Summary: Mr X complained the Council failed to provide costs information about the care for his mother (Mrs M) until five months after the service started, when the Council sent a large bill. I have discontinued my investigation. This is because we could not add to the Council’s investigation, and we are unlikely to achieve a different outcome.

The complaint

1. Mr X complained the Council failed to provide costs information about the care for his mother (Mrs M) until five months after the service started, when the Council sent a large bill. Mr X said there was no written agreement, and the Councils communication was poor. This has caused the family financial and emotional distress. Mr X would like the Council to waive the bill.

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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:

• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome, or
• there is no worthwhile outcome achievable by our investigation.

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

3. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)

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How I considered this complaint

4. As part of the investigation, I have considered the complaint and the information Mr X provided.
5. I also considered the Council’s response, relevant law, and guidance.
6. 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

7. I have summarised below the key events leading to Mr X’s complaint. This is not intended to be a detailed account.
8. Mrs M went to hospital in December 2022 with a serious medical condition.
9. In February 2023, Mrs M left hospital and moved into a care home.
10. In March / April, Mrs M returned to the family home where she lives with her husband, Mr M. Carers provided Mrs M with care in her home. This was funded by the NHS Discharge to Assess reablement scheme for six weeks.
11. In the middle of April, a social worker visited Mrs M at home. The social worker explained ongoing care would be chargeable and a financial assessment would be needed. No detailed financial discussions took place.
12. The social worker spoke with Mr S (Mrs M’s son and Mr X’s brother) who said he was happy to be the contact for any financial assessment. Mr S completed the referral and sent this to the Council. The Council received it at the end of April.
13. The NHS Discharge to Assess scheme ended and Mrs M’s care became fully chargeable from the middle of May.
14. In early October, the Council visited Mrs M at home. The Council explained Mrs M was responsible for her care costs from the middle of May.
15. The Council wrote to Mr S at the end of November. The letter said it had completed the financial assessment and enclosed details of the calculations. Mrs M was assessed to pay the full cost of her care from the middle of May. From the middle of July, Mrs M’s savings dropped below the threshold. After this time, she was responsible for paying a maximum weekly contribution towards her care of around £10.
16. On the same date, the Council also sent an invoice for the charges from the middle of May to the middle of November. Mr X said his mother has not paid this bill; the Council has sent threatening letters demanding payment. Mr X said Mrs M is paying the monthly bills for her current care package.

The complaint

17. Mr X complained in the middle of November. He said the Council had not completed a financial assessment or contacted the family for five months and then issued a large bill.
18. The Council responded to the complaint in the middle of December. It explained the contributions Mrs M should pay towards her care and apologised for the lack of communication.
19. Mr X was not happy with the response and the invoices for care costs and emailed the Council in the middle of January 2024. The Council responded in early February and explained the care fees and provision. Mr X complained to the Ombudsman later in February.

Analysis

20. I intend to discontinue my investigation.
21. In response to my enquiries, the Council recognised the cost of the care was not confirmed until around four months after the care package started. It agreed to waive the bill for the five-month period from May to September 2023. This matches with Mr X’s preferred outcome. There is nothing significant we could add by investigating the case further.
22. The Council also said it has put mechanisms in place to ensure financial assessments are completed in a timely manner. The Council has also strengthened handover arrangements between internal teams. This is in keeping with the type of service improvement we would recommend.
23. It is therefore unlikely further investigation would lead to a different outcome. I do not consider any additional worthwhile outcome is likely to be achieved.

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Final decision

24. I have discontinued my investigation. This is because we could not add to the Council’s investigation, and we are unlikely to achieve a different outcome.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman