Summary: Ms X complained the Council failed to tell the family the outcome of a financial reassessment of their mother’s contribution towards her home care and delayed sending amended invoices for the contributions. The Ombudsman finds the Council at fault for being unclear about the result of the reassessment, delay in invoicing, failure to explain the late invoice and failure to put the complaint through its complaints procedure. The Council has agreed to apologise and to write off the debt caused by late, backdated adjustments. This is a suitable remedy for the injustice caused by the Council’s faults.

The complaint

1. Ms X complained the Council:
• failed to tell her or her sister in September 2017 the outcome of its financial reassessment of their mother's ability to contribute towards her home care, and then
• delayed sending amended invoices until August 2018, three months after her mother's death.
2. This resulted in a debt to the Council due from her mother's estate. Ms X said she was reluctant to pay this given the Council's failures.

Back to top

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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. 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)

Back to top

How I considered this complaint

5. I have considered information from:
• Ms X’s complaint and from a telephone conversation with her;
• the Council’s response to my enquiries; and
• the Care Act 2014.
6. I gave Ms X and the Council the opportunity to comment on this draft decision. I have considered the comments received before making a final decision.

Back to top

What I found

Charging for home care

7. Where a council arranges home care and support to meet a person's needs, it may charge the adult for the cost of the care. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The scheme must comply with the principles in law and guidance, including that charges should not reduce a person’s income below Income Support plus 25%. The Council can take a person’s capital and savings into account subject to certain conditions. If a person incurs expenses directly related to any disability he or she has, the Council should take that into account when assessing his or her finances. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)
8. Councils must give a written record of its financial assessment to the person receiving care or their representative. Councils review assessments each year.

Events 2017 - 2018

9. In 2017 Ms X’s mother, Mrs Y, was receiving a package of care at her home. She contributed to the care package based on a financial assessment the Council carried out in 2016. The Council invoiced Ms X and her sister, Ms C, for the contributions. The sisters kept the account up to date.
10. In September 2017 the Council carried out a reassessment of Mrs Y’s ability to pay towards her care. The Council says it wrote to Ms C shortly afterwards. The Council has provided a copy of the letter but Ms C says she never received it. The letter explains what factors the Council took into account and the Council’s assessment that Mrs Y’s contribution towards her care should double.
11. The Council continued to invoice Ms X and Ms C at the same rate as before the reassessment and they continued to pay on time.
12. In 2018 Mrs Y’s health deteriorated and she died in May 2018.
13. After Mrs Y’s death the Council sent a number of invoices and credit notes to
    Ms X and Ms C which they were happy to settle. These finalised the care finances by taking into account the care Mrs Y received at home and periods when she received no care because she was in hospital.
14. In early August 2018 the Council sent Ms X and Ms C an invoice that listed backdated adjustments to Mrs Y’s contributions to her care. The invoice listed extra weekly contributions due from September 2017 to May 2018. The contributions were virtually as much as Mrs Y had already paid. They were in line with the financial reassessment carried out in September 2017. The Council did not send an explanatory letter with the invoice.
15. Ms X and Ms C queried the new invoice and the Council told them the adjustments were the result of the financial reassessment the previous year. They explained the Council had not told either of them the outcome of the assessment and they had just continued to pay according to the invoices received.
16. The Council pursued the debt. In response, Ms X wrote a letter of complaint to the Council. She said she did not understand how the Council could bill her so late and how her mother’s contributions could have doubled.
17. The Council replied to Ms X’s complaint with two letters in November 2018, one from its Financial Assessments and Benefits Team and one from its Adult Social Care debt recovery team. The Council said it had experienced problems when transferring to a new financial system. It said some client contributions to care had not transferred and the Council had had to identify them manually. Mrs Y’s case had been one of these. However, as the Council had sent Ms C the letter about contributions in September 2017 it considered Ms C was aware of the amended contributions and they were payable. Neither letter explained Ms X could pursue her complaint through the Council’s complaints procedure.

Ms X’s complaint to the Ombudsman and the Council’s response

18. Ms X complained to the Ombudsman and we made enquiries of the Council about the complaint. In its response to our enquiries the Council said it had not referred Ms X’s complaint in 2018 to its complaints procedure. It said it had now reviewed
    Ms X’s concerns and proposed settling the complaint by:
• apologising to Ms X and Ms C for the difficulties they faced regarding the reassessment of Mrs Y’s contributions towards her care; and
• writing off the late, backdated adjustments to Mrs Y’s contributions.
19. I confirmed this would be a suitable remedy.

Findings

20. In September 2017 the Council was right to reassess Mrs Y’s ability to contribute towards her care. However it is not clear the Council ever told Ms X or
    Ms C the outcome of the reassessment. That lack of clarity is fault.
21. The Council accepts it delayed invoicing Ms X and Ms C for the increased contributions it calculated were due from September 2017 onwards. The Council took almost a year to send an invoice and failed to provide an explanation with it. The delay and lack of explanation is fault.
22. The Council responded to Ms X’s complaint but did not consider it through the Council’s complaints procedure. That was fault.
23. The Council’s faults mean Ms X was caused frustration and uncertainty and she lost the opportunity to have her complaint fully reviewed by the Council earlier.
24. The Council’s proposals to settle the complaint (at paragraph 18 above) will be a satisfactory remedy for the injustice caused by the Council’s faults.

Back to top

Agreed actions

25. Within a month of this decision the Council will:
• apologise to Ms X and Ms C for the difficulties they faced regarding the reassessment of Mrs Y’s contributions towards her care; and
• write off the late, backdated adjustments to Mrs Y’s contributions.

Back to top

Final decision

26. I have now completed my investigation because the Council’s agreed actions will remedy the injustice caused to Ms X by its fault.

Back to top

Investigator's decision on behalf of the Ombudsman