Summary: Mr X complained about Mr Y’s care charges. Mr X said Mr Y was caused distress by a large, unexpected bill. We find the Council at fault for not recording its decision making or acting on Mr X’s request for the care hours to be reduced. The Council has agreed to apologise and waive the charges.

The complaint

1. Mr X complains about charges Mr Y incurred for care following a discharge from hospital. Mr X says he was assured Mr Y would receive reablement care which would incur no costs for the first six weeks. Mr X says he made attempts to cancel this after less than four weeks, but Mr Y has been invoiced for care hours for over two months. Mr X also disputes the level of hours being charged for and says he has been invoiced for hours that were not received. As a result, Mr X says Mr Y has been caused distress and frustration and has been left with a large, unexpected bill for his care.

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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(1), as amended)

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How I considered this complaint

4. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and policy

6. 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)
7. Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently.
8. Regulations require intermediate care and reablement to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support. Councils may charge where services are provided beyond the first six weeks but should consider continuing providing them without charge because of the preventive benefits. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)

What happened

9. I have summarised below some key events leading to Mr X’s complaint. While I have considered everything submitted, this is not intended to be a detailed account of what took place.
10. Mr Y was admitted to hospital following a fall. Prior to his discharge from hospital, the Council’s adult social care department assessed Mr Y’s eligible needs and decided he would benefit from a package of support for daily living tasks.
11. Mr X has said he was told the package of care would be classed as reablement care and would not be chargeable for the first six weeks.
12. Mr Y was discharged from hospital and his package of care started.
13. Around four weeks after the care began, Mr X asked for the care hours to be reduced. Mr X repeated this request two weeks later and then asked for the care package to be cancelled entirely as it was no longer needed. Mr Y was billed for the care he received up to that point.
14. In response to our enquiries, the Council said it had clearly informed Mr Y that his care package would be chargeable. However, it also said this could have been commissioned as reablement service which would have been non-chargeable for up to six weeks. The Council said this may not have been provided due to availability at the time but said this is unclear from its files. The Council also said it did not act properly on Mr X’s request to reduce the care hours. To recognise the ambiguity and potential miscommunication, the Council has agreed to waive the charges Mr Y incurred for his care and write to Mr X with an apology.

Analysis

15. The Council has agreed Mr Y’s care could have been commissioned as reablement care, dependent on availability at the time, but its files are not clear on this. It has also agreed it did not properly act on Mr X’s request to reduce the care hours Mr Y was receiving. This amounts to fault and creates uncertainty around whether Mr Y incurred avoidable charges for the care he received, which is injustice. However, the Council has agreed to waive the charges Mr Y incurred and apologise for this and I find that to be a suitable remedy to the injustice.

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Action

16. To remedy the injustice identified above, the Council should complete the following actions within one month of the date of this decision:
• Write to Mr X to apologise for the uncertainty caused by its failure to properly act on his request for Mr Y’s care hours to be reduced and for not clearly recording its decision around the availability of reablement care. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
• Write to Mr Y to confirm it has waived the charges he incurred for his care.
17. The Council should provide us with evidence it has complied with the above actions.

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Decision

18. I find fault causing injustice. The Council has agreed actions to remedy injustice.

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Investigator's decision on behalf of the Ombudsman