Summary: Mr X complains that the Council did not explain that his mother would be charged for her residential care. He complains that the Council did not correctly complete a financial assessment and handled his complaint poorly. Mr X says letters from bailiffs have caused distress. He says he has spent time and trouble chasing the Council for a response to his complaint, and that the Council’s actions have caused frustration. The Ombudsman finds fault for the Council not keeping proper records of what it told the family about charging for care, and for the way it handled Mr X’s complaint. This caused injustice. The Council has suggested that it apologise to Mr X and make a payment to reflect the injustice. This is a suitable remedy. The Council has also agreed to make service improvements. The Ombudsman does not uphold the part of Mr X’s complaint about the financial assessment because we have found no fault.

The complaint

1. The complainant, who I refer to here as Mr X, complains on behalf of his mother, Mrs Y. Mr X complains that the Council:
1. did not tell him, his sister or Mrs Y that she would be charged for the period she was in a care home as a temporary resident;
2. did not complete the financial assessment correctly; and,
3. handled his complaint poorly.
2. Mr X says letters threatening bailiff action have caused distress, he has spent time and trouble chasing the Council for a response to his complaint, and the Council’s actions have caused frustration.

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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)
5. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)

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How I considered this complaint

6. Mrs Y has given written consent for Mr X to represent this complaint on her behalf.
7. I considered the information and documents provided by Mr X and the Council. I spoke to Mr X about his complaint. Mr X and the Council had an opportunity to comment on an earlier draft of this statement. I considered all comments before I reached a final decision.
8. I have considered the relevant legislation, statutory guidance and policies, set out below.

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What I found

9. Local authorities have a duty to charge for residential care. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 (‘the regulations’) and the Care and Support statutory guidance 2014 (‘the guidance’).
10. When a local authority arranges a care home placement, it has to follow these rules when undertaking a financial assessment to decide how much a person has to pay towards the cost of their residential care.
11. There are some circumstances where a local authority does not have to do a financial assessment immediately. The regulations say that if a local authority is satisfied from the evidence that the person’s financial resources do not exceed the limit, then the authority can be treated as having carried out a financial assessment.
12. The guidance sets out principles for charging for care and support. One of these principles is that the approach to charging should be clear and transparent so people know what they will be charged.
13. The guidance also says that local authorities should make sure there is sufficient information and advice available to make sure that the person or their representative can understand any contributions they are asked to make.

Complaints procedure

14. The Council has a procedure for dealing with complaints about adult social care. This says that the Council aims to send a final response to a complainant within 20 working days.
15. It says where complaints are more serious or complex, investigations should be completed within six months of receiving the complaint. It says the Council must tell the complainant if it becomes apparent that the investigation is going to take longer than this.

What happened

16. Mrs Y was admitted to hospital in September 2017. In October 2017, the decision was made that Mrs Y needed a short-term placement at The Grange care home. The Council’s records say that the financial assessment process was discussed with Mrs Y’s daughter, Ms Z.
17. On 1 November, Mrs Y moved to the care home from hospital.
18. In December, Mrs Y was assessed as being unable to return home. A request was made to make Mrs Y’s short-term placement permanent.
19. On 12 February 2018, Mrs Y became a permanent resident at the care home.
20. The day after, the Council called Ms Z. The Council’s records say it told Ms Z that funding had been agreed and it would send a financial assessment form to calculate Mrs Y’s contributions towards her care.
21. At the end of February, the Council sent Mrs Y a letter with an invoice and a copy of the financial assessment. The letter explained how the Council had assessed how much she had to contribute towards her care costs.
22. The letter said that the rate from 1 November 2017 to 11 February 2018 had been worked out “based on [her] state pension and pension credit and the rate we apply to savings between £14,250 and £23,250”.
23. The invoice showed that Mrs Y had been charged for care from the day she moved to the care home.
24. The financial assessment showed that that Council had taken into consideration Mrs Y’s pension and pension credit. It outlined the contributions Mrs Y must pay for her care costs from the date she moved in.
25. Shortly after this, the Council sent Mrs Y a credit note. This credited her account with the amount the Council had charged for her first six weeks in care, which should have been free.
26. In March, Mr X complained to the Council. He said the Council had not told him, Mrs Y, or Ms Z about any charges or about a financial assessment. He said Mrs Y did not have savings between £14,250 and £23,250, as said in the Council’s letter to Mrs Y.
27. In May, Mr X chased the Council four times for a response to his complaint. In mid-May, the Council returned Mr X’s call. It apologised for the delay. It said the invoice had been put on hold. It said the matter had been flagged as a priority because of the delay.
28. The next day, the Council emailed Mr X. It apologised for the delay. It said his complaint had been referred to the wrong department for investigation, which was a mistake. It said his complaint was now with the right department, and the investigator had been asked to look at it as a matter of urgency. The Council apologised for the mistake and the increased frustration.
29. In June, Mr X asked the Council for an update. The Council said it hoped to get its complaint response to Mr X in the next week or so.
30. The Council sent its complaint response to Mr X in August. It apologised for the length of time taken to investigate and respond. It said it was under pressure due to the volume of work which resulted in delays.
31. The Council said it told Ms Z about charges and the financial assessment process. It said charges are set by the government.
32. Mr X contacted the Council and said that no one had spoken to Ms Z about charging. He asked to escalate his complaint. Mr X said neither Mrs Y nor Ms Z had signed anything to say this had been discussed with them. He again questioned the Council’s invoice which said the rate had been calculated based on Mrs Y’s savings.
33. The Council replied the same day saying it would send Mr X a formal response by the first week of September.
34. The Council sent Mr X its second response to his complaint in March 2019. It apologised for the lengthy delay. It said that the first six weeks of Mrs Y’s care was free. It explained how the charges for the seventh week onwards had been calculated.
35. The Council signposted Mr X to the Ombudsman.
36. Mr X replied. He asked the Council to answer the points in his complaint that had not been addressed. He said that a financial assessment had not been done.
37. The Council replied saying records showed that charges had been discussed with Ms Z, and that a financial assessment had been done. It said that Age UK had been asked to help find a suitable placement. It said Age UK send out booklets about charging.
38. Mr X then complained to the Ombudsman.

Analysis

Charging for care

39. Mr X complains that the Council did not tell him, Ms Z or Mrs Y that she would be charged for the period she was in a care home as a temporary resident (part a of the complaint). Mr X says the first time they became aware that Mrs Y was being charged for contributions to her care was when they received the invoice in February 2018.
40. The Council says it told Ms Z that Mrs Y would need to contribute towards the cost of her care.
41. The Council’s records say that in October 2017 the Council “discussed [the] financial aspect of transfer to residential care”. The records for this month also say, “following discussion with daughter anticipate Mrs [Y] would require a [Council] contract”.
42. The Council’s records from February 2018 say it called Ms Z and “advised that funding had been agreed and that they would receive a financial assessment form to calculate [Mrs Y]’s contribution”.
43. The Council accepts that there is nothing in writing to say it explained to Mrs Y or her family that she would be expected to pay a contribution to her care costs.
44. I cannot find that the Council told Mrs Y about contributions because the records do not show this. There is nothing to show what was explained to Mrs Y, Mr X or Ms Z. The records should be clear about exactly what was explained.
45. The guidance says the approach to charging should be clear and transparent so people know what they will be charged. Because of the poor record-keeping, I cannot find that the Council acted in line with the guidance.
46. Further to this, the records do not show that sufficient information and advice was given to Mrs Y or her family to make sure they understood about charging. For this reason, I cannot find that the Council acted in line with the guidance.
47. The Council says Age UK would have sent information to Mrs Y and her family about charging for care. The Council is responsible for charging for care therefore the Council is responsible for telling people about charging. The guidance is clear about this. I do not find it appropriate for the Council to rely on other agencies to tell people about charging for care.
48. The Council says social workers in hospital are very busy and have limited time, so putting things in writing would add delay. I do not agree. The Council has a responsibility to be clear and transparent about charging.
49. If time is taken to explain contributions to care, and if sufficient advice and information is given in line with the guidance, it would not take more time for that person to sign a form saying they understand what has been explained.
50. In this case, the Council could have told Mrs Y at any point in the first six weeks of her care that she would soon be expected to contribute towards care costs.
51. I find the Council at fault for not having proper records about what was discussed with, or explained to, Mrs Y or her family, in line with the guidance.
52. However, I do not find that this fault caused injustice because the Council correctly charged for the care, in line with the law.

Financial assessment

53. Mr X complains the Council did not complete the financial assessment correctly (part b of the complaint). He says the letter sent to Mrs Y with the invoice said the Council included her savings when it calculated the amount she had to contribute to her care. He says Mrs Y did not have savings between £14,250 and £23,250 as the Council said.
54. The Council accepts that the letter was “badly worded”. It says it calculated Mrs Y’s contributions based on the fact that she had no savings.
55. The Council’s letter implied that Mrs Y had savings in the above amount. However, the financial assessment itself does not mention any savings. It says the contribution was calculated based on Mrs Y’s pension and pension credit.
56. I find that the Council’s letter is misleading. The Council accepts that this part of the letter was “an error”. It would have been best practice make it clear to Mrs Y and her family on what basis or information the Council had calculated her contributions.
57. While I find that the letter was misleading, I do not consider this significant enough to constitute fault. Ultimately, the Council completed the financial assessment correctly and Mrs Y’s care costs were correctly calculated.
58. The Council based its financial assessment on recent information it had about Mrs Y’s benefits. The Council was satisfied from this information that Mrs Y did not have finances that exceeded the limits.
59. The Council’s financial assessment was in line with the regulations (see paragraph 11). For this reason, I do not find the Council at fault for the fact that it did not do a financial assessment for Mrs Y as soon as she moved into the care home.

Complaint handling

60. Mr X complains the Council handled his complaint poorly (part c of the complaint). He says there were unacceptable delays.
61. Mr X complained in March 2018. Mr X repeatedly chased the Council for a response in May and June. The Council told Mr X it would send its response in June. It sent its first complaint response in August. This is two months after the Council said it would respond, and five months after Mr X complained.
62. Mr X asked to escalate his complaint in August 2018. A week later, the Council said it would respond by the beginning of September. The Council sent its response in March 2019. This is seven months after Mr X asked for a review of his complaint, and a year after he initially complained.
63. This is fault.
64. The Council accepts that there were “clear errors” and delays in handling Mr X’s complaint.
65. Neither of the Council’s complaint responses answer the part of Mr X’s complaint about Mrs Y’s savings being used in the financial assessment.
66. The Council accepts that it failed to answer this part of Mr X’s complaint. I find the Council at fault for this.
67. I find that these faults in handling Mr X’s complaint caused him injustice. He had to wait a year for the complaint to be completed, and the Council did not answer each aspect of his complaint. This contributed to Mr X’s frustration, and meant he spent time and trouble chasing the Council.

Agreed action

68. The Council accepts that it was at fault for the way it handled Mr X’s complaint. The Council has suggested that it apologise to Mr X in writing for this and make a payment of £250 to reflect Mr X’s time and trouble. This amount is in line with the Ombudsman’s published guidance on remedies.
69. I find that these are suitable remedies for the injustice caused by this fault. The Council should take these actions within four weeks of this decision.
70. The Council says it has reminded staff of the importance of responding clearly and in full to complaints. I am satisfied that the Council has taken action to address the individual errors that led to significant delays.
71. Within three months of this decision, the Council has agreed to review with staff the way they record discussions and explanations about charging.
72. Within three months of this decision, the Council has agreed to consider implementing a form (for example) for people to sign to show that contributions have been explained and the person understands. This would avoid any future similar recurrence.
73. The Ombudsman will need to see evidence that these actions have been completed.

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Final decision

74. I have completed my investigation and uphold parts a and c of Mr X’s complaint. This is because I have found fault causing injustice.
75. I do not uphold part b of Mr X’s complaint. This is because I have found no evidence of fault.

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Investigator's decision on behalf of the Ombudsman