Summary: Mr B complains the Care Provider, Rusthall Lodge Housing Association Limited, did not provide him with full information about the care fees and annual fee increase before his relative, Mrs C, moved into its care home. I have discontinued my investigation of the complaint. The Care Provider has already made a suitable offer to Mr B to remedy the complaint which he has accepted. We would not be able to achieve anything more for Mr B or Mrs C so it is not worthwhile to continue the investigation.

The complaint

1. Mr B complains the Care Provider did not provide him with full information about the care fees and annual fee increase before his relative, Mrs C, moved into its care home.
2. Mr B says he has lost trust in the Care Provider and Mrs C’s funds are depleting sooner than they would have.
3. Mr B says he would like the Care Provider to be honest and upfront, and a refund of the increase in care fees.

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The Ombudsman’s role and powers

4. 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)
5. Part 3 and Part 3A of the Local Government Act 1974 give us our powers to investigate adult social care complaints. Part 3 is for complaints where local councils provide services themselves. It also applies where a council arranges or commissions care services from a provider, even if the council charges the person receiving the care. In these cases, we treat the provider’s actions as if they were council actions. Part 3A is for complaints about care bought directly from a care provider by the person who needs it or their representative, and includes care funded privately or with direct payments using a personal budget. (Part 3 and Part 3A Local Government Act 1974; section 25(6) & (7) of the Act)
6. 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 there is no worthwhile outcome achievable by our investigation. (Local Government Act 1974, section 24A(6), as amended, section 34(B))
7. We normally name care homes and other care providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), as amended)

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How I considered this complaint

8. I read Mr B’s complaint and spoke to him about it on the phone.
9. I considered information provided by Mr B and the Care Provider.
10. Mr B and the Care Provider have had an opportunity to comment on my draft decision.

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What I found

11. The Care Quality Commission (CQC) is the independent regulator of health and social care services in England. The CQC’s Fundamental Standards are the standards below which care should never fall.
12. Regulation 19 of the Care Quality Commission (Registration) Regulations 2009 sets out the obligations to ensure that care providers give timely and accurate information about the cost of their care and treatment to people who use services.
13. To meet this regulation, providers must make written information available about any fees, contracts and terms and conditions, where people are paying either in full or in part for the cost of their care, treatment and support.
14. Providers must notify people of any changes to their terms and conditions, including increases in fees and give them sufficient time to consider whether they wish to continue with the service.

What happened

15. This is a summary of events, outlining key facts and it does not cover everything that has occurred in this case.
16. In late November 2023, Mrs C moved into the care home, Rusthall Lodge.
17. A few days later, the care home sent a contract to Mr B for him to sign and return to it.
18. On 1 December 2023, Rusthall Lodge sent a letter to Mr B informing him of the annual fee increase which would take effect on 1 January 2024. Mr B queried this with Rusthall Lodge. On 29 February 2024, it told Mr B it is obliged to give reasonable notice about fee increases, in line with CQC regulation 19, and its policy is to provide one months’ notice. It said notice was given to Mr B on 1 December 2023.
19. On 7 March 2024, Mr B raised a formal complaint with Rusthall Lodge. He believed it should have informed him of the annual fee increase before Mrs C began her stay at Rusthall Lodge, and he was not happy with how Rusthall Lodge had responded to his query.
20. On 14 March 2024, Rusthall Lodge sent its complaint response to Mr B. It apologised that Mr B was not happy with its response about the increase in fees, but said its website and contract explains it reviews fees on an annual basis and increases take place in January, of which it gives notice of at the start of the previous December.

Analysis

21. Sometimes we will recommend a financial payment to the person who brought their complaint to us. This might be to reimburse a person who has suffered quantifiable financial loss, or it might be more of a symbolic payment which serves as an acknowledgement of the distress or difficulties they have been put through. But our remedies are not intended to be punitive and we do not award compensation in the way a court might. Nor do we calculate a financial remedy based on what the cost of the service would have been to the provider.
22. The Ombudsman has published guidance to explain how we calculate remedies for people who have suffered injustice because of fault by a council or care provider. Our primary aim is to put people back in the position they would have been in if the fault by the council or care provider had not occurred.
23. During the enquiry stage of my investigation, Rusthall Lodge made an offer to Mr B to remedy the complaint, which he accepted. It offered him:
• an apology;
• a payment of £2,000 which is made up of a refund of the increase in care fees for three months, and a £500 payment to acknowledge the distress caused to Mr B and Mrs C; and
• assurances it has revised its current processes to ensure openness and transparency in relation to care fees.
24. I have not investigated Mr B’s complaint further. This is because Mr B indicated he would like a refund of the increase in care fees for three months, which Rusthall Lodge has provided. He also wanted Rusthall Lodge to be honest and upfront, and it has assured him it has revised its current processes to ensure openness and transparency with care fee related matters.
25. I am also satisfied, that in the circumstances of this complaint, £2,000 is a suitable amount to remedy Mr B’s complaint, and the Ombudsman would not recommend more. The payment also includes a £500 payment to acknowledge the distress caused to Mr B and Mrs C which is a suitable amount to acknowledge the impact of the distress caused and is in line with our guidance on remedies.
26. So, the Ombudsman would not recommend anything more for Mr B or Mrs C, and a further investigation would not achieve a different or worthwhile outcome.

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Final decision

27. I have ended my investigation and uphold Mr B’s complaint. The Care Provider has taken action which has resolved the outstanding issue and no further action by the Ombudsman is needed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman