has no policy before 2017 requiring it to regularly review financial assessment.
28. The Council’s current (April 2018) non-residential care charging policy says that the Council should ‘regularly reassess a person’s ability to pay and take account of any changes in their resources, particularly when there is a change in circumstance or at the request of the individual’. The policy says the Council, where appropriate, may automatically reassess contributions based on changes it becomes aware of through policy, benefits or regulation changes.
29. Miss B was first financially assessed in 2009. Since then there are no records of financial assessments carried out by the Council. I consider it was fault for the Council to not carry out regular financial assessments to ensure that Miss B’s situation remained the same. Miss B has savings over the £23,250 threshold and a ‘light touch’ assessment would have been adequate as she would have always been assessed as being able to pay for her own care. But, I do consider the Council should have carried out an assessment, ideally annually, or at least every two years.
30. In order to remedy any injustice, the Council has offered to carry out backdated financial assessments. This seems to me to be a reasonable remedy in the circumstances. Mr C has said that as Miss B has always had savings above £23,250 he does not consider the backdated financial assessments are needed.

The Council wrongly told Miss B that she would receive one day at the day centre without charge.

31. It is clear from the social workers notes that cost of care was discussed with Miss B and that she turned down more care as she did not want to pay the cost in 2014. The support plan from 2014 also says the day care is self funded by Miss B.
32. Mr C says he believes that Miss B thought, from about 2012 onwards, that one day a week was funded by the Council and so she did not have to pay for this.
33. I have found no evidence the Council told Miss B that she would not need to pay for one day at the day centre. There is evidence from the social workers notes that from 2014 Miss B was aware that she needed to pay for day care. There was also a £123 direct debit from Miss B’s account every month to the Council and there is evidence that Miss B did manage her financial affairs with help.
34. While I appreciate there may now be some confusion over what happened, I cannot find any independent evidence to support Mr C’s view that Miss B was unaware that she was paying for the day care provided by the Council at the time. The events occurred along time ago and without independent evidence I cannot say there was fault by the Council. The little evidence available does not support Mr C’s view.

Refund of day centre fees

35. The day care provider sent a list of the dates that Miss B did not attend to the Council but the Council did not adjust the charges at the time. I consider this was fault, given that Miss B was funding the costs.
36. Mr C complained to the Council that Miss B was charged for occasions when she did not attend the day care centre. The Council investigated and proposes to refund £1339 to Miss B. It has sent a list of the dates, so Mr C can check them with his records. This seems to be to be a satisfactory remedy to this part of the complaint.

Agreed action

37. That the Council ensures the £30 cap mentioned in its leaflet of 2011 was applied to the charges made to Miss B for 2011 within two months of the date of the decision on this complaint, if records are still available for this period.
38. That if Mr C provides a list of any dates Miss B has not been refunded for not attending the day care centre, the Council will investigate and provide a refund if appropriate, within 2 months of the date of the decision on this complaint.
39. That the Council pays £250 towards Miss B and Mr C’s time and trouble in pursuing the complaint, within 2 months of the date of the decision on this complaint.

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Final decision

40. I have completed my investigation of this complaint. This complaint is upheld and I consider the remedies detailed above are a satisfactory to remedy to the injustice caused.

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Investigator's decision on behalf of the Ombudsman