Summary: Mr and Mrs X complained about the Council’s handling of the care charges for their adult son, Mr Y’s, attendance at a day centre. The Council was at fault as it failed to explain Mr Y would be required to contribute to his care costs when it arranged the care package. It then further delayed explaining the charges, failed to communicate clearly with Mr and Mrs X and failed to explain there would be a charge for non-attendance. The Council agreed to cancel the debt prior to April 2019, make a payment to Mr and Mrs X to acknowledge the frustration caused to them and review its processes to prevent a recurrence of the fault.

The complaint

1. Mr and Mrs X complained about the Council’s handling of care charges for their adult son, Mr Y’s attendance at a day care centre between 2018 and 2020 which was arranged and funded by the Council. Mr and Mrs X complained the Council;
• failed to communicate that Mr Y had to pay towards the cost of his attendance at the day care centre;
• failed to inform him or them that he would be charged on days he did not attend;
• failed to inform him or them that Mr Y should give the day care centre prior notice for the days he did not attend; and
• failed to respond to them when they raised concerns about invoices, instead referring them to the day care centre.

Mr and Mrs X said the Council requesting payment was causing them and Mr Y distress and uncertainty and would lead to financial hardship should they have to pay the debt.

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The Ombudsman’s role and powers

2. 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)
3. 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

4. I read the documents provided by Mr and Mrs X.
5. I discussed the complaint with Mr and Mrs X and Mr Y on the telephone.
6. I read the documents the Council provided in response to my enquiries.
7. Mr and 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

Assessment and planning

8. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult who appears to have need for care and support. They must provide an assessment to all people regardless of their finances or whether the council thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and what they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved. The council must carry out the assessment over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell the individual when their assessment will take place and keep the person informed throughout the assessment.
9. Where councils have determined that a person has any eligible needs, they must meet these needs. When a council has decided a person is or is not eligible for support it must provide the person to whom the determination relates (the adult or carer) with a copy of its decision.
10. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
11. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning, with the final amount of the personal budget confirmed through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be an amount enough to meet the person’s care and support needs.
12. Section 27 of the Care Act 2014 gives an expectation that councils should conduct a review of a care and support plan at least every 12 months. The authority should consider a light touch review six to eight weeks after agreement and signing off the plan and personal budget. It should carry out the review as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. As well as the duty to keep plans under review generally, the Act puts a duty on the council to conduct a review if the adult or a person acting on the adult’s behalf asks for one.

Charging

13. Section 14 of the Care Act states councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs.
14. Once a council has identified that an adult has eligible care and support needs it must decide if it will charge for meeting those needs. In order to do so it must assess a person’s finances, including income and savings, to see if they should make a contribution to their care. It must give a written record of the financial assessment to the person. It should explain how the assessment has been carried out, what the charge will be and how often it will be made, and if there is any fluctuation in charges, the reason. The council should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.

What happened

15. Mr Y is an adult and has a learning disability and Asperger’s syndrome as well as a physical illness. In 2016 Mr Y was attending a day care centre (The Centre) that provided care and support services. This was not arranged by the Council. The Centre sent a safeguarding referral for Mr Y to the Council outlining its concerns about a deterioration in Mr Y’s mental health. The Centre requested a reablement plan and funding for Mr Y to attend the Centre five days a week.
16. The Council’s case notes record it completed an eligibility assessment for Mr Y in March 2017. It had a meeting with the Centre, Mr and Mrs X and Mr Y. It outlined a plan that included referrals to other services and for Mr Y to attend the Centre two days a week funded by the Council. There is no record in the case notes of any discussion about funding with Mr Y or his parents.
17. In April 2017 the Council records show it sent Mr Y a financial assessment form which was returned in May the same year.
18. In April 2018 the Council completed the financial assessment and sent Mr Y a charging letter that stated his contribution to his personal budget was £65.69 each week from March 2018, the financial assessment did not record any living costs for Mr Y. The letter did not specify the charges were in relation to Mr Y attending the Centre, however it stated it was the amount Y needed to pay towards his personal budget that the Council used to pay for his care and support. The Council began to send invoices to Mr Y for his contribution to the care costs.
19. Mr and Mrs X stated that on their advice Mr Y began taking the invoices to the Centre for support as they felt it was an administrative error. In July 2018 the Centre requested a new financial assessment form from the Council for Mr Y “due to lack of funds”. The Council completed the reassessment in November 2018 and told Mr Y he was liable for £45.70 a week towards his personal budget. It sent the charging letter to Mr and Mrs X as Mr Y’s representatives and continued to send monthly invoices.
20. In March 2019 a Community Care Practitioner (CCP) began a care act review with Mr Y on behalf of the Council. The CCP contacted the Council and asked about the funding for Mr Y’s placement at the Centre. They said the previous care plan in 2017 specified the Council would fund two days a week at the Centre but Mr Y had been receiving invoices for this service. The CCP asked the Council to confirm the costs and why Mr Y was receiving the invoices. On 15 April 2019 Mrs X also contacted the Council and queried the invoices. She stated she had been referring the invoices to the Centre who told her it would deal with them. Mrs X asked the Council to contact the Centre to discuss the charges. The Council informed Mrs X the service was chargeable and Mr Y had been assessed which it explained in the charging letter it had sent. The Council also replied to the CCP stating Mr Y had been assessed for his contribution and had been informed in writing.
21. In May 2019 Mr X wrote to the Council and stated they had not been informed of any changes to Mr Y’s funding. Mr X said he had been passing the invoices to the Centre who had told him it would sort it out with the Council. The Council responded to Mr X and stated Mr X needed to provide evidence for a financial reassessment but in the meantime it would continue to issue invoices.
22. In June 2019 the Council reassessed Mr Y’s care needs. It stated he still had eligible needs and was funded to attend the Centre two days a week. In July the Council produced a support plan which said Mr Y continued to attend the Centre to support his needs. It set out his personal budget of £115.12 for two days a week attendance at the Centre. This was followed by a reablement plan which was in place from August 2019 until October 2019 due to a deterioration in Mr Y’s mental health. Neither of these plans identified any changes to Mr Y’s services or funding.
23. In July Mr X again contacted the Council as invoices continued to arrive and asked it to contact the Centre about the funding. He also returned an invoice to the Council asking it to refer to his email. The Council replied that it could not discuss finances with the Centre and advised Mr X to contact the social worker or customer services department at the Council.
24. In September 2019 Mr X again contacted the Council about the invoices by phone. The Council records show it told Mr X it had been in contact with the Centre and the Centre would make contact with Mr X to discuss the matter. In July and August Mr X returned further invoices asking the Council to refer to a staff member at the Centre. There was no further contact between the Council and Mr and Mrs X until September 2020.
25. In September 2019 the Council contacted the Centre. The records note the Centre specified it would speak with Mr Y and Mr X and report back to the Council. In November 2019 the Council contacted the Centre again. The Centre advised it would speak to Mr Y as soon as it could about his care charges and arrears and would also contact his father and let him know the outcome. In January 2020 the Centre informed the Council that it had not seen much of Mr Y due to illness but it would try to arrange a meeting.
26. In a further phone call in March the Centre told the Council Mr Y said he should not have to pay a contribution and when the Centre tried to discuss this with him Mr Y got very anxious and frustrated. In April the Centre requested a new financial assessment form for Mr Y as he stated he could not afford the charges. In July the Centre confirmed it had completed a financial reassessment form for Mr Y and had sent it to him to sign. In August the Council contacted the Centre as it had not received the financial reassessment form. The Centre stated it would follow this up with Mr Y and Mr and Mrs X. In September 2020 the Council sent the Centre an email advising it of Mr Y’s new assessed charges and suggested a meeting with Mr and Mrs X to discuss the matter.
27. In September 2020 the Council spoke with Mrs X who asked for the debt to be written off. The Council agreed the debt for services prior to November 2018 could be written off as there was no proof Mr Y had been informed he would be charged for the service. The Council decided as it had sent the charging letter to Mrs X in November 2018, who was said to manage Mr Y’s money, she would remain responsible for ensuring the debt was paid. In October 2020 the Council suggested setting up a payment plan.
28. In October 2020 the Council completed a support plan review and Mr Y said he no longer required support from adult social care and was no longer attending the Centre. The Council ended the support plan on Mr Y’s request.
29. Mr and Mrs X complained to the Council in October 2020. They stated that neither Mr Y nor they, acting as Mr Y’s representatives, had ever been informed of any changes in the funding for Mr Y’s attendance at the Centre. They stated they had been trying to sort the matter out for a number of years with the Centre and that Mr Y’s attendance had been sporadic during that time. Mr and Mrs X requested the Council write off the outstanding bills.
30. The Council responded to Mr and Mrs X in December 2020. It stated it had already agreed to waive the charges prior to November 2018. It had sent the outcome of the financial reassessment in November 2018 to Mr and Mrs X informing them of Mr Y’s contribution. It also stated Mr Y had been charged for sessions at the Centre that he did not attend because he had not given 48 hours notice as required. It stated it may reconsider some of the charges if Mr and Mrs X could provide good reason for Mr Y’s not attending the Centre without giving notice. It also stated the Centre had informed it that it could not recall advising Mr and Mrs X not to worry about the invoices and felt this may have been misconstrued.
31. Mr and Mrs X complained again to the Council. They stated they were unaware the service was chargeable. They said they were also unaware there were charges for not attending without notice.
32. The Council responded to Mr and Mrs X and stated it would have expected the Centre to inform it if Mr Y was not attending a large number of sessions. The Centre had not done so and so the Council offered a 25% reduction of the outstanding debt. It stated if the matter had been brought to its attention at the time it may have addressed it earlier.
33. Dissatisfied with the Council’s response Mr and Mrs X complained to us. They complained about the charging and about the Council’s communication with themselves and the Centre. Mr Y stated if he had been aware of the charges he would have stopped attending the Centre.

My findings

34. The Council assessed Mr Y in March 2017 and found him to have eligible care needs and produced a care and support plan to meet those needs. The care and support plan should have been reviewed at least every 12 months. There is no record of a review of Mr Y’s eligibility or care and support plan until July 2019 which is 16 months later than the legislation states. That was fault however when the Council completed the review it did not find any changes were needed to Mr Y’s eligibility or care and support plan, and therefore the delay did not cause Mr Y any injustice.
35. In March 2017 the Council agreed to fund Mr Y’s placement at the Centre for two days a week. In April 2018, 13 months after the assessment, it completed a financial assessment of Mr Y and decided that he would need to contribute towards his care costs. The delay in completing the financial assessment was fault. However, the Council did not backdate the charge and so this did not cause an injustice.
36. There is no evidence the Council explained to Mr Y or Mr and Mrs X in March 2017 that he would need to contribute to the cost of his care package. That was fault. The Council had already agreed to write off the invoice prior to November 2018.
37. The Council sent the charging letter to Mrs X in November 2018 which set out the contribution Mr Y was required to pay towards the personal budget. Mr and Mrs X state they thought this was an error and attempted to resolve the matter with the Centre. When this did not solve the problem Mrs X spoke to the Council in April 2019 at which point it explained that the service was chargeable.
38. The Council was aware Mr Y had paid no invoices on the account for over a year but had not taken any action to follow this up. The failure to ensure that Mr and Mrs X understood that Mr Y was liable for the charges was fault. However, it did provide an explanation in April 2019 at which point Mrs X was aware Mr Y must pay a contribution for the services at the Centre. There is no fault in the Council charging Mr Y for services provided to him from 16 April 2019 onwards less 25% as discussed in paragraph 39.
39. The Council charged Mr Y for days he did not attend the Centre but did not give notice. The Council has provided no evidence it informed Mr Y he must give notice if he was not going to attend. The failure to advise Mr Y of the required notice period was fault. However, the Council has already agreed to write off 25% of the outstanding amount to reflect the injustice caused by the fault. This is a sufficient remedy for the injustice caused.
40. Mr and Mrs X attempted to understand and resolve the issue of charging once they started to receive the invoices. They spoke in the first instance to the Centre and then directly to the Council. Mr and Mrs X repeatedly asked the Council to discuss the matter with the Centre. The Council initially said it could not discuss it with the Centre and then referred Mr X back to the Centre and communicated only with the Centre for one year. The Council let the situation drift. It failed to resolve the situation in a timely way with Mr and Mrs X and relied on the Centre to do so. This was fault.
41. In its response to my enquiries the Council stated it communicated with the Centre on Mr X’s request, it went on to state Mr and Mrs X should not have relied on the Centre to resolve the issue which is a contradiction. The Council’s poor communication with the Centre, Mr Y and Mr and Mrs X was fault. It caused Mr Y and Mr and Mrs X frustration and time and trouble and meant the situation went on for longer than it should have.

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Agreed action

42. The Council agreed to clear the debt owed by Mr Y prior to 15 April 2019 within one month of this decision, as it did not adequately inform Mr Y or Mr and Mrs X about any charges levied for the service or for non-attendance without notice.
43. The Council agreed to pay Mr and Mrs X £100 to recognise the frustration and time and trouble caused to them by the Council’s poor communication within one month of this decision.
44. The Council agreed to review the way it communicates with service users about charging and about their potential contribution to the cost of care at the time it assesses their eligible needs. The Council will provide us with evidence that it has completed this review within three months of this decision.

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Final decision

45. I have completed my investigation. I have found fault leading to injustice and the Council has agreed to my recommendations to remedy that injustice.

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Investigator's decision on behalf of the Ombudsman