Summary: Mr X complained the Council charged for home care services without his agreement or carrying out a financial assessment. The Council also continued to send him invoices for care services he had cancelled. We have found the Council to be at fault. We are satisfied Mr X would not have agreed to receive the care package had the Council acted correctly. To remedy the injustice to Mr X, the Council has agreed to apologise, cancel all outstanding care charges, make a symbolic payment and review its practices.

The complaint

1. Mr X complains the Council charged for care services without his agreement or carrying out a financial assessment. He also continued to receive invoices for several months after he cancelled the care package.
2. He says this has caused considerable distress that continues to this day.
3. Mr X is represented by his son in law, Mr P, in making this complaint.

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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. 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)
6. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.

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How I considered this complaint

7. I discussed the complaint with Mr P and considered the written information he provided. I made written enquiries of the Council. I took account of all the information before reaching a draft decision on the complaint. Mr X and the Council were given the opportunity to comment on this. I considered all comments received before making my final decision.

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What I found

Relevant law

8. Councils can make charges for care and support services they provide or arrange. They must assess a person’s finances to decide what contribution they should make.
9. Councils should ensure there is sufficient information and advice available to ensure the person needing care or their representative can understand any contributions they are asked to make.

What happened

10. I have summarised below some of the key events leading to Mr X’s complaint. This is not intended to be a detailed account of what took place.
11. In June 2021, Mr X, who is in his eighties, was admitted to hospital after a fall. In order for him to continue to live at home independently the Council arranged a period of short term reablement care at home provided by a care agency. This was provided at no cost to Mr X for three weeks.
12. Mr P says Mr X made it clear from the start that he did not want to receive care that he had to pay for.
13. Mr X was discharged back home in July 2021.
14. Two weeks later a care review took place on 29 July 2021. This was conducted over the phone. Mr X agreed to a financial assessment. The Council says Mr X was sent a financial assessment form to complete. The Council also emailed Mr X’s daughter (Mrs P) on 2 August 2021 with a copy of a relevant factsheet and confirmation that the care package would become chargeable after three weeks.
15. The Council says Mr X did not complete the financial assessment form. He was sent a letter on 23 July 2021 stating he would therefore be charged the full cost of any care services received, unless he provided his bank account and pension details.
16. Mr P says Mr X did not receive either the financial assessment form or letter. Nor did Mrs P receive the email or factsheet.
17. Mr X was charged the full cost for care services from 23 August 2021.
18. In October 2021, Mr X received two invoices for care charges of £363 and £874. Mr P says this was the first time he became aware Mr X was being charged for his care. Mr X immediately cancelled the care package.
19. Mr X continued to be charged for care until 27 April 2022. The Council has accepted there was an error and cancelled the charges that has accrued since Mr X cancelled the care package in October 2021. This was because the Council was not told by the care provider it was no longer providing services. The Council has established this was due to a communication error with the care agency.
20. Mr X complained to the Council. Whist his complaint about continuing to receive invoices was upheld, the rest of his complaint was not. The Council said Mr X had failed to provide relevant information and was made aware by officers that his care package would be chargeable.
21. Dissatisfied with this response, Mr X complained to the Ombudsman.
22. In response to my enquiries, the Council said:

• It is the responsibility of the service user to provide financial information.
• In the absence of such information being provided the Council carried out a “light touch” financial assessment. This assumed Mr X had above the relevant capital threshold and so made him liable for the full cost of the care services her received.
• A case note from discussions with Mr X and his daughter on 2 August 2021 recorded their agreement to a long term package of care. There was no record of Mr X stating he would refuse care if it was chargeable.

Analysis

23. The Care and Support Statutory Guidance 2014 makes it clear that the approach to charging for care and support needs should be clear and transparent so people know what they will be charged. 
24. I am satisfied the Council told Mr X and his family that only the first three weeks of reablement care would be free. This was evidenced in the email sent to Mrs P in early July 2021. It is clear that Mrs P was heavily involved with her father’s care and the Council could rely on her to pass this information onto Mr X. Mrs P was also provided with a copy of the relevant factsheet. Both the email and the fact sheet provided information about the Council’s financial assessment and explained this was necessary to establish how much he would need to contribute.
25. It is unfortunate if Mrs P did not receive this email as she claims. But I do not consider it was through any fault by the Council. The Council correctly addressed the email and there is no evidence it was not delivered. So, I have no reason to conclude the email was not correctly sent. My decision if therefore based on the presumption this email was received by Mrs P. Up to this point I am satisfied the Council acted without fault by providing information about the potential for Mr X making a contribution towards the cost of his ongoing care.
26. Notwithstanding the fact Mr X and his family were aware of this, the Council still had a responsibility to carry out financial assessment and tell then Mr X how much he would be expected to pay before the care became chargeable. This is what the Ombudsman would expect to happen.
27. The Council says Mr X failed to complete the financial assessment and it was justified in charging the full cost. In making this claim, it has relied on letter sent to Mr X on 23 July 2021. Mr P says Mr X did not receive this letter.
28. In my view, the chronology from the case notes casts doubt over whether this letter was sent.
29. The case notes record the reviewing officer (Officer J) speaking to Mr X on the phone on 29 July 2021. Her case note reads, “Discussed finances with Mr X who states he has below the threshold in savings, but does receive two good pensions. Mr X gave permission to refer for a financial assessment. Mr X would like me to discuss this further with his daughter (Mrs P)”.
30. Officer J spoke to Mrs P on 2 August 2021. The case note records her agreement to a long-term package of care being arranged. There was no reference to financial matters, although I accept this does not necessarily mean no such discussion took place. When Officer J actioned the long-term care package, she completed a form that confirmed she has requested a financial assessment to be carried out by the Council’s Financial Assessment Team on 29 July 2021.
31. This was six days after the only letter the Council has provided. According to the Council’s records, Mr X had not yet agreed to the financial assessment, and it had not been actioned by Officer J.
32. The Council has also provided the Ombudsman with an uncompleted, undated financial assessment form. I have seen no evidence this was sent to Mr X and is a likely explanation as to why it was not completed.
33. If the Council was aware Mr X had already been subject to a light touch assessment (as per its letter dated 23 July 2021), this should have been mentioned to Mr X and Mrs P by Officer J when she spoke to them on 29 July 2021 and 2 August 2021 respectively, rather than saying she would be requesting a financial assessment. Mr P says when they heard nothing further from the Council they assumed, having told the Council Mr X had less than the relevant threshold in savings that it was being provided at no cost to him.
34. There are no further case notes about financial matters until Mr X contacted the Council in April 2022 to say he was still being charged for care services that he cancelled in October.
35. This narrative of events, leads to conclude, on the balance of probabilities, that Mr X was not informed, prior to the care package starting that he would be charged. Nor is there evidence he was sent an invoice four weeks after the care package starting. This is what should have happened and would have given Mr X the opportunity to cancel the care package sooner than he did.
36. Overall, I am satisfied, on the evidence I have seen that the Council did not properly advise Mr X of his liability to pay the full cost of his care package or attempt to carry out a financial assessment. This was fault.
37. There was further fault when Mr X continued to receive invoices for ongoing care up to April 2022. The Council has accepted this should not have happened and was due to communication errors with the care agency. It has taken action to ensure this does not happen again and so I do not intend making any further service improvement recommendations about this aspect of the complaint.

Injustice

38. I must now consider what, if any, injustice arose from these faults. Mr P is adamant Mr X would not accept a care package he had to pay for. This is borne out by the fact Mr X cancelled it as soon as he received the first invoice in October 2021.
39. Mr X says he should not be expected to pay care charges he was neither told about nor agreed to. He says this large, unexpected bill caused significant distress and anxiety about how he would afford to settle the large debt that had accrued without his knowledge. This was made worse by the further invoices been sent for care he did not receive. This is injustice.
40. While the Council partially amended the outstanding invoice in respect of the care services he had been wrongly charged for, this does not remedy the distress caused to Mr X for several months. Not does it address the fact the Council failed to complete a financial assessment. This injustice requires a remedy.
41. Where we identify fault causing injustice, we try to put the complainant back in the position has the fault not occurred. In this case, I am satisfied Mr X would not have accepted the package of care once it became chargeable in August 2021. My recommendation below acknowledges this.

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Agreed action

42. The Council has agreed to take the following action within four weeks from the date of my final decision:
1. Apologise in writing to Mr X.
2. Cancel all outstanding care charges owed by Mr X.
3. Pay Mr X £100 as a symbolic payment to acknowledge his distress caused by the Council’s fault in this matter.
4. Reflect on the issues raised in this decision statement and identify any areas of service improvement. The Council should prepare a short report setting out what the Council intends to do to ensure similar problems not reoccur. This report should be sent to the Ombudsman.
43. The Council should provide us with evidence it has complied with the above actions.

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Final decision

44. I have found the Council to be fault and made recommendations to the Council to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman