Summary: The Council assessed Mrs Y in line with its charging policy and in line with Annex C of Care and Support Statutory Guidance and so there was no fault in charging Mrs Y for her care.

The complaint

1. Mr X complained for his mother Mrs Y about Northamptonshire County Council’s (the Council’s) charge for Mrs Y’s care, in particular that his father Mr Y had to buy a car to take Mrs Y to appointments and she also paid for physiotherapy. Mr X said this caused Mrs Y a financial loss.
2. Mr X also complained Mrs Y’s care calls were less than the allocated time.

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What I have investigated

3. I investigated the first complaint. My reasons for not investigating the second complaint are at the end of this statement.

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The Ombudsman’s role and powers

4. 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)
5. Although Mr X’s complaint to us is late, I have investigated it because he has disabilities which may have made it more difficult to complain and the complaint is on behalf of his mother who has dementia and who could not complain herself. And, all the relevant documents are available for me to complete a robust investigation.
6. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. 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

7. I considered Mr X’s complaint to us, the Council’s responses to his complaint and documents described later in this statement.
8. Mr 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, guidance and policy

9. Councils have the power to charge for care. To work out how much the adult should pay, councils carry out a financial assessment. Guidance explains a person receiving care and support outside a care home will need to pay their daily living costs such as rent, food and utilities so the charging rules must ensure they have enough money. They must be left with the minimum income guarantee as set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 (Care and Support Statutory Guidance, paragraph 8.42)
10. Guidance allows councils to take into account most benefits when financially assessing for charges, including attendance allowance (a disability benefit paid at two rates: lower and higher). (Care and Support Statutory Guidance, Annex C Paragraphs 14 and 16)
11. The Council changed its charging policy in 2018, having carried out a consultation with those affected. The earlier policy in 2017 was more generous and did not include the higher rate of attendance allowance in the financial assessment. The changes in the 2018 charging policy meant a financial assessment took into account the lower and higher rate of attendance allowance. This meant an increase in the charge for people who received the higher rate of attendance allowance, unless they had additional DRE (see next paragraph).
12. Disability Related Expenditure (DRE) are expenses that a person has to pay connected to their disability. They are an allowance in a person’s financial assessment which reduces their weekly charge. DRE can include:
• specialist items and services such as wheelchairs
• extra heating or laundry costs
• equipment and aids
• regular payments such as wheelchair insurance and gardening costs.
13. Guidance says:
• A council must leave a person with enough money to pay for necessary DRE to meet needs that are not being met by the local authority
• The care plan may be a starting point for considering DRE, but councils need to be flexible.

(Care and Support Statutory Guidance Annex C, Paragraphs 39 and 41)

14. The Council’s charging policy made an allowance for reasonable expenses they had as a result of the disability (DRE). The policy gave some examples of common DRE. The finance team might in some cases ask for evidence of costs. The Council’s policy was to offer everyone a standard rate of DRE - £18 a week for people on the lower rate of disability benefit and £28 a week for people on the higher rate.
15. The Council’s charging policy also offers people the option of a tailored assessment of their DRE if their DRE claim is more than the standard allowances I have set out in the previous paragraph.

What happened

16. I have taken the key events from the Council’s electronic case records about Mrs Y.
17. Mrs Y received home care arranged by the Council from November 2017 to August 2019 when she moved to a different area.
18. In November 2017, a finance officer spoke to Mr X by phone to complete a financial assessment. Mr X went through Mrs Y’s income and savings and provided bank details. Mr X said Mrs Y paid a service charge of £85 a week for their flat and he agreed to send the finance team paperwork about this. The finance team wrote to Mrs Y setting out its financial assessment of her care charge, which included a standard weekly DRE allowance. The paperwork noted the finance team was waiting to receive information about the service charge and the Council would review the financial assessment when it received this information. Mrs Y’s weekly charge was £5.02. Mrs Y received higher rate attendance allowance and so, according to the policy at the time, only the lower rate was taken into account.
19. The finance team received a copy of the paperwork about the service charge in March 2018. An officer checked the papers to see what it included. Their note said ‘items listed on service charge statement would already be accounted for… e.g. utilities. Standard DRE covers items such as windows cleaners. Other items like insurance would not be classed as valid [DRE] expenses. No change in charge.’
20. Changes to the Council’s charging policy came into place in 2018. Mrs Y’s charge went up accordingly due to the new policy taking into account all her attendance allowance. In June 2018, Mr X called the finance team querying Mrs Y’s care charge. He said she should not be paying anything and said when she used to live in a different area, her care was free. The finance officer told Mr X that each council had its own charging policy and the charge had gone up because of a change in policy. The finance officer went through the financial assessment with Mr X and explained the Council took into account half the pension credit because it was a joint payment to Mr and Mrs Y. Mr X said the Council should not take attendance allowance into account. The finance officer said the Council did include attendance allowance. Mr X also mentioned the service charge and the finance officer said this had already been accounted for in the standard DRE allowance.
21. In July, the finance team completed a review of the financial assessment on the phone. The review included a tailored assessment of Mrs Y’s DRE. The charge was recalculated to include additional DRE and backdated to April 2018. An explanation of the charge from April 2018 gave Mrs Y’s DRE’s including ground rent, incontinence aids, hygiene, health and medical, laundry, household maintenance, transport, wheelchair, window cleaner and gardener. The total weekly DRE was £45.83. The weekly charge was £9.36.
22. In August, the finance team reduced the invoice due to an error it had made previously in the calculations.
23. In March 2019, a finance officer spoke to Mr X who confirmed Mrs Y’s finances were the same. There was no change to the financial assessment or charge.
24. In June 2019, Mr X spoke to a finance officer who told him Mrs Y’s charge went up slightly in April due to the normal yearly rise in state benefits. Mr X had a query about ground rent and so the finance officer sent a letter with a return envelope for him to provide documents about the service charge
25. Mr X sent the service charge documents and the finance team reassessed Mrs Y’s charge, recalculated it to include a higher amount for ground rent and raised a credit on the invoice.
26. Mrs Y moved to a different area in August 2019.
27. The Council continued to invoice Mrs Y from August 2019 to January 2020 for her care. This was after she and Mr Y moved. The records indicate the Council applied a credit to the account for the period she should not have been charged for after the move.
28. Mr X complained to the Council in October 2020 saying Mrs Y had received an invoice for £400. He said Mrs Y did not owe the Council anything and wanted the debt removed. He also said Mrs Y did not have to pay anything for her care in the new area,
29. The Council’s complaint response said the charge was in line with the Council’s charging policy and was correct, so it would not cancel the debt.
30. Unhappy with the Council’s response to the complaint, Mr X complained to us. He told us that as well as the service charge, there were additional car and physiotherapy costs that the Council did not consider as DRE for Mrs Y.

Was there fault?

31. The fact that Mrs Y does not currently pay a charge for her care in a different area did not mean the Council was at fault in charging her. Some councils charge for home care and some do not. This is allowed by law.
32. There was no fault by the Council. It was entitled to charge Mrs Y for her care and it did so in line with Care and Support Statutory Guidance and its charging policy. Councils are entitled to have standard allowances for DRE as long as they consider individual circumstances. So there was no fault in the November 2017 financial assessment.
33. There was also no fault in the change to policy in 2018 to include the higher rate of attendance allowance. This was in line with Annex C of Care and Support Statutory Guidance which permits councils to include attendance allowance as long as it considers DRE. I am satisfied the tailored assessment of Mrs Y’s DRE reflected her expenses and was in line with Annex C of Care and Support Statutory Guidance and included an amount for health costs (which could include physiotherapy). The Council did not have to consider Mr Y’s expenses in buying the car and there is no record of this being raised during the telephone assessment anyway.
34. The records show that when Mr X sent the finance team a copy of the service charge agreement, the finance team considered the individual elements covered by the service charge and decided whether those elements could be a DRE. The conclusion was they were already accounted for in the financial assessment. This was in line with the Council’s charging policy and so there was no fault.

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Final decision

35. The Council assessed Mrs Y in line with its charging policy and in line with Annex C of Care and Support Statutory Guidance and so there was no fault in charging Mrs Y for her care.
36. I have completed the investigation.

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Parts of the complaint that I did not investigate

37. I have not investigated the second complaint because Mr X has not used the Council’s complaints procedure. We normally expect people to complain to a council before we investigate and I consider Mr X should have made a formal complaint at the time. He can complain to the Council now should he wish and it can decide whether to exercise discretion to investigate the agency’s call times.

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Investigator's decision on behalf of the Ombudsman