Summary: Mrs X complained when the Council invoiced her for her late Aunt’s (Mrs Y’s) outstanding care fees. The Council has admitted fault for its delay in sending Mrs Y an invoice for the fees. It has apologised for this delay. The Ombudsman has found no injustice caused by this delay. We have completed our investigation.

The complaint

1. Mrs X complained when the Council invoiced her for her late Aunt’s (Mrs Y’s) outstanding care fees. She says Mrs Y was not accountable for the outstanding fees. She says the Council did not send Mrs Y any invoices for the fees. She says the Council was rude and unsympathetic when she spoke to them about the fees.

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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. I have considered Mrs X’s complaint and the Council’s responses to Mrs X and to my enquiries.
5. I have spoken to Mrs X about the complaint.
6. I have written to Mrs X and the Council with my draft decision and considered their comments.

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What I found

7. The Government says that anyone with assets over £23,250 is responsible for the full cost of their care. If an individual is already living in a private residential care home and their capital falls below £23,250, they can ask for a financial assessment.
8. In many cases, the Council may pay part of the care costs. This amount varies depending on an individual’s financial circumstances.
9. The Council should work with an individual to complete a financial assessment. This will determine how much they will be asked to contribute.
10. An individual’s contribution towards their care home costs should leave a weekly personal expenses allowance. The Government has set this at £24.90 per week.

What happened

11. Mrs Y lived in residential care home for 10 years until she passed away in June 2018. This complaint is about Mrs Y’s outstanding care fees for the period between November 2017 and June 2018.

November 2017 – June 2018

12. In November 2017, Mrs Y’s capital assets had fallen below £23,250. The Council arranged to carry out a financial assessment for Mrs Y to calculate her revised contribution. It sent Mrs Y a letter to confirm the financial assessment date as 7 December. The Council said that Mrs Y declined to have a family member present during the assessment.
13. The Council have confirmed that Mrs Y was fully involved in the financial assessment. It said there was no evidence Mrs Y lacked capacity regarding her care and support needs. It said that the care home manager and Mrs Y’s GP confirmed she had capacity.
14. The assessment concluded that Mrs Y’s weekly contribution was £336.03. I have seen a financial statement formal declaration signed by Mrs Y, dated 7 December 2017. This declaration confirms that Mrs Y understood that she was required to pay her assessed contribution.
15. In April, the care home fees increased. The Council carried out a revised financial assessment. This assessment showed Mrs Y’s revised weekly contribution as £345.72 per week.
16. On 22 May, the Council sent Mrs Y a letter confirming her required weekly contribution.
17. On 3 June, Mrs Y passed away.
18. On 15 June, the Council sent Mrs X (executor of Mrs Y’s will) an invoice for the outstanding debt of £10,407.69. This was Mrs Y’s care contribution for the 29 week period between November 2017 and June 2018.

Mrs X’s complaint

19. Mrs X was shocked to receive the invoice from the Council. She says she was told by the care home that the late Mrs Y had no outstanding fees. The Council said this was because, the Council pays the total fees to the care home then invoices the individual directly for their contribution.
20. Mrs X said Mrs Y did not receive any invoices from the Council until May 2018. This was when the Council wrote to Mrs Y to confirm her revised contributions following the reassessment of her finances.
21. In its response to Mrs X’s complaint, the Council confirmed and apologised for its delay in sending Mrs Y an invoice. It said, as a result of Mrs X’s complaint, it would review its working practice to try and mitigate this in the future.
22. The Council went on to say the outstanding invoice needed paying. It said, at the time of the financial assessments, the Council advised Mrs Y and she understood she needed to contribute to the cost of her care. I have seen a declaration signed by Mrs Y which confirms she will pay the fees.

My findings

23. From the evidence I have seen, the Council carried out Mrs Y’s financial assessment accordance with the Care Act 2014. It reassessed Mrs Y when her circumstances changed.
24. The Council asked whether Mrs Y wanted to have a family member present during the assessment, which she declined. The Council, along with the care home manager and Mrs Y’s GP deemed her to have capacity to make decisions about her care and support. Mrs Y signed a declaration stating that she understood that she would be required to make contributions to her care fees.
25. The Council has admitted it was at fault for the delay in sending Mrs Y an invoice for the fees and has apologised for this. It has also offered to take £100 off the total debt. However, Mrs Y was liable for the fees and the evidence shows she was aware of this. Therefore, Mrs X, as executor, needs to pay the outstanding fees.

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Final decision

26. I have completed my investigation. The Council was at fault for its delay in sending an invoice to Mrs Y. However, I have not identified a significant injustice to Mrs Y, or Mrs X.

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Investigator's decision on behalf of the Ombudsman