Summary: There was fault by the Council. It delayed carrying out a financial assessment which led to distress and uncertainty when the family were told of the fees owed a year later. The Council has apologised and waived the fees owed which remedies the injustice caused.

The complaint

1. The complainant, who I shall call Mrs X, complains the Council did not charge Mrs M (her mother) correctly for the first 8 weeks she spent in the residential care.
2. Mrs X also complains that a delay in invoicing her mother for the charges caused them financial hardship.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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 read the papers put in by Mrs X.
6. I considered the Council’s comments about the complaint and any supporting documents it provided.
7. Mrs X and the organisation 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

Law and guidance

8. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
9. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.

Key facts

10. Mrs M received care at home which was partially funded by direct payments. Mrs M went into emergency respite care on 26 February 2021 as it was felt she could not stay at home safely. The social worker sent Mrs X the financial assessment forms on 2 March 2021. There is a note on the file that the Direct Payments continued to run during this time as the Council was unsure of the notice period that Mrs X would need to pay. A file note of 10 March 2021 extended the respite care period for 2-4 weeks. The Council extended this on 18 April for a further 3-4 weeks and suspended the direct payments from this date.
11. The decision was made on 8 May 2021 that Mrs M would remain in residential care. The value of her property was disregarded until 30 July 2021.
12. On 31 July 2021, as Mrs M had property worth more than the upper capital limit, the Council told her she needed to pay the full cost of her care.
13. The Council has said there was a delay in carrying out the financial assessment and apologised for this in the response to Mrs X’s official complaint. The Council received the form on 13 April 2021 but did not complete the assessment until 25 May 2022. Mrs Y received an invoice for £4749 on 6 June 2022.

My analysis

14. There has been fault by the Council. There was a delay in carrying out the financial assessment of over a year. In addition to this the Council did not take into account the charges for short term care when carrying out subsequent financial assessments.
15. The Council apologised and reduced the care bill by 10%, to recognise the impact of the delay when it considered Mrs X’s official complaint. During the course of this investigation the Council agreed to waive the remaining charges. This remedies the injustice to Mrs X.
16. I have considered whether to impose a remedy for service improvement. The Council has explained that the delay occurred in 2021. Since then, the Council now completes most financial assessments within 15 days. So, I do not consider a service improvement is needed.

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Agreed action

17. The Council has confirmed to Mrs X in writing that the outstanding fees have been waived. (This part of the remedy is already complete.)

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Final decision

18. I have completed my investigation of this complaint. This complaint is upheld, as there was delay by the Council in carrying out a financial assessment. The actions already taken by the Council remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman