Summary: Mr X complained about the Council’s decision to charge him for the non-residential care he receives. The Council was not at fault.

The complaint

1. Mr X complained about the Council’s decision to charge him for the non-residential care he receives and about an outstanding charge it has asked him to pay to the Care Provider. Mr X said the Council made a mistake as he has never had to pay towards his care before. Mr X said this has caused him a great deal of stress and upset. He wants the Council to erase the debt.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), 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 considered the information provided by Mr X.
5. I spoke with Mr X.
6. I considered the information provided by the Council.
7. Mr X and the Council had the opportunity to comment on the draft version of this decision. I considered their comments before making a final decision.

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What I found

Charging for adult social care

8. The Care Act 2014 sets out the legal framework for charging. Councils can make charges for care and support services they provide or arrange. They must do so in line with the Care and Support (Charging and Assessment of Resources) Regulations 2014. Charges may only cover the cost the council incurs.
9. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The assessment must comply with the principles in law and guidance, including those charges should not reduce a person’s income below Income Support plus 25% (also known as 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 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)

The Minimum Income Guarantee

10. The Social care – charging for care and support Local Authority Circular DHSC (2019)1 sets out the level of the minimum income guarantee.

The Council’s charging policy for non-residential adult social care services

11. The Council’s policy states the charge it calculates is based upon disposable income, which is calculated by comparing weekly assessable income against an income threshold. The income threshold is the basic amount of money that a person would be assessed as needing to live on under Income Support /Pension Credit Guaranteed amounts, plus 25%. It will vary dependent on a person’s age and individual circumstances. If a person has any disposable income their weekly charge will be the lower of:
• 47% of the disposable income
• 100% of the value of their Personal Budget
12. The Council considers the following income during a financial assessment:
• All state benefits with the exception of DLA (Mobility) and Carers' Premium
• All occupational pension income
• Tariff income from capital and savings
• Any other income other than earnings
13. The Council will make allowances for the minimum income guarantee, housing costs and disability related expenses before charges are calculated on the remaining sum.

What happened

14. Mr X has received a care package, arranged through the Council, for several years. The care package supports him with his personal care in his home. He receives an hour a day of support, seven days a week.
15. In May 2019, Mr X was awarded two components of Personal Independence Payment (PIP). As Mr X’s financial circumstances had changed, in February 2020, the Council completed a financial assessment. It considered Mr X’s and his wife’s benefits to determine the best value calculation as his wife also receives support in their home. The financial assessment established that Mr X would have to pay a contribution towards the care he received.
16. In calculating the contribution payment, the Council took into account the following income of Mr X and his wife:
• PIP
• Disability Living Allowance
• Pension Credit Guarantee
• State Retirement Pension
17. The Council disregarded essential expenditure which is Mr X and his wife’s core support charge and their rent. It factored in their minimum income guarantee and calculated 47% of the net income which would be Mr X’s contribution towards his care fees.
18. In March 2020, the Council wrote to Mr X and explained to him the financial assessment showed he would have to pay a contribution towards his care package. The Council informed Mr X how it had calculated the charge and how much he would have to pay each week. Mr X had requested direct payments so he could receive support from a care provider of his choice. The Council explained Mr X would need to pay the calculated contribution into his direct payment bank account to ensure there were sufficient funds to pay his care bills.
19. In May 2020, Mr X spoke with the Council about him having to pay a contribution towards his care package. The Council’s records show the Council asked Mr X if anything looked incorrect in his financial assessment and Mr X said his income details looked fine. Mr X then said he would check his documents again and contact the Council if he felt the calculation was incorrect.
20. In January 2021, Mr X contacted the Council upon receiving an invoice in relation to his care fee contribution he had not paid. Mr X wanted to know why he had to pay a contribution towards his care fees as he had never paid before March 2020. The Council explained to Mr X again how it had calculated his contribution payment and the benefits it had considered in doing so. The Council asked Mr X to confirm if the benefits information it had for him was correct.
21. In February 2021, Mr X complained to the Council. He said shortly after when the Council told him he had to pay a contribution towards his care, he spoke with a Council Officer who said the Council’s calculations may have been incorrect and that they would sort it out. He said he assumed the Council would then resolve the matter however he had continued to receive charging notifications which stated he owed money as he had not paid his contributions. Mr X said he could not afford to pay his contributions, the money he allegedly owed to the Care Provider was increasing and the whole matter has been extremely stressful for him.
22. Following Mr X’s complaint, the Council spoke with Mr X and said it had not informed him previously that it had calculated his contribution incorrectly. During the conversation, Mr X confirmed the information the Council had in relation to his benefits was correct. The Council informed Mr X if he was struggling to make payments for his contribution, it could refer him to the Welfare Rights Team to see if he was entitled to any other benefits.
23. During this time, the Care Provider made the Council aware Mr X was refusing to pay his contributions which meant there was insufficient money in the account to pay for his care. Mr X had also incurred a debt due to payments he had not made previously. In September 2021, the Care Provider informed the Council it was no longer able to support Mr X with his care as it had not been paid. The Council changed Mr X’s care package from direct payments to commissioned care and contracted another care provider to deliver his care. This means the Council now pays the new Care Provider but Mr X is still required to pay a contribution to the Council towards his care package.
24. Mr X remained unhappy and complained to us.

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Findings

25. The Council calculated Mr X’s contribution towards his care package in line with the relevant statutory guidance, regulations and the Council’s own policy. It left Mr X with an amount above the minimum income guarantee which is set by the Government. Mr X also confirmed the information the Council had in relation to his income was correct. There was no fault with how the Council completed the financial assessment with Mr X.
26. In addition, the Council informed Mr X following the financial assessment that he was required to pay a contribution towards his care package. It explained to him how it had calculated the charge, the amount he was required to pay and that he had to ensure the funds were available in his direct payment bank account. I am satisfied the Council properly notified Mr X of the charge.
27. Shortly after Mr X received the Council’s letter notifying him of his payment contribution, Mr X said the Council informed him it had incorrectly calculated his income and that it would resolve the matter. There is no evidence which shows the Council informed Mr X of this. The Council’s records show that Mr X spoke with the Council once in relation to this matter in 2020 and that Mr X said he would contact the Council once he had checked his documents. Mr X did not contact the Council again in relation to this matter until January 2021. The Council was not at fault.
28. Mr X wants the Council to erase his debt. However, the Council is entitled to charge Mr X for the care and support he receives. There was no fault in the way the Council calculated Mr X’s contribution towards his care fees and how it informed Mr X of this.
29. The Council has a duty to ensure Mr X’s care needs are met. The Council changed Mr X’s care package from direct payments to Council commissioned care to ensure Mr X would continue receiving the support he required. This is what we would expect the Council to do. The Council was not at fault.

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Final decision

30. I have now completed my investigation. There was no fault by the Council.

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Investigator's decision on behalf of the Ombudsman