Summary: Mrs X complained on behalf of her mother, Mrs Y that the Council failed to provide regular invoices in relation to Mrs Y’s care costs. Mrs X says this caused avoidable worry and frustration. We found the Council to be at fault regarding this matter. The Council has agreed to make a payment to Mrs X to remedy the injustice caused, and to monitor the invoicing of Mrs Y’s care costs.

The complaint

1. Mrs X complained on behalf of her mother, Mrs Y that the Council failed to provide regular invoices in relation to Mrs Y’s care costs. Mrs X says the Council agreed to provide invoices every four weeks, but it delayed providing invoices on several occasions. Mrs X says this caused her avoidable worry about the payment of her mother’s care costs and frustration caused by requesting invoices from the Council.

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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 discussed the complaint with Mrs X and considered the information she provided.
5. I made enquiries to the Council and considered the information it provided.
6. Mrs X and the Council have had the opportunity to comment on a draft of this decision. I have considered their comments before making a final decision.

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What I found

Reablement care

7. If a person has been in hospital, they may need some temporary support and care when they return to their home. This is known as reablement care. Reablement care provides services to help people live independently and is provided by a team of mainly care and support professionals.
8. Regulations require reablement care to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support.

Charging for residential care

9. The Care Act 2014 provides a single legal framework for charging for care and support under sections 14 and 17. It enables a council to decide whether to charge a person when it is arranging to meet a person’s care and support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
10. When a council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person has to pay towards the cost of their residential care.

Charging for Adult Social Care – the Council’s policy

11. The Council’s policy says: “When an individual chooses for the council to provide or arrange services using their personal budget, either a 4 weekly invoice is sent to clients requesting the payment of their personal contribution or in some cases, providers may be paid net of the clients contribution. This will include any charges associated with any other financially assessed services and/or any flat-rate charges where applicable.” (London Borough of Croydon, Adult Social Care Policy – Charging for Adult Social Care, 9.2)

What happened

12. This chronology includes key events in this case and does not cover everything that happened.
13. Mrs Y lived with her daughter, Mrs X. Mrs Y has a health condition which means she requires care and support. Mrs X provided care for her mother while she was living with her.
14. Mrs Y’s health condition deteriorated, and Mrs X found it increasingly difficult to care for her. Because of this, Mrs X considered the possibility of Mrs Y moving into residential care. As a result, the Council carried out a financial assessment for Mrs Y. Following the assessment, the Council decided Mrs Y would need to pay for some of her care costs.
15. In 2020, Mrs Y was admitted to hospital. When Mrs Y was discharged, she moved back to Mrs X’s home. Following her discharge from hospital, Mrs Y received reablement care.
16. Mrs Y’s health condition continued to worsen and as a result, Mrs X found she was no longer able to provide care for Mrs Y.
17. Mrs Y moved to a residential care home in July 2020. The Council agreed to provide invoices for Mrs Y’s contribution towards her care costs.
18. In September 2020, Mrs X contacted the Council to query an invoice. She said the amount charged wrongly included costs for reablement care. Mrs X said she had already clarified with the Council that these costs should not be invoiced, and she asked for the error to be corrected.
19. The Council apologised for the error and said it would issue a revised invoice for the correct amount.
20. Mrs X contacted the Council shortly after and said she had not received the revised invoice. She also asked how often the Council would provide invoices going forward.
21. The Council apologised for the time taken to resolve the issue and told Mrs X it would resume invoicing once it had updated its system. It said that invoices would then be issued every four weeks.

Mrs X’s complaint

22. Mrs X complained to the Council on 16 October 2020. She said she had only received one correct invoice since Mrs Y had moved to residential care in July 2020. Mrs Y said this was causing her to worry about the family’s finances, particularly in view of the previous incorrect charges.
23. The Council provided its stage one complaint response on 9 November 2020. It apologised for the delay in responding and for the length of time taken to raise an invoice. The Council said the delay was caused by its change of financial systems which meant Mrs Y’s funding details were not processed in time for the invoices to be created. The Council said it had resolved the issue and Mrs X would receive four-weekly invoices going forward.
24. Mrs X contacted the Council again in January 2021 and said she had not received an invoice for almost six weeks. Mrs X asked the Council to send her an invoice and for subsequent invoices to be provided every four weeks.
25. Mrs X escalated her complaint to stage two on 22 January 2021 as she was not satisfied with the Council’s actions. Mrs X said she had only received two invoices despite the Council telling her it would send them every four weeks. Mrs X said she considered the Council should forfeit part of the payment if it did not issue invoices within a certain timeframe.
26. The Council replied on 18 February 2021. It said its stage one response acknowledged the delays and had apologised for this. The Council acknowledged Mrs X had not received subsequent invoices and said this was due to its new financial charging system which was still experiencing some teething problems. It said the Council was working hard to rectify the issues and suggested Mrs X may wish to set up a standing order as a temporary solution. The Council said it was unable to forfeit part-payment of the care charges.

What happened next

27. Mrs X contacted the Council again in July 2021 and said she was still not receiving the invoices every four weeks. Mrs X said she would not set up a direct debit for the care charges because she did not trust the Council to provide invoices for the correct amount.
28. The Council replied and provided Mrs X with a statement of account. It said it had issued invoices since May 2021.
29. Mrs X emailed the Council on 22 July 2021 and said she had not received the last two invoices. She said the last invoice received was in May 2021.
30. The Council replied to Mrs X the next day. It said it had looked into the matter and found it had not created an invoice for Mrs Y in June 2021. The Council apologised to Mrs X for the error.
31. Mrs X remained dissatisfied with the Council’s response and brought her complaint to us.
32. Mrs X says the Council was late in sending invoices between August and October 2021.

Analysis

33. The Council’s charging policy says it will send invoices on a four-weekly basis. The Council’s correspondence to Mrs X also specified this.
34. The Council says it changed its billing system in September 2020 and this created problems with the migration of data from the old system to the new. The Council says it carried out parallel billing runs to identify any issues, but some delays were caused because of the implementation of the new system and its related processes. The Council says it is working closely with professionals with expertise in the new billing system to quickly address any issues that arise. It says it is doing all it can to avoid delays which could create anxiety for service users about their ability to pay for care costs.
35. The Council has acknowledged it was late in sending some invoices to Mrs X. I have seen the Council’s records relating to the invoices created and have identified seven occasions where the Council issued late invoices.
36. While I acknowledge the Council’s comments about the difficulties it faced when implementing its new billing system, I have found the delays incurred in issuing late invoices to Mrs X to be fault. This is because the Council did not adhere to the process regarding income collection as set out in its charging policy.
37. The Council says it offers a standing order or direct debit facility which may be used to avoid any delayed payment by the service user. It says it offered this option to Mrs X as part of its complaint response.
38. Mrs X says she does not want to use this method because she does not trust the Council to charge the correct amount following its error regarding the charges for Mrs Y’s reablement care.
39. I acknowledge the comments from both parties regarding this matter. However, while Mrs X can set up a standing order which may mitigate the impact of delays in invoicing, it remains that the Council should adhere to its charging policy and issue its invoices every four weeks.
40. Mrs X says the delays caused by the Council issuing late invoices have caused her avoidable worry and frustration over a period of several months. It is positive the Council has acknowledged the delays and has apologised to Mrs X for this. However, I do not consider this adequately addresses the injustice caused to Mrs X.

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Agreed action

41. To address the injustice identified, the Council has agreed to take the following action within one month of the final decision:

• Make a payment of £175 to Mrs X in recognition of the worry and frustration caused by the Council’s actions.

42. The Council has also agreed to take the following further action:

• Monitor the billing of Mrs Y’s care charges for a period of 24 weeks (equivalent to six billing runs) to ensure the Council issues invoices to Mrs X on time. This period should commence from the next billing run after the date of the final decision, and
• The Council contacts Mrs X in the event of any late invoices during this monitoring period, to facilitate payment of the care charges without further delay.

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Final decision

43. I have found fault by the Council regarding this matter and the Council has agreed to take the above actions to resolve the complaint. I have therefore concluded my investigation.

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Investigator's decision on behalf of the Ombudsman