Summary: Mr X complained about the Council’s actions in relation to his late mother’s care charges. The Council was at fault. It billed Mr X incorrectly and its communication with Mr X was poor. The Council agreed to apologise to Mr X and pay him £150 to recognise the distress and frustration the matter caused him. The Council will also issue Mr X the correct invoice.

The complaint

1. Mr X complained about the Council’s actions in relation to his late mother’s, Mrs Y, care charges. He said the Council:
• issued a bill for Mrs Y’s contribution towards her care costs however, it did not explain to Mr X how the charges were calculated, despite Mr X requesting this information; and
• delayed responding to his concerns.
2. Mr X said this caused him distress and frustration. He wants the Council to provide him with a breakdown of how it calculated the charge and he wants the Council to provide him with a remedy in relation to its poor communication.

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The Ombudsman’s role and powers

3. 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)
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 spoke with Mr X about his complaint and considered the information he provided.
6. I considered the information the Council provided.
7. Mr X and the Council 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

Charging for permanent residential care

8. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
9. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.

Charging for temporary residential care

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 a permanent admission is required.
11. A council can choose whether to charge a person where it is arranging to meet their needs. In the case of a short-term resident in a care home, the council has discretion to assess and charge as if the person were having their needs met other than by providing accommodation in a care home. Once a council has decided to charge a person, and it has been agreed they are a temporary resident, it must complete the financial assessment in line with the Care and Support (Charging and Assessment of Resources) Regulations 2014 and the Care and Support Statutory Guidance.

What happened

12. Mrs Y had health problems. On the 7 July 2021, Mrs Y commenced a placement in a care home for respite care. From this date, the Council fully funded Mrs Y’s care at the Care Home.
13. On the 5 August 2021, the Council completed a financial assessment with Mrs Y. It determined Mrs Y was to pay a weekly contribution towards her care of £233.71 from the 5 August 2021.
14. On the 19 September 2021, Mrs Y became a permanent resident at the Care Home. However, between mid-September 2021 and early October 2021, Mrs Y became unwell and was admitted to hospital. During this time, the Council kept Mrs Y’s place at the Care Home open and did not charge Mrs Y for it.
15. On the 7 October 2021, Mrs Y returned to the Care Home as a permanent resident. The Council completed a further financial assessment with her. It established Mrs Y was to pay a weekly contribution of £163.85 towards her care from 7 October 2021. Mrs Y died on 3 December 2021.

The Council’s communication with Mr X

16. Following Mrs Y’s death, the Council sent Mr X an invoice for £3241,84. He complained to the Council in January 2022 and said the amount it was charging did not correlate to the financial assessments it had completed with his late mother. Mr X also said the Council had not factored in that Mrs Y stopped receiving attendance allowance and severe disability allowance when she was at the Care Home.
17. The Council responded to Mr X’s complaint in May 2022 and:
• recognised its communication with Mr X had been poor. It apologised to Mr X; and
• removed the attendance allowance and severe disability allowance from the financial assessment for the period when Mrs Y was a permanent resident at the Care Home between 7 October 2021 and 3 December 2021. As a result, it subtracted the difference from the final bill. It said the balance due was therefore £2836.63.
18. Mr X complained to us. He was still not clear how the Council calculated the charges and said his late mother’s attendance allowance and severe disability allowance had stopped before October 2021 and the Council did not consider this.

The Council’s response to my enquiries

19. In response to my enquiries, the Council said:
• it was aware Mrs Y’s attendance allowance and severe disability allowance had stopped before October 2021 and so did not include these benefits at all in the financial assessment it completed in August 2021;
• it had applied the wrong amount of pension credit to the account so had now amended the contribution from 5 August 2021 until 19 September 2021 and had notified Mr X of this. This meant Mrs Y’s contribution between these dates was £158.45 instead of £233.71; and
• the outstanding bill had been adjusted and was now £2351.98.

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Findings

20. The Council told Mr X the final bill was £2836.63. However, the Council should have charged Mrs Y:
• £158.45 from the 5 August 2021 until 19 September 2021; and
• £163.85 from the 7 October 2021 until 3 December 2021.

This equates to £2351.98. The Council told Mr X the incorrect charge. It failed to apply the correct amount of pension credit to the assessment. The Council was at fault. This caused Mr X distress and frustration.

21. The Council recognised its communication with Mr X had been poor and apologised to him. This was appropriate. In response to our enquiries the Council said it had notified Mr X of this. This was appropriate.
22. Mr X said the Council did not consider his late mother’s attendance allowance and severe disability allowance had stopped before October 2021. I have reviewed the financial assessment the Council completed with Mrs Y and found the Council was not at fault as it did not take into account those benefits.

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Agreed action

23. Within one month of the final decision, the Council agreed it will:
• apologise to Mr X and give him a symbolic payment of £150 to acknowledge the distress and frustration the matter caused him; and
• issue Mr X the correct invoice of £2351.98.
24. The Council will provide us with evidence it has complied with the above actions.

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Final decision

25. I have now completed my investigation. The Council was at fault. It has agreed to our recommendations to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman