The Ombudsman's final decision:
Summary: The Council failed to communicate properly with the late Mrs X. Officers wrote to her at the wrong address and telephoned her when she could no longer speak. Its actions caused significant distress in Mrs X’s last months, and the Council will now apologise to her daughter Ms Y, review its processes and offer a sum in recognition of the distress.
- Ms Y (as I shall call the complainant) complains that the Council misled her late mother Mrs X about the need to pay for care; failed to send financial assessment forms to the right address and then issued a bill for full cost on the basis Mrs X had failed to complete them; and tried to ring Mrs X when it had been told she was no longer able to speak. After Ms Y complained, the Council delayed in issuing a financial assessment causing additional distress at the time Mrs X was at the end of her life.
The Ombudsman’s role and powers
- 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)
- 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)
How I considered this complaint
- I considered the information I received from Ms Y and from the Council. We spoke to Ms Y. Both Ms Y and the Council had an opportunity to comment on a draft of this statement before I reached a final decision.
What I found
Relevant law and guidance
- Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. If a person incurs expenses directly related to any disability he or she has, the Council should take that into account when assessing his or her finances. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)
- Where a local authority has decided 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 of that assessment to the person. This could be provided alongside a person’s care and support plan or separately, including via online means. It should explain how the assessment has been carried out, what the charge will be and how often it will be made, and if there is any fluctuation in charges, the reason. The local authority should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.
- Mrs X suffered from a degenerative disease. As her condition deteriorated, she moved into her daughter’s home in May 2019. In June Ms Y asked the Council for help from the social care and occupational therapy teams. Ms Y says Mrs X asked the Council to contact Ms Y when necessary as Mrs X’s speech was deteriorating.
- Following an assessment by the occupational therapist, the Council put in place a reablement package from August 2019. Its records show it sent a copy of its leaflet on the Financial Implications of Non-Residential Care to Ms Y on 6 August 2019.
- The Council says the provision of reablement care was not without some problems. The reablement officer agreed with Mrs X and Ms Y that a package of two care visits a day (later increased to four) would be set up after the reablement period was complete. She recorded, “Advised (Mrs X) that I would recommend that an ongoing POC x 2 pop in daily visits to help support her long-term needs, and that I would put a review in place for 6 weeks to review her further after she has been to her Neurology appointment …All financial implications have been discussed with all relevant party at review, hard copies also given at review underlying all details of financial implications on 28/8/19”.
- The Council’s financial assessment officer telephoned to arrange an assessment. The case recording shows on 19 September he spoke to Mrs X who asked him to contact Ms Y. The Council’s notes state there was no reply by telephone and he could not leave a message for Ms Y.
- On 4 October the Council wrote to Mrs X at her former address. It asked her to make contact to arrange an assessment. It said if she did not wish to disclose financial information she would be charged the full cost of her care. It said if she did not make contact within 14 days it would assume she did not want to disclose her finances.
- The Council issued an assessment on 17 October on the basis that Mrs X would pay the full cost of her care. It was sent to Mrs X’s previous address. A social worker visited Mrs X and Ms Y on 12 November and recorded ‘(Mrs X) and her daughter are aware that there will be a financial contribution to the current care package - they are awaiting this financial assessment to take place and advised they have already signed the implication's form.’
- In December 2019 Mrs X received a bill for £1300, the full cost of her care so far. Ms Y telephoned the Council to complain. Mrs X completed an online complaint in which she said the financial assessment had not been completed. She also said the social worker led her to believe the care would be provided free of charge.
- The financial assessment officer made an appointment to complete a financial assessment on 14 January 2020. At the assessment he explained the disability related expenses which would be allowed. He noted on the records that when he returned to the Council offices, he realised he had made an error about one of the allowances so telephoned Ms Y to explain. He issued a notification to Mrs X at her daughter’s address.
- The Council responded to Mrs X’s complaint in February. It did not uphold her complaint she had been misled about the requirement to pay for her care. It said the Financial Implications leaflet had been shared with her in August and there was no evidence to suggest the social worker had ever said care would be free of charge.
- The Council said although practitioners had recorded Mrs X had difficulty speaking, this had not been included in her full record: the Council said that had now been updated. It said her finance records showed her address recorded as her previous, permanent address and said in the absence of specific information to the contrary, finance officers would use that address by default. It said it would learn from this to prevent a similar situation arising again.
- Ms Y made additional claims for disability related expenses which the Council approved on 02 February 2020. It issued a revised bill for £1006 on 06 February.
- Mrs X’s condition deteriorated further and she became eligible for full NHS funding which she received from 18 April. Sadly Mrs X died on 27 April.
- In August the Council issued a further invoice for £1038 addressed to Mrs X.
- Ms Y complained to the Ombudsman. She said the Council’s actions in contacting her mother by telephone when it knew she could not speak, and sending letters and invoices to a previous address even though the social worker was visiting at the right address, had caused considerable additional distress during Mrs X’s last months, both to Mrs X and to herself.
- The Council says it upheld the complaints about poor communication in its original response. It says it “endeavours to learn from complaints and has shared the outcome of this complaint in team meetings to increase awareness. The authority again apologises that (Mrs X)'s daughter received a less than satisfactory service which led to her complaint and for any upset this may have caused her and her late Mother”.
- The social care staff visited Mrs X at Ms Y’s house. The package of care was provided to her there from the start. It was poor practice therefore for the Council not to be able to ensure mail was sent to the right address. The assumption that Mrs X would be a full cost payer came about because of the Council’s own error but caused Mrs X and Ms Y considerable worry and distress.
- It was a matter of record for the social care staff that Mrs X could no longer speak properly. Again the failure to communicate that to the finance team was poor practice and led to distress for Mrs X.
- The Council says it has already apologised for the poor service to Mrs X and Ms Y. Although its letter of 4 February 2020 began ‘I am sorry you have had cause to complain about the service you have received from Adult Social Care and for any upset that this may have caused’, that does not seem to me to be a proper apology for the failure to communicate properly with Mrs X, which was caused by a failure of departments to liaise with each other.
- I also note the Council addressed the final invoice to Mrs X and not to Ms Y, although it must have known Mrs X had died several months previously.
- There is evidence Mrs X and Ms Y were told there would be financial implications for the service. There was no fault there.
- The Council says it has shared the learning gained from Mrs X’s complaint in terms of communication. Within one month of my final decision, it will provide me with details of the practical steps it intends to take to improve its practice in this area;
- The injustice caused to Mrs X cannot now be remedied. Ms Y however was not only caused distress because of the way the Council treated Mrs X but also had to manage this at a difficult time for herself. Within one month of my final decision the Council will make a proper apology to Ms Y for its actions and offer the sum of £500 in recognition of the injustice she was caused by its actions.
- I find fault on the part of the Council which caused injustice to Ms Y: completion of the recommendations outlined at paragraphs 26 and 27 will remedy that injustice.
Investigator's decision on behalf of the Ombudsman