Summary: Mrs X complained about a failure to inform her and her family about care contributions and about short calls. We upheld the complaint because Mr Y’s care and support plan did not include his care contribution within his personal budget. The information the Council provided about charging before care started was too general. This caused avoidable distress. The Council accepted care calls were short which was fault causing Mr Y avoidable distress which cannot be remedied as he has died. Mrs Y also likely had to step in and provide some care. The Council will apologise, make symbolic payments for Mrs Y, offer a debt repayment plan and will complete contract monitoring to reduce the risk of recurrence.

The complaint

1. Mrs X complained her mother Mrs Y was not told about care charges for her late father Mr Y’s care. She also complained about short care calls by Nationwide Care Services Ltd (the Care Provider). Mrs X said this caused a financial loss and meant her mother, Mrs Y was having to provide care which the care workers should have done.
2. Mrs X is also unhappy about the Council’s response to a request for records of emails and calls between council officers and her and her sister.

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The Ombudsman’s role and powers

3. We normally expect someone to refer the matter to the Information Commissioner if they have a complaint about data protection. However, we may decide to investigate if we think there are good reasons. (Local Government Act 1974, section 24A(6), as amended)
4. We make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
5. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A) and 25(7), as amended).
6. The Council commissioned the Care Provider to deliver care and support services under powers and duties in the Care Act 2014. It acts on behalf of the Council and we can investigate complaints about its services.
7. 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)
8. 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)
9. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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What I have and have not investigated

10. I have investigated the complaint in paragraph one. I have not investigated the complaint in paragraph two because the Information Commissioner (ICO) is the expert body dealing with complaints about data and Mrs X can pursue this issue with the ICO.

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How I considered this complaint

11. I considered evidence provided as well as relevant law, policy and guidance.
12. Mrs 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

13. The Care Act 2014 allows councils to charge for most care and support (apart from reablement or intermediate care which is free temporary care.) Councils work out the charge based on a financial assessment of the person’s income and capital.
14. If a council decides a person is eligible for care and support, it must draw up a care and support plan (before care starts). The plan must include a personal budget which includes the contribution a person pays towards their care and the contribution a council will make. (Care Act 2014, section 25).
15. Councils often carry out financial assessments after care services have started. We generally regard this as fault.
16. Councils must provide information and advice about adult social care including about charging arrangements. (Care Act 2014, section 4). Care and Support Statutory Guidance says the information provided should be thorough enough and shared early on in the care assessment and planning process.

What happened

17. A note on Mr Y’s social care assessment in August 2023 said his daughter (Mrs X’s sister) was made aware the Council would be completing a financial assessment and Mr Y may need to pay towards his care. The outcome of the social care assessment was Mr Y was eligible for care and support. The Council commissioned the Care Provider to deliver two calls a day for 30 minutes each (with two carers on each call) and a sitting service for three hours a week to enable Mrs Y to go out.
18. Another note on the social care assessment said the social worker gave Mrs X’s sister leaflets about charging and emailed them to her on 29 August. The Council has not provided me with a copy of the email the officer sent attaching the charging leaflets. Mr Y’s care and support plan set out the agreed personal budget for Mr Y. It did not include his client contribution.
19. Case records indicate the Care Provider’s service started on 11 September and the following day a social worker and Mrs Y spoke on the phone. The social worker told Mrs Y any charge for Mr Y’s care would start from the day the Care Provider’s services began.
20. An internal record noted a telephone financial assessment was started with one of Mr Y’s daughters on 30 October and completed on 13 November. The Council wrote to Mr Y with the outcome of the financial assessment on 15 November. It said his maximum weekly charge was £435.02 from the date care started (11 September.) The letter went on to explain if care cost less than this, then the weekly charge would be the actual cost.
21. Mrs X wrote to the Council in December about an invoice Mrs Y had received. She said they were told Mr Y’s care would be free and care workers only stayed 10 minutes (rather than 30) and so Mrs Y had to provide care.
22. Mr Y died in December 2023.
23. The finance team and Mrs X exchanged a series of emails between December 2023 and March 2024. The finance team said the family had been made aware of the charge in a discussion during Mr Y’s care assessment, in a phone call with Mrs Y and in leaflets emailed to Mrs X’s sister. Mrs X said her sister was not emailed leaflets about the charge and they had since received a further invoice. She said they had never agreed to pay a charge.
24. Mrs X asked for details of the Council’s complaints procedure at the end of March 2024. The finance team referred the complaint to the complaints team at the start of April and Mrs X chased the matter up at the end of April. A team manager sent an internal email in June saying they were responding to the complaint.
25. The Council’s first response to the complaint in July 2024 said:
• Charges were discussed when Mr Y had a social care assessment.
• The finance team tried to gather information to complete the financial assessment at the end of October 2023. Charges were also discussed with other family members
• The Council was sorry:
1. there was little communication by the social worker with Mrs X and Mrs Y. Conversations were mainly with the other sibling.
2. the Care Provider did not stay for 30 minutes and for any upset this caused.
3. the complaint was not forwarded to the complaints team in a timely manner
4. the finance team, did not provide clear updates and issues referred to other departments were not responded to.
• Mrs X’s sibling only raised concerns about short calls on 20 November and said she wanted to cancel care.
• The Council would investigate further the concerns raised about the Care Provider’s level of care.
26. Mrs X escalated her complaint to the review stage of the Council’s complaint procedure. It replied in December 2024 with no significantly different findings from the first response. So Mrs X complained to us.

Findings

27. Councils should include details of a person’s charge (client contribution) in their care and support plan as part of the personal budget, which should be available before care starts. The failure to include the charge in Mr Y’s personal budget in the care and support plan was fault. It caused avoidable distress in November when the family received the financial assessment letter and again when they received the first large invoice in December.
28. Mrs Y and Mrs X’s sister were told that Mr Y’s home care was chargeable at the end of August 2023, but they did not receive any details of how the charge would be calculated. On a balance of probability, they were not given written information about the financial assessment process. The records refer to an email to Mrs X’s sister with leaflets attached, however, I have not seen a copy of this email and she denied receiving it. Care and Support Statutory Guidance says information a council provides needs to be thorough enough to enable people to make informed decisions. The failure to provide leaflets was therefore fault causing avoidable distress.
29. The Council accepted Mr Y’s care calls were short. This was fault which caused Mr Y the distress of not having his needs met and meant Mrs Y to have to step in and deliver care.
30. There was also delay in complaint handling. The Council took too long to respond to the complaint at both stages of the complaint procedure. This was fault causing avoidable frustration.

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Agreed Action

31. When a council commissions or arranges for another organisation to provide services, we treat actions taken by or on behalf of that organisation as actions taken on behalf of the council and in the exercise of the council’s functions. Where we find fault with the actions of the service provider, we can make recommendations to the council alone.
32. Here we have found fault with the service of the Care Provider and make the following recommendations to the Council. Within one month the Council will:
• Apologise to Mrs Y. 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.
• Make Mrs Y a payment of £500 in total. This reflects the avoidable distress of (1) receiving notification of a high client contribution and an invoice for two to three months of care and (2) having to provide Mr Y with care due to the Care Provider’s short calls
• Offer an affordable debt repayment plan for the estate to repay money owed.
33. Within three months, the Council will complete contract monitoring checks to ensure the Care Provider is adhering to call durations set out in council-commissioned care packages. Monitoring can be a sample of client care packages for the previous three months.
34. The Council should provide us with evidence it has complied with the actions in the last two paragraphs.

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Decision

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

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman