Summary: Mr X complains about the Council’s handling of the charges for his wife’s care and the decision to backdate charges for a second evening carer between 10 December 2018 and 7 July 2019. There is nothing in the Council’s records to justify the backdated charge, as Mrs X has been paying for a second evening carer all along. The Council has agreed to withdraw the backdated charges, apologise, pay financial redress and take action to prevent a repetition of the problems experienced by Mr & Mrs X.

The complaint

1. The complainant, whom I shall refer to as Mr X, complains about the Council’s handling of the charges for his wife’s care and the decision to backdate charges for a second evening carer between 10 December 2018 and 7 July 2019.

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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, sections 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I have:
• considered the complaint and the documents provided by Mr X;
• discussed the complaint with Mr X;
• considered the comments and documents the Council has provided in response to my enquiries; and
• shared a draft of this statement with Mr X and the Council, and invited comments for me to consider before making my final decision.

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What I found

What happened

5. Mrs X lives at home with her husband. She has reduced mobility. Since 2015, the Council has arranged for carers to visit in the mornings and evenings to meet her needs. Mrs X has to pay the full cost of her care as she has chosen not to share information about her finances with the Council.
6. In July 2018 a moving and handling assessment identified the need for two carers when assisting Mrs X into bed. The assessment says her bed was too low, so carers were stooping and bending when helping her into bed. It says Mr X was finding it difficult to assist with moving and handling in the bed. The assessment also identified the need for a profiling (i.e. adjustable) bed.
7. The Council wrote to Mrs X on 31 August. It said following the moving and handling risk assessment, it would provide one carer in the mornings with Mr X assisting the carer, but two carers in the evenings. It said this followed reports from the care agency that carers were at risk of injury having Mr X as the second carer in the evenings.
8. Mrs X’s support plan says she needed one carer in the mornings but two carers in the evenings due to “fatigue and change of abilities”.
9. When the Council wrote to Mr X on 16 October it said:
• it acknowledged a lack of information about an increase in care and fees;
• it noted Mr X disputed statements about his difficulties in providing support;
• the Occupational Therapist Service assessment had resulted in a change in Mrs X’s support to include single care in the mornings and dual care in the evenings;
• under a new support plan it was commissioning 2 hours a week of dual care to support evening transfers and 4.17 hours of single care with a weekly charge of £90.39;
• before this Mrs X received 7 hours of support a week with a weekly charge of £90.72;
• following previous correspondence (the Council wrote to Mrs X on 24 March 2017 saying she would have to pay £90.72 a week) and discussions, it was reducing the weekly charge between 22 February and 11 June to £90.72;
• it apologised for the difficulties experienced.
10. At the end of November 2018 the Council changed Mrs X’s care provider. She was in hospital at the time but returned home on 7 December. The Council continued to provide two carers in the evenings. Her support plan refers to a weekly personal budget of £90.39, which included £29.30 for dual care. Other documents refer to single carer visiting seven mornings a week (£63.30) and dual care seven evenings a week (£30.36). This gives a total of £93.66 a week.
11. On 8 January 2019 the care provider asked the Council for a moving and handling risk assessment. It said carers were struggling to provide care in the mornings without Mr X’s help. Mrs X went back into hospital on 11 January. She returned home at the end of January with the same package of care.
12. The Council wrote to Mr X on 25 March about Mrs X’s charges from 8 April. It said she would have to pay the full cost of her care, as she had chosen not to disclose information about her finances. It said the amount she had to pay may change but this would depend on the amount of service received each week. It did not say what the standard charge would be.
13. On 29 April the care provider asked the Council for a moving and handling risk assessment, as the carers were struggling to meet Mrs X’s needs in the mornings.
14. The Council visited Mrs X on 17 July to review her needs. She said she was happy with the current care arrangements and Mr X confirmed he was happy to continue supporting his wife. He said they had been charged for care while his wife was in hospital. The Council agreed to look into this.
15. On 30 July the care provider told the Council Mrs X needed two carers for both morning and evening visits. The Council updated Mrs X’s assessment. The assessment says she wanted to be supported twice daily by formal carers and required dual care in the evening due to fatigue to achieve these outcomes:
• managing toilet needs;
• maintaining personal hygiene;
• being appropriately clothed;
• making use of her home safely.
16. On 31 July, the Council told Mr X what the care provider had said and said it would visit on 6 August to discuss different options. The Council produced a support plan based on providing two carers in the mornings and evenings (£215.18 a week for 14 hours of carer time at £15.37 an hour).
17. The Council visited Mr & Mrs X on 14 August. According to its case notes, they were both happy and signed the assessment. Mr X said the costs for the previous care provider in the support plan were wrong (it says they were £249.05 a week from March to June 2018) but the Council said it had not amended them. The Council updated Mrs X’s support plan. This provided for a weekly personal budget of £94.83, including £30.74 for dual care in the evenings, from 17 July. The Council has provided a document which shows this is what Mrs X had been paying.
18. The Council wrote to Mr & Mrs X on 23 August. It said she owed £1,111.49 for the period from 10 December 2018 to 7 July 2019. It said this reflected the service provided by the care provider. In September the Council invoiced Mrs X for £1,111.49. The invoice describes this as a personal budget “reconciliation”.
19. Mr X wrote to complain about the backdated charges. He said the fee agreed in October 2015 was £90.72 a week and had not been increased significantly until August 2019.
20. When the Council replied in October it said:
• it had told Mr X the amount his wife had to pay could change and referred to its letter of 25 March 2019;
• it had reviewed the charges for the period from 10 December 2018 to 7 July 2019 (30 weeks);
• the charges came to £3,880.91 (£129.36 a week);
• Mrs X had paid £2,769.42 (£92.31 a week), which left £1,111.49 to be paid (£37.50 a week).
21. According to Mrs X’s support plan, from 17 July 2019 she continued to receive the same level of care for which the Council charges her £94.83 a week.
22. Mrs X stopped receiving any care when she and her husband went into isolation because of COVID-19.

Is there evidence of fault by the Council which caused injustice?

23. The Council’s records contain some contradictory information about the charges for Mrs X’s care. Records from November 2018 identify a weekly charge of either £90.39 or £93.66 a week, but it appears Mrs X was paying £92.31 a week. The Council’s letter of 25 March 2019 did not even say what Mrs X’s charge was. Council’s need to provide clear information about charges. The failure to do so was fault by the Council.
24. However, what is clear is that Mrs X was assessed as needing two carers in the evenings and the Council confirmed this in August 2018. Throughout the disputed period (10 December 2018 to 7 July 2019), the Council has provided one carer in the morning and two carers in the evenings. This has been reflected in Mrs X’s personal budget and all the evidence the Council has provided shows she has paid for the care she has received. There is nothing in the Council’s records to justify the additional charge. The care provider wanted to send two carers in the mornings but this was not agreed. Mrs X continued to receive the same care after the disputed period and the charge remained at broadly the same level.
25. The Council is therefore at fault. It needs to withdraw the additional charge, apologise and pay financial redress for the distress it has caused and the time and trouble it has put Mr X to in pursuing his complaint.

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Agreed action

26. I recommended the Council:
• within four weeks, writes to Mr and Mrs X withdrawing the additional charge, and apologising for the distress it has caused and the time and trouble it has put Mr X to in pursuing the complaint, and pays them £250;
• within eight weeks, identifies the action it needs to take to make sure it provides people with clear information about their charges and does not invoice people for charges for which there is no justification.
27. The Council has agreed to do this. To prevent a repetition, the Council will:
• only charge what it has recorded on its system;
• identify any discrepancies between what is recorded on its system and the services care providers actually deliver;
• update its letters to ensure there is clarity around charging and budgets, and the maximum charges for full cost payers.

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Final decision

28. I have completed my investigation as the Council has agreed to take the action I recommended.

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Investigator's decision on behalf of the Ombudsman