Summary: The complainant (Mrs X) said the Council failed to follow the right process when charging her for care services. The Council accepted its fault and offered to waive Mrs X’s outstanding care charges and remind its staff of the need to provide advance information on charging. There is nothing more we could achieve for Mrs X so we discontinue this investigation.

The complaint

1. Mrs X says the Council failed to follow the right process when calculating chargeable care costs. She complains the Council:

• Failed to provide her with advice on the rules for care charges before her financial assessment and start of her care services;
• Delayed her financial assessment;
• Lost documents provided by her for the financial assessment;
• Misled her when advising she would not be charged anything or very little;
• Failed to end social care services despite Mrs X’s request to stop them.

2. Mrs X also says the Council failed to properly consider her complaint.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service but must use public money carefully. We do not start or continue an investigation if we decide further investigation would not lead to a different outcome. (Local Government Act 1974, section 24A(6), as amended)
4. We can decide whether to start or discontinue an investigation into a complaint within our jurisdiction. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended)

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How I considered this complaint

5. I spoke with Mrs X and considered the information she provided.
6. I made enquiries with the Council and considered the information it provided.
7. I reviewed the Council’s information leaflets ‘Your support, your way’ and ‘What you should expect to pay for care services in 2021’. I also read the Council’s website information on Adult Social Care complaints.

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What I found

Legislative framework

Councils’ statutory duties

8. The Care Act 2014 and the Care and Support (Charging and Assessment of Resources) Regulations 2014 (Regulations) provide details of councils’ duties towards their residents with eligible social care needs and rules for charging for the services provided.
9. When exercising their social care functions councils must follow the Care and Support Statutory guidance (Statutory Guidance) issued by the Department of Health and Social Care, which is based on the Care Act 2014, unless they have very good reasons not to. They should also follow the Regulations.

Financial assessments

10. Where a local authority has decided to charge, it must carry out a financial assessment of what the person can afford to pay and, once complete, it must give a written record of that assessment to the person. This could be provided alongside a person’s care and support plan or separately, including via online means. (Care and Support statutory guidance paragraph 8.16)
11. In carrying out financial assessments councils must have regard to the detailed guidance setting out how both capital and income should be treated. (Care and Support statutory guidance paragraph 8.17)
12. Councils must ensure a person’s income is not reduced below a specified level after charges have been deducted. This is called the minimum income guarantee. The purpose of this is to ensure the person has enough money to pay their daily living costs such as rent, food and utility bills. In addition, where a person receives benefits to meet their disability needs that do not meet the eligibility criteria for local authority care and support, the charging arrangements should ensure that they keep enough money to cover the cost of meeting these disability-related costs. (Care and Support statutory guidance paragraph 8.42)
13. When making decisions on charging local authorities should be clear and transparent so people know what they will be charged. Where a local authority has decided to charge it should explain in the financial assessment how the assessment has been carried out, what the charge will be and how often it will be made. The local authority should ensure this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice. (Care and Support statutory guidance paragraph 8.2 & 8.16)

Complaints

14. A local authority must make clear how to complain about any aspect of the financial assessment or a decision to charge. Complaints about the level of charge levied by a local authority are subject to the usual care and support complaints as set out in the Local Authority (LA) Social Services and National Health Service (NHS) Complaints (England) Regulations 2009.
15. When dealing with social services complaint a local authority must:
• Investigate the complaint in a manner appropriate to resolve it speedily and efficiently;
• During the investigation keep the complainant informed about the progress;
• After completing the investigation send the complainant a written response within six months from the day the complaint was received, unless other term has been agreed.

(The LA Social Services and NHS complaints (England) Regulations 2009 Regulation 14)

What happened

Care needs assessment, care and support plan

16. During Mrs X’s care needs assessment in the beginning of February 2021 the Council found out she had eligible care needs as needed support with mobility around the house and personal care including getting in and out of bed, washing, dressing and food preparation. Direct payments were discussed but Mrs X did not think she could have managed to organise care by herself. As part of the assessment Mrs X received the Council’s leaflets ‘Your support, Your way’ and ‘Compliments, Complaints, Comments and Concerns’.
17. Two weeks later the Social Care assessor visited Mrs X to discuss her care arrangements. Mrs X said during this visit the Social Care assessor could not give her any details of the financial assessment process but reassured her it was unlikely she would have to contribute towards her care costs. Even if she did, Mrs X understood it would not be more than £10- £20 per month. The Council could not provide meeting notes from this meeting.
18. Following the social care assessor’s visit the Council issued care and support plan for Mrs X. It decided she needed one hour of support twice a week from a Care Provider. The care plan included agreed Personal Budget and the cost of the Care Provider’s services for Mrs X. The starting date of the Care Provider’s services for Mrs X was set for the beginning of the second week in March.
19. The Care Provider began its services for Mrs X following the care and support plan.
20. At the end of April, when the Council was finalising Mrs X’s financial assessment, Mrs X asked it to increase support for her by adding extra hours. The amended care and support plan issued at this time suggested she needed care for three hours a week.

Financial assessments and charging

21. In the second week of March the Council asked Mrs X to provide evidence of her financial circumstances for a financial assessment. With no reply received the Council sent another letter two weeks later. Mrs X says she did not receive these letters.
22. In mid-April the financial assessor sent another letter telling Mrs X she would be liable for the full amount of care costs as there were no documents sent for the financial assessment.
23. A few days later Mrs X sent documents, well before the deadline set in the Council’s letter.
24. Although Mrs X received an automatic acknowledgement her documents reaching the Council, on the day of the deadline Mrs X called the Council to confirm the documents reached the financial assessor. The financial assessor could not find these documents. Mrs X wished to explain her financial circumstances during a telephone conversation but the Council’s officer insisted on carrying out the assessment on papers.
25. Following Mrs X’s telephone call, the financial assessor found the documents sent by Mrs X and used them for assessing Mrs X’s chargeable care costs. The Council calculated Mrs X’s care charges from when she first started receiving care in the beginning of March.
26. In the beginning of May Mrs X received the Council’s letter with the details of her contribution towards the Care Provider’s services, which were based on the financial assessment. Mrs X immediately called the Care Provider explaining she could not afford to pay for her care and asking them to stop providing their services. She also called the Council and her Social Care assessor. Both the Care Provider and the Social Care assessor reassured her there must have been a mistake and she should continue to receive care services.
27. In June and July the Council sent Mrs X further invoices. On many occasions she communicated her concerns about her inability to pay for her care to the financial assessor, Social Care assessor and her Social Worker and asked to stop her care package.
28. In July a different officer re-assessed Mrs X and found out she should be charged more as, due to the change in her circumstances, the carer premium should not be deducted from her income.
29. In the end of July Mrs X cancelled all her care arrangements.

Complaint

30. In the end of July 2021 Mrs X’s representative called the Council to complain about the Council charging Mrs X for her care services.
31. A month later in its response the Council said:
• Mrs X needed long-term care so did not qualify for six weeks of free of charge services;
• Mrs X received information about her financial assessment during the care needs assessment in the beginning of February 2021;
• The Council assessed she should pay the full cost of care as failed to provide required financial information;
• The Council correctly issued invoices for the services provided to Mrs X, which followed Mrs X’s assessed weekly contributions;
32. The Council also apologised for the delay in carrying out the financial assessment.
33. In January 2022 the Council asked again Mrs X pays £1,109 as an overdue cost of care chargeable from her. On the same day Mrs X called the Council explaining she did not consider it responded properly to her complaint as she was still waiting for a telephone call from the officer who looked into her complaint. Several times she tried to call the Council but did not receive a response.
34. A few days later the Council provided its response to Mrs X’s review request, confirming its position.

Analysis

35. When responding to my enquiries the Council accepted there were some gaps in the case recording which made it difficult to find out to what extent the cost of care was explained to Mrs X. The Council recognised this was fault and offered to remedy any injustice suffered by Mrs X.
36. Remedies offered by the Council match what Mrs X wished to achieve by her complaint. In such circumstances there is nothing else to achieve by continuing this investigation.

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Agreed action

37. The Council agreed to:
• Waive the full sum of Mrs X’s outstanding care charges of £1,109;
• Remind the Council’s staff of the need to provide all service users with advanced and detailed information on how much they would be expected to pay towards their care before any charges are due.
38. The Council will complete above actions within four weeks of the final decision and will send us the evidence this has happened.

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Final decision

39. I have ended my investigation and uphold Mrs X’s complaint. The Council has offered to take action which would resolve the outstanding issues and no further action by the Ombudsman is needed.

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Investigator's decision on behalf of the Ombudsman