Summary: Miss Y complained the Council wrongly assessed Mr X’s care contributions and sent a backdated invoice for day centre fees. Miss X says if the Council had completed its assessment correctly, Mr X would not have used the service. The Ombudsman finds the Council at fault, which caused Mr X and Miss Y avoidable and unnecessary distress and financial strain. The Council has agreed to waive the outstanding invoice.

The complaint

1. Miss Y complains the Council wrongly calculated Mr X’s care contributions and sent him a backdated invoice for owed contributions towards his weekly day centre visit.
2. Miss Y says this has caused Mr X avoidable and unnecessary distress and financial strain.

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The Ombudsman’s role and powers

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)
4. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
5. 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)

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What I have and have not investigated

6. Miss Y complains about matters which started in December 2022. She complained to us in December 2024. Miss Y only became aware of the issue in August 2024. I have decided there is good reason to exercise discretion and investigate from December 2022.

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How I considered this complaint

7. I considered the information and documents provided by Ms X and the Council. Ms X and the Council had an opportunity to comment on a draft of this decision. I considered all comments received before making this final decision.
8. I also considered the relevant statutory guidance, as set out below.

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What I found

What should have happened

9. 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)
10. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. Councils have no power to assess couples according to their joint financial resources. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.

What happened

11. In December 2022, Mr X signed a document stating he understood he may have to contribute to his adult social care costs, pending a financial assessment.
12. In March 2023, Mr X began attending the day centre on a weekly basis. He started whilst waiting for the Council to complete his financial assessment.
13. The Council completed Mr X’s financial assessment. The Council told him that he had to contribute £3.10 per week to access the day centre. Mr X decided to continue.
14. In May, the Council completed a needs assessment with Mr X. He told the Council he thought the day centre was not particularly beneficial for him.
15. In February 2024, the Council reviewed Mr X’s needs assessment. Mr X told the council again he thought the day centre was not particularly beneficial for him.
16. In May, the Council told Miss Y it had reassessed Mr X’s contribution. It told her Mr X had to contribute £6.39 per week to access the day centre. Mr X decided to continue to attend the day centre.
17. In August, the Council sent Mr X an invoice for £4413.94. Miss Y contacted the Council. The Council told Miss Y it had made errors in its financial assessments for Mr X, and he was liable to pay backdated contributions. Mr X stopped going to the day centre. Miss Y made a formal complaint.
18. In its stage one complaint response, the Council told Miss X the mistakes it made in the two financial assessments meant it had undercharged Mr X by £63.46 per week in 2023 and £64.57 per week in 2024. The Council apologised for its mistakes. It told her once it realised its error in May 2024 it reassessed Mr X’s contribution and sent him a letter in June. Miss X says they did not receive the letter. Miss X escalated her complaint to stage two.
19. In its final complaint response, the Council told Miss X it decided Mr X is liable to pay the backdated contributions because he signed the document in December 2022 which said he understood he would have to contribute to his adult social care costs.

Analysis

20. The Council accepts it made errors on Mr X’s two financial assessments which caused him to be significantly undercharged for his contributions. There is no evidence Miss Y and Mr X could have known the Council’s calculations were incorrect. There is no dispute Mr X agreed he would have to contribute towards his care, and he did pay the contributions which were calculated by the Council at the time. However, due to the errors made by the Council he did not make an informed choice to attend the day centre. This is fault.
21. Mr X was clear with the Council that he did not feel the day centre was essential for his care and immediately stopped attending once the Council told him about his full contribution. Therefore, on balance, if the Council had not made the error with its calculations, and Mr X knew the correct contributions at the time, it is likely he would not have attended the day centre and incurred the additional costs. For this reason, I consider Mr X should not be liable for the outstanding contributions.
22. The Council apologised for the faults it made in two financial assessments. I am satisfied this apology and waiving the outstanding contributions would remedy the unnecessary and avoidable distress caused to Mr X and Miss Y.

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Action

23. Within four weeks of my final decision, the Council has agreed to:
1. waive the £4413.94 additional costs it is seeking from Mr X.
2. write to Mr X and Miss Y and confirms to confirm it has waived the £4413.94 additional costs.
24. The Council should provide us with evidence it has complied with the above actions.

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Decision

25. I find fault causing injustice. The Council has agreed to waive the additional costs it has charged.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman