Summary: Mrs X complains on behalf of her mother, Mrs Y, about inaccurate information regarding social care charges provided by the Trust and the Council. Mrs X says this led to Mrs Y accepting social care support which she would have rejected, had she known it would be chargeable. Mrs X says an invoice for the services caused upset and distress. She would like the Council to waive the charges. We will not investigate this complaint. An Ombudsman investigation is unlikely to achieve more than the Council’s local complaint investigation.

The complaint

1. Mrs X complains on behalf of her mother, Mrs Y. She complains about the actions of Gateshead Health NHS Foundation Trust (the Trust) and South Tyneside Metropolitan Borough Council (the Council). She complains that:
• when her mother was an inpatient at the Trust’s hospital, hospital staff incorrectly told them there would be no charge for the social care Mrs Y received at home after leaving hospital;
• the Council failed to give them the correct information about charges before the service became chargeable;
• the Council relied on giving Mrs Y and a friend verbal information about charges without checking Mrs Y could understand this and provide informed consent; and
• the Council’s financial assessment was delayed.
2. Mrs X says this led to Mrs Y accepting social care support that she would have declined if she had known she would need to pay for it. She says Mrs Y suffered avoidable stress and upset at an unexpected invoice for the services. Mrs Y would like the Council to waive the charges.

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The Ombudsmen’s role and powers

3. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
4. We may investigate complaints made on behalf of someone else if they have given their consent. We may also investigate a complaint on behalf of someone who cannot authorise someone to act for them, if we consider them to be a suitable representative. (Health Service Commissioners Act 1993, section 9(3) and Local Government Act 1974, sections 26A(1) and 26A(2), as amended)
5. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we would find fault, or
• the fault has not caused injustice to the person who complained, or
• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

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

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What I found

Key events

8. Mrs X says:
• the Trust’s hospital told her and Mrs Y that Mrs Y’s social care when she returned home from hospital would be free of charge for six weeks;
• Mrs Y was tired when she left hospital and the Council did not check properly whether Mrs Y could understand any verbal information it gave her about social care charging when she returned home;
• Mrs X has lasting power of attorney for her mother and so the Council should have involved her in any discussions about charges;
• the Council failed to ensure they both had the required information before changing Mrs Y’s care from free support to chargeable support;
• the Council delayed carrying out a financial assessment of Mrs Y; and
• as a result, they were surprised and distressed by an invoice for around four weeks of social care support.
9. Council records indicate:
• Mrs Y could understand information and make her own decisions;
• immediately after she left hospital in Mid-March 2025, the Council arranged a free short-term support service for Mrs Y;
• the Council contacted Mrs Y by telephone shortly after she left hospital, spoke to Mrs Y’s friend rather than her, and told her about the service becoming chargeable;
• in late March 2025, the Council carried out an in-person assessment of Mrs Y’s needs. The record of this assessment meeting states the assessor told Mrs Y her support would be free initially, but would become chargeable if she needed it for longer;
• a few days later, the Council telephoned Mrs Y to tell her the service would become chargeable soon;
• in early April 2025, the Council changed Mrs Y’s support from the short-term free service to the chargeable service;
• in mid-April 2025, the Council sent Mrs Y a form for a financial assessment;
• at the end of the month, Mrs Y cancelled the service stating she no longer needed it; and
• the Council chased Mrs Y for the completed financial form in early May 2025. She had disposed of it thinking it was no longer needed, so the Council issued a new one for Mrs X to complete on Mrs Y’s behalf. The Council completed its financial assessment and sent the written decision two weeks later. It followed this up with an invoice for the chargeable care.
10. The Council’s local response to Mrs X’s complaint says it has taken steps to improve communication about social care charging with people being discharged from hospital. It has provided the hospital with written information to share with patients and their families. It has also reminded the hospital to check it has given this information to patients. However, the Council will not waive the charge as it considers it told Mrs Y three times about charging for services, before the free service became chargeable.

My analysis

11. Councils must presume a person can make their own decisions unless there is proof to the contrary (Mental Capacity Act 2005). When somebody can make their own decisions, councils are usually expected to communicate directly with them, unless, for example, a person asks a council to communicate with a relative instead. It is unlikely we would find fault in the Council treating Mrs Y as being able to make her own decisions and communicating directly with her about care charges.
12. When people leave hospital, in some circumstances they can receive free support at home until their local council completes an assessment of their longer-term social care needs. In this Council’s area, this service is called the Home Independence Crisis Support Service (HICSS). 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)
13. This means that, in practice, a person can have an assessment of their longer-terms care needs and have support in place before the Council completes a financial assessment of how much they can afford to pay towards their care. As long as the Council informs the person that their care is chargeable subject to a financial assessment and completes that assessment correctly without avoidable delay, we are unlikely to find fault with the Council even if there is a gap between the start of the service and the financial assessment.
14. Even if there had been fault by the Trust and Council in their initial communication with the Mrs Y about care charges, the Council corrected this by giving Mrs Y the correct information twice before the service became chargeable. An investigation by the Ombudsmen is therefore unlikely to find that fault by the Council or Trust caused Mrs Y a financial loss. As Mrs Y was aware the service would be chargeable before it started, the Ombudsmen would have no grounds to recommend for the charges to be waived.
15. The Council has already put service improvements in place to improve communication with people who are in hospital and may need social care support after discharge. An investigation by the Ombudsmen is unlikely to recommend additional service improvements.

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Decision

16. We will not investigate this complaint about communication regarding social care charges and delay in financial assessment. An investigation is unlikely to find that fault by the organisations caused financial loss to Mrs Y, achieve the complainant’s desired outcome. or add to the Council's previous investigation.

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Investigator's decision on behalf of the Ombudsman