Summary: Miss C complained on behalf of her father, Mr D that the Council had not provided clear and transparent information about the likely level of the contribution he would have to make towards his care charges before he agreed to a care package and then delayed in completing the financial assessment. We found the Council did not provide clear enough information about the likely level of the contribution and took 12 weeks to confirm the amount, causing a large debt to build up. The Council has agreed to pay £1000 to Mr D which can be offset against the outstanding amount, to agree an affordable repayment plan for the remaining debt and to improve its procedures for the future.

The complaint

1. Miss C complained on behalf of her father, Mr D, that the Council failed to advise the family about the likely contribution towards care charges Mr D would have to pay from August 2023. The Council only mentioned the financial assessment briefly during a telephone call and provided no details in writing. It also took four months to complete the financial assessment during which time care charges accrued of more than £1700. Mr D and the family were very shocked and distressed to receive such a large invoice and feel the Council misled them. They have now cancelled the care.

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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. I have considered the complaint and the documents provided by the complainant, made enquiries of the Council and considered the comments and documents the Council provided. Miss C and the Council 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

Charging for care at home

5. 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.
6. 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)

Care and Support Statutory Guidance

7. This guidance sets out the process for carrying out financial assessments. It says that a council’s approach to charging for care and support needs should be clear and transparent, so people know what they will be charged.
8. It also says local authorities should ensure there is sufficient information and advice available in a suitable format for the person’s needs, to ensure that they or their representative are able to understand any contributions they are asked to make. Once it has completed the financial assessment it must give a written record to the person along with their care and support plan or separately via online means. It should explain how the assessment was carried out, what the charge will be and how often it will be made. The local authority should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.

What happened

9. Following a stay in hospital in August 2023 Mr D was due to be discharged home with a care package. His wife, Mrs D, was his main carer. The hospital social worker advised Mrs D on 7 August 2023 that she needed to complete an online financial assessment form to identify any contribution that Mr D may have to make towards the cost of his care. They confirmed with Mr D the following day that he was aware he may have to make a contribution. The Council repeated this during a telephone call on 18 August 2023.
10. Mrs D with the help of Miss C completed the online financial assessment form on 18 August 2023. The form contained a table with the heading ‘Non-residential’. The first line of the table said the maximum non-residential care contribution would be £176.50. It did not say this was what Mr D was likely to have to pay or give any other information about the possible outcome.
11. Mr D came home on 22 August 2023 with a package of care: four calls a day with two carers at each call.
12. On 1 November 2023 the Council sent the outcome of the financial assessment to Mr D saying he would need to pay the maximum contribution of £176.50 per week along with an invoice for around £1700 for the charges since 22 August 2023, asking for payment by 10 December 2023.
13. Miss C wrote to the Council on 9 November 2023 saying the Council had never made clear that there would be a charge for the service even though she and Mrs D has questioned this many times. She also said Mr D should have been offered reablement care for six weeks without charge after being discharged from hospital and he had been readmitted to hospital on two occasions in September and October, so the charges were incorrect. She said the letters from the Council were threatening given they talked about legal action and debt recovery. She said they were now managing without the care package.
14. The Council replied on 22 November 2023. It said the Council had spoken to Mrs D twice in August 2023 and made her aware that Mr D would have to pay towards the cost of his care. It also said the application form provided details of the financial contribution and was mirrored in the letter of 1 November 2023. It suggested she contact the social work team directly regarding the reablement care and said that no refunds were due for care charges for the first 28 days of absence from home. It apologised for the delay in completing the financial assessment and said this was due to a backlog. It also apologised for the wording of the letter if it had caused stress at a difficult time.
15. The Council sent another invoice for around £700 for care charges and Miss C complained to us.
16. We referred the complaint back to the Council to respond to Miss C. It replied to her in January 2024 saying that the social worker had spoken to Mr and Mrs D and Miss C about the financial assessment and had provided clear information. There was no miscommunication or lack of clarity. In respect of the reablement care the Council said that this was only suitable for people with the potential to rehabilitate within the six week period whereas Mr D had long-term needs and required ongoing support.
17. Miss C then complained again to us.

Analysis

18. While I agree the Council was clear with Mr D and his family, that Mr D may need to contribute towards his care charges, I do not consider it was clear about how much that charge might be. There is no evidence that this key piece of information was discussed or explained to them before the care started. Mr D and Mrs D agreed to a care package without knowing it would cost a significant amount of money: over £760 a month.
19. I accept the application form referred to a ‘maximum non-residential care contribution’ of £176.50 but there was no explanation what this meant or whether it would apply to Mr D’s case. The Council did not provide anything in writing to supplement the information on the online application form and no-one discussed likely figures with them. I understand the Council cannot give a definitive answer until the financial assessment is complete, but the guidance indicates that the Council should ensure it provides clear and transparent information so that people know what they will be charged and can make an informed decision about their care. I do not consider it provided clear and transparent information in an accessible format to Mr D or his family.
20. The Council could have provided more detailed information, for example by providing notes on the application form or a standard letter to explain that £176.50 was an indicative figure the family could rely on and enable them to make an informed decision about accepting the care package. The failure to do so was fault.
21. This fault was exacerbated by the time it took to complete the financial assessment: 12 weeks. By the time Mr and Mrs D and Miss C received confirmation of the charge, Mr D had incurred a debt of £1700. The guidance indicates the information on charges should be provided at the time the care and support plan is sent out, not three months later.
22. This caused them distress and worry at an already difficult time. They cancelled the care as soon as they could, indicating that if they had known the true cost at the time, they may well have not agreed to it in that form.
23. I have not identified fault in respect of the issue of reablement care as it appears the Council was clear Mr D’s needs were too great to benefit from this and he would need long-term care.

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Agreed action

24. In recognition of the injustice caused to Mr D and his family, I recommended the Council within one month of the date of my final decision:
• pays Mr D £1000 which can be offset against the outstanding care charges;
• agrees an affordable repayment plan for the remaining balance; and
25. within three months:
• ensures that it provides more information about the likely level of a person’s contribution before they agree to the care package; and
• takes steps to reduce the time taken to complete the financial assessment process.
26. The Council should provide us with evidence it has complied with the above actions.

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Final decision

27. I consider this is a proportionate way of putting right the injustice caused to Mr D and I have completed my investigation on this basis.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman