Summary: We will not investigate Miss X’s complaint, made on behalf of her mother Mrs Y, about the Council’s charging and invoicing for Mrs Y’s care. In response to the complaint the Council has reduced the bill based on the information received about the care provision, and explained the outstanding charges. We could not add to the Council’s investigation and explanation and there is no different outcome an Ombudsman investigation would achieve. There is not enough evidence of fault in the Council’s fee backdating decisions to warrant investigation.

The complaint

1. Mrs Y has home care and makes a contribution to her fees. Her daughter Miss X complains the Council:
1. charged the wrong amount for some of the care fees;
2. said it would not backdate the care charges by more than four weeks but backdated them for seven months;
3. gave an unclear explanation of the fees it considers are still due;
4. issued an amended invoice in reply to her complaint rather than a complaint response.
2. Miss X says the matter has caused Mrs Y extreme stress and anxiety. She wants clear explanations of the amended fees and why they were backdated by seven months instead of four weeks, to assure Mrs Y she has been invoiced correctly.

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The Ombudsman’s role and powers

3. The Ombudsman investigates 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 may decide not to continue with an investigation if we decide:

• there is not enough evidence of fault to justify investigating; or
• we could not add to any previous investigation by the organisation; or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6))

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How I considered this complaint

4. I considered information from Miss X and the Council, and the Ombudsman’s Assessment Code.

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My assessment

5. Miss X wants the Council to explain its decisions on the amended care charges. In response to Miss X’s complaint, the Council considered the information provided by the family about some of the care visits to Mrs Y and reviewed the fees invoice. Officers set out in their response where they have removed fees previously charged for. They have shown if part or all the fee remains chargeable for visits the family has queried. The Council has reduced the invoice amount in line with its findings.
6. I realise Miss X says the Council’s explanation of the fees is unclear. But officers have set out the charges due after taking account of the earlier billing errors. They have quoted the family’s information about the disputed visits in their explanation, given the relevant dates to show which charge is being discussed, then made their decision on each charge. I do not consider an Ombudsman investigation of the fees matters would get any additional clarity about the charges Miss X is seeking from the complaint. We could not add to the investigation the Council has already done and communicated here.
7. Miss X says an officer told a family member the Council would not backdate Mrs Y’s care charges by more than four weeks but then backdated them for seven months to October 2021. She considers the Council has not explained why it made its backdating decision and wants this clarified as another complaint outcome. The Council has apologised for any misunderstanding about the backdating of the fees. It has explained it has followed standard practice by backdating the fees by four weeks from the date of Mrs Y’s 2021 financial assessment, not four weeks from the date of the delayed invoice being issued. There is not enough evidence of fault in the Council’s fee backdating decision, or in its explanation of that decision, to warrant an investigation.
8. The Council has accepted it delayed in issuing the invoice and has apologised. But that delay does not mean the Council is required to waive all or part of the fees contribution Mrs Y was determined as having to pay as soon as the financial assessment was done. Due to the Council’s delay in doing the financial assessment, Mrs Y has received some care from July to October 2021 without charge. She then had the benefit of the care from October 2021 onwards. There is not enough evidence that it is fault for the Council to consider those adjusted fees payable to warrant us investigating.
9. The Council accepts it should have replied to Miss X’s complaint about the fees before it sent out an amended invoice. It has apologised for this and changed its process to avoid similar incidents. This is the outcome we would seek on this issue were we to investigate, so there is no different outcome investigation would now achieve on this part of the complaint.

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Final decision

10. We will not investigate Mrs Y’s complaint because:
• an investigation would not add anything further to the Council’s assessment and explanation of the care fee invoice and could not achieve a different outcome; and
• there is not enough evidence of fault in the Council’s fee backdating decisions to warrant investigation; and
• an investigation would not achieve a different outcome on the Council reissuing the invoice before responding to Miss X’s complaint.

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Investigator's decision on behalf of the Ombudsman