Summary: Mrs X complains the Council did not properly deal with charges for her husband’s care. The Council agrees it is at fault because care charges were not properly explained to Mrs X and it calculated care charges incorrectly. Mrs X was incorrectly charged. The Council has agreed to refund all the relevant charges. This is an appropriate remedy.

The complaint

1. The complainant, whom I shall refer to as Mrs X, complains on behalf of her husband Mr X, that the Council has not dealt properly with charging for his care because it failed to:
• provide adequate information and support;
• complete financial assessments properly; and
• deal with her complaints about problems
2. Mrs X says Mr X was wrongly charged, suffered financial loss, and she was caused avoidable distress.

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The Ombudsman’s role and powers

3. 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)
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)

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How I considered this complaint

5. I spoke to Mrs X about her complaint and considered documents she provided. I made enquiries of the Council and considered its response and the supporting documents it provided.
6. 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

What happened?

7. This is a brief chronology of key events. It does not contain everything I reviewed during my investigation.
8. Mr X went into short term residential care after leaving hospital in April 2022. A financial assessment for short term residential care for Mr X was completed.
9. Mrs X sent queries to the Council about the financial assessment and charges for Mr X’s care.
10. Mr X then went into long term residential care in October 2022. A second financial assessment for long term residential care for Mr X was completed.
11. Mrs X complained to the Council about charges for Mr X’s care. The Council upheld Mrs X’s complaint that it missed opportunities to ensure Mrs X understood the costs involved and agreed to refund some costs.
12. Mrs X contacted the Council querying the accuracy of the financial assessments.
13. The Council agreed that the financial assessments had been completed inaccurately.

Analysis

14. The Council commissioned Serco to undertake Financial Assessments and collect payments on the council’s behalf.
15. The Council has upheld Mrs X’s complaint and agreed that:
• Its support for Mrs X in understanding different elements of the care charges was not good enough;
• Supporting information and advice would have been helpful if it had been provided in writing;
• A copy of the first financial assessment was not shared with Mrs X;
• Mr X’s contribution towards his care was incorrectly calculated; and
• An incorrect invoice was sent to Mrs X due to a system error.
16. I have reviewed the charging assessments and supporting documents. These show that there was an error made when calculating Mr X’s income as it wrongly took Mrs X’s pension income into account. I agree with the Council’s explanation that this was a human error.
17. The Council agrees that when Mrs X made a formal complaint in December 2022 the response included the financial assessment outcome which unknowingly wrong at that time. The Council missed opportunities to correct the mistake. It was not addressed until Mrs X later queried the charges again.
18. The Council has apologised to Mrs X and refunded top up charges she paid for Mr X from 2022. It has now also recalculated Mr X’s care costs correctly back to April 2022.
19. The Council has also identified necessary service improvements as a result of Mrs X’s complaint. It has:
• Completed an audit of the financial assessment process. This found that, “Our critical review or assessment on the activity gives us a substantial level of confidence (assurance) on service delivery arrangements, management of risks, and operation of controls and / or performance. There are some improvements needed in the application of controls to manage risks.”;
• Introduced additional financial checks to ensure a person’s contribution does not exceed their income;
• Made a decision to insource the provision of Adult Care Finance and Exchequer services in 2024; and
• Committed to undertake a lessons learnt exercise.
20. I consider this to be an appropriate remedy.

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Final decision

21. I have found fault by the Council, which caused injustice to Mrs X. The Council has provided an appropriate remedy. I have now completed my investigation.

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Investigator's decision on behalf of the Ombudsman