Summary: Mrs X complained the Council failed to make Mrs Y aware she had to contribute towards the cost of her care and support. She also complained the Council failed to update Mrs Y’s address, meaning she did not receive important correspondence. We found the Council gave Mrs Y correct information about charging at the outset and made her aware she may have to contribute to the cost of her care and support. However, the Council failed to correctly update Mrs Y’s address and failed to inform her it had started to charge her.

The complaint

1. Mrs X complained the Council failed to make Mrs Y aware she had to contribute towards the cost of her care and support.
2. Mrs X said Mrs Y only became aware when the Council chased her for arrears of more than £9,000. She said the Council did not sensitively inform Mrs Y about the debt, causing distress.
3. Mrs X also complained the Council failed to update Mrs Y’s address, meaning she did not receive important correspondence.
4. Mrs X said Mrs Y was upset by the Council’s actions and suffered anxiety, causing panic attacks.

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The Ombudsman’s role and powers

5. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
6. 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

7. As part of the investigation, I considered the complaint and the information Mrs X provided.
8. I made written enquiries of the Council and considered its response along with relevant law and guidance.
9. Mrs X 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

10. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
11. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
12. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home. After charging, a person’s income must not reduce below a weekly amount known as the minimum income guarantee (MIG). This is set by national government and reviewed each year. A council can allow people to keep more than the MIG. (Care Act 2014)
13. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care.

What happened

14. I have summarised below some key events leading to Mrs X’s complaint. This is not intended to be a detailed account of what took place.
15. Mrs Y signed a financial assessment form in May 2017. The form confirms Mrs Y’s care and support was subject to financial assessment to calculate what contribution she may have to pay towards the costs. At that time, Mrs Y’s income was below the threshold, and she did not have to contribute to the costs of her care and support.
16. The Council wrote to Mrs Y on 7 November 2018, providing her financial assessment. Her income remained below the threshold, so she did not have to contribute. The Council included a letter telling Mrs Y she was eligible to claim benefits (the attendance allowance and pension credit). The Council said if Mrs Y did not claim, it may still assume this income in her future assessments. It gave Mrs Y details of how to contact the Department for Work and Pensions (DWP) to claim and said it would check in four weeks.
17. The Council sent a reminder letter to Mrs Y about claiming benefits on 17 December 2018. It said it checked with the DWP and Mrs Y had not claimed. The Council said as Mrs Y was receiving Council funded care and support it expected her to claim benefits she is entitled to. It gave her the DWP contact details again.
18. Mrs Y moved home in September 2019. A Council case note on 4 September 2019 confirmed Mrs Y was due to move and an officer recorded the new address.
19. The Council sent two letters to Mrs Y on 30 September 2019. The first letter confirmed Mrs Y had claimed the attendance allowance benefit. It told her to claim the severe disability premium as well. The Council warned Mrs Y she was expected to claim additional benefits she was entitled to. It said this benefit will be assumed as income in her financial assessment on 1 December 2019, resulting in an increase in her contributions towards the cost of her care. The Council sent this letter to Mrs Y’s new address.
20. The second letter included Mrs Y’s financial assessment. The Council confirmed she must start contributing £36.94 towards the cost of her care. Oddly, the Council sent this letter to Mrs Y’s old address.
21. The Council started invoicing Mrs Y for the cost of her care in October 2019. Unfortunately, it sent the invoices to her old address.
22. A Council officer spoke with Mrs Y by telephone on 11 December 2019. Mrs Y confirmed she had not claimed the severe disability pension credit. The officer told Mrs Y to make a claim and said the Council would assume the benefit as extra income in four weeks.
23. The Council wrote to Mrs Y in August 2021 about outstanding charges dating back to October 2019. Unfortunately, the letter went to Mrs Y’s old address.
24. A Council case note dated 11 October 2021 states Mrs Y did not receive her latest care plan. An officer recorded Mrs Y’s current address was listed as a temporary address on the Council’s computer system while her old address was listed as the permanent address. The officer recorded they would contact the Council’s IT department to change the address.
25. Unfortunately, the Council continued to send financial assessments and invoices to Mrs Y’s old address.
26. When the Council received no reply from Mrs Y to its invoices, it telephoned her about the outstanding charges in December 2022.
27. Mrs X complained to the Council on 23 December 2022. She said:
• The Council did not send letters to Mrs Y’s new address after she moved in 2019.
• The Council phoned Mrs Y to chase the debt rather than contacting her carers.
• The Council did not provide the forms and agreement Mrs Y signed.
28. The Council sent its final complaint response on 22 March 2023. It apologised for the distress Mrs Y suffered as a result of its phone call chasing the debt.
29. The Council said a social worker made a note on 4 September 2019 that Mrs Y was moving home. However, the primary address was not updated. Invoices are issued based on a service user’s primary address.
30. On 11 October 2021, an officer in the social work team identified Mrs Y had moved address. Unfortunately, this was not recorded correctly, and the invoice address was not updated.
31. The Council’s process is to call service users when there are invoice arrears, and the Council has not received a response to letters.
32. The Council said it would give Mrs X a copy of the agreement signed by Mrs Y in May 2017.

My investigation

33. Mrs X told us Mrs Y moved home in 2019. At that time, Mrs Y was not paying towards the costs of her care and support.
34. Mrs X said Mrs Y received a phone call from the Council in 2022 chasing payment of £9,000. This was the first time Mrs Y knew she was being charged for her care and support and she was very distressed.
35. Mrs X said Mrs Y did not want to stop her care package and has set up a direct debit to pay for her care going forward.
36. The Council told me its social work team considers there was a mix up with Mrs Y’s address on the Council’s computer system.
37. The Council said it updated Mrs Y’s address in August 2019. However, when the Council changed to a new record database in November 2019, it appears the new address was changed to a temporary address, and the previous address was marked as a permanent address.
38. The Council said this was unfortunately not picked up at the annual review in September 2020 as it was conducted by phone due to the COVID-19 pandemic.
39. The Council changed Mrs Y’s address manually in October 2021 when the error was identified after Mrs Y did not receive her care plans.
40. The Council acknowledged it sent some letters to the wrong address, but it said it spoke to Mrs Y and she knew she had to claim outstanding benefits. She also knew she should be paying towards the cost of her care and support.

Analysis

41. I found the Council did record Mrs Y’s new address when she moved home. It used her new address in a letter it sent on 30 September 2019. Unfortunately, it appears this was a one off and the Council sent subsequent letters and invoices to Mrs Y’s old address.
42. Also, when the Council introduced a new computer system in November 2019, the new address was not transferred correctly. This was a known issue the Council also experienced with other resident’s addresses. The Council ran an error report to search for these issues but unfortunately it did not identify the error on Mrs Y’s account.
43. Despite the issue with Mrs Y’s address, the Council did provide her with relevant information about care and support charges before she moved home. This included a warning about benefits and contributions towards the cost of her care.
44. I found Mrs Y received letters from the Council between 2017 and 2019 which included her financial assessments and details of benefits she could claim. The Council followed this up by checking whether Mrs Y claimed the benefits she was entitled to. When she did not claim, the Council sent reminder letters and also spoke to Mrs Y on the telephone. The records I have seen show Mrs Y claimed some benefits and knew she could claim more but decided not to. The Council made Mrs Y aware she was expected to claim all the benefits she was entitled to, and the Council would include them in her financial assessments even if she did not claim them.
45. The issue with Mrs Y’s address, and some documents not reaching her, was seemingly not picked up by the Council straight away because it was doing reviews remotely during the COVID-19 pandemic.
46. The Council says the issue with Mrs Y’s address was caused by the move to a new computer system. While I found this was partly the case, I also found there was some human error. That was fault. The Council had Mrs Y’s new address and wrote to her about claiming benefits. Unfortunately, at the same time, the Council sent Mrs Y’s new financial assessment to her old address. The assessment had details of Mrs Y’s contribution to the cost of her care. This was a missed opportunity and could have prevented the issues which arose later. I also found the Council failed to correctly update Mrs Y’s address across all departments in October 2021. This was another missed opportunity to inform her about her care and support charges.
47. The fault does not change the fact Mrs Y was liable to contribute to the costs of her care and support. I found that, despite the fault, the Council gave Mrs Y the relevant information about charging at the outset and she knew she may have to contribute. I also found Mrs Y knew she should claim benefits, and this would be included in her assessments. Mrs X received the care and support she is now being charged for, and I have not seen evidence she would have cancelled her care package if she had known the Council started charging her. While the Council was at fault for failing to tell Mrs Y it had started to charge her, and for sending invoices to the wrong address, the invoices and charges themselves did not arise because of any fault by the Council. The charges from the Council therefore remain payable.
48. It was a shock for Mrs Y to learn she owed so much in care and support charges. This caused Mrs Y’s distress. It was also distressing for Mrs Y to be landed with a large debt to manage, through no fault of her own. The Council’s failure to correctly update her address meant Mrs X lost the opportunity to make regular payments for her care and support. This is her injustice.

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Agreed action

49. Within four weeks of my final decision the Council will:
• Apologise to Mrs Y for failing to correctly update her address, resulting in it sending important charging correspondence to her old address.
• Apologise for the distress it caused when it told Mrs Y she owed a significant sum in unpaid care and support charges.
• Pay Mrs Y £500 to recognise the distress it caused when it left her with a large debt to manage through no fault of her own.
50. The Council will use this complaint as learning for officers to ensure they correctly update resident’s records and that this is reflected across Council departments.
51. The Council should provide us with evidence it has complied with the above actions.

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Final decision

52. I completed my investigation. I found the Council gave Mrs Y correct information about charging at the outset and made her aware she may have to contribute to the cost of her care and support. However, the Council failed to correctly update Mrs Y’s address and failed to inform her it had started to charge her.

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Investigator's decision on behalf of the Ombudsman