Norfolk County Council (20 003 947)

Category : Adult care services > Charging

Decision : Upheld

Decision date : 16 Feb 2021

The Ombudsman's final decision:

Summary: There was fault by the Council in the way it managed a transition between care providers and poor communication about whether or not Mr Y could bank unused care hours. This caused confusion, avoidable distress and a gap of three months in Mr Y’s care provision. The Council has already taken some action to remedy the injustice by crediting/waiving charges. It will also make payments of £250 and £1000 to Ms X and Mr Y respectively and offer a further apology.

The complaint

  1. Ms X complained Norfolk County Council (the Council):
      1. Was unclear about whether Mr Y, her son, was allowed to bank care hours or whether he would be charged for any agreed care hours he did not use each month
      2. Did not manage a change in care provider appropriately.
  2. Ms X said this caused her and Mr Y avoidable distress and confusion about outstanding bills and resulted in lost care hours and overcharging.

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The Ombudsman’s role and powers

  1. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
  2. I exercised discretion to investigate Ms X’s complaints although they are about events which happened over a year before she complained to us. This is because Ms X had been raising concerns informally with the Council’s social care team from 2018 on and the Council delayed in responding to her formal complaint.
  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. 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

  1. I considered the Council’s response to the complaint and Ms X’s complaint to us and supporting documents. I also considered the Council’s response to my enquiries and documents described later in this statement. I discussed the complaint with Ms X.
  2. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

  1. A council must carry out an assessment for any adult with an appearance of need for care and support, applying national criteria to decide if a person is eligible for care. (Care Act 2014, section 9)
  2. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. (Care Act 2014, sections 24 and 25)
  3. Our published Principles of Good Administrative Practice (December 2018) sets out the standards we expect when we investigate the actions of local authorities. We expect councils to be customer focussed. This means:
    • Informing people what they can expect and what the organisation expects of them; and
    • Dealing with people promptly and sensitively, taking account of their individual circumstances.

What happened

Background

  1. Mr Y is an adult with autism and Attention Deficit Hyperactivity Disorder or ADHD (People with ADHD may have a short attention span, fidget constantly and act without thinking). Mr Y has been eligible for social care services since he became an adult. He lives in his own flat. Mr Y obtained good qualifications at school and college and went to university.
  2. Mr Y’s care and support plans described his care needs. The Council commissioned three different care providers to provide four hours of support a week to meet his needs:
    • Dimensions: November 2016 to end of August 2018
    • AEA: December 2018 to November 2019
    • First Choice: November 2019, ongoing.

Complaint (b) is about the transition from Dimensions to AEA. There is no complaint about First Choice, the current provider.

  1. Mr Y’s social care assessment said he had a history of destroying his belongings when anxious and he found periods of change stressful and difficult to deal with due to his autism.

Mr Y’s social care records

  1. I have summarised relevant entries in the Council’s case notes below.
  2. In May 2018 Ms X and Mr Y met with the social worker and a worker from Dimensions. Ms X and Mr Y were concerned about the charge for Mr Y’s care. The social worker noted Mr Y wanted to suspend his care for the month and bank the hours and then use them the following month if he wanted to continue with the care.
  3. The social worker left. Mr Y’s case was not immediately reassigned to a new social worker.
  4. At the end of June, the duty social worker spoke to Dimensions which had served notice. The duty social worker spoke to Dimensions again in July noting the previous social worker’s discussion about banking hours. Dimensions explained Mr Y had banked 10 hours. The duty social worker noted the lack of clarity about what had been agreed about banking hours.
  5. At the end of June, Ms Y spoke to the duty social worker saying Mr Y was in shock about Dimensions ending and had smashed up his flat. Ms X said he had banked 24 hours of support. She asked if he had to pay his charge for this.
  6. A new social worker was assigned at the start of August. She spoke to Mr Y’s mental health worker who said a change in routine was difficult for Mr Y and tended to lead to him stopping his medication and destruction of belongings.
  7. The social worker and Dimensions emailed and the social worker explained Dimensions needed to adjust the hours it was claiming to reflect the hours actually used and then this would produce a credit on the system to reflect Mr Y’s over payment.
  8. The records indicate Mr Y was hard to contact in August. In the middle of August, the social worker wrote to him to try and arrange a meeting and said she was trying to find a new care provider. The following week, the social worker wrote again to say she had found a new provider (AEA) and wanted to arrange a three-way meeting. The social worker also spoke to Ms X who said Mr Y was refusing contact with her at present and was angry about Dimensions ending. The social worker explained:
    • Dimensions was adjusting the hours
    • Mr Y would get a credit
    • In future hours could not be banked with a new care provider
    • Mr Y would need to agree how much notice he had to give in future if he wanted to cancel a session and not be charged for it.
  9. In the middle of September, the social worker and Ms X met. Mr Y was supposed to attend the meeting as well, but changed his mind. A manager from AEA was also invited, but Ms X changed the time of the meeting at short notice and so AEA was not able to make the meeting.
  10. The social worker and Ms X met at the end of September, to try and resolve the issue of the charges for banked hours. The social worker said she needed approval from her managers. The social worker wrote to Mr Y after the meeting and said that any automatic letters about charges would stop until the issue of the banked hours had been resolved.
  11. At the end of October, the social worker discussed Mr Y’s support with AEA. She reported Mr Y was reluctant to attend a meeting for an assessment. His mental health worker said meeting new people was very difficult for Mr Y. The social worker emailed Mr Y to say AEA wanted to meet him on 21 November. The meeting went ahead and AEA started to provide support at the start of December 2018.
  12. The records I have seen suggest Mr Y did not engage well with the support worker at AEA and it was left that he would contact AEA when he wanted a service, but there was a period of several months where he did not make contact. A new social worker was assigned to Mr Y and she reviewed his care and support plan in April 2019, noting he ‘struggled to engage in this review however expressed his wishes and feelings. It is hoped that by reinstating a package of support based on previous provision, he will be able to engage.
  13. The review also noted Mr Y’s ‘frustration at social services, the way he was told about [the] previous provider ending and confusion over charges, new service to be added to plan.’

The complaint to the Council

  1. Ms X complained to the Council in January 2020. She said in her complaint letter that she only found out about 6 weeks before Dimensions stopped, but Dimensions had told her that the social worker knew it was handing back the contract much earlier. Ms X also said Mr Y became acutely distressed when he found out the news and smashed up his belongings.
  2. The Council did not respond to Ms X’s complaint and so she sent a second letter in March. She raised additional issues about AEA’s lack of provision, about the AEA support worker not successfully engaging Mr Y and about still being invoiced for charges although Mr Y had not had a service.
  3. The Council did not reply until July. It said:
    • It was sorry for the delay in responding
    • It would credit £735 for AEA between 1 July and 3 November 2019 and First Choice between 2 and 22 March 2020.
    • Providers have to enter the number of hours used onto the Council’s computer system so Mr Y would only be charged for the hours actually delivered.
    • Charges for banked (unused) hours were waived. The agreement about banking hours was only intended as an arrangement for one month as Mr Y wanted to carry over May’s unused hours to June 2018.
    • Mr Y did not engage with AEA or First Choice, he cancelled some, but not all sessions. Mr Y needed to give notice if he wanted to cancel sessions, otherwise he would get charged.
    • Dimensions told the social worker in May 2018 that it was ending the contract. It gave formal notice at the end of June. It was sorry Mr Y was not told promptly.
    • The new social worker found an alternative provider (AEA), but it would not start until Mr Y had been assessed and Mr Y was reluctant to engage.
    • The social worker could have assisted more to set up appointments with the proposed provider.
  4. The Council’s final response to the complaint in September 2020 said:
    • Dimensions gave the Council notice at the start of May 2018 that the service would end in August 2018.
    • Mr Y should have been told at the earliest opportunity.
    • His social worker left post in May 2018 and Mr Y’s case should have been reassigned. A new social worker took over in July and she confirmed in August that AEA had capacity from September and tried to set up appointments with Mr Y in August.
    • Action should have been taken at an earlier stage to find a new provider and this would have given Mr Y time to come to terms with the transition.
    • Mr Y’s social worker emailed Dimensions to make it clear that any banking should be within one month and it was intended they deliver the agreed hours within any one month and not store up hours over months in the way that happened.
    • Invoices had been adjusted to deduct charges for Dimensions banked hours between May and August 2018 (20 hours).
    • Mr Y had only been charged for AEA’s hours between 7 January and 11 February 2019 and between 3 and 10 June 2019. All other charges had been credited. The total charges credited for Dimensions and AEA was £472.
    • The Council was sorry Mr Y was without support when Dimensions stopped. Earlier planning would have given a better chance of a successful transition. Mr Y was hard to engage during this period.

Was there fault and if so, did this cause injustice?

Complaint a: There was a lack of clarity about whether Mr Y was allowed to bank care hours or whether he would be charged for any agreed care hours he did not use each month

  1. I uphold this complaint. The Council has already accepted fault in the way it dealt with the issue of banking unused hours. The failure to be clear about what had and had not been agreed was not in line with our expected standards of communication and customer focus and caused avoidable confusion and distress for Mr Y and also for Ms X as she supports him with finances.

Complaint b: The Council’s management of a change in care provider

  1. The records indicate the social worker knew about Dimensions ending the contract by May 2018 at the latest and possibly sooner. Mr Y has autism and the Council was aware change was difficult for him. So it was particularly important for any changes to his care to be managed sensitively. I find the Council failed to manage the change in provider appropriately. Those supporting Mr Y should have told him as soon as they became aware of the position. The search for a new provider could have then started much earlier. While this may not have avoided all the anxiety for Mr Y, it would have lessened it. Had potential providers been identified sooner, it may also have avoided some or all of the three-month gap in provision. I note the Council identified this fault in its complaint responses.
  2. There was also a delay in responding to Ms X’s complaint. This was an additional fault, putting her to avoidable time and trouble in escalating the complaint.

Agreed action

  1. The Council already recognised fault in the way it handled Mr Y’s case and has apologised and waived some charges for banked hours and for hours Mr Y did not use with all the care providers. This is a partial remedy to redress some of the confusion caused by poor communication around banking care hours.
  2. In addition to the charges already waived, the Council will, within one month of my final decision, provide a further written apology and payments of:
    • £250 to Ms X to reflect the delay in responding to her complaint and the avoidable distress for a three-month period during 2018 when there was a gap in provision for Mr Y
    • £1000 to Mr Y to reflect the high distress and lack of service caused by the poor management of the transition between providers and the three-month gap in provision. This is in line with the guidelines set out in our Guidance on Remedies. I have taken into account Mr Y’s known difficulties with managing change. I note Mr Y was at times hard to reach for appointments, but I am satisfied that if the Council had started the process of searching for a provider sooner, then there would have been no gap, or perhaps a shorter gap in service. Transition would have been distressing for Mr Y even if it had been planned properly and in good time, but the Council’s fault exacerbated Mr Y’s distress.

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Final decision

  1. There was fault by the Council in the way it managed a transition between care providers and poor communication about whether or not Mr Y could bank unused care hours. This caused confusion, avoidable distress and a gap of three months in Mr Y’s care provision. The Council has already taken some action to remedy the injustice by crediting/waiving charges. It will also make payments of £250 and £1000 to Ms X and Mr Y respectively and offer a further apology.
  2. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman

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