Summary: The Council was at fault for how it charged Mr X for his care. The Council took appropriate action when it recognised errors in its invoicing, however, was at fault for raising Mr X’s expectations around a review of his financial assessment. The Council has agreed to apologise for the injustice caused. There is no evidence of fault in how it made reasonable adjustments to meet Mr X’s needs for using its service.

The complaint

1. Mr X complained about the Council’s actions around his care charges, he said it:
• increased his care costs without informing him;
• failed to carry out a requested financial assessment;
• failed to consider his needs and make reasonable adjustments when communicating and billing him for his care; and
• continues to send bills for care he did not receive.
2. He said the matter has caused him distress and uncertainty. He wants the Council to tell him about future increase in care costs, provide financial compensation and for all past bills to be sorted.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. 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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What I have and have not investigated

5. Mr X knew about the matter complained of in November 2024, I have therefore considered his complaint from November 2024 to August 2025 when he received his stage two response from the Council. I have not investigated after August 2025. Any matters after this date would be subject to a new complaint, to the Council in the first instance.

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How I considered this complaint

6. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
7. 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 guidance

Adult Social Care: Charging

8. 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)
9. 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. 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.
10. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home. After charging, a person’s income must not reduce below a weekly amount known as the minimum income guarantee (MIG). This is set by national government and reviewed each year. A council can allow people to keep more than the MIG. (Care Act 2014)

The Council’s charging policy and debt recovery

11. The Council’s policy states a person’s ability to contribute towards the cost of their social care will be reviewed at least annually and earlier if there are significant changes in either the financial circumstances of the person, or at the request of the individual or their representative.
12. The overall approach will be to obtain payment while at the same time working with any individuals to making payments. The policy says the Council are not able to offer a face to face visit in the service user’s home unless it is deemed necessary by a finance officer.
13. The Council policy recognises a person may require additional support, it says it will try and support a person or their representative by:
• Good communication around chargeable services;
• Effective and efficient collection of all money due, ensuring financial circumstances and mental capacity are considered;
• Prevention of arrears by prompt billing and collection of money due;
• By considering how different approaches impact on a person or their representative’s wellbeing; and
• Discussing debts with a person or their representative and acting reasonably.

What happened

14. In early November 2024 the Council sent Mr X an invoice for outstanding care and support contributions between June 2024 and August 2024.
15. In early December 2024 Mr X and his father complained to the Council and asked why there had been an increase in the amount Mr X paid towards his care. They said the increase had been made without notifying Mr X and the irregularity of the invoices was causing Mr X difficulties and distress.
16. In its response the Council said:
• there had been an increase in the cost from April 2024. The amount on its system used to calculate Mr X’s contribution at his review in June 2024 had not been updated to reflect this increase and was therefore incorrect;
• it would remove the increased charges from June 2024 until December 2024, when Mr X became aware of the new amount. The increased amount would be charged from December 2024;
• if requested, its finance team could carry out a review of Mr X’s financial assessment;
• if Mr X felt the increase meant he could no longer reasonably afford the care, he may want to consider reducing his hours of support;
• its finance team produced invoices based on information provided by Mr X’s care provider each week. As the amount of care he received changed each week, it sent out invoices when it had received the correct number of hours from the carers so not to cause Mr X any confusion or worry; and
• it was sorry for the delay in the increased amount being entered onto the system and the difficulties this had caused. It would carry out a review Mr X’s financial assessment as soon as possible.
17. In June 2025 Mr X complained again to the Council about the same matter. He added that an officer had told him there was no requirement to inform him of charge increases and a review of his financial assessment had not been carried out as advised.
18. The Council upheld Mr X’s complaint. It said the increase had been removed as previously advised and apologised for the incorrect advice given about notifications of charge increases. It said it had no record of a request for a reassessment of Mr X’s financial assessment.
19. Mr X escalated his complaint and added there had been no affordability check completed, he wanted an easier billing process and for past bills to be sorted.
20. The Council’s response said it carried out a yearly review of Mr X’s financial assessment and explained if this reaches the maximum level for affordability, the Council would be responsible for paying for his care. It said it was in the process of setting up an online billing system so Mr X would be able to see all correspondence and the maximum he would be charged each year. Further, officers would be happy to meet with Mr X again to ensure he understood the billing process.
21. Mr X remained unhappy with the Council’s actions and responses and asked us to investigate.

The Council’s response to us

22. The Council said it recognised Mr X found understanding his billing challenging. It had provided support by communicating through a family member, provided explanations where required, offered face to face support and issued revised invoices where confusion had arisen. It had no record showing care not being delivered to Mr X.
23. It said Mr X had capacity to make decisions, but it remained open to making further adjustments if required.

Analysis

24. The Council recognised Mr X had been charged incorrectly due to an error on its system, and he had been not informed of the increase at his financial assessment review. This was fault. However, the Council removed the charge for the period Mr X was unaware of the increase and apologised. These are actions we would expect the Council to take.
25. In its response to Mr X and his father in December 2024, the Council advised a financial assessment review would be organised as soon as possible, this would have raised Mr X’s expectation that it would have been completed sooner than the annual review in mid-2025. This would have caused Mr X distress, frustration and uncertainty, particularly given his difficulties in understanding the billing process. I find fault with the Council’s actions.
26. The evidence shows the Council has acted in line with its policy and considered Mr X’s needs when invoicing him for his care. It has explained the charges, offered face to face meetings and communicated through an advocate. There is no fault with the Council’s actions.

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Action

27. To remedy the injustice caused, within one month of the final decision the Council agreed to take the following action:
1. apologise to Mr X for raising his expectations around his financial assessment review. We publish guidance on remedies which sets out our expectations for how councils should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended.
28. The Council will provide us with evidence it has complied with the above actions.

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Decision

29. I find fault causing injustice.

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Investigator's decision on behalf of the Ombudsman