Summary: Miss X complained on behalf of her late mother, Mrs Y, about the Council’s handling of care charges while Mrs Y was in residential care. Miss X complains the Council failed to provide information about care charges in a timely manner and invoiced Mrs Y for increased care charges without prior discussion. Miss X says the Council’s actions caused significant avoidable distress. We found fault by the Council. The Council has agreed to provide an apology and a financial remedy and make service improvements.

The complaint

1. Miss X complained on behalf of her late mother, Mrs Y, about the Council’s handling of care charges while Mrs Y was in residential care. Miss X complained the Council failed to adequately explain the charging arrangements for Mrs Y’s care and failed to provide appropriate information about the charges in a timely manner. Miss X complained the Council invoiced Mrs Y for increased care charges without prior discussion.
2. Miss X says the Council’s actions caused significant avoidable distress. She would like the Council to make service improvements to ensure its care charging payment systems work effectively. Miss X would also like the Council to ensure it provides the correct charging information to service users in a timely manner.

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The Ombudsman’s role and powers

3. 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)
4. We may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:
• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

5. We normally name care homes and other care providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), 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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How I considered this complaint

7. I considered evidence provided by Miss X and the Council as well as relevant law, policy and guidance.
8. Miss X and the Council had an opportunity to comment on a draft of this decision. I considered any comments before making a final decision.

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What I found

Charging for permanent residential care

9. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014, and councils should have regard to the Care and Support Statutory Guidance.
10. The financial limit, known as the ‘upper capital limit’, exists for the purposes of the financial assessment. This sets out at what point a person can get council support to meet their eligible needs. People who have over the upper capital limit must pay the full cost of their residential care home fees. Once their capital has reduced to less than the upper capital limit, they only have to pay an assessed contribution towards their fees. Where a person’s resources are below the lower capital limit they will not need to contribute to the cost of their care and support from their capital.

Deferred payments

11. A deferred payment agreement (DPA) is an arrangement with a council that lets service users use the value of their home to cover care home costs. A deferred payment agreement may be made if the value of a service user’s home takes them over the threshold for paying for care home costs themselves. The agreement allows service users to delay selling their home to cover the cost of residential care.

The Council’s social care charging policy

12. The Council’s policy says that where it charges for care, it will do so fairly and transparently. The policy says the Council will ensure individuals are given clear information about charging and how their contributions have been calculated. The policy also says the Council will give clear and simple information about charging at the right time.

Principles of good administrative practice

13. In 2018 the Ombudsman published a guidance document (updated in January 2025), setting out the standards we expect from bodies in jurisdiction “Principles of Good Administrative Practice”. This includes:
• Stating the criteria for decision making and giving reasons for decisions
• Keeping proper and appropriate records
• Explaining clearly the rationale for decisions and recording them

What happened

14. This chronology includes key events in this case and does not cover everything that happened.
15. Miss X’s mother, Mrs Y, had a diagnosis of dementia. Mrs Y owned her own home but in March 2024, she moved into a residential care home, (Care Home A) as she was struggling to manage living in her own home. Mrs Y paid the cost of her care charges directly to Care Home A.
16. Shortly after Mrs Y moved into Care Home A, Miss X asked the Council to carry out a care needs assessment.
17. In May 2024, Miss X asked the Council to carry out a financial assessment as she said Mrs Y’s savings had reduced.
18. The Council carried out a financial assessment in September 2024. It assessed Mrs Y as being liable to pay the full cost of her care, and sent a DPA application form to Miss X.
19. Miss X sent the completed DPA application to the Council.
20. As part of the Council’s consideration of the DPA application form, its DPA team requested clarification of the full cost of Mrs Y’s placement at Care Home A.
21. In October 2024, the Council’s Service Placement Team (SPT) told the DPA team that Care Home A is an Integrated Residential and Nursing Care Framework (IRN) home which usually accepted the standard IRN rate. The SPT stated however that it could not confirm this until the Council had received an individual support plan for Mrs Y.
22. The DPA team notified the adult social care team that it had received the DPA application. It also provided a sustainability check for the application, based on the standard IRN rate.
23. In early November 2024, the Council issued a purchase order to Care Home A for the care provided to Mrs Y. The purchase order stated the chargeable rate as the standard rate for IRN residential care.
24. Care Home A contacted the Council on the same day. It said it needed to discuss the purchase order and that it could not meet Mrs Y’s care needs for the standard IRN rate. Care Home A said Mrs Y’s care needs were high and she required constant attendance.
25. The Council responded and asked Care Home A what rate it was charging. Care Home A replied and clarified that at that time, Mrs Y was self-funded, paying approximately 50% more than the standard IRN rate. Care Home A said it had not agreed to the IRN rate, and the Council had not consulted it regarding this matter.
26. Shortly after, the SPT told the adult social care team that Care Home A had disputed the care fees. It said the care home proposed charging the same rate as then paid by Mrs Y until early November 2024, then reducing the charge to approximately 25% more than the standard IRN rate.
27. The Council emailed Miss X in late November 2024 and said it was progressing the DPA application. The Council said the deferred payment would start from 17 September 2024.
28. On 28 November 2024, the Council sent an invoice to Miss X for Mrs Y’s care fees. The invoice showed the care fees to be the IRN rate.
29. On 2 December 2024, the Council’s social work team asked the DPA team to amend the care fees to reflect the higher rates as stated by Care Home A.
30. On 3 December 2024, the Council agreed the amended weekly rate.
31. Sadly, on 3 December 2024, Mrs Y died. Miss X notified the Council on 5 December 2024.

What happened next

32. The Council sent an amended invoice to Miss X on 30 December 2024, showing the revised care charges and the outstanding balance.
33. On 8 January 2025, the Council sent a revised purchase order to Care Home A, reflecting the amended care charges.
34. Miss X called the Council on 9 January 2025. She said she had received the invoice, but the Council had not told her how to pay the care charges, so she had continued to pay Care Home A directly. Miss X said she was unaware that she would receive any invoices from the Council.
35. The Council called Miss X on 14 January 2025. It said Miss X needed to request a refund of the care fees paid to Care Home A, so that she could pay the Council’s invoice.
36. Care Home A refunded Miss X on 30 January 2025.
37. On 31 January 2025, the Council spoke to Miss X. It advised that Care Home A had charged the full cost for Mrs Y’s placement, which meant the care fees had further increased.
38. The Council sent a revised invoice to Miss X on 31 January 2025, showing the amended care charges.
39. On the same day, Miss X paid the amount invoiced on 30 December 2024, rather than the amount invoiced on 31 January 2025.

Miss X’s complaint

40. Miss X complained to the Council on 9 February 2025. She said the Council had changed the care fees and had increased them without any discussion, after Mrs Y had passed away. Miss X said she felt misled, and the process had been very stressful.
41. On 27 February 2025, the Council issued a further invoice to Miss X, showing the amount paid on 31 January 2025, and the final outstanding balance.
42. The Council provided its complaint response to Miss X on 5 March 2025. It apologised for the confusion and distress caused, and for the timing of the invoices following Mrs Y's passing. The Council said the billing issue arose as a result of changes in the purchase orders, and acknowledged that it had not communicated this to Miss X in a timely manner. The Council acknowledged delays in sending the amended purchase order and acknowledged this had caused significant stress and confusion. The Council said the amount invoiced on 27 February 2025 remained payable as Mrs Y was liable to pay the full cost of care. The Council said it did not uphold Miss X’s complaint because it had correctly applied and charged the care fees.
43. Miss X remained dissatisfied with the Council’s response and brought the complaint to the Ombudsman. Shortly after, Miss X paid the remaining balance to the Council.

Analysis – the Council’s records

44. The Council’s records show it has no written confirmation of the weekly charge initially thought to have been agreed with Care Home A. Although the Council initially charged Mrs Y’s care fees at the standard IRN rate, it has no record to demonstrate this amount was ever agreed.
45. As previously stated, we published guidance on what constitutes good administrative practice, which includes keeping proper and appropriate records. We would expect the Council to retain a record of the agreed care charges, to demonstrate how it made its decision on what to charge Mrs Y. The Council’s failure to retain this record is not in line with the principles of good administrative practice. This is fault causing an injustice to Miss X, namely uncertainty as to how/if the Council discussed the care fees with Care Home A prior to invoicing.

Delays by the Council

46. The evidence indicates delay by the Council regarding the raising of the amended purchase order following the change in care fees. The Council requested a new purchase order on 3 December 2024 but did not send it to Care Home A until 8 January 2025, five weeks later. It is positive the Council identified this delay itself as part of its response to our enquires. Nevertheless, the delay identified is fault which delayed the raising of the amended invoice.

Notification of the change in care fees

47. The Council’s records confirm neither the adult social care team nor the SPT notified Miss X about the change in care charges; the Council increased the care charges without prior discussion with Miss X.
48. This is not in line with the Council’s social care charging policy. This states the Council will be transparent when it charges for care, and that it will provide clear and simple information about charging, at the right time. The evidence indicates the Council did not provide clear information to Miss X in a timely manner. This is fault.
49. The Council acknowledged this as part of its complaint response dated 5 March 2025. However, it did not uphold the complaint because it said the charges were payable. Although the charges may have been payable, this does not negate the impact of the fault identified to Miss X. She says the Council’s actions caused significant additional and avoidable distress at a time which was already extremely upsetting. I acknowledge the Council’s apology as part of its complaint response, but do not consider this fully addresses the fault identified or the injustice to Miss X.

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Action

50. To address the injustice identified, the Council has agreed to take the following action within one month of the final decision:
1. Provide a further apology to Miss X for the fault identified, including the uncertainty caused by the lack of records relating to the agreed care charges;
2. Make a symbolic payment of £250 to Miss X in recognition of the distress, confusion and uncertainty caused;
3. Provide evidence of the steps taken by the Council to ensure it keeps families informed about changes in care home charges;
4. Provide evidence of the steps taken by the Council to ensure it checks with care home managers about their expected rates, and
5. Remind staff to keep proper and appropriate records regarding the negotiation and agreement of care charges.
51. The Council should provide us with evidence it has complied with the above actions.

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Decision

52. I have found fault causing injustice. The Council has agreed to take the above actions to remedy the injustice identified and I have therefore concluded my investigation.

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Investigator's decision on behalf of the Ombudsman