Summary: We will not investigate this complaint about adult social care charges, because there is not enough evidence of fault to justify investigating and it is unlikely further investigation would lead to a different outcome.

The complaint

1. Ms B says the Council is unfairly backdating charges for adult social care. Ms B says she told the Council at the relevant time about a change to her mother (Ms C’s) income, so the Council should accept its error and not backdate the charges. Ms B is stressed and says Ms C cannot afford the charges.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome, or
• we cannot achieve the outcome someone wants.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

3. I considered information provided by the complainant and I considered the Ombudsman’s Assessment Code.

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My assessment

4. Ms C receives adult social care arranged by the Council. The Council can charge for this care; it completes a financial assessment to decide what contribution a person must make towards their care. The Council should review this at least each year.
5. Ms C had an increase in her benefit income (benefit D) and a lump sum payment in 2020. The Council is correct to reassess Ms C’s contribution towards adult social care based on that change, and it can backdate any change to Ms C’s assessed contribution. The Ombudsman cannot achieve the outcome Ms B wants, for the Council to waive the charges.
6. Ms B says she told the Council of the increase in income in 2020. There is no evidence to support the telephone discussion about this, and so an Ombudsman investigation is unlikely to find evidence to justify a finding of fault by the Council.
7. Ms B says the Council should have identified this sooner than 2023 in its annual reviews. The Council refers to letters sent to Ms B from 2018 onwards stating it is the responsibility of the service user and/or financial representative to tell the Council of any changes in income or capital. Without any such information there was no reason for the Council to assume there had been any change to Ms C’s income or capital and so it based its annual reviews on the information it held, applying an automatic uplift to benefits.
8. The Council sent the outcome of reviews to Ms B in 2021 and 2022 and she did not tell the Council it had not applied benefit D. Ms B argues the Council should have contacted the Department for Work and Pensions (DWP) to get information for its annual reviews, as this is implied in the Council’s letters. The Council explains it does not have the resource to contact the DWP about every financial assessment, so would only do so if it felt there was a need. It is unlikely the Ombudsman would find this was fault, it is not reasonable to expect the Council to contact the DWP for every financial assessment and it can rely on information provided by the service user about their finances. There is nothing to support the Council should have known about benefit D any sooner than it did in 2023.
9. To recognise there is an impact by the delay in adjusting the charge between 2020 and 2023, the Council has advised Ms B it can agree a repayment plan rather than having to pay the debt in one go. This is correct action by the Council. If the Ombudsman found fault by the Council, it is unlikely we would achieve much more than this.
10. Ms B is unhappy that she had asked to attend an appeal in person, and this question has not been responded to or granted. While this is frustrating for Ms B, it would not warrant an Ombudsman investigation. It is unlikely to change the outcome of the core matter.

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Final decision

11. We will not investigate Ms B’s complaint because there is not enough evidence of fault to justify investigating; we will not be able to find out what happened in 2019. Even if we did, that would not mean the debt is not due as there is no dispute Ms C had an increase in income. If the process was correctly followed Ms C’s contribution towards her care charges would have increased in 2020 and she would have been paying regularly rather than now having a debt to pay off. To allow for this, the Council has confirmed Ms C can pay by instalments and can contact it to agree a repayment plan. The Ombudsman cannot find the charges should be waived, as the charges themselves would be rightly due and are not a direct injustice of any potential fault by the Council. So, the Ombudsman cannot achieve the outcome Ms B wants, and it is unlikely an Ombudsman investigation would achieve anything further.

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Investigator's decision on behalf of the Ombudsman