Summary: Ms B complained the Council unreasonably backdated a charge for permanent nursing care and failed to respond to her correspondence. The Council delayed changing the status of the caring arrangements and in carrying out a financial assessment. That meant Ms B and her family were faced with a large backdated bill. The Council also delayed responding to Ms B’s correspondence which led to her going to time and trouble to pursue the complaint. An apology, agreement to cancel the increased charges between February 2017 and August 2017 and a payment to Ms B is satisfactory remedy for the injustice caused.

The complaint

1. The complainant, whom I shall refer to as Ms B, complained the Council:
• unreasonably backdated a charge for permanent nursing care when it had not told the family about the charge or carried out a financial assessment; and
• failed to respond to Ms B’s correspondence.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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

4. As part of the investigation, I have:
• considered the complaint and Ms B's comments;
• made enquiries of the Council and considered the comments and documents the Council provided;
• considered the Council’s comments on my draft decision; and
• considered Ms B’s comments on my draft decision.

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What I found

5. The Care Act 2014 came into force in April 2015. It provides a single legal framework for charging for care and support and replaces all other legislation, guidance and regulations in relation to charging and financial assessment.
6. Section 14 of the Act explains the power of the local authority to charge for the cost of care. Section 17 explains the duty to undertake an assessment of financial resources.

Chronology of the main events

7. Ms B’s mother moved into a nursing home on a temporary basis in January 2017. Before that move took place the Council provided Ms B’s sister with a fact sheet on the Council’s charging policy for residential services.
8. The Council carried out a care assessment on 23 January 2017 and the family agreed to pay a £60 per week top up.
9. The Council carried out a review on 20 February 2017 which changed the status of the placement to permanent nursing care. The Council did not amend its computer records and continued to charge the temporary care amount.
10. On 17 March Ms B returned the financial assessment form to the Council. In the covering letter Ms B explained she was confused about the procedures and timetable and understood she had completed the financial assessment for short-term care. Ms B told the Council she understood the process for applying for permanent care had begun at the assessment on 20 February 2017 and she asked whether the Council needed further information. The Council did not respond to that letter.
11. On 2 May Ms B contacted the Council to find out how the family could obtain permanent care for her mother. The Council told Ms B to ask for a financial assessment.
12. On 22 June the Council identified the case was still recorded on its records as a short-term placement. The Council amended that to permanent care.
13. The Council carried out a financial assessment on 4 August. The Council then sent Ms B an invoice on 4 September. That invoice included backdated charges to 20 February 2017, when the care became permanent. Ms B queried the invoice on 27 September.
14. Ms B contacted the Council again on 9 November to ask for an explanation. Ms B followed that up with a letter on 19 November. When Ms B did not receive a response she contacted the Council again on 14, 18 and 21 December. The Council wrote to Ms B on 16 January 2018 but did not address the issue of the backdated charges. The Council told Ms B it would write to her separately about that. The Council did not do that until 10 July 2018.

Analysis

15. The Ombudsman would expect the Council to tell families about changes in charges for care as soon as possible after the change has occurred. Where the Ombudsman considers a Council has delayed telling families about the change in charges he would not expect a council to backdate the charges. What I have therefore considered is whether the Council properly informed Ms B and her family about the increased charge when her mother became a permanent resident in the nursing home in February 2017.
16. I have carefully considered the documentary evidence. I am aware when Ms B’s mother first moved into the nursing home the Council provided Ms B’s sister with a fact sheet on charging for residential services. The fact sheet explained the difference between temporary and permanent residential care and explained temporary charges only apply for short-term or respite care. The Council suggests provision of this document put the family on notice the charges for permanent residential care would be more than those charged for temporary residential care. However, having considered the factsheet, I note it does not specify what the charge for permanent care is. Nor does it explain the charge is higher for permanent care. So, I do not consider that factsheet would have made the family aware either that the amount would increase if the placement were made permanent nor what that increase would be.
17. I am satisfied though the Council carried out an assessment for permanent residential care on 20 February 2017. I am also satisfied Ms B and her sister were present at that assessment. However, although it is clear the assessment was for permanent residential care there is nothing in that assessment to suggest the Council made Ms B and her sister aware of the increased charge which would result. I would have expected the Council to put Ms B and her sister on notice at that point that the charges would likely increase, depending on the financial assessment. Failure to do that is fault.
18. I am also concerned about the delay completing the financial assessment. The financial assessment should have taken place shortly after the February 2017 review. However, because the Council failed to make the change to permanent care on its computer records, which is also fault, the Council did not carry out the financial assessment until 4 August 2017. That again is fault. As the Council failed to carry out the financial assessment promptly Ms B and her sister had no way of knowing either that the charge for their mother’s care would increase or what that increased charge would be. I am particularly concerned the Council did not clarify that given Ms B returned a financial assessment form on 17 March 2017 where she asked the Council to clarify what was happening with the application for permanent care. In that letter Ms B also referred to her belief she had completed the financial assessment form for short-term care. That was an opportunity for the Council to identify it had failed to move the case onto permanent care and to carry out the financial assessment for permanent care. That was also the case when Ms B contacted the Council again to ask about how the family could get long-term care on 2 May 2017. Failure to do identify in March and May 2017 that the Council had not changed the status of the placement to permanent care is fault.
19. So, the Council is at fault for delaying completing the financial assessment and for the delay telling Ms B about the increased care charges. I now have to consider what injustice that fault caused Ms B. Had the Council acted as it should have done following the review meeting in February 2017 it would likely have promptly completed a financial assessment and put in place the increased payments for care from March 2017. Because the Council did not tell the family about the increased payments for a further seven months Ms B was left with a much larger bill than she expected. Given the delay finding out about the increased amount the family needed to pay is caused by fault by the Council I do not consider it appropriate for the Council to charge Ms B for any period before the financial assessment in August 2017. I therefore recommended the Council cancel the difference between the short-term care charge and the permanent care charge between 20 February 2017 and 4 August 2017, when it completed the financial assessment. The Council has agreed to that.
20. The Council also failed to respond to Ms B’s communications in March 2017 and September 2017. The Council then delayed responding to Ms B’s correspondence in November and December 2017 and only responded to her complaint about the charges in July 2018. Failure to respond to some of Ms B’s correspondence and delay responding to other correspondence is fault. Those delays led to Ms B having to go to time and trouble to pursue her complaint. To remedy that injustice I recommended the Council pay her £100. The Council has agreed to that.

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Agreed action

21. Within one month of my decision the Council should:
• apologise to Ms B for the faults identified in this statement;
• pay Ms B £100 to reflect the time and trouble she had to go to pursuing her complaint; and
• cancel the difference between the temporary care charge and permanent care charge between 20 February 2017 and 4 August 2017. If Ms B has paid any of the difference in charges for that period the Council should refund that amount.

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Final decision

22. I have completed my investigation and uphold the complaint.

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Investigator's decision on behalf of the Ombudsman