London Borough of Islington (19 002 161)

Category : Adult care services > Charging

Decision : Upheld

Decision date : 28 Aug 2019

The Ombudsman's final decision:

Summary: Mr X complained the Council sent him a bill for care charges in a format he could not understand and without telling him it had carried out an assessment. On the evidence seen, the Council was at fault. It has remedied the injustice caused by cancelling the care charges from its bill and by refunding some of the charges Mr X paid for his care.

The complaint

  1. Mr X complained about a bill the Council sent for care charges between November and December 2018. He said that Council did not tell him he had to pay for his care and did not tell him it had carried out a financial re-assessment. He also complains the bill was sent in a format he could not understand.

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The Ombudsman’s role and powers

  1. 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)

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How I considered this complaint

  1. As part of the investigation I have considered the following:
    • The complaint and the documents provided by the complainant.
    • Documents provided by the Council and its comments in response to my enquiries.
    • The Care Act 2014 (section 14, 17 and 26)
    • The Care and Support Statutory Guidance 2014
    • The Care and Support (Charging and Assessment of Resources) Regulations 2014
  2. Mr X and the Council had an opportunity to comment on my draft decision and I considered their comments before I made a final decision.

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What I found

  1. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. A council can begin charging from the date it starts to incur costs to meet a person’s care and support needs. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care.
  2. When a council decides to charge it must carry out a financial assessment of what the person can afford to pay and, once complete, it must give a written record to the person. This is provided alongside a person’s care and support plan or separately. It should explain how the assessment has been carried out, what the charge will be and how often it will be made. The council should ensure this is provided in a format the person can easily understand.

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What happened

  1. The Council first assessed Mr X’s care needs in 2013 and he contributed towards the cost of his care then. He was reassessed in 2016 as not having to contribute towards his care and support.
  2. In September 2017 Mr X moved into new accommodation and received an increase in benefits. His social worker forgot to refer Mr X for a re-assessment and as a result Mr X did not contribute towards the cost of his care between September 2017 and October 2018.
  3. The Council carried out a reassessment of Mr X’s finances in October 2018 and noticed his increased benefits. It then sent Mr X a bill for care charges which were due in November 2018.
  4. The Council met with Mr X and his advocate in January 2019 and provided the necessary information to enable Mr X to understand the re-assessment and the bill he had received for care charges.
  5. Mr X said he would pay care charges from January 2019. He asked the Council to waive its care charges for November and December 2018, as he said that he did not understand the charges until January 2019.
  6. Mr X complained to the Council in January 2019 after it refused to waive the charges.
  7. In its complaint response on 11 February 2019, the Council told Mr X that its records showed care professionals told him about paying care charges verbally in the past. It also said, due to an error, Mr X had been receiving free care between September 2017 and October 2018. The Council said it would not waive the charges.
  8. On 21 February 2019 Mr X got back in touch with the Council to ask what he could do next. He said the Council knew about his learning difficulties and reduced memory, so he could not be expected to understand the bill without explanation, or to remember what the Council had told him several years earlier.
  9. On 27 March 2019 the Council maintained it would not waive the care charges and signposted Mr X to the Ombudsman.
  10. Mr X brought his complaint to the Ombudsman on 10 May 2019.

Council’s response to my enquiries

  1. The Council provided confirmation it had carried a re-assessment of Mr X’s finances in October 2018.
  2. It accepted its letter to Mr X in October 2018 was not in a format he could understand. It also accepted Mr X was not aware of the position until the meeting with his advocate in January 2019
  3. As a result, the Council has amended the start date for Mr X’s re-assessment to February 2019 and it has cancelled all charges before this date. This means the Council will refund Mr X the sum of £429.86.
  4. The Council has also reviewed Mr X’s re-assessment following additional information provided by his advocate. Mr X’s contribution to his ongoing care costs has been reduced to £72.37 per week.
  5. The Council said it will review how it communicates with its service users to ensure it sends information in an accessible format in the future.

Analysis

  1. The Council has accepted fault for failing to send details of Mr X’s new assessed contributions in a format he could understand. This meant Mr X was not aware the Council had carried out a financial review and he was not aware of the outcome, or that he had to pay towards the cost of his care.
  2. The Council has accepted that Mr X was not aware of the increased contribution he must pay until January 2019.
  3. The Council has agreed to start charging Mr X fees from February 2019, instead of the earlier date of November 2018. This means Mr X does not have to pay towards the cost of his care between November and December 2018 and the charges he paid between January and February 2019 are to be refunded.
  4. The Council’s actions remedy the injustice caused.

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Final decision

  1. The Council was at fault for not providing Mr X with a copy of his financial re-assessment in a format he could understand. I have completed my investigation because the Council has offered an appropriate remedy.

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Investigator's decision on behalf of the Ombudsman

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