Summary: The Council has accepted it failed to inform Mr and Mrs X of a significant increase in the rate of Mrs X’s care prior to the new care starting. This caused Mr X distress as he fell into arrears. In recognition of this fault, the Council has agreed to reduce the amount owed to reflect the rate Mrs X would have paid, had the care been provided by her former, cheaper care provider. It also said it would train staff to ensure against the fault occurring in future. The Council has agreed to apologise to Mr X and provide us with evidence that the arrears have been reduced as promised and the relevant training carried out. Mrs X has now passed away, so this investigation has only considered injustice caused to Mr X.

The complaint

1. Mr X complained that the Council failed to inform him and his wife that Mrs X’s new care provider would cost significantly more than their previous provider.
2. Mr X also said he had received invoices late from the Council for Mrs X’s care.
3. He said a lack of information from the Council led to him being behind on payments which has caused him distress.

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The Ombudsman’s role and powers

4. 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)
5. Part 3 and Part 3A of the Local Government Act 1974 give us our powers to investigate adult social care complaints. Part 3 is for complaints where local councils provide services themselves. It also applies where a council arranges or commissions care services from a provider, even if the council charges the person receiving the care. In these cases, we treat the provider’s actions as if they were council actions. (Part 3 and Part 3A Local Government Act 1974; section 25(6) & (7) of the Act)
6. If we are satisfied with an organisation’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)
7. Under our information sharing agreement, we will share this decision with the Care Quality Commission.

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How I considered this complaint

8. I considered the information provided by Mr X and the Council.
9. I considered the relevant law and guidance as set out below.
10. I considered our Guidance on Remedies
11. I considered comments made by Mr X and the Council on a draft decision before coming to a final decision.

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What I found

Charging for social care

12. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in settings other than care homes.
13. A council has discretion to charge for non-residential care following a person’s needs assessment. Where it decides to charge, a council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care and Support Statutory Guidance. (Care Act 2014, section 14 and 17)
14. When charging for care and support, councils should be clear and transparent so people know what they will be charged. (Care and Support Statutory Guidance 2022, Section 8)

What happened

15. Mrs X paid for her care, as she was assessed as being able to afford to pay her care costs. The Council remained responsible for commissioning her care.
16. In 2020 and 2021 Mrs X received several hours of care per week which cost her approximately £70 a week.
17. Her care provider stopped operating in 2021, so the Council commissioned a new care provider to provide her care. This care provider charged Mrs X £210 per week. This sum was for slightly increased care hours; however the rate was still significantly higher.
18. Mr X said they were not aware of the significantly increased cost until they received a bill for the care. He said had they known of the cost difference they would not have agreed to pay for it.
19. Mr X complained to the Council about this and the Council responded in March 2022. The Council said the care provider should have informed Mr and Mrs X of the increase in care costs but maintained that they should pay the full amount owed.
20. Mr X brought his complaint to the Ombudsman in the same month. During our investigation, the Council accepted that it was at fault for not informing Mr and Mrs X of the increased cost of the new care provider.
21. The Council said in recognition of its fault, it would recalculate the amount owed to reflect the rate Mrs X would have paid had the care been provided by her former, cheaper care provider. In addition, it said it would remind its social care staff of the importance of informing people about care costs prior to any care commencing.
22. The Council has also accepted that there were delays in invoicing for care in that year due to one of the care providers being late issuing the invoices to the Council. Mr X said this caused him distress as he lacked information about what money was outstanding.

My findings

23. The Council did not inform Mr and Mrs X prior to her new care starting that the rate was significantly more expensive. This was fault.
24. The Council has agreed to recalculate the amount Mr X owes to reflect what they would have paid had the care been provided by the former, cheaper care provider. It has also agreed to carry out a service improvement to prevent the fault occurring in future. In addition to this we recommend that the Council apologise to Mr X and provide us with evidence of these remedies being carried out.
25. Following Mr X’s complaint to the Council, the Council carried out its own investigation. During its complaints process, the Council identified that Mr and Mrs X had not been informed of the increased cost of care but it did not make any remedy for this and still charged the arrears in full. This was fault leading to avoidable time and trouble for Mr X in taking his complaint to the Ombudsman. We have recommended a symbolic financial payment to recognise this.
26. The Council was late in providing some invoices to Mr X. We recommend that the Council apologise to Mr X for the uncertainty this delay caused him.

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Agreed action

27. Within one month of the date of my final decision, the Council has agreed to:
• apologise to Mr X for failing to inform him of Mrs X’s increased care costs, for identifying this during their complaints process but taking no steps to remedy it and for issuing several invoices late, causing him distress;
• provide evidence that it has reduced the outstanding arrears to reflect the rate Mrs X would have paid for care with the former, cheaper care provider; and
• pay him £100 in recognition of the avoidable time and trouble he went to in bringing his complaint to the Ombudsman, when the Council had already identified that a fault had occurred.
28. Within three months of the date of my final decision, the Council has agreed to provide evidence that it has reminded the Council’s social care staff of the importance of informing people about their care costs prior to any care commencing.

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Final decision

29. I have completed my investigation and found fault leading to injustice. The Council has agreed to make a financial remedy and provide evidence of agreed remedies being carried out.

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Investigator's decision on behalf of the Ombudsman