Summary: Mrs S complained that her sister received an invoice for care charges which were sometimes above the weekly amount they were told would be owed. There was no fault by the Council. Miss X self funded her care and the Council told her that if the carers billed for increased charges, these would be passed on. The charges were also reduced when the weekly care was reduced.

The complaint

1. The complainant, Mrs S, complains for her sister Miss X. Mrs S complains the Council made weekly charges for care above the agreed amount from May 2022 onwards. Mrs X also complains the Council delayed responding to an official complaint made in March 2022.

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The Ombudsman’s role and powers

2. 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)
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 evidence provided by Mrs S and the Council as well as relevant law, policy and guidance.
5. Mrs S 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

6. Miss X moved into an extra care facility run by the Council. The facility consisted of flats, with on-site carers available. Miss X pays for the full cost of her care.
7. The Council emailed Mrs S on 12 April 2022. It said the costs would increase to £436 per week consisting of:
• Carer 1 for 4 x care calls, 2 hours per day is £262 per week.
• Carer 2 for 1 x 30 minute care calls per day is £65 per week.
• Supported living staffing presence charge of £108 per week.
8. Mrs S complains that on multiple occasions the invoices for care were higher than £436 and they have not paid the charges above this amount. Miss X moved out in October 2023. The Council says that Miss X owes £1279 for arrears.
9. In response to my enquiries the Council said ‘for 12 April 2022 to 26 July 2023, the planned number of home care hours was 17.5 hours per week. However, the care delivered to the client exceeded the care plan on many occasions, as the care provider was required to provide additional care and support during the home care calls. Any additional minutes provided were invoiced to the Council by the care provider. Due to the client previously choosing not to engage with the financial assessment process, Miss X was being charged for the full cost of her care, i.e, all care costs invoiced to the Council by the care provider were passed onto the client. Miss X’s family made a request to Adult Social Care on 24 April 2023 to review the care plan. The care package was increased to 22 hours and 45 minutes per week from 27 July 2023 based on an increase in Miss X’s care and support needs’.
10. The Council said that financial assessment letters issued to ‘full cost’ clients contain the following information regarding a possible fluctuation in cost due to a service level change ‘if your service levels change or the cost of providing your care increases, you will be automatically billed for the revised cost of your service. The revised amount payable will be due from the date your service changed.’ This letter was sent to Mrs S in 2022.
11. The weekly statement shows the weekly charge from April 2022 until July 2023 varied from £115 per week up to £518 per week.
12. I have looked at all the information and find no fault by the Council. The Council billed Miss X for the full cost of her care, sometimes this was below £436, sometimes this was above. Given the time that has elapsed there is no way to decide why certain number of hours care were given each week or to check this. Miss X moved out of the facility 18 months ago and it is unlikely there will be records to show why care charges increased on a certain week.
13. Mrs S complains the Council delayed responding to her complaint of March 2022. The Council said ‘having looked at the records we hold, Mrs S’s communications were treated as an informal complaint and Officers within the service were asked to try and resolve it’.
14. The Council has apologised for a delay in responding to a complaint in its complaint response, but it is not clear the date of the complaint it refers to. I can see that there was a slight delay in applying adjustments to the account but I cannot see this caused a significant injustice or there was significant fault. Mrs X could have put in a complaint to the Ombudsman in 2022 if the Council did not respond to her official complaint then. Now, three years later it is difficult to determine what happened and so I find no fault.

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Decision

15. I have completed my investigation and I find no fault. This complaint is not upheld.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman