Summary: Ms X complained the Council charged her mother, Mrs Y, for care the family had been told was free of charge. We found fault as the Council failed to properly communicate when free care ended and chargeable care began or to communicate in a timely manner when Ms X challenged the charges. This caused avoidable distress and frustration for the family. The Council has already apologised and completed an appropriate remedy which Ms X and Mrs Y accepted.

The complaint

1. Ms X complains that the Council organised a six-week package of care for her mother, Mrs Y, which the family were told would be free, only for the Council to send an invoice for care services after the package had ended.
2. Ms X says this has caused both her and Mrs Y considerable distress and frustration.

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The Ombudsman’s role and powers

3. 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)
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 all the information Ms X provided and discussed this complaint with her. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
6. Ms X and the Council had the opportunity to comment on my draft decision. I have taken any comments received into consideration before reaching my final decision.

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What I found

Assessment

7. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
8. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Plan

9. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Charging for social care services: the power to charge

10. 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)

Financial assessment

11. 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. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
12. 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.

What happened

13. I have set out below a summary of the key events. This is not meant to show everything that happened.
14. Ms X is representing her mother, Mrs Y, in this complaint.
15. In September 2022, Ms X made contact with the Council to request support for Mrs Y in getting hot meals ready at Mrs Y’s home.
16. In mid-November 2022, Ms X again contacted the Council as Mrs Y’s support needs had now increased. A few days later, a social worker from the Council (Officer A) contacted Mrs Y to arrange a Care Act assessment.
17. Later in November, Officer A met with Ms X and Mrs Y and decided Mrs Y was eligible for a care and support plan. The assessment recorded that the Council’s financial charging policy was discussed with Mrs Y who agreed for a financial assessment (FA) to be completed.
18. Mrs Y’s plan was completed at the beginning of December 2022 and proposed 14 hours support per week with a provisional start date of 19 December 2022.
19. On 21 December 2022, Ms X contacted the Council to chase what was happening with Mrs Y’s care package. She was concerned as Mrs Y was falling more frequently and a recent fall had led to a hospital visit. An Occupational Therapist from the Council contacted Mrs Y and discussed her immediate needs. Ms X then contacted the Council and requested that care for Mrs Y should start urgently.
20. The next day, the Council decided to provide Mrs Y with assistance from its urgent care and support service. This was to start the following day, would last for two weeks and was free of charge.

2023

21. On 4 January 2023, Officer A sent a referral through to the Council’s FA team.
22. The Council’s free care ended on 8 January 2024 and chargeable care began the next day. At this point the Council had not yet completed Mrs Y’s FA, so she was unaware what amount she would have to contribute. Ms X stated that Mrs Y was now more mobile, was falling less and would require less assistance. It was agreed for Mrs Y to receive seven hours assistance per week.
23. The Council completed Mrs Y’s FA on 12 January 2023 and assessed her maximum weekly contribution to be £149.20.
24. On 2 February 2023, Ms X called the Council to dispute the 6 weeks of care fees Mrs Y had been billed for. Ms X and Mrs Y thought the care had been free.
25. Ms X cancelled Mrs Y’s care package on 6 February 2023.
26. At the end of March 2023, Ms X emailed the Council to again state that she believed the care Mrs Y had received was free of charge.
27. At the beginning of April 2023, the Council passed Ms X’s query onto the team who had been dealing with Mrs Y’s care package.
28. At the end of July 2023, Officer B from the Council contacted Ms X to discuss her concerns that the care should not have been chargeable.
29. Ms X chased Officer B to find out what was happening in early-August 2023, as she was now getting debt recovery letters about Mrs Y’s outstanding bill.
30. Throughout August, Officer B tried to contact the agency who had delivered the chargeable care to discuss the charges. At the end of August, an online meeting was held between Officer B, Ms X and the agency.
31. At the end of October 2023, Ms X chased Officer B to see what the position was with the outstanding invoices. Officer B advised the Council was looking into the matter and he would respond to her complaint when he had more to tell her.
32. By mid-November 2023, Ms X made a formal complaint to the Council. She was unhappy the matter had not been resolved and that Mrs Y continued to get debt collection letters, the latest of which threatened her with court action.
33. The Council responded to the complaint later in November. It did not uphold any of Ms X’s complaints but signposted her to the Ombudsman.
34. Ms X complained to the Ombudsman at the beginning of December 2023.

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Analysis

35. Ms X complains Officer A told her that Mrs Y would receive a free, six-week package of care, running from the end of 2022 into the beginning of 2023.
36. Evidence shows that Mrs Y was advised in mid-November 2022 that the Council charged for adult social care services. The Council’s records of the initial conversation with Mrs Y showed that it had considered a free six-week package of care for Mrs Y (Reablement care) but that this was not considered suitable when taking into account her needs.
37. Evidence also shows that when Officer A visited Mrs Y later in November 2022, she discussed the Council’s financial charging policy with Mrs Y. She also advised the Council would need to complete an FA and a support plan. I have seen no evidence the Council told Mrs Y she would receive six weeks of free care.
38. In its response to my enquiries, however, the Council advised there was a lack of evidence to show that Mrs Y was informed of the initial two-week package from its urgent care and support service being free or why it was free.
39. Following my enquiries being sent to the Council, it sent a letter to Ms X in May 2024. In the letter, the Council apologised and said its view was that it had not clearly communicated to her or Mrs Y about what was and was not a chargeable service.
40. In response to my enquiries, the Council said it acknowledged that after Ms X had challenged its decision to charge Mrs Y for the care being delivered, its communication did not meet expected standards. I agree. This lack of clear communication is fault. It would have caused avoidable distress, frustration and confusion for Ms X and Mrs Y.
41. To remedy the injustice caused to the family, the Council said it had decided to write off Mrs Y’s £671 debt for chargeable care she received. It also decided to offer Ms X £250 for the time and trouble she had taken to deal with the complaint. This information had been shared with Ms X in the Council’s letter to her.
42. At the time of writing this decision, both the Council and Ms X confirmed she had accepted the offer, the debt had been written off and she had received the £250 payment.
43. I am satisfied, that in the circumstances of this complaint, the offer already completed by the Council was sufficient to remedy the injustice caused to Ms X and Mrs Y. I will therefore make no further recommendations.

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Final decision

44. I have now completed my investigation. I uphold this complaint with a finding of fault causing an injustice.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman