The Ombudsman's final decision:
Summary: Mr X complains the Council is overcharging Mrs Y for the care she receives from its care provider, Icare Solutions (Wirral) Ltd. Mrs Y’s commissioned calls do not appear to have reflected her actual needs. This has resulted in significant overcharging, made worse by other failings within the charging system. The Council needs to correct these problems, apologise, recalculate Mrs Y’s charges and pay financial redress.
- The complainant, whom I shall refer to as Mr X, complains the Council is overcharging Mrs Y for the care she receives from its care provider, Icare Solutions (Wirral) Ltd (the Care Provider).
The Ombudsman’s role and powers
- 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)
- 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, sections 30(1B) and 34H(i), as amended)
- We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
How I considered this complaint
- I have:
- considered the complaint and the documents provided by Mr X;
- discussed the complaint with Mr X;
- considered the comments and documents the Council has provided;
- considered the Ombudsman’s guidance on remedies; and
- invited comments on a draft of this statement from Mr X and the Council, for me to consider before making my final decision.
What I found
- Mr X’s mother-in-law, Mrs Y receives support from two care workers four times a day. She started receiving support in September 2019. From May 2020 the length of the commissioned calls increased:
- Morning – from 45 to 90 mins
- Lunch – from 30 to 60 mins
- Teatime – from 30 to 60 mins
- Bedtime – from 45 to 60 mins
- commissioned calls (as reflected in paragraph 7 above);
- the Care Provider’s claimed call times (used to create invoices);
- the Care Provider’s electronic call monitoring (actual call times based on the care workers logging in and out of each call by telephone); and
- Mr X’s analysis of call lengths (set out in a spreadsheet).
- from 30 September 2019 to 1 March 2020 the Care Provider had provided actual call times based on electronic call monitoring;
- from 2 March to 31 May 2020 the Care Provider had provided commissioned call times, rather than accurate call times;
- from 1 to 21 June 2020, the Care Provider had provided actual call times;
- from 22 June 2020 to 3 January 2021, the Care Provider had provided commissioned call times, rather than accurate call times; and
- from 4 January 2021, the Care Provider had provided actual call times
- where no time had been recorded it charged Mrs Y for the commissioned call (even if average call length was significantly less); and
- if one care worker did not log the visit, it based the charge on the commissioned call.
Is there evidence of fault by the Council which caused injustice?
- There is no dispute over the fact the Care Provider was claiming too much for the calls it delivered. That is fault for which the Council is accountable. It has accepted this by offering to reduce Mrs Y’s charges. The issue in dispute is the extent of the overcharging and whether the basis of the proposed reduction is fair.
- There are two key problems which reflect further fault by the Council:
- Mrs Y’s commissioned calls appear to have been too long and did not reflect her actual needs; and
- The high proportion of unlogged calls (66%) has enabled the Care Provider to claim for commissioned calls too often.
- When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them. So, although I found fault with the actions of the Care Provider and the Council, I have only made recommendations to the Council.
- I recommended the Council:
- Within four weeks, writes to Mrs Y’s family apologising for the faults identified in this statement and pays Mr X £250 for the time and trouble he has been put to in pursuing the complaint:
- Within six weeks, recalculates the charges for Mrs Y’s care based on average recorded call times;
- Within eight weeks:
- works with the Care Provider to significantly reduce the number of unlogged calls;
- reviews the practice of defaulting to commissioned calls when one care worker logs in but the other does not; and
- considers whether other full cost payers have been affected in the same way as Mrs Y and, if so, identify them and remedy any injustice they may have been caused.
The Council has agreed to do this.
- I have completed my investigation on the basis there has been fault by the Council causing injustice which requires a remedy.
Investigator's decision on behalf of the Ombudsman