Summary: Mr X complains the Council failed to deal properly with the charges for his late mother’s care. There was a long delay in completing his mother’s financial assessment. The Council apologised for not going ahead with the financial assessment in September 2021, but has not apologised in writing for the delay in rearranging it. The Council’s communications with Mr X about the charges for his mother’s care lacked clarity, which caused confusion. The Council needs to apologise to Mr X these failings. However, the Council has not charged as much as it could have done for his mother’s care, so there is no basis to ask it to waive any of the outstanding charges.

The complaint

1. The complainant, whom I shall refer to as Mr X, complains the Council failed to deal properly with the charges for his late mother’s 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, sections 30(1B) and 34H(i), as amended)
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. This complaint involves events that occurred during the COVID-19 pandemic. The Government introduced a range of new and frequently updated rules and guidance during this time. We can consider whether the council followed the relevant legislation, guidance and our published “Good Administrative Practice during the response to COVID-19”.

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What I have and have not investigated

6. I have investigated the Council’s handling of the charges for Mr X’s mother’s care since she moved to a care home in August 2021.
7. I have not investigated Mr X’s complaint about the lack of support provided for his mother when she returned home from hospital earlier in August 2021. This is because the events happened a long time ago and it is no longer possible to remedy any injustice to his mother because she has died. The restriction set out in paragraph 4 above prevents me from investigating any claimed injustice to Mr X from these events. This is a late complaint and there are no grounds to exercise the Ombudsman’s discretion to investigate it. Mr X did not contact us until January 2024, having raised his concerns with the Council in September 2023, over two years after the events happened.
8. Nor have I investigated Mr X’s concerns about his mother’s discharge from hospital in August 2021, as that is a matter for the relevant integrated care board and falls within the remit of the Parliamentary and Health Service Ombudsman.

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How I considered this complaint

9. I have:
• considered the complaint and the documents provided by Mr X;
• discussed the complaint with Mr X;
• considered the documents the Council has provided;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Mr X and the Council, for me to consider before making my final decision.

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What I found

What happened

10. Mr X’s mother, Mrs Y, moved to a care home in August 2021. The Council arranged the placement on a respite basis. Before the move, Mr X signed a financial declaration on behalf of his mother on the basis he had power of attorney for her property and financial affairs. This said Mrs Y did not have savings over £23,250, she owned her own home and was willing to disclose information about her finances. Mr X also confirmed he understood: “social care is chargeable and that if I am assessed as having to pay some/all of the costs of me care and support, I will be invoiced retrospectively for the assessed amount from the date on which the service(s) began”.
11. The Council arranged to do a financial assessment over the telephone on 14 September 2021, but did not go ahead with it.
12. In October 2021 the Council told Mr X it had not yet visited his mother at the care home because of ongoing problems with COVID-19. It said it would extend her respite placement for two months. The Council noted Mrs Y owned her own home, which it would take into account in a financial assessment if her placement became permanent. It told Mr X about the possibility of a deferred payment agreement, which would have avoided any need to sell the property while Mrs Y remained alive.
13. On 26 May 2022 the Council gathered information from Mr X for a financial assessment. It asked him to provide evidence of Mrs Y’s finances, which he did on 29 May. The financial assessment said the Council would not disregarded the value of Mrs Y’s home.
14. The Council wrote to Mrs Y with the outcome of her financial assessment in June 2022 and sent her two letters to her home address. One letter said she had to pay £266.40 a week towards the cost of her care from 20 August 2021. This was based on Mrs Y having been in respite care. The second letter said Mrs Y had to pay £317.53 during “the first four weeks”. It suggested she may have to pay a lower amount after that, because her income would reduce, but did not identify a reduced amount. Nor did the letter say from when the charge would apply.
15. On 4 July the Council sent Mr X an invoice for his mother’s stay at the care home from August 2021 to 6 May 2022 (£9,894.86). It sent further invoices on:
• 1 August (£1065.60) for 7 May to 3 June 2022
• 29 August (£1065.60) for 4 June to 1 July 2022
• 26 September (£1065.60) for 2 July to 29 July 2022
• 24 October (£1065.60) for 30 July to 26 August 2022
• 21 November (£38.06) for 27 August 2022
16. All these invoices were based on the respite charge of £266.40 a week. Mr X has only paid the final invoice for £38.06.
17. The Council visited Mrs Y on 11 August to assess her long-term needs under the Care Act 2014. The next day it told Mr X it would complete the assessment. It noted it had previously spoken to him about a deferred payment agreement. He said they were renovating his mother’s home and had no plans to rent it out. The Council told him his mother would be a self-funder when her care home placement became permanent, as she owned a property. Mr X said he was unhappy about receiving a request for a large back payment, due to the delay in completing the financial assessment. The Council apologised for the delay and said it would let him know what would happen if he did not enter into a deferred payment agreement.
18. Later that day, the Council e-mailed Mr X confirming what they had discussed. It told him if he did not accept a deferred payment agreement, it would only fund his mother’s placement for the 12-week disregard period after it became permanent. It advised Mr X to take some legal advice. It also told him how to register his mother’s power of attorney with the Office of the Public Guardian, as he had not yet done this.
19. Mrs Y’s placement in the care home became permanent on 28 August. That meant the 12-week disregard of her property was due to end on 20 November.
20. The care provider invoiced Mr X directly for his mother’s care between 28 August and 24 December 2022. Its invoices were based on the Council’s weekly charge of £317.53 for a permanent placement. Mr X paid all the care provider’s invoices.
21. The Council started invoicing Mr X again in January 2023. It sent invoices on:
• 16 January (£952.59) for 24 December 2022 to 13 January 20223
• 13 February (£1,270.12) for 14 January to 10 February 2023
• 13 March (£1,270.12) for 11 February to 10 March 2023
• 10 April (£1,270.12) for 11 March to 7 April 2023
22. The charges were based on those for a permanent placement (£317.53 a week). Mr X paid three of the invoices, leaving one for £1,270.12 outstanding.
23. Mrs X died on 1 April.
24. The Council wrote to Mr X on 20 April saying his mother owed £15,427.38 in outstanding charges for the cost of her care.
25. When the Council replied to Mr X’s complaint in October, it said:
• While Mrs Y was in respite care her contribution towards the cost of her care had to be paid to the Council.
• When her placement became permanent her contribution had to be paid directly to the care provider.
• In August 2021 Mr X confirmed he held power of attorney for his mother. He agreed: to provide all the information the Council needed about her finances; to tell the financial assessment team of any changes which might affect the amount she had to pay; and to pay all invoices promptly.
• In October 2021 Mr X said a deferred payment agreement may help, while they carried out work to his mother’s home.
• In August 2022, when Mr X said he would not be selling his mother’s property and would not enter into a deferred payment agreement, it told him it would only support her placement during the 12-week property disregard, after which her care would need to be funded privately.
• On 2 August 2022 Mr X told the Council he would pay the backdated respite bill. There was no evidence of him disputing the charges.
• It had apologised for not going ahead with the financial assessment on 14 September 2021.
• It had to assign Mrs Y’s case to another officer in May 2022 because the original officer was unavailable.
26. The Council says the outstanding balance is £15,155.21. This is £272.17 less than the figure in paragraph 23 above, as the Council has removed the charges for the six days after Mrs Y died, which it had included in the invoice dated 10 April 2023 (see paragraph 20 above).

Is there evidence of fault by the Council which caused injustice?

27. There was a long delay by the Council in completing Mrs Y’s financial assessment. This resulted in Mr X being presented with a large bill for backdated payments. The Council apologised for not attending a meeting arranged in September 2021 but failed to apologise for the long delay in rearranging the meeting. Its letters about the charges were unclear and failed to explain the difference between charging for respite care and charging for permanent residential care. It didn’t tell Mr X the care provider would start invoicing in 2022, which caused further confusion. These faults require an apology.
28. There was also a long delay in assessing Mrs Y’s needs under the Care Act. It appears this was partly because of COVID-19 and partly because a member of staff was unavailable. However, there was a financial advantage to Mrs Y from the delay (£51 a week), as the Council continued to charge her for a respite placement, rather than a permanent placement.
29. Although the Council told Mr X it would take account of his mother’s property when her placement became permanent (after the 12-week property disregard), as it is entitled to do under Annex B of the Care and Support Statutory Guidance, it has not done so. This has been of significant financial advantage to Mrs Y and her estate (over £680 a week). After getting the care provider to invoice Mrs Y for 16 weeks, the Council inexplicably started invoicing her itself again. However, given the financial advantage to Mrs Y and her estate, this did not cause injustice which requires a remedy.
30. The outstanding balance the Council is asking Mr X to pay from Mrs Y’s estate reflects the fact she did not pay all her assessed charges. There are no grounds to ask the Council to waive any of these charges.

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Agreed action

31. I recommended the Council:
• Within four weeks writes to Mr X apologising for the long delay in completing his mother’s financial assessment and the confusion this and its communications about the charges caused; and
• Within eight weeks, identify the action it is going to take to ensure it does financial assessments promptly and it communicates more clearly with people about the charges for their care.
32. The Council has agreed to do this. It should provide us with evidence it has complied with the above actions.

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Final decision

33. I have completed my investigation on the basis there has been fault by the Council causing injustice which requires an apology.

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Investigator's decision on behalf of the Ombudsman