Summary: Mrs B complained on behalf of her father, Mr C that the Council had failed to make reasonable adjustments to ensure Mr C could read and understand financial information about his care costs, despite knowing he had a visual impairment. We found fault in the Council’s actions which meant Mr C did not understand he had to pay his care costs allowing a large debt to build up over nearly two years. This caused Mr C uncertainty and distress and Mrs B distress on receiving the invoice. The Council has agreed to apologise to Mrs B and Mr C, make symbolic payments to them both and improve its procedures for the future.

The complaint

1. Mrs B complained on behalf of her father, Mr C, that Worcestershire County Council (the Council) failed to ensure that Mr C was able to pay his bills, including care costs or read correspondence about financial matters, despite knowing he had a visual impairment. This caused a large debt of his care costs to build up. The Council then sent an invoice for £60,000 to Mrs B giving her only two weeks to pay. This caused Mrs B and Mr C significant distress.

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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 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. 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

5. I have exercised discretion to investigate Mr C’s complaint from January 2023 when care resumed. It was not reasonable to expect him to complain sooner as he was not aware of the situation and Mrs B only became aware of the problems in November 2024.

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How I considered this complaint

6. I considered evidence provided by Mrs B and the Council as well as relevant law, policy and guidance.
7. Mrs B 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

8. Reasonable adjustments for people with disabilities
   The reasonable adjustment duty is set out in the Equality Act 2010 and applies to any body which carries out a public function. It aims to make sure that a disabled person can use a service as close as it is reasonably possible to get to the standard usually offered to non-disabled people.
9. Service providers are under a positive and proactive duty to take steps to remove or prevent obstacles to accessing their service. If the adjustments are reasonable, they must make them.
10. The duty is ‘anticipatory’. This means service providers cannot wait until a disabled person wants to use their services but must think in advance about what disabled people with a range of impairments might reasonably need.

Charging for social care services

11. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)

Financial assessments

12. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment.
13. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home.
14. The capital limits, specified in regulations issued under the Care Act 2014, set the levels of capital (excluding any capital that has been disregarded) that a person can have while qualifying for financial support from their local authority.
15. A person with assets above the upper capital limit (currently £23,250) is responsible for the full cost of their care in a care home. A person with assets between the capital limits will pay what they can afford from their income, plus a means-tested contribution from their assets (calculated as £1 per week for every £250 of capital between the capital limits). A person with assets below the lower capital limit will pay only what they can afford from their income.

What happened

16. Mr C is elderly and lives alone. His has a visual impairment along with personal care needs. He had received care in the past and following an assessment in December 2022 he started to receive care at home in January 2023. The care assessment noted he was visually impaired.
17. The Council sent a letter to Mr C offering to carry out a financial assessment and requesting financial details. In March 2023 as it had not received a reply it wrote to Mr C informing him that he would have to pay the full cost of his care.
18. In May 2023 during a nursing review Mr C expressed confusion over whether he needed to pay for his care.
19. In June 2023 during a review of his care needs he discussed his eyesight with the social worker. He said it was not good, and he had a friend who sometimes helped him, but her handwriting was not very good. The social worker suggested he telephoned the Council to carry out the financial assessment.
20. In August 2023 a worker telephoned him to specifically discuss support with his visual impairment. He said he did not want to be registered blind and did not want any support as he managed with the care input he received. He said the main issue was his care contribution and the fact he understood he did not need to pay. But he had now had a letter saying he owed £1000. The worker agreed to get the finance team to discuss the situation with him.
21. During August 2023 Mr C also called the duty team to say he was concerned about a bill he had received for his care. The duty worker rang back to say he had to pay the full cost of his care. They noted he was visually impaired and suggested this may be the reason he had not responded to letters. The worker suggested that the finance team should telephone him to discuss the matter.
22. A telephone review of his care needs in September 2023 noted that due to his limited eyesight, Mr C would not be able to manage his medication.
23. Later in September 2023, after the Council received some bank statements, it carried out a financial assessment. It confirmed in writing to Mr C that he had to pay the full cost of his care due to savings and capital over £23,250.
24. In July 2024 Mr C’s three children, including Mrs B obtained a lasting power of attorney (LPA) for Mr C’s property and finances. This meant they were able to make decisions on behalf of Mr C regarding financial matters.
25. In November 2024 his care records noted that he had lost 90% of his sight.
26. On 27 November 2024 the Council sent Mrs B notification that Mr C owed over £60,000 in care fees and gave her an additional 14 days to pay.
27. In December 2024 Mrs B made a formal complaint. She said the Council’s actions in sending an invoice for a £60,000 debt with only two weeks to pay was unreasonable. She also said the Council, in the financial assessment had taken into account the value of the house in which he was living and that it had not considered his visual impairment or his vulnerability.
28. The Council replied on 9 January 2025. It said it had carried out a financial assessment in March 2021 which concluded that, owing to his level of capital, Mr C had to pay the full cost of his care. Care stopped in June 2021. In January 2023 care resumed, and the Council concluded Mr C had to pay the full cost of his care because it did not receive any financial information from him. It said it had carried out another assessment in September 2023 after receiving some financial information and concluded Mr C still had capital over the threshold, so was liable for the full cost of the care.
29. The Council requested full details of Mr C’s financial circumstances to enable it to review the situation and assess when his capital would fall below the threshold of £23,250. In respect of communication it apologised if its previous communication did not accommodate Mr C’s needs or the complexity of the situation. As Mrs B had an LPA it would send future correspondence to her and ensure it was adapted to be accessible and supportive of his circumstances. In respect of the debt, it said it could not delay recovery action but would reassess the figures on receipt of the requested financial information.
30. In March 2025, the Council completed a full reassessment of Mr C’s finances from 7 January 2023. It noted that Mr C had saved up to pay off his mortgage and given his children some money to visit him and carry out repairs to his house. His savings were now well below the capital threshold. But his income was high enough for him to pay of the full cost of his care. The Council confirmed the amounts from January 2023 and said it had not taken the value of Mr C’s house into account in any of the calculations.
31. Mrs B complained to us. In August 2025 the Council confirmed the debt was around £35,000.

Findings

32. The Council was aware from December 2022 that Mr C was visually impaired, and it was noted in his care assessments and reviews that he needed care due to this fact. The Council provided care via an agency to ensure his personal care needs were met but it did not at any point consider his communication needs or whether he required any reasonable adjustments. This was fault which meant that Mr C did not understand the financial assessment process, or what was required of him.
33. In March 2023 the Council simply treated him as liable for the full cost of his fees because he had not responded to its letters. I consider the Council should have made reasonable adjustments to ensure Mr C understood the information sent to him. This could have been making sure the Council telephoned him to discuss the situation or communicating with a family member or friend on his behalf.
34. On only one occasion between January 2023 and November 2024 did the Council discuss communication needs with Mr C: during the care review in June 2023, the worker suggested he telephoned the financial assessment team to discuss the financial assessment. But no further formal arrangements were made or other options explored. This was another missed opportunity to properly consider Mr C’s communication needs and make some reasonable adjustments.
35. Mr C expressed confusion over the care costs on several occasions, and a duty team worker highlighted the problem in August 2023. I accept that staff gave some explanations in response and advice to contact the financial team, but no-one took responsibility for properly considering Mr C’s communication needs and whether reasonable adjustments should be made. It could have anticipated those needs and made simple adjustments as early as January 2023, but it failed to do so and missed many further opportunities over the next 22 months to put matters right.
36. This was fault which caused Mr C confusion and uncertainty. It also meant that a large debt accrued unnecessarily which caused Mrs B distress when she received the invoice in November 2024.
37. I have not found fault with the way the Council carried out the financial assessment when it finally had all the correct information.

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Action

38. In recognition of the injustice caused to Mr C and Mrs B, I recommended the Council within one month of the date of my final decision:
• apologise to Mr C and Mrs B;
• pay Mr C £300 and Mrs B £150;
• clarify with Mr C and Mrs B any reasonable adjustments Mr C requires, record those adjustments and confirm them in writing;
• discuss with Mr C and Mrs B a suitable repayment arrangement for the debt. Once any requested supporting information such as bank statements is supplied, the Council should agree to an arrangement within a further month of receipt of the information.
39. And by the end of March 2026:
• arrange training for adult social care staff (including the financial assessment team) on the Council’s reasonable adjustment duty, using our Focus Report: ‘Equal Access: Getting it right for people with disabilities’, as a guide.
40. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman