Summary: There was fault by the Council which issued an invoice for the late Mr Y’s homecare for a period when he was in hospital. The Council has already taken some action to resolve the complaint by apologising and removing charges. It will also apologise, issue an itemised invoice and reduce the outstanding bill by £100 to reflect Ms X’s avoidable distress.

The complaint

1. Ms X complained the Council did not charge her late father Mr Y correctly for his care, meaning bills were inaccurate. She also complained about it issuing demand letters and taking too long to sort the matter out. She said this caused avoidable distress, time and trouble and a financial loss to the estate.

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The Ombudsman’s role and powers

2. The law says we cannot normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. Complaints which have not been through a council’s complaint procedure are 'premature.’ (Local Government Act 1974, section 26(5), section 34(B)6)
3. 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)
4. Our services are free and we are publicly funded so use our resources carefully. We do not start or continue an investigation if we decide any injustice is not significant enough to justify our involvement (Local Government Act 1974, section 24A(6), as amended, section 34(B))
5. 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)
6. 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

7. I have investigated charging during a hospital admission for a week in August 2022 although this is a late complaint. This is because the Council put the bill on hold for many months without resolving the matter or contacting Ms X with an update. Ms X may have thought the Council did not intend to pursue the debt and so she had no reason to complain to us sooner.
8. I have not investigated charging during the hospital admission in August 2024. This is a premature complaint and is about the charge for two days of homecare. The injustice to Mr Y’s estate is not significant enough for an LGSCO investigation.

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How I considered this complaint

9. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
10. Ms 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

11. Mr Y had a council arranged homecare package which he paid for. The complaint is about charges when he was in hospital in August 2022.
12. In September 2022, the Council sent an invoice for £1873 for Mr Y’s care which was 14 hours each week between 1 and 28 August 2022. The evidence indicates Ms X contacted the Council by phone and the Council placed the account on hold. Ms X contacted the Council several times in 2023 and formally complained to the Council about the invoice in July 2024, saying her father was in hospital 15 to 23 August 2022. The Council upheld Ms X’s complaint, apologised for the distress caused and explained:
• The contract between the Council and care agency said the agency was obliged to keep a care package open when a client went into hospital. The first seven days was at the agency’s expense. The Council would instruct the agency to rectify the matter and the first seven days charge would be removed.
• The care agency told the Council a family member had asked it to keep the care package open while Mr Y was in hospital which is why the charge had shown up on the final bill. However, the agency did not seek permission from the Council as the Council required it to do. As a result, Mr Y would not be charged for any days he was in hospital (only for calls on the day of admission and day of discharge). The Council upheld this complaint and would remove charges.
13. On 2 September 2024, the Council issued an invoice which removed the charge for 15 to 21 August 2022. (The credit was for £401). The invoice also had charges for later periods of care in 2024. On 23 September and 8 October, the Council issued reminder letters for this invoice.
14. On 22 October 2024, the Council wrote to Mr Y saying the invoice had not been paid and asked him to pay it or get in touch. It said the Council would recover the debt through the court if he did not get in touch.
15. On 3 January 2025, the Council issued a reminder to pay the original (unamended) invoice for care in August 2022; it said the total due was £1873. The next page said the account balance was £1596.
16. On 31 January 2025, the Council issued a credit note for £67 to ‘part cancel’ the invoice for the week of 22 August 2022.
17. It was unclear to us whether the Council had adjusted Mr Y’s account to remove charges for the dates he was in hospital in August 2022, given in January 2025 it had issued a reminder notice for the original August 2022 invoice. So we asked the Council for its internal accounting records. These records show it has made credits of £117, £67 and £401 for August 2022 when Mr Y was in hospital.

Findings

18. The Council was at fault for charging Mr X when he was in hospital in 2022 as this was not in line with its agreement with the care agency. It has removed charges and apologised which is a partial remedy for the injustice. Ms X, who is an executor to the estate has suffered avoidable distress and time and trouble resolving this matter.

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Agreed Action

19. Within one month of my final decision, the Council will
1. reduce the outstanding bill by £100 to reflect the avoidable distress to Ms X
2. issue a fully itemised invoice (including the £100 reduction in (a). The invoice will set out clearly each of the credits it has made over time and exactly what period each credit covers.
3. apologise again in writing. 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
20. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman