Summary: Ms X complained the Council was at fault when it wrongly charged for social care provision for her adult son, Mr Y and did not help her with the associated disability-related expenditure (DRE) payments. Ms X also complained the Council sent her invoices when she was not Mr Y’s appointee. The Council was not at fault when it charged Mr Y for his social care provision and was not at fault for the help provided with Mr Y’s DRE payments. The Council was at fault for sending Ms X, Mr Y’s invoices when she was not Mr Y’s appointee. This caused Ms X frustration and the Council will apologise.

The complaint

1. Ms X complained the Council was at fault when it wrongly charged for social care provision for her adult son, Mr Y, and did not help her with the associated disability-related expenditure payments. She also complained the Council sent her Mr Y’s invoices when she was not Mr Y’s appointee, she said the Council communicated poorly and had poor complaints handling. Ms X said this has caused her considerable distress, avoidable time and trouble and a financial burden.

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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 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)

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How I considered this complaint

4. I considered:
• the information Ms X provided and spoke to her about the complaint;
• the information the Council provided and its response to my enquiries;
• relevant law and guidance, as set out below; and
• our guidance on remedies, published on our website.
5. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

The Care Act 2014 and charging

6. In 2014, the Government introduced the Care Act. This legislation replaced all previous guidance about how councils assess and provide care for adults in need. It includes guidance on charging for care.
7. 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).
8. If a council decides to charge for care, it must complete a financial assessment. People who have over £23,250 of eligible capital have to pay for the full cost of their care fees.
9. Councils should clearly discuss with the person or their representative at the outset that care and support is a chargeable service and that where the person has been assessed as being able to afford to do so, they will be required to contribute to the cost of that care. They should ensure any subsequent fee changes are clearly communicated to the person or their representative.

Direct payments

10. Direct payments are a funding choice in personal budgets. They allow a person to purchase their own care and support services, with the aim of maximising the person’s involvement and control over how their needs are met.

Disability-related expenditure

11. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care. When doing so, a council should make an assessment to allow the person to keep enough benefit to pay for necessary disability-related expenditure (DRE) to meet any needs it is not meeting. The Care and Support Statutory Guidance sets out a list of examples of such expenditure. It says any reasonable additional costs directly related to a person's disability should be included. What counts as DRE should not be limited to what is necessary for care and support.

What happened

12. Mr Y is an adult with educational needs and adult social care needs. When Mr Y turned 18 years old he received universal credit payments. In 2023 Mr Y lived in supported living accommodation. Council records noted Mr Y’s contributions were nil towards his residential and non-residential direct payments. The Council assessed Mr Y as not having mental capacity in relation to his property and finances. Ms X was Mr Y’s appointee for finances.
13. In summer 2023 Ms X told the Council she wanted to stop her appointee role and the management of Mr Y’s direct payments.
14. In January 2024 Mr Y moved from direct payments to Council commissioned care.
15. Council records show it started to charge Mr Y for contributions toward his adult social care needs in mid-February 2024.
16. In late March 2024 a professional appointee service, Service 1, started to act as Mr Y’s financial appointee.
17. In early April 2024 the Council sent a letter to Ms X. It said a financial assessment showed Mr Y would have to pay towards the cost of the services he received. The letter included a copy of the financial assessment which set out the amount Mr Y needed to contribute to his care costs and how this was calculated.
18. The same day Ms X emailed the Council about Mr Y’s financial contribution and asked the Council to ring her. Ms X told the Council she was no longer Mr Y’s appointee and should not have been sent the financial assessment. She told the Council she was not warned about the fee contributions, she said there had not been a change in Mr Y’s care and queried the contribution fee. Ms X said Mr Y had not previously paid a contribution towards his care. There was initially confusion which Council team should help Ms X with her concerns. The Council agreed to review Mr Y’s financial contribution to the cost of his care and support.
19. As part of the Councils financial review it agreed to look at Mr Y’s disability-related expenditure (DRE). In mid-April 2024 Ms X confirmed she would provide evidence of Mr Y’s DRE.
20. Ms X’s legal representative wrote to the Council in April 2024 regarding the charges. The Council responded later that month and asked for Mr Y’s DRE information by mid-May 2024, after which the Council said it would finalise Mr Y’s financial assessment and confirm his contributions.
21. In mid-June 2024 the Council sent Mr Y, via Service 1, an invoice for his care contributions, from mid-February 2024 to early June 2024. In mid-June 2024 Ms X informed the Council her legal representative was no longer acting for her.
22. In late June 2024 Ms X sent the Council Mr Y’s DRE information. She said there was illness in the family which was why the DRE information was not sent in by the Council’s May 2024 deadline. Ms X also told the Council she was unhappy it did not help or explain how to fill in the DRE forms for Mr Y and said this was contrary to government guidance which explained the Council should make the assessment for DRE. The Council responded to Ms X three days later. It thanked her for Mr Y’s DRE information and asked her for receipts. It said the Council’s DRE agreement had been fulfilled because it sent all the DRE information to Ms X’s legal representative, who was acting on her behalf at that time. Ms X responded and said it would take her time to gather DRE expense receipts and she would consider her next steps.
23. Ms X raised her concerns again about Mr Y’s financial contributions at a multi-disciplinary meeting attended by Ms X, the Council, health professionals and staff supporting Mr Y. Ms X said she was told Mr Y’s weekly fee contributions had been reduced because of the DRE information she provided the Council.
24. In early July 2024 the Council emailed Ms X twice and said the Council’s finance team was considering the DRE information. It explained the Council was able to charge for provision of services to meet Mr Y’s needs under the Care Act 2014. It provided her with details of the Adult Social Care Mr Y received for which Mr Y could be charged a contribution, as opposed to support for his education which he was not charged for.
25. Ms X responded and said she would pass the information to Service 1. She told the Council the invoice should not have been sent to her. She said once she had submitted the DRE receipts she should no longer be sent Mr Y’s invoices.
26. Ms X said she was not provided with the breakdown of the charges, and the Council did not send any further responses. Ms X remained unhappy and complained to us.
27. In late August 2024 the Council wrote to Service 1. It had recalculated Mr Y’s contribution to his care charges to include his DRE information. This reduced his contribution.
28. In early September 2024 the Council sent a credit note to Service 1. It explained Mr Y had been overcharged for his care between mid-February 2024 and early June 2024. The changes took account of the DRE reductions. This reduced the amount Mr Y owed and the Council paid the overcharged amount to Mr Y.

Enquiries

29. In response to my enquiries Ms X said Mr Y paid the weekly contributions including the built-up arrears. The Council said Mr Y did not owe any outstanding fees.
30. The Council said it did send Ms X, Mr Y’s invoices when she was no longer Mr Y’s appointee because the service was going through a major IT system change and the appointee’s name and address details were not changed on its IT system in a timely manner.

My findings

Financial contributions

31. The Council was entitled to charge for provision of services to meet Mr Y’s needs under the Care Act 2014. The Council sent a letter to Ms X about Mr Y’s weekly fees in early April 2024 which it said included financial information she had provided. The letter included a breakdown of the weekly charges Mr Y needed to pay. Once Ms X provided the Council with the DRE information the Council amended Mr Y’s weekly contributions and the amount the Council overcharged Mr Y was backdated and paid to Mr Y in early September 2024. This was appropriate and in line with the regulations. The Council was not at fault for the way it charged Mr Y a contribution towards his care costs. Ms X was unhappy the Council did not help her with the DRE information. The Council explained it contacted Ms X’s legal representative about this and it was not at fault.

Appointee

32. The Council was at fault when it sent Mr Y’s financial assessment to Ms X in early April 2024. The Council was aware in late June 2023 Ms X no longer wanted to be Mr Y’s appointee and a new appointee, Service 1, was in place for Mr Y from late March 2024. The Council explained it was updating its IT system at the time and incorrectly wrote to Ms X, this caused Ms X frustration. The Council continued to send Ms X, Mr Y’s invoices until Summer 2024 which caused further frustration.

Complaints handling and communication

33. Ms X raised concerns about Mr Y’s fee contributions in an email in April 2024 and in a multidisciplinary meeting in July 2024. The Council responded to Ms X’s concerns and explained the breakdown of weekly charges in a letter dated early April 2024, sent an invoice in mid-June 2024 and emailed Ms X in July 2024 explaining the weekly contributions. This was appropriate and the Council was not at fault.

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Action

34. Within one month of the final decision the Council will apologise to Ms X to acknowledge the frustration caused when it sent her Mr Y’s adult social care invoices and financial assessment when she was not his appointee.

We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology.

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Final decision

35. I have completed my investigation finding fault causing personal injustice. The Council has agreed to take action to remedy the injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman