London Borough of Sutton (20 010 214)

Category : Adult care services > Charging

Decision : Not upheld

Decision date : 31 Aug 2021

The Ombudsman's final decision:

Summary: There is no fault in how the Council assessed whether Miss Y should contribute towards the cost of her care.

The complaint

  1. Mrs X complains on behalf of her daughter, Miss Y, about how the Council assessed whether Miss Y should pay anything towards the cost of her care. In particular, Mrs X says the Council:
  1. did not tell her the purpose, or potential consequences, of the financial assessment.
  2. did not provide help to complete the assessment when she asked for it.
  3. did not take into account the evidence of Disability Related Expenses she provided.
  1. Mrs X says as a result, her daughter has to pay too much towards the cost of her care and support.

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The Ombudsman’s role and powers

  1. 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)
  2. 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 complaint and the information Mrs X provided.
  2. I made written enquiries of the Council and considered its response along with relevant law and guidance.
  3. Mrs 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

Adult Social Care – charging

  1. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14)
  2. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The scheme must comply with the principles in law and guidance, including that charges should not reduce a person’s income below the Minimum Income Guarantee. The Council can take a person’s capital and savings into account subject to certain conditions. 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)

What happened

  1. Miss Y has a learning disability. Until 2017, Miss Y received support from the Council’s children’s services. This is always a free service.
  2. In 2017, the Council assessed Miss Y and confirmed that she would continue to need support as an adult.
  3. Until 2020, Miss Y’s income meant she did not have to contribute towards the cost of her care. In July 2020, the Council reviewed Miss Y’s finances. Miss Y’s benefits had increased. The Council therefore assessed that Miss Y could now afford to contribute towards the cost of her care.
  4. Mrs X complained to the Council that it had not made it clear there would be a cost for Miss Y’s care package. She said the Council had not provided enough guidance on how to complete the financial assessment, despite her asking for it.
  5. In August 2020, Mrs X and the Council met to discuss Mrs X’s concerns. At this meeting, the Council agreed to produce information for families transitioning from children’s to adult services to explain the different process, including the potential cost.

My findings

Did not tell her the purpose or consequences of the financial assessment

  1. Mrs X completed a Financial Assessment on Miss Y’s behalf every year from 2018. The outcome letters the Council sent Mrs X following these in 2018 and 2019 say:

“we have calculated that you are unable to contribute towards your personal budget.”

  1. The letter then asks Mrs X to tell the Council about any changes in Miss Y’s financial circumstances and warns that if she delays declaring an increase in income:

“your weekly contribution will be backdated to include the change and you may be asked to pay any backdated contribution.”

  1. The obvious implication from this is that although Miss Y’s circumstances in 2018 meant she didn’t have to contribute to the cost of her care, there could be circumstances in which she would.
  2. When the Council reviewed Miss Y’s care plan in July 2020, it wrote to Mrs X and said:

“Adult Social Care have agreed to fund the following care package through Direct Payments”

  1. Mrs X says she understood this to mean the Council would be paying for the cost of the care package. However, the letter closes by saying:

“Every input from Adult Social Services is means tested and depending on the assessment by the finance team, there might be a contribution by [Miss Y] towards [t]his care package.”

  1. I therefore find no fault in how the Council told Mrs X that Miss Y might have to pay for the cost of her care.
  2. Although I have not found fault, I do note that neither the covering letter nor the Financial Assessment form itself say what the purpose of the assessment is. The Council may wish to consider amending the letter or the form to include an explanation along with the guidance it has already agreed to produce.

Did not provide help to complete the assessment

  1. In June 2020, Mrs X emailed the Council with some questions about the Financial Assessment.
  2. From the Council’s records, it appears that it responded to this email by telephone. I therefore do not have a record of what the Council told Mrs X.
  3. However, a few days later Mrs X emailed the Council to ask for a new copy of the Financial Assessment and said the telephone conversation was “very helpful”.
  4. Therefore, I find the Council did provide Mrs X help when she asked for it and find no fault in the Council’s actions.
  5. Further to my observation in paragraph 22, the Council does not provide any guidance on completing the Financial Assessment when it sends it out. In response to my enquiries, the Council acknowledged that a factsheet might help those completing the form to understand what information to provide.

Disability Related Expenses

  1. Mrs X says the Council did not take into account the DREs she told it Miss Y has.
  2. In August 2020, the Council responded to an email from Mrs X explaining the evidence it would need to consider any DREs.
  3. In September, the Council sent an email to Mrs X explaining DREs in detail and why some of the expenses Mrs X claimed would not be included. It asked for more evidence for some others. Following this, the Council amended Miss Y’s contribution to reflect an additional DRE.
  4. There is no evidence the Council failed to consider any information Mrs X provided before deciding whether to include any DREs in Miss Y’s Financial Assessment. Therefore, I find no fault.

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Final decision

  1. I have completed my investigation. There is no fault by the Council.

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Investigator's decision on behalf of the Ombudsman

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