Summary: Miss X complained the Council put care in place for her grandmother despite making it clear they did not want it or to pay for it. We did not find the Council at fault for how it initially considered her grandmother’s wish for continued care. We found fault it did not complete a financial assessment before starting the care, causing distress. It was also at fault for delay with Miss X’s complaint causing frustration. The Council has agreed to apologise to Miss X and her grandmother to remedy the injustice. The Council has also agreed to update us on the progress and completion of an online cost estimator on its website to support care planning.

The complaint

1. Miss X complains the Council provided, and charged for, care provision for her grandmother (Mrs Y) despite her telling it several times they did not want it and not to put it in place. She said it did not get consent from her to do this as her grandmother’s Power of Attorney, and it did not provide evidence she agreed to it. She says this has caused significant distress and frustration, with charges she should not have to pay for.

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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 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)
3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome (Local Government Act 1974, section 34(3), as amended).
4. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (Local Government Act 1974, section 26A or 34C)
5. When considering complaints, 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.
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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How I considered this complaint

7. I discussed the complaint with Miss X, who is bringing it on behalf of Mrs Y, and considered her views.
8. I made enquiries of the Council and considered its written responses and information it provided.
9. Miss X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

What happened – summary of key relevant events

10. Mrs Y is elderly and has dementia. Miss X is Mrs Y’s granddaughter. She holds Power of Attorney (POA) under Health and Welfare and Finances.
11. In April 2024, following discharge from a period in hospital, a temporary enablement package was put in place to support Mrs Y at home. This was four calls a day to help with daily living tasks. This care service is free of charge for up to six weeks.
12. In late April 2024, a Social Worker carried out a care needs assessment with Mrs Y to explore if she needed care to continue. Miss X’s mother was present. The assessment noted Mrs Y did get confused but could communicate and make her care and support needs known. It noted she wanted to remain at home and was happy with the current support by the Care Agency. The Social Worker proceeded on the basis for care to continue.
13. A few days later, the Social Worker emailed Miss X “following my visit and discussion with your mother please see the attached…personal financial leaflet”. This included a leaflet about finances and charges for care.
14. In early May 2024, the Care Agency asked the Council if it should stop care to Mrs Y as her funding was ending. The senior Social Worker told the Care Agency to continue providing long term care and funding had transferred to the Council.
15. In June 2024, the Council sent Miss X financial assessment forms to complete for Mrs Y. She did not complete these.
16. In July 2024, the Council sent Miss X the financial assessment forms again. Miss X then called the Social Worker. She said she never agreed for the care to continue. She said Mrs Y had been in hospital several times and never extended care after the first six weeks, as she would settle back and could manage herself. She asked it to stop care immediately. The Council informed the Care Agency.
17. Miss X then completed the financial assessment forms for Mrs Y. The Council later confirmed the amount Mrs Y should contribute to her outstanding care costs.
18. In August 2024, Miss X formally complained and disputed the invoice for the extra seven weeks care. She said she told the Social Worker several times not to continue the care. She said mid-way through the six weeks she spoke to the Care Agency as the Council told it to stop care. She told the Care Agency to carry on until the six weeks but made it clear they did not want to pay for any care after that. She said the Care Agency told her she would not be charged, and it would allow care to continue as they could not leave Mrs Y under its duty of care. She assumed it had been sorted by the Care Agency with the Council. She also said Mrs Y did not have capacity to agree to the ongoing care. As she was Mrs Y’s POA, she said the Council needed Miss X’s consent to extend the care, but the Council did have evidence of her agreement.
19. In September 2024, the Council responded at Stage 1. It said at the care assessment visit, both Mrs Y and Miss X’s mother agreed for care to continue, and the financial implications discussed. The Social Worker arranged this, informed the Care Agency, sent Miss X a financial leaflet and later the assessment forms. It said it appeared to be an unfortunate misunderstanding of meetings and discussions. Given this, it offered to waive 50% of the outstanding charges. Miss X disagreed and escalated her complaint.
20. Between November 2024 and January 2025, the Council sent updates to Miss X about delays with her complaint and apologised each time.
21. In February 2025, the Council responded at Stage 2. It said it was not notified that Mrs Y no longer wanted or required care she was receiving at the time. It recognised Miss X held POA and she did not give consent. But it said Mrs Y was deemed as able to make her own decisions about care and support. It continued to offer 50% off the outstanding invoices.
22. In response to my enquiries, the Council said its delay to Miss X’s complaint was due to human error. It had implemented a clearer process about its responses to complaints to avoid similar delays in future.

Analysis

23. The Ombudsman makes impartial decisions based on evidence. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what we think was more likely to have happened.

Continuing the care and communication about finances

24. I appreciate Miss X says Mrs Y had never extended the care over the six-week period after several previous hospital discharges. She says this supports her view that her family would never have agreed to it. However, the evidence from Mrs Y’s care assessment noted Mrs Y wanted her care to continue. The notes also show the Social Worker considered Mrs Y’s presentation at the time and did not raise concerns about her capacity in their professional opinion. I am satisfied it appropriately considered this, and it was a decision it was entitled to take. I do not find the Council at fault with how it initially considered Mrs Y’s wishes about continued care, as it deemed her able to make these decisions. I recognise Miss X says she made it clear early on she did not want care extended for Mrs Y after the six weeks. But from the Council’s view, its duty was to Mrs Y, not Miss X, as it was satisfied Mrs Y had capacity with eligible needs.
25. When considering care, the Council should provide clear information about charging and the financial assessment process.
26. Mrs Y’s care assessment says the Social Worker discussed the contribution and potential care charges with Mrs Y and Miss X’s mother. I note the Social Worker sent Miss X a financial leaflet (outlining how care is charged for) shortly after the assessment, which appears to support this. But there are no specific details or notes. This appears to have been an informal conversation by the Social Worker. We expect councils to keep detailed notes of these discussions to evidence what information it covered. Especially as Mrs Y was moving from reablement care (free of charge) to a chargeable service. This is fault with record keeping. The Council accepted shortcomings with its communication. On balance, I am satisfied Mrs Y likely knew the continued care would be chargeable, but not what her contributions might be.
27. Following on from this, the Council is at fault for not completing a financial assessment before the chargeable services began. We expect councils to do this so people can make informed decisions about care and consider the financial impact, which did not happen in Mrs Y’s case. This caused injustice with distress as the Council should have confirmed how much she would be expected to pay before starting to charge for the continued care. It also did not send the financial forms to Miss X until June 2024, a month after the continued care started. Under Section 19(3) of the Care Act 2014, a council can meet needs that appear to be urgent without having completed a financial assessment, but this is the exception, not the rule. In this case, the evidence does not suggest the Council viewed Mrs Y’s needs as urgent.
28. I appreciate Miss X says as she never completed the forms, that means they should not have to pay. But ultimately, they were aware continued care would be chargeable, and Mrs Y continued to accept the visits and did receive care services. Given this, it is not appropriate to make recommendations about the outstanding care fees. However, the Council has offered to waive 50% of the charges of its own accord. This is a positive offer. It is open to Miss X to now accept this if she wishes. I would expect the Council to offer a repayment plan if Miss X considers it necessary.
29. I recognise Miss X said they let the care visits to Mrs Y continue beyond the six-weeks due to an earlier mistake about the Care Agency and Council stopping her care early. She thought it had been sorted with care being covered by the Care Agency. I cannot see further supporting evidence of the Care Agency or Council telling Miss X this. I have seen an email from the Care Agency asking if it should stop care in early May 2024, but the Council responded to say no. There is no other supporting evidence such as notes or recordings of this discussion so, on balance, I cannot make a finding on this.

The Council’s response to the draft decision

30. In response to my draft decision, the Council raised concerns with our expectations that financial assessments should be completed before care services begin. In our view, the Care Act 2014 outlines the steps that must be taken when providing a package of care to meet a person’s needs. It requires the care and support plan to include details of the personal budget. This means it should include the amount the adult is required to contribute to the cost of the package, which in turn must be based on the financial assessment.
31. The Council said it did not have the resources to do this. It was of the view it would not delay starting care to those it had assessed as having eligible needs. It said it was in the early stages of getting an online tool to give people an idea of what care costs may look like. This would enable an individual to input relevant financial details, and it would provide an estimate of their likely contribution towards their care and support needs. Individuals could use this in the care and planning process while the Council gathered the information to enable it to complete the financial assessment.
32. We have accepted this as a workable approach as it would give an indication of potential costs for individuals to consider. But it does not replace a full financial assessment which gives the accurate cost and enables an informed decision, and we would still expect the Council to complete these in a timely manner.

Complaint handling

33. The Council sent its Stage 2 response to Miss X’s complaint five months after she escalated it. This is a notable delay and is fault. This caused frustration for Miss X. However, I note the Council sent Miss X three emails (in November 2024 and January 2025) advising it needed more time when it missed its expected dates and gave apologies each time. I consider there is some mitigation here by keeping Miss X updated which is good practice. On balance, I am satisfied it has already remedied the injustice to Miss X by its previous apologies for the fault. I do not consider it necessary to recommend a further apology around its complaints handling. The Council has acknowledged its delay and has acted to prevent this in the future, which I consider appropriate.

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Agreed Action

34. To remedy the injustice set out above, the Council has agreed to carry out the following actions:
35. Within one month of the final decision:
• Apologise to Miss X and Mrs Y for the injustice caused by not completing a financial assessment before chargeable care started (in line with our guidance on making an effective apology).
36. Within two months of the final decision:
• The Council will send written reminders to relevant staff of the importance of providing clear information about charging and the financial assessment process to service users, and ensuring they accurately record in detail any discussions and advice given around this.
37. Within six months of the final decision:
• The Council will have an online cost estimator tool for care and support on its website; and
• It should send the LGSCO an update at the three-month point with evidence of what progress it has made on this by that time.
38. The Council should provide us with evidence it has complied with the above actions.

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Decision

39. I find fault causing injustice. The Council has agreed to my recommendations to remedy the injustice caused. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman