Summary: Miss Y complained on behalf of Mr X that the care provider incorrectly billed the Council for three years for Mr X’s care, which caused a backdated outstanding balance. We find the Council at fault for poor oversight and management of its commissioned care provider. This caused significant distress and worry for the family. The Council will apologise and arranges a reasonable and affordable payment plan.

The complaint

1. Miss Y complains on behalf of Mr X. She says the care provider incorrectly billed the Council for Mr X’s care between 2022 and 2025. She says the care provider has since tried to recover the cost of this care by issuing backdated invoices.
2. She says Mr X cannot afford to make this repayment, and it has caused significant distress and worry for the family.

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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 complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
5. 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

6. I considered evidence provided by Miss Y, the care provider and the Council as well as relevant law, policy and guidance.
7. Miss Y 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

Legislation and guidance

Charging for social care services: the power to charge

8. 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

9. 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.

Personal Budgets

10. Everyone whose needs the council meets 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.
11. There are three main ways a personal budget can be administered:

• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.
  (Care and Support Statutory Guidance 2014)

What happened

Background information

12. Mr X has lived in supported living since August 2022.
13. In November 2022, the Council carried out a financial assessment. It wrote to Ms Z, his financial appointee, to confirm Mr X would need to contribute to the cost of his care and set out the weekly amount he was liable to pay. The cover letter stated it will send an invoice every four weeks showing the amount to pay.
14. The finance team sent a second letter confirming it would send a copy of the contribution letter to the Care Provider, who would collect the contribution from Mr X.
15. In November 2023, the Council completed its annual financial reassessment and wrote to Ms X to confirm an increased contribution. It again said an invoice would be sent every four weeks.
16. In April 2024, the Care Provider emailed Mr X’s social worker after realising the Council had been deducting client contributions from its payments. It said it was seeking clarification on whether it should be collecting these contributions itself, and who was responsible for recovering any outstanding amounts.

What happened

17. In June 2025, the Care Provider sent Ms Z multiple bills covering three years of backdated care costs. It said Mr X had an outstanding balance of £18,331.97 and stated payment was due within 21 days of receipt of invoice.
18. From June, Ms Z has received the monthly invoices for Mr X’s care and made each payment.
19. Miss Y, a representative of Mr X complained to the care provider. It said it had invoiced the Council instead of Ms Z in error. It said as soon as it noticed, it sent out the outstanding invoices in June. It explained it aims to bill the client contribution element within 30 days, but there are sometimes delays.
20. The care provider offered a payment plan to settle the balance. It proposed Mr X could pay £2,865.87 per month, plus current monthly invoices. Miss Y says this amount is not feasible as Mr X is in receipt of benefits, and his total benefit income is significantly lower than this.
21. Miss Y brought her complaint to us.

Council response to enquiries

22. Although Mr X receives his care from the care provider, this is part funded by the Council. The Council said:
• The care provider has never invoiced the Council for the weekly charge, and this should have been invoiced directly to Mr X or Ms Z. As this is an Individual Service Fund (ISF) case, the provider should invoice directly.
• It did not make any payments in respect of Mr X,
• It was not aware of the payment plan offered as this was between Mr X and the care provider.
23. The Council was also asked how it maintained oversight of the placement and ensured the contributions were being invoiced and collected correctly. It said this did not apply because the care provider should have collected the weekly charge.

My findings

24. When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them.
25. The Council commissioned Mr X’s placement and completed the financial assessments which decided the level of his client contribution. While the care provider was responsible for collecting that contribution, the Council remained responsible for ensuring the placement was properly managed, including putting clear financial arrangements in place.
26. The Council did issue a letter in November 2022 which confirmed the intended arrangement. This shows the Council established how contributions should be managed and communicated this to Mr X and Ms Z. It also issued yearly financial assessment outcome letters, so Ms Z was aware Mr X was required to contribute to his care.
27. Despite this, no invoices were issued for a period of three years. The Council did not take steps to satisfy itself the care arrangements were working and that contributions were being made in line with the agreement. This is fault.
28. In April 2025, the care provider contacted the Council to clarify who was responsible for collecting the client contributions after identifying they had not collected them. This shows the Council did not properly implement or maintain the 2022 arrangement or ensure both parties understood and followed it. This is fault.
29. Further, the financial assessment letters issued by the Council in 2023 and 2024 stated that invoices would be sent every four weeks. This inconsistency likely caused confusion for Mr X and Ms Z about who would invoice them and when payments were expected. The Council did not ensure its communications were clear and consistent. This is fault.
30. The Care Provider accepted it failed to invoice Mr X or Ms Z over a prolonged period due to an oversight. However, as the Council commissioned the service and retained responsibility for oversight, it remains accountable.
31. The failure to issue invoices over a prolonged period led to a significant debt accruing, which caused Mr X and Ms Z distress and worry. The proposed repayment arrangements added to this distress because they did not sufficiently consider Mr X’s financial circumstances. The Council could have avoided this injustice by maintaining proper oversight and clear, consistent financial arrangements.
32. While I acknowledge the distress caused by the outstanding debt, Mr X and Ms Z were informed of the assessed contribution and remain liable for the cost of care. The Council should ensure any repayment arrangement is reasonable and reflects Mr X’s ability to pay.

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Action

33. To remedy the injustice from the above faults, within four weeks of the date of my final decision, the Council will apologise to Mr X in line with our guidance Making an effective apology.
34. Within three months of the date of my final decision the Council will:
• Work with the care provider, to arrange an appropriate payment plan that considers Mr X’s financial situation. Ensuring his monthly payments are reasonable and affordable.
• Review and amend the financial assessment outcome letter, to ensure the invoicing and payment process is clear, specifically when an Individual Service Fund (ISF) case and payment is made directly to the care provider.
35. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman