Summary: Mr X, complained of the Council’s handling of his mother’s, Mrs X’s, care package. The Council provided Mrs X with a copy of the financial assessment letter including the personal budget without delay so it was not at fault. It also cancelled the care package when requested without fault. However, the Council was at fault for overcharging Mrs X for the hours of care she received and failed to provide Mrs X with a copy of the estimated personal budget. The Council has agreed to reimburse Mrs X the money it overcharged her by to remedy the injustice caused.

The complaint

1. Mr X complained of the Council’s handling of Mrs X’s care package. He said the Council failed to do a two-week review of the care package which meant his mother did not have the opportunity to reduce the care visits. As a result, he said the Council overcharged her by £500. Mr X also said the Council failed to provide her with a copy of the financial assessment and personal budget. This has caused Mrs X distress, frustration and uncertainty.

Back to top

The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
3. If there has been fault which has caused significant injustice, or that could cause injustice to others in future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), 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)

Back to top

How I considered this complaint

5. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
6. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

Back to top

What I found

Relevant law and guidance

7. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
8. 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.
9. Everyone must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.

What happened

10. In September 2024, the Council was notified that Mrs X’s family could not meet her care needs. The records show the Council completed a visit to Mrs X and put in place a two-week package of non-chargeable emergency care. The records show the Council advised Mrs X that it would convert the emergency care to long term care after the two-week period which would then be a chargeable service. The Council sent Mrs X the financial assessment form to fill in mid-September.
11. At the start of October 2024, the records show a social worker carried out another visit to Mrs X. The social worker documented that Mrs X knew she would have to pay for her care and the Council would undertake a financial assessment. The social worker also recorded Mrs X wanted four hours of respite care per week and care calls reduced to one a day.
12. Mrs X returned the completed financial assessment form mid-October 2024 and the Council issued the financial assessment letter ten days later which included the personal budget. The letter told Mrs X how much she would pay per week for her care. At the end of October 2024, the records show Mrs X contacted the Council to stop the care package as she wanted to arrange this privately with the same provider. The care ended on 1 November at Mrs X’s request.
13. Mr X made a complaint to the Council on Mrs X’s behalf. He complained of the following:
• The two-week care review did not happen following the emergency care package resulting in a £500 overcharge
• The Council did not send the financial assessment letter and personal budget so Mrs X was not aware of the charges for the care
• Mrs X was unable to stop the care package as the Council’s phone line was constantly engaged.
14. Mr X has provided a list of visits and calls with the Council. There was a total of five visits and/or calls in October.
15. The Council issued a final response in January 2025 saying that Mrs X advised the social worker she wished to reduce her care calls to one a day at the start of October. The Council said the package of care was non-chargeable at this point. Therefore, Mrs X was only required to pay care fees from the period of 12 October-1 November.
16. Mr X remained dissatisfied with the Council’s handling of the matter and complained to us.

Council’s response to our enquiries

17. The Council said it reduced Mrs X care visits to one a day as requested on 12 October, at point the care became chargeable. However, the Council has confirmed it charged Mrs X for a 60-minute care visit each morning when in fact she only received 45 minutes in line with her support plan. The Council has offered its apologies to Mrs X and has agreed to reimburse her the cost of 15 minutes for each of her morning care visits between 12 October and 1 November.
18. The Council said it apologises to Mrs X for not sending out the estimated personal budget letter to her which would have given an estimate cost of the care. It has said this was an error on the social worker’s part. However, the Council said Mrs X was aware she had to pay for the care costs and it did not know the actual assessed cost until Mrs X returned the financial assessment form. Mrs X did not return this until mid-October, when the care had already become chargeable.

My findings

Personal budget and financial assessment

19. Mr X complained Mrs X did not receive a copy of the financial assessment letter or personal budget. The records show that when Mrs X returned the financial assessment form, the Council issued the financial assessment letter including the personal budget within ten days. Therefore, the Council was not at fault.
20. However, the Council failed to notify Mrs X of the estimated cost of her care prior to the care package becoming chargeable. The care and support statutory guidance says the council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. The Council accepts it did not do this which was fault. However, this has not caused a significant injustice to Mrs X as she required the care and she was aware she was a full cost payer. However I have made a service improvement recommendation to prevent future injustice from similar fault.

Care charges

21. Mr X complained the Council failed to do a two-week review of the care package which meant his mother did not have the opportunity to reduce the care visits and was overcharged by £500. The records show Mrs X had a non-chargeable package of care in place until 12 October. Mrs X notified the social worker on 2 October she wished to reduce the care calls to one a day and four hours of respite per week. From 12 October, the care calls were reduced to one a day in the morning in line with Mrs X’s wishes.
22. However, the Council overcharged Mrs X for the morning care visits. Carers visited Mrs X for 45 minutes in the morning in line with what was recorded in Mrs X’s support plan. The Council charged Mrs X for 60-minute care visits which was fault. This has caused Mrs X distress, frustration and uncertainty. The Council has agreed to reimburse Mrs X the cost of 15 minutes of her morning care visits between 12 October and 1 November which will amount to approximately £110. I am satisfied this is a sufficient remedy.
23. Mr X also complained Mrs X then decided she wanted to cancel the care entirely but could not do this as the Council’s phone line was busy. Mr X has provided a list of visits and calls with the Council. There were a total of five visits and calls in October where Mrs X could have cancelled the package. The Council cancelled the care package following a call from Mrs X at the end of October without fault.

Back to top

Action

24. Within one month of the final decision, the Council has agreed to take the following action:
1. Reimburse Mrs X the cost of 15 minutes of her morning care visits between 12 October and 1 November.
2. Remind the relevant officers to ensure an estimated personal budget is shared with the person at the start of the care and support planning process.
3. Review how it ensures care visits are charged in line with what is recorded within the support plan.
25. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

26. I find fault causing injustice. The Council has agreed actions to prevent future injustice from similar fault.

Back to top

Investigator's decision on behalf of the Ombudsman