Summary: Mr D complained that the Council repeatedly failed to invoice him for his mother’s homecare. We found fault which caused Mr D significant inconvenience and frustration. The Council has agreed to make a payment to Mr D to remedy this and to agree solutions with the care provider.

The complaint

1. Mr D complained on behalf of Mrs J that the Council repeatedly failed to invoice him for her homecare provision between January and July 2022, then from July to December 2022.
2. As a result, he could not keep track of the charges, leading to her being overcharged, has had to spend time checking many invoices at once, and she is not receiving the service she is paying an arrangement fee for.

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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 to Mr D about his complaint and considered the information he sent, the Council’s response to my enquiries and the Care and Support Statutory Guidance.
6. Mr D and the Council 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

Charging for care services

7. Where a council arranges care and support to meet a person’s needs, it may charge the adult for the cost of the care. The legal framework for charging is set out in Sections 14 and 17 of the Care Act 2014.
8. If the person with eligible needs has assets above the upper capital limit (£23,250), and has asked the local authority to arrange their care and support on their behalf, the council may charge an administration fee to cover its costs. This must cover only the costs that the local authorities actually incur in arranging care.
9. The Council’s arrangement fee is £53.64 per week and covers brokerage, procurement/contract management, billing and debt recovery, quality assurance team support, and overheads.
10. Care providers should invoice the council each month. The Council says its payment finance team will follow up any delays and notify the quality assurance officer, who will discuss the issue in quarterly contractual/operational meetings with the care provider.

What happened

11. Mr D’s mother, Mrs J, receives domiciliary care from a care provider. Her care and support has been arranged by the Council, but she is a self-funder. The Council therefore charges her a weekly arrangement fee. It invoices Mr D after it has received the invoice from the care provider.
12. Mr D has lasting power of attorney for Mrs J’s health and finance. He says he needs itemised invoices showing which care visits are being charged for. This is to enable him to check their accuracy as he has a legal duty to satisfy himself to a reasonable standard that all payments have been checked and are correct. The care provider had been providing these itemised invoices since 2020.
13. In January 2022 the care provider stopped sending the breakdown of the charges to Mr D. The invoices for February and March were then issued late by the Council. Mrs J went into hospital in June 2022.
14. Mr D complained in July that he had not received the breakdowns and that the invoices were late. The Council then sent him a breakdown for charges from November 2021 to June 2022 and he identified some errors.
15. The Council asked the care provider to send breakdowns to Mr D but no invoices were issued for care in September and October 2022. In November an invoice was sent for outstanding months, but not including September. Mr D asked to escalate his complaint as the problems were continuing.
16. The Council sent Mr D a further breakdown in December 2022. It said there was an issue with the invoicing that was being investigated, but I have not seen any evidence of any discussions with the care provider or quality assurance team about this. No invoice was issued in December.
17. In response to Mr D’s complaint, the Council told Mr D it would refund Mrs J about £1,480 for the care costs and arrangement fees for the period she was in hospital and for a recovery period afterwards as these had been wrongly charged for.
18. It sent a further invoice for the period 19 December to 15 January, but this did not show payments that had already been made, so Mr D overpaid £1,532. The invoice for February 2023 was issued on time, but I have not seen any evidence that the invoice for the period 16 January to mid-February has been issued.

My findings

19. There have clearly been problems with invoicing by the care provider during 2022, which is fault. This has caused Mr D frustration and significant inconvenience.
20. I have seen no evidence about what these problems were or of any discussions the quality assurance team were having with the care provider to ensure improvement. This is fault. Officers should have escalated the matter in July 2022 and fed back to Mr D about how the problems would be resolved.
21. In response to my enquiries, the Council said the care provider had suffered a cyber-attack and no longer had the data on carers visits for the period 1 January 2022 to 16 September 2022. But it has not said how it is ensuring that invoices for all service users for this period are correct. Nor how it will ensure the care provider issues the breakdowns Mr D requires.

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Recommended action

22. Within a month of my final decision, the Council should:
1. Pay Mr D £500 to remedy the distress caused by fault in invoicing.
2. Ensure there is an agreement in place with the care provider to issue itemised invoices to Mr D.
3. Remind the payment finance team to escalate invoicing problems to the quality assurance team.
4. Discuss the invoicing problems with the care provider to ensure there is a plan in place to prevent future delays.
5. Discuss with the care provider how it is ensuring the accuracy of invoicing for all service users for the period January to September 2022.
23. The Council should provide us with evidence it has complied with the above actions.

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Final decision

24. There was fault by the Council. The actions the Council has agreed to take remedy the injustice caused. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman