Summary: There was fault by the Council. The Council arranged home care for Mrs Y, but did not send her invoices for over 18 months due to a system failure. This meant that she received a large backdated invoice. The Council’s apology, waiving part of the bill and affordable payment plan remedies the injustice to Mrs Y. The Council will also review its procedures to ensure the fault does not recur.

The complaint

1. The complainant, Mrs Y, is represented by her son, Mr X. Mr X complains the Council delayed carrying out a financial assessment which led to a large backdated bill for contributions towards care charges. Mr X says that they are now paying the weekly contribution for current charges but the large backdated bill will cause them financial distress.
2. Mr X also complains the Council asked Mrs Y to sign a document about paying for care and support when there was a power of attorney in place and it was aware that she had ‘substantial difficulty understanding the process’.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. 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)

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How I considered this complaint

5. I read the papers put in by Mr X and discussed the complaint with him.
6. I considered the Council’s comments about the complaint and any supporting documents it provided.
7. Mr X and the organisation 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

Key facts

8. Mrs Y receives care at home following an assessment by the Council in September 2019. The Council says that it requested a financial assessment and Mrs Y and Mr X were told they would need to contribute financially towards the cost of care. The Council says ‘a pre-assessment was completed on 16 October 2019 where Mr X was provided with an indication of the weekly contribution that Mrs Y would be required to make’.
9. The care started on 29 October 2019. There was fault by the Council. It should have completed the financial assessment and the contributions started then, but due to a system error this did not happen.
10. The Council did not find the error until 24 March 2021. The Council completed the financial assessment on 18 June 2021 and Mrs Y received a backdated bill for £6898.

My analysis

11. It is clear there was fault by the Council as an error in its system meant that it did not bill Mrs Y for her care for over 18 months.
12. The Council accepts it was at fault but says that ‘Mr X was aware of the need to make a financial contribution and how much this was likely to be per week but he did not contact the Council to advise he was not receiving a request for payment’.
13. Mr X says that as they did not receive a bill they assumed the NHS was paying. Mr X says they have been paying the weekly charge since the Council invoiced them, but don’t think they should have to pay the backdated charges as it is not their fault the Council did not bill them.
14. Mr X also complains that he had Power of Attorney for Mrs Y but the Council spoke to her about care charges and Mrs Y signed a document agreeing to them which she would not have understood fully.
15. The Council said that ‘Mrs Y was assessed as having capacity but having difficulty understanding the process. Due to this she was supported by her son who holds Power of Attorney, and he was present for the assessment. The Council said ‘a Power of attorney does not become active until a person is assessed as lacking capacity to make the relevant decision’. Mr X says that ‘the Power of Attorney he obtained allowed him to make decisions with Mrs Y’s consent as soon as it was obtained, not just when Mrs Y lost capacity. A financial discussion was held with Mrs Y in her son’s presence, and he supported her to understand the information. She signed the paying for care booklet in her son’s presence as at this time she still retained the capacity to do this’.
16. Mr X wants the Council to waive the £6898 charge. There is clear distress to the family at having such a large bill through no fault of their own. But, Mrs Y has received care and Mr X said they would have paid the financial contribution if the Council had invoiced them in 2019.
17. There is evidence the Council made the family aware there would be a financial charge. But, I do not consider the Council’s argument that Mr X should have told them they weren’t receiving an invoice is a reasonable one. Mr X got Power of Attorney to ensure that his mother’s finances were dealt with and contacted the Council to arrange her care. The fault occurred because of a system failure by the Council.
18. There was fault by the Council, which has caused financial injustice to Mrs Y. However, her injustice is not the cost of the care, which Mr X accepts the family would have paid if they had been invoiced at the time. The injustice is receiving the large backdated bill which the family have not budgeted for. So, I do not consider that it is reasonable to ask the Council to waive the full cost of the care. However, I do consider the Council should reduce the backdated bill by £1000 to recognise the distress its error caused to the family. It should also apologise and arrange a payment plan for the remaining amount which does not cause Mrs Y financial difficulties. The Council may, if the family agree, carry out an assessment of her income and expenditure before deciding on a payment amount.

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Agreed action

19. The Council should send Mrs Y a revised invoice, reducing the total by £1000, within one month of the date of the decision on this complaint.
20. The Council should apologise to the family for the delay in carrying out the financial assessment within one month of the date of the decision on this complaint.
21. The Council should arrange a payment plan for the remaining debt, which should be at an amount that does not cause Mrs Y financial difficulties, within one month of the date of the decision on this complaint.
22. The Council should review its procedures to ensure the fault which caused the delay in the financial assessment does not recur within one month of the date of the decision on this complaint.

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Final decision

23. I have completed the investigation of this complaint. This complaint is upheld as there was fault by the Council. The remedy above is a satisfactory remedy to the injustice caused to Mrs Y and her family.

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Investigator's decision on behalf of the Ombudsman