Summary: We have upheld Ms X’s complaint about the Council’s failure to provide adequate information about the costs of adult social care for her father. We asked the Council to remedy the injustice caused. It agreed to apologise and reduce the costs it charges Mr Y. It will also take action to prevent a recurrence of this issue.

The complaint

1. Ms X complained the Council failed to explain the costs involved when arranging adult social care for her father, Mr Y, after a hospital stay. She said the family cancelled the care as soon as it was told about the charges but is still facing a large bill for outstanding charges and the Council has not explained how these were calculated. Ms X said the family would not have agreed to the care package if the Council had explained the costs involved.

Back to top

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 provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

Back to top

How I considered this complaint

3. I considered information provided by Ms X and the Council.
4. I considered the Ombudsman’s Assessment Code.

Back to top

My assessment

What happened

5. Mr Y lives with his wife, Mrs Y. His son, Mr Z lives close by and has been a full-time carer for his parents since October 2023. Ms X also provides support for her parents.
6. The Council assessed Mr Y’s care needs in May 2024 after he returned home after a hospital stay in May 2024. Its assessment records:
• Mr Y needed support with all aspects of his care and that Mr Z and Ms X were meeting most of his care needs. There is no indication they were not prepared to continue to do so;
• Mr Y needed support to change continence pads and with attaching a catheter bag at night and emptying it in the morning;
• Mr Y could walk with a zimmer frame but needed two carers for transfers.;
• Mr Y needed four care calls per day by two carers on each occasion to support with continence care, washing, dressing, meal provision, medication and preparing for bed. The needs assessment included an indicative budget (estimate) of £620 per week for the cost of providing that package. (Ms X disputes that this level of care was delivered as she said she and Mr Z continued to provide care to their parents).
7. The care package was initially classed as “reablement”, which means it was free of charge. Council records state that, in the assessment visit, it “referenced the financial document” and advised the care would become chargeable either when the assessment was complete or when it transferred to a private provider, whichever happened first.
8. In mid-June, at a home visit, Council records state it explained its charging policy, confirmed that home care services were chargeable and that actual costs would be calculated following a financial assessment. Mr Y agreed to a referral for a financial assessment.
9. In late June, Council records state it telephoned Mr Z to inform him a private care provider had accepted the contract, which would be chargeable from 3 July 2024.
10. The Council tried to contact Mr Y by telephone twice in October 2024, but he did not answer, so it sent a finance form by post. Although the needs assessment recorded Mr Z assisted his parents with their finances, there is no indication the Council recorded any contact details for him or tried to contact him for financial information. The Council send the finance form was returned on 11 November and it emailed for further information the same day. The following day it completed the financial assessment and wrote to Mr Y to explain he needed to pay the full cost of his care because he had capital over £23,250. It subsequently sent an invoice for care for six months in arrears and six months in advance.
11. On 16 November 2024 the family contacted the Council to say they had had considerable difficulty getting information from it about Mr Y’s care, including a copy of the care and support plan, and that they had repeatedly asked for details of the costs, but no information was provided. They cancelled the care package and the Council subsequently cancelled the costs for the period from 2 December 2024.
12. The family complained. They said they had not been told about the costs, despite repeated requests for that information. They had also not seen a care plan or details of the care package, nor signed any contract with the care provider.
13. The Council did not uphold the complaint about a lack of costs information. It said the costs were explained in visits on 19 June and 25 June, including that Mr Y would need to pay the full costs of his care. It also said the details of the care package were discussed and agreed with the family. Although Ms X said emails were sent to the allocated social worker and another officer, the Council said it had no record the family had asked for information. It accepted the care and support plan was not sent to the family, for which it apologised. It also accepted the financial assessment had taken longer than expected, which had been raised with the relevant Head of Service.

My assessment

14. Based on the information the Council provided in response to initial enquiries, I have seen no evidence that the record of the needs assessment or the care and support plan were shared with the family. Although the records reference some discussion about cost, there is no evidence the family were told the actual cost of the care. Even if the needs assessment was shared, that indicated an estimate of £620 per week but the actual cost was £734, a difference of £114 per week for the 21 weeks the package was in place. There is also no evidence that any written information about charging, such as a leaflet explaining charging for adult social care, was ever provided. On balance, if we were to investigate further it is likely we would find the Council at fault for not providing appropriate costs information when the care package was arranged.
15. The Council took 20 weeks to complete a financial assessment following the social worker’s referral in June. This included a delay in obtaining financial information because the Council had not recorded any contact details for Mr Z at the assessment visits. If we investigated further, it is likely we would find the Council at fault for a delay in carrying out the financial assessment and confirming the actual costs of the care that Mr Y was being asked to pay.
16. These faults caused the family an injustice because they were not aware of the costs involved so could not make an informed choice about whether the care package was needed or whether it could be reduced. I note the family cancelled the package as soon as they were informed of the costs and have been managing Mr Y’s care without the need for a care package since December 2024. Therefore, I consider it is more likely than not that they would not have agreed to the full package if they had known about the costs when the package was arranged.
17. It is also unclear why the Council decided such a significant package of care was needed, given that Mr Z and Ms X were already providing a significant amount of care, and Mr Z, who lived close by, had given up paid employment to care for Mr and Mrs Y. There is no indication in the records they were unwilling to continue doing so, nor that there were any case tasks they would not be able to manage. Further, I have seen no evidence of a review of the level of care, after Mr Y had settled at home following his hospital discharge. On balance, if we were to investigate further, it is likely we would find the Council at fault for the way it assessed the care Mr Y needed and its failure to share the care and support plan, which meant the family did not know what care the care provider should be providing and therefore could not report any failure to deliver the full package. It also prevented the family from having meaningful discussions with the Council about whether Mr Y still needed the level of care initially envisaged.
18. In light of the above, we asked the Council to take steps to remedy the injustice caused and it has agreed to take the following action within two months of the date of this decision:
• Apologise to Ms X, Mr Y and Mr Z in line with our guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice;
• Waive the sum of £2,394, which is the difference between the indicative budget and the actual costs for the 21 weeks the care package was in place;
• Reduce the remaining costs by 50% to remedy the family’s inability to make an informed choice about the care package due to the lack of clear information about costs and their inability to raise any concerns about whether the care provider was delivering all the care in the plan because the Council did not send the plan to them;
• Issue a revised invoice for the costs outstanding after the above adjustments have been made; and
• Remind relevant staff of the importance of providing as much information as possible about charging for adult social care and the costs of a package of care at the time it is arranged, of clearly recording the advice given and to consider confirming information in writing, for example, by sending a costs leaflet.

Back to top

Final decision

19. We have upheld this complaint about a lack of information about the costs of adult social care. The Council has agreed to apologise, reduce the charges and take action to prevent a recurrence of this issue.

Back to top

Investigator's decision on behalf of the Ombudsman