Summary: We will not investigate this complaint about charges for an adult social care package. This is a late complaint. Even if it were not late, we would not investigate. The complainant accepted the care knowing they might have to pay for it. The Council apologised for its delay and offered a repayment plan for the debt. There is no significant injustice to justify an investigation. It is unlikely the Ombudsman would add to the Council’s investigation or reach a different outcome.

The complaint

1. Mr B says he did not know he would be charged for his adult social care, so could not make an informed choice. Mr B was surprised to receive a large bill, he says he cannot afford to pay it and it causes him distress.

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The Ombudsman’s role and powers

2. 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)
3. 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 not enough evidence of fault to justify investigating, or
• any fault has not caused significant enough injustice to the person who complained to justify our involvement, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

4. I considered information provided by the complainant.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Mr B knew about the issues he complains about by March 2023 and had completed the Council’s complaints procedure by September 2023. Mr B has given no good reason why he did not then promptly complain to the Ombudsman. So, this is a late complaint because Mr B knew of the issues over 12 months before he complained to the Ombudsman.
7. Even if the Ombudsman decided to exercise discretion to consider this late complaint we would not investigate.
8. The Council’s duty under the Care Act 2014 is to assess the care and support needs of adults in its area who it knows may need support. If the Council assesses the person has eligible needs, then it must meet those needs. The Council must complete a financial assessment to decide if the person must pay any or all the care costs. There are no timescales set out for the completion of the care and support assessment or the financial assessment.
9. The Ombudsman expects, based on the wording of the statutory guidance supporting the Care Act, that councils complete financial assessments before care services start. This would enable people to know how much they must pay, if anything, before the care starts. However, in practice this rarely happens.
10. Councils have a duty to provide information about the charging arrangements for care and support. The Council told Mr B before the care package started that care and support was chargeable and a financial assessment would decide how much Mr B would pay. Mr B signed a document to confirm he knew care was chargeable. So, although Mr B did not know the costs when the care package started, Mr B accepted the care package on that basis knowing he may need to pay some or all the costs.
11. The Council caused a one-month delay to complete the financial assessment; it has apologised to Mr B for this.
12. Mr B needed care and the Council followed the correct financial assessment process to decide how much he could pay. While waiting for the outcome of the financial assessment care costs were accruing, and Mr B received a bill for over £1000 which came as a surprise. The Council has offered a repayment plan for the debt. So, there is not a significant enough injustice to justify an investigation. It is unlikely an Ombudsman investigation would add to the Council’s investigation, which gives a thorough explanation of what happened, or reach a different outcome.

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Final decision

13. We will not investigate Mr B’s complaint because it is a late complaint. But even if it were not, we would not investigate because it is unlikely we would achieve a different outcome. Mr B accepted care knowing he might have to pay for it. The Council has correctly assessed what Mr B can pay and has offered a repayment plan for the debt. The Council has apologised for its delay. These are the actions we would expect to recognise the impact on Mr B.

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Investigator's decision on behalf of the Ombudsman