Summary: The Council delayed too long in assessing Mrs X’s finances properly. As a result, she was faced with a large and unexpected invoice. Mr A also complains the Council tried to contact him on an incorrect address. The Council agrees to apologise for the delays, offer a sum in recognition of the distress caused and agree a payment plan.

The complaint

1. Mr A (the complainant) complains the Council delayed so long in carrying out a financial assessment of his mother’s assets that she owed a significant and unexpected amount in charges. He also says the Council tried to contact him with the wrong details.

Back to top

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)

Back to top

How I considered this complaint

4. I considered the information provided by Mr A and by the Council. Both Mr A and the Council had the opportunity to comment on an earlier draft of this statement and I considered their comments before I reached a final decision.

Back to top

What I found

Relevant law and guidance

5. 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)
6. 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.
7. The Care and Support Statutory Guidance (‘the guidance’) says “The principles are that the approach to charging for care and support needs should ….be clear and transparent, so people know what they will be charged.”

The Care Act section 19 (3) says “A local authority may meet an adult's needs for care and support which appear to it to be urgent (regardless of whether the adult is ordinarily resident in its area) without having yet—

(a)carried out a needs assessment or a financial assessment”.

In most circumstances, councils should complete financial assessments before they create care and support plans and before any care services begin. This means people can make informed decisions about the care and support they want, taking into account the financial impact.

What happened

8. Mrs X’s care needs were assessed on 4 May 2022. The social worker noted that she had given Mrs X a copy of the Council’s charging leaflet. Mrs X signed an agreement to pay a contribution to the cost of her care. It said, “I confirm I have been told I might have to pay a charge and that if I do this will be backdated to the start of any services I have received”. It also confirmed she had received the charging leaflets.
9. Mr A says after this assessment the Council began to make a payment to Mrs X of £260 a week which she used to pay for her care.
10. The Council’s records show an unsuccessful attempt to telephone Mr A, who was acting for his mother, on 12 May followed by an email the same day saying,” We need to make an appointment for a Welfare Benefits Adviser to contact you so the financial assessment can be completed” and providing contact details. Mr A responded the following day. Another officer emailed him on 19 May confirming their telephone call that it hadn’t been possible to arrange a telephone assessment on the available dates, so Mr A would contact the Council to book in an assessment call for the week beginning 13 June.
11. The next record of contact on the Council’s files is in September. An officer rang Mr A and apologised for the delay which she said was “due to the backlog”. Her file note says she acknowledged Mr A was at the point of organising a telephone assessment which did not happen (the Council’s note on its record confirms it should have contacted Mr A again when he did not respond in June), and she offered him a postal or email assessment which he accepted. She wrote to him the same day.
12. On 20 September Mrs X telephoned the officer and said Mr A was away but would complete the assessment documents on his return. The officer noted “I stressed the importance to establish if there is a contribution to be paid for her care: so we wait to receive the documents as soon as possible”. Mr A sent all the required documents to the Council on 3 October.
13. On 15 December the Council wrote to Mr A indicating that Mrs X’s contribution to the cost of her care would be £182 a week. It said “The contribution will apply from 4th May 2022 so you may owe us some money. We will contact you separately to let you know how to pay this.”

The complaint

14. Mr A wrote to the Council on 3 January. He said “By making payments to her of £259.39 without giving us any indication of how and when her contributions might be calculated, you have encouraged mum to employ carers and pay them. When we made our initial appeal for help, we were told that mum might have to contribute something: the inference was something small…a minor contribution, as she had no savings of any substance. We did not realise you were intending to re-claim two thirds of the money you have been sending her. We did not know that instead of offering her £259.39 per week, you are actually offering £77.01”. He said he was not complaining about the assessment as they always knew there was a contribution: he was complaining about the delay and the consequent stress to Mrs X. He confirmed that Mrs X did not have the resources to pay back any debts the Council said she owed.
15. An officer responded in February. She upheld the complaint about the delay. She said, “We will however expect your mother to repay the outstanding contributions which have accumulated since her service started but we will of course be prepared to only ask her to repay an amount that is affordable for her for the backdated payments.” She did not uphold the complaint that they had been told any contribution would be a small amount: she said the social worker did not recall indicating that and would not be able to comment on the amount of contribution in any event.
16. Mr A did not receive the complaint response. He wrote to the Council again at the end of August to say his mother had just received a final demand for nearly £3000. The Council sent a copy of the complaint response letter to him. In September Mr A replied that the letter had gone into a junk email folder. He added that Mrs X had now received an invoice from the Council for £9260 which she could not pay.
17. A service manager wrote to Mr A upholding the response which had been sent in February. He said there had been “reasonable attempts” by the Council to undertake the assessment. He apologised for the delay between the information being received and the assessment being concluded but said the debt remained outstanding.
18. Again, Mr A did not receive the letter. He contacted the Council at the beginning of 2024. An officer wrote to him in February and said it was due to an error by the Customer Relations Team: he said an email address had been recorded on the file when Mr A first complained but the preferred response method was noted as ‘post’. He said, “The result of this was that the two response letters were issued as if by email but no email was actually sent by the council's complaints system.” He apologised for the mistake and the delay in rectifying it.
19. Mr A complained to the Ombudsman. He said by its delay the Council had forced an unwanted debt on his mother which she had no means of paying. He said the payments made to his mother by the Council had been used in good faith to pay for the care she needed. He refuted the Council’s suggestion that the delay was his fault for not communicating with it and pointed out that the Council had been at fault in its communication with him.
20. The Council says it has apologised for the two months’ delay in finalising the assessment after it had received the necessary documents but does not intend to waive the contributions as Mr A and Mrs X had ample information that contributions would be backdated.

Analysis

21. There was a delay in following up contact with Mr A to undertake the assessment. After initial attempts to make an appointment for the assessment failed, the Council should have contacted him again when it did not hear from him in June as planned. That is recognised in the Council’s contact call in September.
22. There was a further delay of two months once the requested documents were received. In all it seems there was a delay of about 5 months (June to September, and October to December) which is attributable to the Council.
23. As a result, Mrs X received a bill much larger than was anticipated. Had the assessment been undertaken in a timely manner, the accrued debt (and the consequent anxiety and stress) would have been considerably less.
24. In addition, there were errors by the Council in the way it communicated with Mr A about his complaint. It has acknowledged the failure to send emails which were logged on the Council’s records as having been sent. That only added to the anxiety suffered over the escalating debt.
25. It is clear the money was paid to Mrs X and used for her care and the Council cannot waive the charges as if that did not happen. The Council provided Mrs X with sufficient information about its charging processes. However, the difference between the indicative charge and the actual charge was significant.

Back to top

Agreed action

26. Within one month of my final decision the Council will apologise comprehensively to Mrs X for its errors both in the delay and in the failure of communication around the complaint response.
27. Within one month of my final decision the Council will offer a payment of £500 to Mr A in recognition of the anxiety caused to him by the delays in communication and correspondence; it should offer £1000 to Mrs X in recognition that the delay in making the assessment has caused a larger than expected debt.
28. Within one month of my final decision the Council will also agree a sensible payment plan for the repayment.
29. The Council should provide us with evidence it has complied with the above actions.

Back to top

Final decision

30. I find there was fault on the part of the Council which caused injustice; that will be remedied by completion of the recommendations at paragraphs 26 to 28 above.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman