Summary: The Council was at fault for overcharging Mr Z for his care and support and for failing to properly consider how much it had overcharged him by. This caused his representative, Ms X, confusion. However, the Council ultimately reimbursed Mr Z more than it had overcharged him by, so the fault did not cause him financial harm. The Council will apologise to Ms X and take action to prevent similar fault in future.

The complaint

1. Ms X complained the Council:
1. Did not communicate appropriately with her while it was assessing her father, Mr Z’s, need for care and support and deciding if he needed reablement care following his discharge from hospital;
2. Failed to charge Mr Z properly for his care. Ms X said the Council failed to reduce Mr Z’s care charges after he changed his care package several times. She said the Council wrongly charged Mr Z for care visits which did not go ahead, which should have been free and for visits which were too short or were late. Ms X also said the Council charged more per hour than she had been told to expect; and
3. Did not respond appropriately to her concerns about errors with Mr Z’s care charges.
2. Ms X said this meant Mr Z was overcharged and that the issues caused her frustration and distress at an already difficult time.

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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. 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 not investigated Ms X’s complaint that the Council did not communicate properly with her while it was assessing Mr Z needs and its subsequent decision that Mr Z did not need reablement. That decision meant Mr Z was not eligible for six weeks of free reablement care after he was discharged from hospital. A previous Ombudsman investigation considered whether the Council was at fault in how it decided Mr Z did not need reablement and found it was not. Therefore, any flaws relating to the Council’s communication did not cause a significant personal injustice, as the underlying decision to refuse reablement was sound.
6. The Ombudsman does not typically recommend a council reimburse someone for the cost of a care visit unless the care provided was fundamentally inadequate. Our previous investigation also considered Ms X’s complaint that the care and support Mr Z received was flawed. We concluded we would not investigate that matter because any flaws in the care Mr Z received were minor enough to not cause a significant personal injustice. Given this, I will not investigate Ms X’s complaint about the Council’s refusal to reimburse Mr Z the cost of care visits that were short or late, as we have already decided those issues did not cause Mr Z a significant personal injustice and so would be unlikely to recommend the Council reimburse him.

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How I considered this complaint

7. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
8. Ms X 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

Relevant law and guidance

9. 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 (this is care provided other than in a care or nursing home) following a person’s needs assessment. (Care Act 2014, section 14 and 17)
10. 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 will ask for details for a person’s income and capital.
11. Capital generally covers buildings, land and savings including stocks and shares and money held in banks or in cash. Someone with over £23,250 in capital will be classed as able to afford the full cost of their care.

What happened

12. This section sets out the key events in this case and is not intended to be a detailed chronology.
13. Mr Z began receiving care at home on 13 January 2024, after being discharged from hospital. Ms X said that while Mr Z was in hospital, she was told he would only need to contribute to his care a week after he returned home, on 19 January, because his care up to that point was the responsibility of the NHS. In fact, the NHS funded Mr Z’s care for five days after his discharge, up to 17 January.
14. The Council asked Mr Z to provide financial information so it could decide what he would need to pay.
15. Between 13 January and 9 March (an eight-week period), Ms X reduced Mr Z’s care package several times, ultimately from 2:15 hrs per day to 30 minutes per day. On 9 March, she cancelled Mr Z’s package altogether.
16. By late March the Council had not received the information it needed from Mr Z in order to complete his financial assessment. As a result, it decided he would need to pay the full cost. The Council sent Mr Z’s invoice in mid-April. It came to just over £1300 and noted Mr Z had received 62:45 hrs of care while his care package was in place.
17. Ms X challenged the Council’s invoice because she felt it had overcharged Mr Z for a number of reasons. These were:
• While Mr Z had been in hospital, she was told his care would cost less per hour than he was being charged;
• Mr Z had been charged for visits on 14 and 15 January, which Ms X said did not happen.
• The Council had charged Mr Z from 16 January, not 19 January as she expected; and
• The Council had failed to update Mr Z’s fees to reflect when his care package reduced.
18. The Council replied shortly after and said:
• While Mr Z was receiving care, the hourly cost was £21.96. Ms X had said she had been told the cost was £20.85 per hour, but the Council said there was no evidence of this; and
• It would reduce Mr Z’s fees to reflect when he had been overcharged after his care package reduced. The Council also said it would only charge Mr Z for his care from 19 January, given Ms X had been told that would be the case.
19. The Council later told Ms X it had reduced Mr Z’s outstanding balance by £192.12. It noted this was because it had overcharged Mr Z after his care packaged reduced in weeks one, two and six. This amounted to 8:45 hrs of care at £21.96 per hour.
20. However, records show Mr Z was actually overcharged after his care package reduced in weeks two, seven and eight. He was overcharged by 4:30 hrs of care, which equates to £98.82.

Findings

21. The Council was not at fault in how much it charged Mr Z per hour for his care. It charged him the correct amount; £21.96 per hour.
22. Ms X was unhappy the Council charged Mr Z for visits she said did not happen on 14-15 January. However, in that period, the NHS was responsible for Mr Z’s care. There is no evidence the Council charged Mr Z for any visits on those days. It was not at fault.
23. Further, Ms X said the Council wrongly charged Mr Z for visits between 16 and 19 January. After Ms X told the Council she felt Mr Z had been overcharged, it agreed it would adjust Mr Z’s fees to reflect it would only charge him for his care from 19 January onwards. This was a decision for the Council to make, but in any event, the April invoice shows it had never charged Mr Z for his care between 16-19 January.
24. When Ms X received Mr Z’s April invoice, she told the Council she thought it had overcharged him after she had reduced his care package several times. In response, the Council concluded it had overcharged Mr Z, but by the wrong amount. It also attributed the overcharges to the wrong weeks. This was fault and meant Ms X experienced avoidable confusion as she tried to understand whether the Council had reimbursed Mr Z appropriately.
25. The Council was also at fault for failing to update Mr Z’s fees when his care package changed. This meant it initially billed him for more care than he received. However, as noted above, the Council reduced the charges for Mr Z’s care package by more than the amount it had overcharged him by. Therefore, the fault did not cause him financial harm.

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Action

26. Within one month of the date of my final decision, the Council will take the following actions.
1. Apologise to Ms X for the confusion caused by its failure to properly consider how much it had overcharged Mr Z by. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council will consider this guidance in making the apology.
2. Identify why it failed to update Mr Z’s care fees appropriately when it became aware his care package had changed. The Council will consider what steps are necessary to prevent similar fault in future and will tell the Ombudsman when it will complete those steps by.
27. The Council will provide us with evidence it has complied with the above actions.

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Decision

28. I find fault causing injustice. The Council has agreed actions to remedy that injustice and prevent fault in future.

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Investigator's decision on behalf of the Ombudsman