Summary: Mrs B complains that the Council issued her with a backdated large bill for contributions towards social care services, without having appropriately informed her about liability for such charges. The Ombudsman finds there was fault by the Council in this matter. The Council has agreed to waive the bill and to apologise to Mrs B for the injustice caused her by the fault. That is a satisfactory remedy.

The complaint

1. The complainant, whom I shall call Mrs B, complains the Council did not complete a financial assessment until January 2020 but then advised her she must pay a contribution towards the cost of a course she has been attending at a creative education centre. The Council then issued Mrs B with an unexpected bill for £1600 contributions, backdated to July 2019. That caused her distress, and she was put to unnecessary time and trouble trying to resolve the matter.

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

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How I considered this complaint

4. I considered all the information provided by Mrs B about her complaint. I made written enquiries of the Council and took account of the information and evidence it provided in response.
5. I have taken account of relevant legislation and statutory guidance, and of the Ombudsman’s guidance on remedies.
6. Mrs B and the Council had an opportunity to comment on a draft of this decision.

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What I found

Legal and administrative information

7. The Care Act 2014 says councils must provide information and advice about care and support for people in its area. The Care and Support Statutory Guidance says councils should make all reasonable efforts to ensure information and advice they give meets an individual’s requirements, is comprehensive and is given at an early stage. The approach to charging for care and support needs should be clear and transparent so people know what they will be charged. The guidance states:
   “Where a local authority has decided to charge, except where a light touch assessment is permissible, 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”.

What happened in this case

8. Mrs B has mild learning difficulties and she suffers from depression. Since November 2017 she has been attending a creative arts education centre which promotes positive mental health and wellbeing. The attendance was authorised by the Council as appropriate support for her social care needs.
9. The Council says that although the service provider (the arts centre) submitted invoices and received payment for the service it provided, in July 2019 a fault in process within the Council meant that it was not identified at this time that Mrs B might be liable to make a contribution towards the cost of the service. When the Council completed its annual review of Mrs B’s social care needs in November 2019, attendance at the arts centre was approved for the next twelve months and notification was sent to the Council’s financial assessment team.
10. Mrs B was not asked at the time of the review to complete a financial assessment form to establish what contribution she might be required to pay towards the service she was receiving at the arts centre. Because a financial assessment form had not been completed, the Council’s finance team was unable to determine if a contribution was required from Mrs B. The case was not looked at again until December 2019, when an assessment form was sent out to Mrs B. She completed it, and the Council received it back from her on 31 December 2019.
11. On 22 January 2020, having assessed how much Mrs B would need to pay, the Council wrote to her again. The letter set out that Mrs B had been assessed to pay £75.93 a week from 1 July 2019 increasing to £101.25 a week from 4 November 2019. The letter failed to clearly distinguish between the maximum amount Mrs B would be expected to contribute and what the service actually cost. which was £50 a week. That was fault.
12. On 14 February 2020, the Council sent Mrs B an invoice for the charge of £50 a week for the service from the arts centre, for the period 1 July 2019 to 9 February 2020, a total of £1,600. The invoice stated that payment was due in 28 days.
13. Mrs B was very distressed about the large and unexpected bill and contacted her social worker. The Council notes that the worker agreed to make enquiries but there is no evidence that a meaningful response was ever provided to Mrs B. That was fault.
14. On 14 February 2020, before Mrs B had received the large bill for backdated contributions, the Council received a complaint made from a representative acting for Mrs B about the letter of 22 January. The Council replied to that letter of complaint on 4 March, which was just outside the published ten working day timescale for response. In the complaint response the Council clarified that Mrs B’s required contribution was in fact calculated at £50 a week. The Council apologised for the time taken to reach this point, but said that its records showed that Mrs B had been made aware that she would need to make contributions to the support, subject to the outcome of financial assessment. However, the Council has now confirmed there is no evidence in the case notes that officers discussed client contributions with Mrs B in July or November 2019. That was fault, and it was compounded by the failure to recognise and acknowledge it when the complaint was dealt with.

Injustice to Mrs B

15. As a result of failings by the Council, Mrs B received a large bill she had not been expecting. That caused her considerable distress, and meant that she had been denied the opportunity to decide before the debt accrued whether she wished to continue attending the centre, given the cost she would incur. In addition, she was put to avoidable time and trouble trying to clarify what had happened and what her correct contribution would be, and in pursuing her complaint about the matter.

Agreed action

16. In recognition of the injustice identified above, when it responded to my enquiries the Council offered to apologise to Mrs B and to waive the £1,600 calculated as Mrs B assessed contribution for the period 1 July 2019 to 9 February 2020.
17. I recommended that the Council write to Mrs B within four weeks of the date of the decision on this complaint setting out its apology and confirming, for the avoidance of doubt, that the sum has been waived. The Council agreed to this recommendation.
18. I welcome the steps the Council has already taken to improve and make clearer its template letter used to notify service users about assessed contributions.
19. The steps set out above provide a satisfactory remedy for the injustice caused by the Council’s faults in this case.

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Final decision

20. I have completed my investigation on the basis set out above.

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Investigator's decision on behalf of the Ombudsman