Summary: Mr X complained the Council has incorrectly calculated the final redemption figure for his late mother’s care contribution. Mr X also complained that he received incorrect calculations of charges regularly from the care home during his mother’s time there. Mr X says the Council did not provide charges in a clear and plain manner and disputes the final balance. The Ombudsman does not find fault with the final balance or clarity of the invoices.

The complaint

1. Mr X complained the Council has incorrectly calculated the final redemption figure for his late mother’s, Mrs Y’s, care contribution. Mr X says the Council has duplicated payments to the care home, from the estate and the Council, in the accounting. Mr X says this has caused miscalculations.
2. Mr X also complained that he received incorrect calculations of charges regularly from the care home during his mother’s time there. Mr X says the Council did not provide charges in a clear and plain manner.

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The Ombudsman’s role and powers

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

5. I have considered all the information Mr X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
6. Mr X provided comments on my draft decision. I considered Mr X’s comments before making my final decision.

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What I found

Legislation and guidance

7. The Care Act 2014, the Care and Support Statutory Guidance and the Care and Support (Deferred Payment) Regulations 2014 sets out the establishment of a universal deferred payment scheme towards the cost of care homes. Or supported living accommodation.
8. Deferred payment agreements are designed to prevent people from being forced to sell their home in their lifetime to pay for their care. By entering into a deferred payment agreement, a local authority agrees to defer the payment of charges due to it from the adult, for the costs of meeting needs in a care home or supported living accommodation.
9. The guidance notes that the payment for care and support is deferred and not “written off”. The costs of provision of care and support will have to be repaid by the individual at a later date.
10. In principle, a person should be able to defer the entirety of their care costs; subject to any contribution the local authority is allowed to require from the person’s income. The local authority will need to consider whether a person can provide adequate security for the deferred payment agreement (paragraph 9.36).
11. If the person is considering a top-up, the local authority should also consider whether the amount or size of the referral requested is sustainable given the equity available from their chosen form of security (paragraph 9.37).
12. Paragraph 8.2 of the Guidance says that when a council decides to charge for care, including care home costs, it should be “clear and transparent, so people know what they will be charged”.

Council corporate complaints procedure

13. The Council has a two-stage corporate complaints procedure.
14. The Council will not consider a complaint through its corporate complaints procedure when it is something the Council did not previously know about. First, the Council will try to resolve the matter as a fault report or service request if appropriate.
15. When a person complains to the Council it should provide a stage one response within a maximum time of twenty working days.
16. If a person asks to go to stage two of the complaints process the Council should provide a response within twenty working days of the request.

Events before 2020

17. Mrs Y lived in a care home. From October 2016, the Council began a deferred payment agreement to part fund Mrs Y’s care home costs.
18. Mr X, Mrs Y’s son, paid towards the care home cost for Mrs X and the Council also paid towards the cost of the care home.

Events from 2020

19. Mr X contacted the Council on 3 February 2020 to query an invoice received for 9 October 2019 to 2 January 2020. Mr X said he paid the care home directly for this time period.
20. The Council told Mr X it had also paid the care home for this time period but could amend this if Mr X had also paid. Mr X provided details of the payments he made to the care home in October, November and December 2019. The Council raised this with the care home.
21. Mrs Y passed away on 11 May 2020.
22. Mr X confirmed with the Council that Mrs Y passed away. Mr X asked the Council to update its system and finalise the amount owed for Mrs Y’s care costs.
23. The Council confirmed it would write to Mr X to confirm the final amount owed for the deferred payments shortly. The Council was still awaiting clarity from the care home on the double payment from October 2019 to December 2019.
24. The care home confirmed with the Council that either Mr X or the Council had overpaid for Mrs Y’s care costs by £2,750.62. The Council told the care home it would deduct this cost from scheduled payments to the care home and reduce Mr X’s final invoice by the same amount.
25. The Council confirmed the final balance owed for Mrs Y’s costs with Mr X on 7 July 2020. The Council said Mrs Y owed £125,975.15 including top-up contributions and interest from the Council.
26. Mr X told the Council on 24 July 2020 Mrs Y’s house sale was due to complete on 31 July 2020. The Council responded to Mr X on 24 July 2020 to revise the final balance owed to £126,036.62. The increase in balance was a result of extra interest charged since 7 July 2020.
27. Mr X queried the final balance owed because of the double-up payments from October 2016 to December 2016 and extra charges for top-up contribution at the start of 2020.
28. The Council responded on 28 July 2020 advising it assisted funding Mrs Y’s care costs from 14 October 2016. The Council said it also paid her top-up contribution from 14 October 2016 to 15 December 2016. The Council also said the care home asked it for payment in October 2019 due to underpayment by Mrs Y. However, when the Council queried this the care home confirmed double payments of £2,750.62 which the Council took off the final balance owed. The Council provided a summary of Mrs Y’s payments and charges.
29. Mr X settled the balance owed in August 2020.
30. Mr X contacted the Council on 16 September 2020 about the final charges on Mrs Y’s account. Mr X said:
• There was a second account number on the final invoice for charges in 2016 which he said he had already paid. Mr X said the Council had double charged for this period.
• Mr X said he had paid the care home directly for contribution from January 2020 to May 2020.
31. The Council responded to Mr X on 29 September 2020. The Council sent Mr X a copy of the account breakdown. The Council said it had already deducted the overpayments of £2,750.62 from the final invoice.
32. Mr X continued to liaise with the Council about his complaint and contacted the care home. The Council advised it had covered top-up contributions when needed if the care home reported underpayment as it has a duty to pay care fees. The Council told Mr X it did not owe a refund on 22 October 2020.
33. Mr X complained to the Council about the final invoice.
34. The Council provided its stage 1 response to Mr X on 3 December 2020. The Council upheld its stance from the contact on 22 October 2020 in which it confirmed it owed no refund to Mr X.
35. Mr X complained to the Local Government and Social Care Ombudsman. As Mr X had not completed the Council’s complaint process, the Ombudsman asked the Council on 4 February 2021 to provide a Stage 2 response to Mr X.
36. The Council provided Mr X with a stage 2 response on 22 February 2021 and redirected him to the Local Government and Social Care Ombudsman.

Analysis

Calculation of final redemption figure

37. Mr X complained the Council has miscalculated the final redemption charges for Mrs Y’s care home costs. Mr X says the Council has double billed him and not considered the full payments he made.
38. The Council part funded Mrs Y’s care home costs under a deferred payment agreement. This enabled Mrs Y to remain in a care home until she passed away. The Council’s payments for Mrs Y’s care are repayable by Mrs Y, or her estate.
39. The Council told Mr X it had not double billed him for Mrs Y’s care and it had considered the full payments Mr X made when finalising the balance owed.
40. Mr X evidenced £29,084.42 of payments to the care home from 8 October 2016 to April 2020. Within the Council’s breakdown of Mr X’s payments, it has detailed £31,677.62. The Council has detailed all Mr X’s evidenced payments in its breakdown. This shows the Council has considered all Mr X’s payments. I do not find fault with the Council.
41. Mr X also complained the Council double billed in 2016 and from October 2019 to May 2020. The final redemption breakdown produced by the Council on 24 July 2020 includes extra charges for October 2016 to December 2016 for top-up contributions and January 2020 to May 2020 for customer contributions. Since Mr X paid the care home during these time periods it is understandable why Mr X would dispute these charges.
42. The care home has already recognised an overpayment by Mr X from October 2019 to May 2020. This resulted in the Council reducing the total balance owed by £2,750.62. This directly addressed Mr X’s overpayments from October 2019 to May 2020.
43. The Council also explained to Mr X that while he paid for the top up contributions in October 2016, there were other periods of missing payments. The missing periods included April 2018 to August 2018 and February 2017 to June 2017. The Council covered top-up contributions when Mr X, or Mrs Y, did not pay these.
44. Overall, the care home charges, whether paid by Mr X, Mrs Y or the Council from 23 September 2016 to 13 May 2020 amounted to just less than £158,000. Given that Mr X, or Mrs Y, paid £31,677.62 during this time. This means, the balance owed would be about £126,000 before considering any further charges or deductions.
45. The Council charged administration fees of £786.55 and interest of £2,702.59. Mr X paid the Council directly £724.77 in 2020 and the Council applied a property disregard of £2,777.67 reduction to Mrs Y’s balance. Since these figures balance out the outstanding balance would remain about £126,000.
46. I do not find fault with the balance calculated by the Council as the final redemption figure.

Clarity of billing

47. Mr X says the billing provided by the care home has been in a clear and plain manner.
48. Statutory Guidance says Council’s must provide clear and transparent billing for people when it charges for care. This is to ensure a person knows what they are being charged for.
49. Each bill produced by the Council for Mrs Y’s deferred payment contributions confirm the reason for the charge. Each bill also shows the cost of the care contribution the Council is providing to the care home per week, the length of time charged for and the resulting total cost.
50. The invoices also confirm the Council will continue to make deferred payments until Mr X or Mrs Y sells the property.
51. While I appreciate Mr X may have considered the billing by the Council unclear, the Council has included all relevant information in the billing. I do not find fault with the Council.

Complaint Handling

52. Mr X contacted the Council first in July 2020 to query the final redemption figure.
53. The Council acted correctly in July 2020 to respond to the query and provide a breakdown of the charges.
54. Mr X contacted the Council on 16 September 2020 to complain about the final redemption figure. As Mr X had brought this matter to the attention of the Council in July 2020, this should have engaged the Council’s corporate complaints procedure.
55. The Council did not log a complaint until 22 October 2020. When the Council did log Mr X’s complaint it did not provide the stage 1 response until 3 December 2020, 30 days later.
56. The Council failed to recognise the complaint for 25 working days and provided the stage 1 response 10 days outside its timescales. This is fault from the Council.
57. While the Council is at fault, I do not consider this caused Mr X a significant personal injustice. The overall delay is not significant itself. Mr X also settled the balance owed in July 2020 meaning the Council’s delay did not cause an accrual of further charges. Since I have found the balance accurate, the Council’s delays have not delayed any remedial action.
58. When the Local Government and Social Care Ombudsman asked the Council to provide Mr X with a stage 2 response, it did so within the timescales outlines in its corporate complaints procedure.

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Final decision

59. I have completed my investigation as there was no fault in the Council’s decision and no injustice to Mr X.

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Investigator's decision on behalf of the Ombudsman