Summary: There is no fault by the Council in levying a charge for Mr Y’s domiciliary care.

The complaint

1. Mrs X complains on behalf of her parents, Mr and Mrs Y. She says the Council failed to inform her parents about the charges for Mr Y’s domiciliary care on his discharge from hospital. Mrs X says her parents believed Mr Y would receive free care for six weeks.

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The Ombudsman’s role and powers

2. 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)
3. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (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 have:

• considered the complaint and discussed it with Mrs X;
• considered the correspondence between Mrs X and the Council, including the Council’s response to the complaint;
• considered information the Council provided to this office;
• considered relevant legislation;
• offered Mrs X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

6. The Care and Support (Charging and Assessment of Resources) Regulations 2014, and the Care and Support Statutory Guidance 2014 (“the Guidance”) set out the charging rules. When a council decides to charge for care, it has to follow these rules when deciding how much a person has to pay towards their care.
7. The law states that people who have over the upper capital limit (£23,250) are expected to pay the full cost of their care. They are known as self-funders. Once their capital has reduced to less than the upper capital limit, they must only pay an assessed contribution.

Key facts

8. At the time of the complaint Mr Y was in his late seventies. He lived at home with his wife.
9. Mr Y was admitted to hospital on 23 March 2023. Prior to this, he was supported at home by Mrs Y and was not in receipt of domiciliary care.
10. Mrs X says the hospital staff informed Mrs Y that Mr Y would receive free domiciliary care for six weeks after his discharge from hospital.
11. I have had sight of an NHS discharge report completed by an NHS occupational therapist. The report, dated 30 March 2023, records, “Patient NOT for reablement poc as assessed to require long term…”.
12. I have had sight of a needs assessment completed by the Council. The assessor recorded Mr Y’s care needs and the details of the domiciliary care package commissioned on his discharge from hospital. The care package consisted of four calls daily to assist with personal care, drinks, meals and mobility.
13. I have also had sight of the notes of a discussion between a social worker and Mrs Y that took place on 30 March 2023, prior to Mr Y’s discharge from hospital. This shows the officer, “spoke to wife [Mrs Y] and advised her that the care package could be chargeable from day one of the service and would be subject to a financial assessment in the community”. Mrs Y confirmed the hospital had told her the same. The records show the social worker sent Mrs Y information about the Council’s charging for non-residential services the following day.
14. Mr Y was discharged from hospital on 18 April 2023.
15. The Council sent a financial assessment form to Mrs Y on 20 April 2023.
16. Following Mr Y’s discharge from hospital, an officer from social services telephoned Mrs Y on 24 April 2023, to complete a welfare check. Mrs Y confirmed the care was going well. The council officer recorded, a ‘financial assessment discussion’ with Mrs Y. The officer explained the capital limits for funding, and that should finances not be declared then the full costs of the service would be charged.
17. The Council wrote to Mrs Y again on 16 May 2023 reminding her of the need to complete the financial assessment form, and that if this was not done then Mr Y would be liable for the full cost of the service, £611.54 weekly. The Council confirmed the start date of charges to be 24 April 2023, and that Mr Y would be billed £2446.16 every four weeks.
18. Mrs Y did not complete the financial form. After discussing the complaint with Mrs X, she informed me Mr Y had capital over the threshold limit.
19. The Councill sent Mrs Y an invoice in June 2023 for £1,223.08. Mrs Y did not pay the invoice so the Council sent a reminder on 4 July 2023, requesting that the amount be paid in full within seven days, and that failure to pay may result in further action.
20. Mrs X says Mrs Y paid the invoice because she was concerned about the possibility of ‘further action’.
21. Mrs X contacted the Council on 11 July 2023 to say Mrs Y had been told care would be free of charge for six weeks. She asked that the Council refund Mrs Y for the six-week period. The Council refused.
22. Mrs X submitted a formal complaint to the Council on Mrs Y’s behalf on 14 July 2023.
23. Mrs Y received a further invoice for Mr Y’s care on 25 July 2023 for ‘just over’ £2,000. Mrs X contacted the Council to complain. The Council agreed to put the account on hold until the complaint had been investigated.
24. The Council investigated the complaint and responded to Mrs X in writing on 4 August 2023. The author of the letter said the complaint had not been upheld, and explained the reasons why, that the records show Mrs Y had been made aware of and understood that care services were chargeable from day one, prior to Mr Y’s discharge from hospital.
25. Mrs X remained dissatisfied and submitted a complaint to this office.
26. Mr Y sadly passed away in September 2023.

Analysis

27. It is not the Ombudsman’s role to decide what a person should pay towards their care, that is the Council’s role. 
28. I am not persuaded by Mrs X’s claim that Mrs Y was unaware of the charges for Mr Y’s care. Whilst Mrs Y may not have been aware of the exact cost, the information provided by the Council is clear that Mrs Y was informed on more than one occasion that care was chargeable from day one of service provision. The Council also provided written information about charges.

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Final decision

29. There is no fault by the Council in levying a charge for Mr Y’s domiciliary care.
30. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman