Summary: Mr X complained the Council issued a care plan for his father, Mr F, with more care than he needed at a significant cost which it did not explain. Mr X said his father would not have agreed to the care plan if the Council had told him the cost, especially as he could manage with less care. The Ombudsman found the Council followed procedure when it drafted the care plans and assessed Mr F’s finances but is at fault for failing to communicate this effectively.

The complaint

1. Mr X complains the Council issued a care plan for his father, Mr F, with more visits per day than necessary at a significant cost which it did not explain. Mr X said his father would not have agreed to the care plan if the Council had told him the cost, especially when he could manage with less care. This has caused Mr X and Mr F distress and Mr F financial distress. Mr X would like the Council to change their procedures and advise people correctly.

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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 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)
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)

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How I considered this complaint

4. As part of the investigation I have considered the following:
• The complaint and the documents provided by the complainant.
• Documents provided by the Council and its comments in response to my enquiries.
• Care Act 2014, the Care and Support (Charging and Assessment of Resources) Regulations 2014, the Care Act statutory guidance.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Relevant legislation

6. 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)
7. 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. Councils have no power to assess couples according to their joint financial resources. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
8. 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)

The Council’s policies and procedures

9. The Council’s website has a lot of information about charging for non-residential care. It explains how much someone pays will depend on their financial assessment which will be calculated and sent to the individual. There is an online contribution calculator which estimates whether a contribution to care is required and how much this is likely to be.
10. The Councils website sets out how much services cost. For example, homecare is £19.66 per hour and charged in 15-minute blocks. A pendant alarm / telecare costs between £6 and £10.35 per week. The website says the Council sends invoices to customers every four weeks.
11. The online leaflet explains if an individual’s capital is below the threshold of £23,250, they can request a financial assessment based on capital and income. It explains the person will be left with a Minimum Income Guarantee (MIG) if they receive non-residential care. This is the amount of income the Government says people are allowed to keep after the Council has completed a financial assessment. The 2023/24 rates set by the Council for over 60s is £214.35. Any amount above this will be a contribution towards their care. The amount will never be more than the maximum costs and will only be for care received.

What happened

12. I have summarised below the key events; this is not intended to be a detailed account.
13. Mr F fell and went to hospital. The Council visited him in February 2023, conducted a care assessment and drafted a care plan to enable him to come home safely. The plan recommended carers to visit Mr F four times a day.
14. Mr F signed a financial referral form and asked for a financial assessment as he had limited savings. He gave the Council permission to talk to Mr X on his behalf.
15. Mr F came home from hospital in the middle of February. The care plan started.
16. The social care assessor emailed Mr X at the beginning of March and said they had ‘sent the finance declaration to the finance assessment team and they will send a letter stating if contribution is required or not and how much it is.’
17. In the middle of March, the Council asked Mr X for further information to complete the financial assessment which he provided. Mr X said he did not receive any correspondence or leaflets from the Council explaining the assessment, neither did anyone refer him to the Council’s website for further information.
18. The Council sent invoices to Mr F at the end of March, April and May. These said his care charges were about £150 per week. Mr X said the Social Work Assessor told him to ignore these invoices as the financial assessment was still ongoing and it was difficult to get the money back. Mr X and Mr F did not pay the invoices.
19. In the middle of June, the Council completed its financial assessment and sent it to Mr F. The assessment recalculated the previous fees, these were roughly the same, around £150 per week.
20. Later in June, the Council sent Mr X a letter saying Mr F was in arrears of around £1,800 in care charges and said payment was due within 14 days.
21. Mr X telephoned the Council after receiving the arrears letter and complained about the care fees. He said the Council advised Mr F would only need to contribute £5-10 per week as his capital was under the threshold.
22. The Council responded to Mr X’s complaint in July. It said Mr F owed about £1,800 and he had to pay within the financial year (this was longer than the original letter said). It apologised for the time taken to complete the initial assessment. It also apologised ‘that you were advised that the weekly contribution would be £5 - £10 per week, this was however in relation to the telecare alarm.’
23. Mr X asked for a review of the complaint. The Council responded at the beginning of August. It said the Council was satisfied the social work assessor explained the finance team would decide if Mr F needed to pay a contribution towards his care once it had completed the assessment. The assessor said they ‘did not advise that the contribution would be between £5 and £10 per week and has always advised that this would be determined by the finance team.’
24. Mr X complained to the Ombudsman in September. He said the Council gave wrong advice during the financial assessment visit. In conversation with me, he said the social work assessor said Mr F would only need to pay between £5 and £10 per week because he had less than £14,000 in savings. Mr X said he thought his father did not need the full care package of four calls a day but the Social Work Assessor said it would be the same low price so he should accept it. Mr X said they followed the Social Work Assessors advice.
25. Mr F moved in with Mr X in October. Mr X told me this was to provide company for his father who was struggling emotionally since the death of his wife.
26. Around the same time, Mr X asked the Council to amend Mr F’s care package. Mr X said his father did not need four visits a day. The plan reduced the number of visits from four to two per day. Mr X told me this only saved his father about £22 a week (costing roughly £130 a week). He asked the Council to reduce the visits to once a day which brought the weekly fee down to around £80 per day. Mr X said this met Mr F’s needs at the time and would have been fine from the start.
27. The Council records show it was satisfied the new support plan met Mr F’s needs based on the change in his circumstances and the natural support Mr X provides.
28. In conversation with me, Mr X said his father was mis-sold the original care package. He was told he would only pay between £5 and £10 per week for four visits and was advised to accept the full care package. Mr X said the carers were only microwaving a meal on two of the visits which he could do for his father. These visits were not needed. Mr X said his father only ever really needed one visit a day, as per his current care plan.

Analysis

29. Mr X said the social work assessor told him to accept the full care package, whether his father needed it or not, as it would not cost any more. I have not seen evidence of this. Mr X said he asked for a reduction in the number of visits to save money and because his father did not need the full package. The Council reassessed Mr F and found as he had moved in with his son, he received natural support from Mr X. The Councils record shows the change in care package does not suggest the original care package was not required, rather it reflects a change in circumstances.

Contribution towards care

30. Mr X said the Council told him his father’s care would either be free, or he might need to pay a small contribution of £5 to £10 per week. The email in March from the social care assessor said the case was to be passed to the finance team for assessment. The finance team would then contact Mr X and tell him if Mr F needed to contribute to his care, and how much this would be. There is no evidence to suggest the social work assessor told Mr X his father’s care would be free or £5 to £10 per week. Instead, it explains the Council will calculate the charges and notify him. The Council is not at fault.
31. However, in its complaint response, the Council said: ‘I apologise that you were advised that the weekly client contribution would be £5 - £10 per week, this however was in relation to the telecare alarm.’ The Council acknowledges a conversation where figures have been discussed which led to Mr X considering his father would only pay a small amount per week. The Council accepts the advice it gave has led to Mr X and Mr F considering this is all they would pay. The Council is at fault for giving misleading information.
32. Mr X said the Social Care Assessor told him to ignore the original invoices and not make any payments while the financial assessment was continuing. I have not seen evidence of this.
33. The Council said it has consistently told Mr X to pay the invoices. Mr X said the Council’s finance team has sent invoices and reminders. The Council is not at fault.

The financial assessment and requesting payment

34. The Councils financial assessment from this financial year sets out Mr F’s income, savings and expenditure. It subtracts the MIG from the income and what is left, is what the Council considers he can afford to pay towards his care. The MIG correlates with the information provided in the financial assessment. The Council has followed the procedure and calculated it accordingly. It is not at fault.
35. While there is no strict timeframe for completing the financial assessment, the Council should complete it in a timely manner. The Council took four months to complete the financial assessment on Mr F. The Council has recognised this was longer than ideal and apologised in its complaint response.
36. Once it had completed the financial assessment, the Council sent Mr F a demand for payment of the arrears to be paid in 14 days. Considering the delay in assessment, I do not consider 14 days long enough to allow Mr X to make the payment. The Council later advised Mr X over the telephone to make routine payments for Mr F’s care and pay an extra amount towards the arrears. This was confirmed in a letter which advised the arrears were to be paid within the financial year, and not the 14 days as originally demanded. I consider this to be a more reasonable timeframe to expect payment to be made. The Council is not at fault.

Correspondence

37. While I have not seen evidence the Council gave wrong advice to Mr F and Mr X, I have not seen evidence of the Council gave correct advice either. The Council has not produced attendance notes from meetings with Mr X and Mr F to confirm what advice it gave in the early stages of care and financial planning. Mr X said he did not receive any written correspondence from the Council or any advice leaflets which explained the process and what to expect. Neither did the Council indicate what the charges might be. Mr X has been clear throughout my investigation and said the Social Care Assessor advised him that his father would only pay £5 - £10 per week for his care, and this would be the same whether he accepted one or four visits per day. Mr X said his father was advised to accept the full care package because of this, even though he may not need it. He followed the advice and accepted the offer. I have not seen evidence to support or undermine what Mr X has said. The lack of written correspondence and detailed attendance notes makes it difficult to know what advice the Council gave. The Council is at fault for not keeping thorough attendance records and following up conversations in writing to ensure clarity of communication.
38. Information is available on the Councils website as set out above. Mr X could have used the online contribution calculator available on the Council's website to roughly calculate how much Mr F should pay. The leaflet online also says what the MIG is, which matches with the information within the Councils financial assessment. Mr X could have calculated what his father ought to pay before he received the Council’s financial assessment and had a better understanding of the process in general had he referred to the Councils website.

Summary of fault causing injustice

39. The Council followed procedure, conducted the financial assessment and requested payment correctly and delayed carrying out the financial assessment.
40. While there is no evidence the Council gave Mr X and Mr F wrong advice, there has been a failure in communication. The Council’s failure to clarify matters in writing has worsened the situation. This has caused Mr F and Mr X distress.

Action already taken by the Council

41. The Council has agreed to give Mr F until the end of the financial year to repay the outstanding amount and has apologised for the delay in carrying out the financial assessment.

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Agreed action

42. Within four weeks of my final decision, the Council agreed to:
• Apologise to Mr F and Mr X and pay £250 for the distress caused by miscommunicating and failing to clarify matters in writing.
• Remind case workers the importance of providing and recording clear and detailed discussions.
43. The Council should provide us with evidence it has complied with the above actions.

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Final decision

44. I have completed my investigation. The Council is at fault for failing to communicate effectively.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman