Summary: Mr and Mrs X complained the Council failed to inform them that Mrs X’s care was chargeable prior to receiving an invoice for the care. Mr and Mrs X also complained about charges being applied after they had cancelled the care package and for cancelled visits. The Council accepted fault for the delay in confirming the care charges and offered to reduce the charges to £1,345.36. The Council accepted the Ombudsman’s recommendation of a further reduction of £774.08 to reflect the injustice caused through the Council’s delay.

The complaint

1. Mr and Mrs X complained the Council failed to inform them that Mrs X’s care was chargeable prior to receiving an invoice for the care.
2. Mr and Mrs X say they were not expecting to incur charges for this care until the financial assessment was completed.
3. Mr and Mrs X also complained about charges being applied after they had cancelled the care package and for cancelled visits.

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The Ombudsman’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. In this report, we 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. We 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)
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 have considered all the information Mr and Mrs X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
7. Mr and Mrs X and the Council both provided comments in response to the draft decision. The Council also accepted the recommendations. I have considered the comments from Mrs and Mrs X and the Council and have reached my final decision.

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What I found

Relevant Legislation and Guidance

8. The Care Act 2014 (the Act) is the legislation that sets out local authorities’ powers and duties in respect of adult social care services. The Department of Health and Social Care also produces statutory supplemental guidance for local authorities on how to discharge these duties. This is called the Care and support statutory guidance (the statutory guidance).
9. Section 14 of the Act gives a local authority the power, with certain exceptions, to charge for care and support it arranges to meet an adult’s needs.
10. Section 17 of the Act explains that, where a local authority decides to charge for care and support, it must assess the adult’s financial resources to calculate the amount (if any) the adult would be likely to be able to contribute towards the cost of the care and support.
11. In carrying out a financial assessment, the local authority must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 (the Charging Regulations). The Charging Regulations set out how local authorities should treat an adult’s income and capital for the purposes of calculating care contributions.
12. The guidance says that a personal budget should specify the amount the service user will have to pay towards the cost of the care, based on the financial assessment. It explains that a personal budget is the mechanism, in conjunction with the care and support plan, that enables the person to exercise greater choice and take control over how their care and support needs are met.
13. A financial assessment should be completed as soon as reasonably practicable. The Ombudsman would expect a financial assessment to be done within four weeks of a care assessment. A care assessment and financial assessment are part of one process.

Background

14. A Council social worker completed a Request for Service form to arrange short term home care for Mrs X in June 2019. The Council completed a care assessment for Mrs X on 19 June 2019. This care assessment identified that Mrs X required care for mobility and transfers, personal care, dressing tasks and continence care to help Mr X in his role as primary carer.
15. The Council’s observations notes show that the social worker told Mr and Mrs X care would be chargeable, but it needed to complete a financial assessment.
16. A carer from the Council’s Short Term and Urgent Support Team began to provide home care for Mrs X from 27 June 2019.
17. The Council completed a Person Led Assessment in August 2019 to determine the long-term care needs for Mrs X. This assessment confirmed Mrs X needed support and reiterated that a financial assessment needed to be completed.
18. Mr and Mrs X completed an online financial assessment form on 29 August 2019. The online assessment confirmed the maximum non-residential care contribution Mr and Mrs X would need to pay was £180.34 per week based on the information provided.
19. Mr X spoke with the Council on 12 September 2019 to discuss the cost for care. The Council call records show the Council told Mr X the cost of care would be £180.34 per week but it could complete a reassessment. Mr X says a figure of about £180 was discussed the Council said this could be less on reassessment.
20. The Council completed the financial assessment on 17 October 2019 and sent a letter to Mr and Mrs X confirming the care costs would be £190.46 per week.
21. Mr X requested the care was cancelled on 21 October 2019.
22. The Council issued a final bill for £3,073.73. Mr X complained to the Council about the balance owed on 21 November 2019.
23. The Council sent its response on 21 January 2020. The Council said:
• The financial assessment form confirmed on 29 August 2019 that the cost for care would be £180.34. It accepted that this appeared to be the first instance that the Council made Mr and Mrs X they would be expected to pay towards care costs.
• It had applied a discretionary reduction to the care costs by removing all charges from 27 June 2019 to 28 August 2019 as Mr and Mrs X were not aware they would need to contribute towards care costs.
• It had only charged £180.34 per week from 29 August 2019 to 16 October 2019 and then the £190.46 up to 21 October 2019.
• Care was still chargeable even if appointments were cancelled, up to 28 days, in line with its policy.
• The revised outstanding balance owed was £1,345.46.
24. Mr and Mrs X disputed the revised balance and raised a complaint with the Ombudsman on 11 March 2020.

Analysis

25. The Council’s observation notes from 19 June 2019 show the Council’s social worker confirmed the care would be chargeable, but it needed to complete a financial assessment.
26. The Council provided this care through its Short Term and Urgent Support Team. This team usually provides reablement care for the Council. Reablement care is free for up to six weeks following discharge from hospital following illness. However, the Council will also use the Short Term and Urgent Support Team to provide interim care when it has been unable to source support for a person. This care is chargeable from the date the care starts unlike reablement care.
27. The Council told Mr and Mrs X that care was chargeable before the care started on 27 June 2019. The Council was not at fault.
28. However, a person should be provided with all information the Council has available at the time of the care assessment. A personal budget should be clear and transparent so that a person can understand the cost of their care.
29. The Council did not explain what care costs might look like for a person in receipt of Mrs X’s level of care. That was fault by the Council.
30. Mr and Mrs X completed the online financial assessment form on 29 August 2019. This was the first instance the Council made Mr and Mrs X aware that the maximum cost of care would be up to £180.34. While this was a maximum cost of care the Council had not yet confirmed what Mr and Mrs X’s care costs would be.
31. The Council did not complete its financial assessment of Mr and Mrs X until 17 October 2019. This meant it took the Council 17 weeks, from the care assessment, to provide Mr and Mrs X with confirmation that the care costs would be £190.46 per week. The Ombudsman would expect the Council to take no longer than four weeks to complete a financial assessment following a care assessment. This 13-week delay was fault by the Council.
32. Once the Council made Mr and Mrs X aware of the care costs, they cancelled the care immediately. This shows that had Mr and Mrs X been aware of the cost of care it would be unlikely they would have agreed to the care.
33. The Council has already accepted fault and reduced Mr and Mrs X care charges to £1345.46. However, to remedy the faults identified The Council should remove all but the first four weeks’ worth of charges from the date of the care assessment.
34. The first four weeks of care charges from 19 June 2019 totals £571.38. This is because the Council began care on 27 June 2019 so the first week is not chargeable and Mr and Mrs X did not cancel any care prior to 19 July 2019. I recommend the Council applies a further reduction of £774.08 to the current balance of £1345.46 to leave £571.38 outstanding.

Agreed action

35. Within one month of the date of our final decision the Council will:
• Apply a reduction of £774.08 to Mrs Y’s outstanding care charge bill in order to reduce the balance owed from £1345.46 to £571.38 to cover the remaining care charges applied outside of the first four weeks following the care assessment.

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Final decision

36. There was fault by the Council. As it has agreed to my recommendation, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman