Summary: Mrs X complains the Council has failed to deal properly with the charges for Mrs Y’s care, by treating her as a full cost payer through no fault of her own and causing her significant distress. The Council has now agreed to backdate its contribution towards the cost of Mrs Y’s care. It also needs to apologise and pay financial redress.

The complaint

1. The complainant, whom I shall refer to as Mrs X, complains the Council has failed to deal properly with the charges for Mrs Y’s care, by treating her as a full cost payer through no fault of her own.

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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 Mrs X;
• discussed the complaint with Mrs X;
• considered the comments and documents the Council has provided in response to my enquiries; and
• shared a draft of this statement with Mrs 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. The Council assessed Mrs Y’s needs in September 2019. She wanted to arrange her own care so asked to receive her personal budget (£116 a week) as a direct payment. The Council gathered some preliminary information about her finances which indicated she would have to contribute £45.35 a week towards her personal budget. The Council agreed to fund Mrs Y’s care from 29 August. Mrs Y had been unwell with a urinary tract infection (UTI) at the assessment.
6. The Council contacted her about doing a financial assessment. Mrs X says Mrs Y, because of the confusion caused by the UTI, ignored the correspondence.
7. In line with the Care and Support Statutory Guidance and its own charging policy, the Council treats people who do not provide information for a financial assessment as full cost payers.
8. By the time Mrs Y provided the information needed for the Council to complete her financial assessment in December 2019, she owed £2,000 for the care she had received. The Council assessed Mrs Y as having to contribute £25.02 a week towards the cost of her care.
9. Mrs X complained to the Council in January 2020 about its decision to apply the charge from the date it completed the financial assessment in December, leaving Mrs Y to meet the shortfall between August and December. She said:
• Mrs Y had been unwell following the assessment and was ill-informed rather than non-compliant
• worry over the charges had affected Mrs Y mental health, for which her GP had prescribed medication
10. When the Council replied to the complaint it said:
• it had explained to Mrs Y about the need for a financial assessment when it assessed her needs
• it accepted Mrs Y was unwell on the day of the assessment and it would have been difficult for her to take information in
• another family member had confirmed she understood what was needed but subsequent attempts to contact her had been unsuccessful
• it was open to Mrs Y to agree a debt repayment plan

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

11. The Council now accepts that, given Mrs Y’s physical and mental health around the time of the assessment, it should have backdated its contribution to her care, rather than leave her to pay the full cost up to December 2019. That will go some way towards remedying the injustice it has caused. However, the Council also needs to apologise for not taking this action sooner and the for the avoidable distress this caused Mrs X and the time and trouble it has put her to in pursuing the complaint. The Council should also pay financial redress to Mrs X. Sadly it is no longer possible to remedy the distress caused to Mrs Y, as she has recently died.

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Agreed action

12. The Council has agreed to backdate its funding for Mrs Y’s care. It has also agreed, within four weeks, to write to Mrs X apologising for the distress it has caused and the time and trouble it has put her to in pursing the complaint on behalf of Mrs Y, and to pay her £200.

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Final decision

13. I have completed my investigation, as the Council has agreed to take action to remedy the injustice it has caused.

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Investigator's decision on behalf of the Ombudsman