Summary: We have decided not to investigate Mr X’s complaint about the Council’s failure to provide appropriate information about the cost of his wife’s care. The Council has now upheld the complaint and agreed to remedy the avoidable stress and missed opportunity to make an informed decision about whether to make changes to the care package. It has also agreed to provide guidance to staff to improve its services in future.

The complaint

1. Mr X complained about the Council’s communication about the costs of his wife’s care, and when it would start charging for it. He said the Council:
• did not explain what Mrs X would need to pay, or how it was calculated;
• did not tell him when it would start charging for her care, which he only found out after the event when he telephoned the Council;
• did not respond to his letter asking for a breakdown but simply send invoices and letters demanding payment.
2. Mr X said the Council’s failings caused avoidable stress and worry. He was also denied the change to make changes to the care package and care provider.

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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 provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

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How I considered this complaint

4. I considered information provided by the Mr X and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Mrs X was discharged from hospital in early July 2023 with a Discharge to Assess care package, involving four care visits per day with two carers attending each time. Mr X said he was told the care package would be free for the first few weeks, following which he and his wife could decide how much care was needed, which they would then pay for. The Council’s complaint response confirmed the care was free for four weeks. It also said it sent Mr X its factsheet about the costs of care, which explained service users with more than £23,250 in savings would have to pay the full cost of their care and that the Council charged £14.17 per hour for care at home. Mr X said he did not receive the costs of care factsheet.
7. Mr X said he had some concerns about the level of care provided and he was meeting some of his wife’s care needs but he did not raise concerns with the Council at that point because he thought the level of care was low due to it being a free service.
8. In late July, a social worker visited. Mr X said they explained his wife would need to pay the full costs of her care because she had savings over £23,250. However, he said they did not explain how much the charges would be, and they did not know when the Council would start charging for Mrs X’s care. The record of the visit indicates the social worker reviewed the care Mrs X needed and advised it would be chargeable from that point. They also confirmed that Mrs X was entitled to free care for up to 28 days, not the six weeks Mr X stated. The record indicates Mr X raised concerns about the level of care because Mrs X remained in bed, and the social worker explained the Council could not control when therapy was provided by health professionals, which was the reason Mrs X remained bed bound, but that was expected to change following a health appointment the following week.
9. Mr X said he telephoned the Council in early September because he was worried as he had not heard anything more about the charges. He spoke to an officer who confirmed Mrs X would need to pay the full costs of her care, which were £980 per week, effective from 31 July 2023. The officer sent a letter to confirm this the same day. Mr X asked for a breakdown to show how the weekly charge was calculated and the Council sent him an invoice for six weeks at £980, which Mr X said “tells me nothing”.
10. On 11 September, Mr X cancelled the care with the care provider and the care ended the next day. On 18 September, a social worker visited to review the care package. Mr X said they told him the care provider should have been showering Mrs X, helping her to exercise and putting her in a chair regularly, but this had not happened. However, Mr X was not aware it should have been happening because he had not received a care plan for Mrs X. The Council records indicate it was concerned the care had been cancelled, but there is no mention of any concern with the level of care provided by the care provider.
11. In October, Mr X complained. He said he was left in ignorance about the care charges between 31 July and 12 September and did not have the opportunity to review the care package, He set out his concerns about the level of care provided and explained he had been meeting some of Mrs X’s needs himself. In view of this, he would potentially have reduced the care package and changed the care provider earlier but was not given the chance to do so.
12. The Council did not uphold the complaint. It said Mr X had been given information about charging for care, so Mrs X remained liable for the charges for the disputed period. It did not address his concerns about the level of care or about not having the chance to review the care package and/or care provider.
13. If we investigated this complaint, it is likely we would find fault because the Council did not provide sufficient information for Mr X to know how much Mrs X would need to pay for her care. It only told him this five weeks after it had started charging.
14. The records show Mrs X needed care in the disputed period and the care was delivered. The Council is entitled to charge for this. However, the failure to provide appropriate information about the cost of that care caused avoidable stress and worry for Mr X and Mrs X and denied them the chance to make an informed decision about the amount of care they wanted to pay for.
15. We therefore asked the Council to consider remedying the injustice caused. It has agreed to:
• apologise to Mr and Mrs X in line with our guidance on remedies which sets out our expectations for how organisations should apologise effectively;
• issuing a credit note equivalent to 30% of the care costs of the care costs for the period 31 July to 12 September; and write to Mr X, who manages their finances, to confirm the amount that remains outstanding;
• share a copy of this decision with relevant staff to ensure the Council learns from what went wrong in this case. This should include ensuring that a personal budget is agreed and set out in a care and support plan sent to the service user as soon as possible after the care is arranged, and that service users should be given full information about the likely cost of their care and the amount they are likely to pay towards this, so they can make an informed choice about what care they want to pay for.
16. For completeness, we will not investigate the complaint about the level of care further because there is insufficient evidence of fault causing injustice. The review in late July did not record any concerns with the level of care provided and Mrs X was recorded as being happy with the care. The only concerns at that stage related to a delay in the provision of therapy by health professionals, which was outside the Council’s control.
17. The Council has agreed to carry out these actions within one month of the date of this decision and will provide us with evidence it has done so.

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Final decision

18. We have upheld this complaint because the Council has agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused to Mr X and improving its service to others.

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Investigator's decision on behalf of the Ombudsman