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Lilies Home Care Ltd (21 010 606)

Category : Adult care services > Charging

Decision : Not upheld

Decision date : 30 Mar 2022

The Ombudsman's final decision:

Summary: Mrs X complained about the Care Provider’s actions in relation to her mother’s care charges. The Care Provider was not at fault.

The complaint

  1. Mrs X complained about the amount the Care Provider charged her mother, Ms Y, for her domiciliary care. She said whilst her mother was staying in hospital on an acute admission, as a goodwill gesture the Care Provider offered to reduce the fee however, it charged her the full rate. Mrs X also complained the Care Provider overcharged her mother during the notice period when she requested to cancel her contract with it. Mrs X said this has caused her and her mother distress. She would like the Care Provider to apologise to them and acknowledge it wrongly charged her mother.

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The Ombudsman’s role and powers

  1. We investigate complaints about adult social care providers and decide whether their actions have caused injustice, or could have caused injustice, to the person complaining. I have used the term fault to describe this. (Local Government Act 1974, sections 34B and 34C)
  2. If an adult social care provider’s actions have caused injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
  3. If we are satisfied with a care provider’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

  1. I spoke with Mrs X and Mrs X’s husband.
  2. I considered the information provided by Mrs X and the Care Provider.
  3. Mrs X and the Care Provider 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

The Care Provider’s contract

  1. The Care Provider’s contract sets out what it will charge when calls are cancelled. It says:
    • if calls are cancelled due to hospital admissions (unplanned), the Care Provider will charge 100% for all scheduled calls for the duration of the hospital stay for a period of 28 days from and including the day of admission to the hospital.
    • any call cancelled with less than 24 hours’ notice will be charged at 100%.
    • any call cancelled with more than 24 hours’ notice will be charged at 50%.

The contract also states, ‘termination of the contract can be made by either party at any time, giving 14 days’ notice of the termination in writing. The 14 days will commence from the date of receipt of the termination request/letter’.

What happened

  1. In February 2021, the Care Provider started delivering care to Ms Y in her home.
  2. On 29 March 2021, Ms Y was acutely unwell and so was admitted into hospital. Whilst Ms Y was in hospital, the Care Provider put Ms Y’s calls on hold and it invoiced her for the care fees at the full rate. Ms Y was discharged to her home on 25 April 2021 and the Care Provider reinstated her calls.
  3. The following day, Ms Y was still unwell and so was admitted back into hospital where she remained until 23 May 2021. The Care Provider put Ms Y’s calls on hold again. During this time, Ms Y’s daughter, Mrs X and her husband contacted the Care Provider and asked if it would consider reducing the rate of the care fees whilst Ms Y remained in hospital. The Care Provider said as a goodwill gesture, it could reduce the rate by 50% for the period Ms Y was in hospital. However, as it had already produced an invoice for Ms Y during her first admission, it asked if Ms Y could pay this fee and then it would not charge her for a further 28 days. This would result in Ms Y paying a reduced care fee during the whole period she was in hospital. The Care Provider said this had been agreed with Mrs X and her husband. It reinstated Ms Y’s calls on 31 May 2021.
  4. On 6 September 2021, Ms Y became unwell and again, she was admitted into hospital. Mrs X and her husband contacted the Care Provider and informed it that Ms Y would be going into a care home after discharge and so requested to terminate her contract. The Care Provider informed Mrs X and her husband under the terms of Ms Y’s contract, they would need to give a 14-day notice period and during this notice period, Ms Y would be charged at the full rate for all scheduled calls. The Care Provider said it offered to reduce the rate of the care fees by 50% for 28 days, as it had done during Ms Y’s previous admissions to hospital. However, the Care Provider said Mrs X and her husband wanted to terminate the contract instead. The Care Provider therefore terminated Ms Y’s contract on 23 September 2021. It produced an invoice for 6 September 2021 and 23 September 2021 of £1185. Mrs X and her husband paid £380 and so £805 remained unpaid. The Care Provider asked Mrs X and her husband to pay the remaining balance.
  5. Following this, Mrs X and her husband complained to the Care Provider and said it had overcharged Ms Y for her care during her initial hospital admissions and during the 14-day notice period, when they requested to cancel the contract. They said although the Care Provider agreed it would reduce the care fee rate by 50% during the initial hospital admissions, they said they had paid the full rate instead. Mrs X and her husband also said Ms Y should only have been charged 50% of the rate during the notice period as it did not say in the contract there would be a full rate charge during this period. They said in the contract it stated there would be a 50% charge for cancellations.
  6. The Care Provider responded to Mrs X and her husband. It explained to them it had correctly charged Ms Y whilst she was in hospital during all periods and when they requested to terminate the contract. It reminded Mrs X and her husband that it required them to pay the remaining balance of £805.
  7. Mrs X and her husband remained unhappy and complained to us.

Response to my enquiries

  1. In response to my enquiries, the Care Provider gave me copies of the invoices it had produced for Ms Y's care fees. It also provided me with payment logs which showed the payments it received for Ms Y’s care fees and when it received them. There was no invoice dated between 26 April 2021 and 31 May 2021. There were also no payments for this period.

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Findings

  1. Mrs X said when her mother went into hospital between March 2021 and May 2021, the Care Provider agreed to reduce the care fees by 50%, however they still paid the full amount. The Care Provider said it made an agreement with Mrs X and her husband where it would not charge Ms Y during her second hospital admission but they would have to pay the invoice when Ms Y was initially admitted into hospital. There is no invoice or evidence of payment received for Ms Y’s care between 26 April 2021 and 31 May 2021. Therefore, I cannot see the Care Provider charged Ms Y at a full rate for the whole period. The Care Provider was not at fault.
  2. The contract required Mrs X to give 14 days’ notice to cancel the care package. Mrs X said the Care Provider should have charged Ms Y 50% of the rate during the 14-day notice period and not the full rate when they requested to cancel the contract. However, the Care Provider’s contract states if calls are cancelled due to hospital admissions, there will be a 100% charge for all scheduled calls. The Care Provider charged Ms Y in line with its policy. It was not at fault.
  3. In addition, the contract states there will be a charge of 50% of fees if calls are cancelled with more than 24 hours’ notice. However, this is only in relation to individual calls which have been cancelled and not hospital admissions.

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Final decision

  1. I have now completed my investigation. There was no fault by the Care Provider.

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Investigator's decision on behalf of the Ombudsman

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