Summary: Mrs X complains the Council failed to inform her of the change in charges to respite care for her husband. She had paid the flat rate to the care home directly but later received a bill for double the amount. Mrs X complained to the Council but there was a delay in their response. We find fault with the Council for delay and miscommunication. This fault has caused Mrs X distress and frustration and we recommend a payment in remedy.

The complaint

1. Mrs X complains the Council failed to tell her of the change in charges to respite care for her husband. She complained to the Council but there was a delay in the Council’s response.
2. The Council admitted fault for the delay and apologised. The Council told Mrs X it would pay for the respite care, but she had already paid it.
3. The delay meant she could not book further respite care for her husband as she was unsure what the charges would be.
4. Mrs X finally got a refund but only because she had to chase this up herself. She would like an apology from the Council.

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The Ombudsman’s role and powers

5. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint or others. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)
6. 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

7. I considered:
• Information provided by Mrs X and the Council;
• The Care Act 2014;
• 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

8. The Care Act 2014 sets out local authorities’ duties around adult social care. The Care and Support statutory guidance sets out how the Care Act should be applied.
9. The Care Act 2014 and the corresponding Statutory Guidance says councils should complete a financial assessment before arranging care services. It also indicates that, in cases when this is not possible, for instance in an emergency, a council should give the person a reasonable estimate of likely charges before they have to decide what support they want the Council to arrange. Furthermore, the Council is still required to complete the formal financial assessment as quickly as possible after that.
10. A temporary resident is someone admitted to a care or nursing home where the agreed plan is for it to last for a limited period, such as respite care, or there is doubt that permanent admission is required. The Care and Support (Charging and Assessment of Resources) Regulations 2014 and the Care and Support Statutory Guidance 2014 set out charging rules for temporary residential care. When the Council arranges a temporary care home placement, it has to follow these rules when undertaking a financial assessment to determine how much a person has to pay towards the costs of this stay.
11. The Council’s Adult Social Care Charging Policy 2020 says there will no longer be a flat rate charge. All residential services will be subject to the relevant financial assessment to be completed online from summer 2020. Everyone who requires funding assistance from the Council needs to be referred for a financial assessment.

What happened

12. Mrs X organised for her husband to have two weeks of respite care in August 2020. The Council said the flat rate would continue.
13. On 14 August the Council told Mrs X the flat rate had stopped and everyone had to pay a contribution.
14. When she received the invoice in November 2020 the amount to pay had increased.
15. Mrs X had already paid the care home directly, and the payment had been accepted.
16. The Council asked the care home to refund Mrs X as a goodwill gesture and wrote to Mrs X to let her know on 1st December 2020.
17. Unfortunately Mrs X did not receive this letter so was not aware the Council asked the care home to refund her.
18. The Council continued to send invoices and final demands to Mrs X, after their letter of 1st December 2020.
19. Mrs X got a final invoice dated 17 May 2021. This showed a refund was due to her.
20. This delay meant that Mrs X was unwilling to book further respite care for her husband for almost a year, as she was not sure how much it would cost.
21. Mrs X brought a complaint to the Council on 9 June 2021.
22. The Council apologised in the complaint response, for not advising Mrs X the flat rate had stopped, and for the delay between December 2020 and April 2021 in responding to her.
23. The Council said they would pay for the respite care as a gesture of goodwill.
24. Mrs X made a stage 2 complaint as she had already paid the bill for the care home and was not satisfied with the response about the delay. Mrs X went to time and trouble chasing this up, and could not book further respite care which was frustrating.
25. Mrs X then brought her complaint to the Ombudsman as she was still unhappy with the response to her stage 2 complaint, and thought the Council’s reply was rude and offensive.

Analysis

26. While I acknowledge Mrs X is unhappy with the Council’s response, the fact she did not receive the letter of 1st December is not the fault of the Council.
27. Mrs X did have further conversations with the Council after 1st December but she was not told she did not have to pay for the respite care.
28. Mrs X only recently received a refund for the care, and she had to chase this up with the care home herself.
29. Mrs X should have been informed the flat rate had ceased before she arranged the care. This is fault.
30. The delay in responding to Mrs X is also fault.
31. The Council have acknowledged this and apologised. This is a suitable remedy.
32. In the response to my enquiries the Council said any offense caused to Mrs X was unintentional and regretful.
33. As the bill was cancelled, the Council should not have sent further invoices and final demands to Mrs X seeking payment. This caused Mrs X distress, especially as she had not received the letter telling her of a refund.
34. I therefore make a recommendation for a nominal payment for time and trouble, distress and frustration caused to Mrs X by the Council’s delay and miscommunication.

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Recommended/ agreed action

35. Within one month of the final decision the Council should pay Mrs X £100 in recognition of the injustice caused to her by the identified faults. The Council should provide us with evidence it has done so.

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Final decision

36. The delay and miscommunication by the Council amount to fault. This fault has caused Mrs X injustice and I have made recommendations to remedy that injustice.

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Investigator's decision on behalf of the Ombudsman