Summary: Mrs X complains about the way the Council ended her care and support plan. She also complains the Council did not provide her with information about how she would be charged for her care. The Ombudsman finds fault with the Council for not completing a reassessment before ending Mrs X’s care.

The complaint

1. Mrs X complains about the way the Council ended her care and support plan in July 2019. She says the Council did not involve her daughter in the process. She also complains the Council did not provide her with any information about how she would be charged. She said she was not aware the Council would still charge her even though she did not receive care when she was on holiday, or when she received reduced care. She was also not aware of the 28-day notice period which meant she had to pay care fees until August 2019 even though the care ended in July 2019.
2. Mrs X is represented by her daughter, Mrs P.

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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 question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
5. 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

6. I spoke with Mrs P and considered the information she provided.
7. I made enquiries with the Council and considered the information it provided.
8. I sent a draft decision to Mrs P and the Council and considered their comments.

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What I found

Legislation and guidance

9. The Care Act 2014 requires local authorities to carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult's needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved. The assessment determines what the person's needs are and whether the person has any needs which are eligible for support from the council.
10. Where councils have determined that a person has any eligible needs, they must meet those needs. The person's needs and how they will be met must be set out in a care and support plan.
11. The care and support statutory guidance highlights that keeping plans under review is an essential element of the planning process. It notes the review will help identify if the person’s needs have changed and can, in such circumstances, lead to a reassessment. Reviews also ensure care and support plans are kept up to date and relevant to the person’s needs. (paragraphs 13.1, 13.4, 13.10)
12. If a local authority is satisfied the circumstances have changed in a way that affects a care and support plan, it must carry out a needs assessment. It must then revise the plan and personal budget accordingly. (paragraphs 13.27)

What happened

13. In May 2018, Mrs X left hospital with a care package arranged by the Council. The Council provided Mrs X with a personal budget for this care. In July 2018, the Council reviewed the care package and reduced it to two daily visits.
14. In July 2019, Mrs X’s care provider told the Council she was independent and no longer needed care.
15. The Council contacted Mrs X to discuss this and agreed with her that as she was now independent, it would cancel her care. The Council did not complete a reassessment before deciding this.
16. Mrs P said the Council invoiced Mrs X for care from July 2019 to August 2019. Mrs P said Mrs X stopped receiving care at the beginning of July 2019. The Council said its personal budget contract noted there was a 28-day notice period.
17. Mrs P also said the Council invoiced her mother for care even though her mother was on holiday and did not receive the care. The Council said personal budget rules meant it could charge service users their assessed weekly contribution even if no, or reduced, services are provided.
18. Mrs P said the Council had not explained the charging rules when it first arranged Mrs X’s care package.
19. In response to our enquiries, the Council acknowledged fault for not reviewing Mrs X’s care plan before ending her care. The Council also noted it did not have any evidence it told Mrs X about its charging rules.
20. The Council has offered to waive the outstanding charges related to the dates when Mrs X did not receive care.

Analysis

21. The guidance is clear that keeping care plans under review is an essential part of the planning process. It also highlights councils must complete a needs assessment when it is satisfied the circumstances have changed in a way that affects the care and support plan.
22. The Council did not complete a reassessment before ending Mrs X’s care plan. This is fault.
23. It is positive to note the Council accepted fault for not completing a reassessment during the enquiry stage of our investigation.
24. I consider the fault identified caused Mrs X an injustice because she did not receive the service she should have. I also consider the fault identified caused Mrs P an injustice. This is because she was caused distress by the uncertainty of not knowing whether her mother still needed care and support.
25. The Council also acknowledged there was no evidence it had told Mrs X about its care charges before it arranged the care package. While I note the Council says the personal budget agreement sets out the charging information, it is good practice for it to highlight the information to service users and their family. This will ensure everyone is aware of how the Council will charge for care and support.
26. The Council has offered to waive the outstanding charges related to the dates Mrs X did not receive care. I consider this offer to be an appropriate remedy.

Agreed action

27. To remedy the injustice caused by the fault identified, the Council has agreed to complete the following:
• Apologise to Mrs X and Mrs P for not completing a reassessment before ending Mrs X’s care and support.
• Waive the outstanding charges related to the dates Mrs X did not receive care.
28. The Council should complete the above within four weeks of the final decision.

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Final decision

29. I find fault with the Council for not completing a reassessment before ending Mrs X’s care. If the Council agrees with my recommendations, I shall be satisfied and will complete my investigation.

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Investigator's decision on behalf of the Ombudsman