Summary: Mrs X complains the Council failed to tell her son he was required to pay towards the cost of his care plan. Mrs X says the Council wrongly charged her son for care he has not received and sent invoices to an incorrect address. Mrs X says the Council’s actions caused stress to herself and her son. The Ombudsman finds some fault by the Council in this matter. The Council has agreed to provide an apology and an explanation for the costs, and to waive the outstanding invoices.

The complaint

1. Mrs X complains the Council failed to inform her son, Mr Y, that he was required to pay towards the cost of his care plan. Mrs X says the Council wrongly charged her son for care he has not received and sent invoices to an incorrect address.
2. Mrs X says the Council’s actions and requests for payment has caused stress to herself and her son.

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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. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. We may investigate complaints from a person affected by the matter in the complaint, or from someone the person has authorised in writing to act for him or her. (section 26A or 34C, Local Government Act 1974)
6. 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

7. I have spoken to Mrs X and considered the information she has provided.
8. I have made enquiries to the Council and considered the information provided by it.
9. Mrs X and the Council had the opportunity to comment on a draft of this decision. I considered these comments before making a final decision.

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What I found

Charging for social care services and financial assessments

10. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14)
11. The Care Act 2014 gives local authorities a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
12. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)
13. The guidance says a personal budget should specify the amount the service user will have to pay towards the cost of the care, based on the financial assessment.

What happened

14. Mrs X’s son, Mr Y, has a learning difficulty and several health issues, including anxiety.
15. Mr Y was living at his own address with support from Mrs X. This support included helping Mr Y manage his finances.
16. Mrs X contacted the Council in March 2017. She said she wanted Mr Y to move to a particular supported living address because his existing accommodation was unsuitable.
17. In April 2017, the Council provided Mr Y with an adult care plan to support him with tasks such as washing, preparing meals, and making sure he took his prescribed medication.
18. The Council decided Mr Y would benefit from supported living accommodation. In April 2017, it contacted Mrs X and told her that funding had been agreed for a care package.
19. In May 2017, Mr Y moved into the supported living accommodation as requested by Mrs X.
20. In June 2017, the Council reviewed Mr Y’s care and support plan. It identified that Mr Y still required support with daily tasks as before. In addition, it also identified Mr Y required additional support in the evening to help reduce his anxiety.
21. At about this time, Mrs X told the Council she had concerns about the staff at the supported living accommodation. She said they did not check to see if Mr Y needed any help, and that she was doing as much to support Mr Y as she had done before he moved to his new home.
22. In July 2017, the Council wrote to Mr Y to tell him how the weekly assessed charge had been calculated and what his contribution to the costs of his care was.
23. The Council carried out additional reviews of the care and support plan in October 2017, February 2018 and October 2018.
24. In February 2019, the Council called Mrs X because Mr Y had not paid the invoices for his contributions to the care plan.
25. Mrs X told the Council that Mr Y did not receive care. During this discussion, the Council told Mrs X it had been sending the invoices to Mr Y’s previous address.
26. The Council wrote to Mrs X and apologised for sending the invoices to Mr Y’s previous address. It confirmed that Mr Y was in receipt of care and said it had been trying to seek assistance from a social worker about the arrears. It said Mr Y’s social worker was no longer working for the Council, and asked Mrs X to seek assistance from social services. It also asked Mrs X to contact the Council to arrange a payment plan for the arrears.
27. Following the call with Mrs X, the Council reissued all the outstanding invoices to her address.
28. A few days later, Mrs X contacted the Council to dispute the invoices. She maintained that Mr Y did not receive care.
29. In September 2019, the Council met with Mrs X and Mr Y to discuss the case. It said it would place a hold on the invoices for 90 days while it reviewed the matter.
30. Mrs X complained to the Council in September 2019. She said the Council did not tell Mr Y he would need to pay towards a care plan, and he had not received any support from the staff at his supported living accommodation. Mrs X also complained the invoices had been sent to a wrong address.
31. The Council responded in November 2019 and said it did notify Mrs X and Mr Y there may be a financially assessed charge toward service provision. It said invoices and bills are generated via different electronic systems, and it acknowledged it sent invoices to an incorrect address. The Council apologised for this. It said it would remind team members to check correspondence addresses for service users when they move home.
32. Mrs X remained unhappy with the Council’s response and brought her complaint to the Ombudsman.
33. Mrs X contacted the Council again in November 2019. She said she had received some letters regarding the care charges but was confused by them as they gave differing amounts.
34. Mrs X agreed that ongoing care costs would be paid but continued to dispute the outstanding invoices for the period up to November 2019.

Analysis

35. I have decided to exercise discretion and investigate the complaint dating back to 2017. This is when Mr Y moved to the supported living accommodation. Although this is more than 12 months ago, Mrs X and Mr Y only became aware of the issue in February 2019. Mrs X brought her complaint to the Ombudsman within 12 months of this date.
36. I am satisfied the Council arranged for and provided care to Mr Y, and that this support was provided during his residence at the supported living accommodation.
37. I have seen several care plans for Mr Y. They confirm the support identified for him at the supported living accommodation and how often this support was to be provided. Mr Y was consulted as part of the care and support plan process so that the required level of care could be determined.
38. I have also seen notes relating to the support provided to Mr Y by the staff at the supported living accommodation.
39. The notes refer to several instances when Mr Y did not co-operate with staff at the supported living accommodation. The notes record that Mr Y liked to spend time at Mrs X’s house and he was not always at the property when the staff went to see him. It is also recorded that Mr Y sometimes would not allow staff to enter his property.
40. Mrs X said Mr Y has difficulty trusting people, including carers. She confirmed that Mr Y would sometimes not allow carers access to his home as a result.

Care provided to Mr Y

41. I am satisfied the evidence shows Mr Y was in receipt of care as specified by the care plans. The records show he did not always make himself available, or declined the support provided by the carers, and that he preferred to spend time at Mrs X’s home. The records also show that Mrs X continued to provide support to Mr Y, and that this was Mr Y’s preference.
42. I acknowledge Mrs X may consider this means that the Council did not provide support to Mr Y. However, I am satisfied the Council did arrange and provide support for him, and on this basis, it is correct that the Council make a charge for providing this. I cannot hold the Council at fault if Mr Y declined support or preferred to spend time at Mrs X’s house.

Notifying Mr Y about the care costs

43. I am satisfied the Council informed Mr Y that he was required to pay towards the cost of his care plan as I have seen several notification letters which confirm this. These letters specify the amount Mr Y was required to pay towards the cost of his care. I have also seen several financial assessments which were completed to calculate Mr Y’s level of contribution. Therefore, I have found no fault by the Council in this matter.
44. It is noted however that the evidence indicates the Council did not also inform Mrs X of the charges. The Council was aware Mrs X dealt with Mr Y’s finances. Had it separately informed her of the charges the matter may not have progressed as it did. However, I acknowledge Mrs X could have had access to Mr Y’s notification letters as part of her role in assisting with his finances.

The invoices

45. The Council acknowledges it sent the invoices to Mr Y’s previous address.
46. Mr Y moved into the supported living accommodation in May 2017. It did not contact Mrs X or Mr Y about the unpaid charges until February 2018. By this time, the amount of outstanding debt had accrued to more than £2,000.
47. The evidence shows Mrs X disputed the arrears with the Council and was confused as to why the charges had been made. There are several records showing Mrs X stated she did not consider Mr Y should pay the invoices and did not fully understand the care costs.
48. Despite this, there is no evidence to show the Council provided an explanation of the care costs to Mrs X after she received the reissued invoices.
49. The Council has acknowledged this, and its error in sending the invoices to Mr Y’s previous address. It has offered to write off the outstanding invoices totalling £3,279.66 and to visit Mrs X and Mr Y to fully explain the charges.

Injustice to Mrs X and Mr Y

50. I am satisfied the Council’s failure to engage with Mrs X and Mr Y regarding the accruing arrears, its error in issuing the invoices to an incorrect address and its failure to provide an adequate explanation of the costs constitutes fault.
51. The primary injustice is to Mr Y as the service user. Following the financial assessments, Mr Y is responsible to pay a contribution towards the cost of his care. Mrs X says the Council’s actions have caused a great deal of stress to Mr Y because he did not understand he was required to make payments. This was compounded when he received numerous invoices totalling more than £2,000.
52. Mrs X says the matter was so stressful for Mr Y that she could not discuss it with him because it would make him too upset.
53. There is also injustice to Mrs X. She says it has been very stressful for her trying to deal with the unpaid invoices on behalf of her son. The lack of explanation from the Council added to this stress.

Agreed action

54. To address the injustice identified, the Council has agreed to take the following action:

• Within two weeks of the final decision, provide an apology to Mrs X;
• Within two weeks of the final decision, provide a full explanation to Mrs X and Mr Y of the costs/charges for Mr Y’s care plan;
• Within two weeks of the final decision, remind staff to update the Council’s billing system as soon as it is notified about a service user’s change of address, and,
• Within four weeks of the final decision, write off the outstanding invoices totalling £3,279.66.

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Final decision

55. I have found fault in the Council’s actions leading to injustice to Mrs X and Mr Y. The Council has agreed to the above recommendations therefore I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman