Summary: On behalf of Miss X, Mrs Y complained the Council failed to inform them of the full cost of Miss X’s care for approximately one year. There is no evidence of fault in the Council’s actions.

The complaint

1. On behalf of Miss X, Mrs Y complained the Council failed to inform them of the full cost of Miss X’s care for approximately one year. Mrs Y told us Miss X received a large bill which has significantly impacted her mental health. Mrs Y would like the Council to explain how Miss X’s care charges are calculated.

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The Ombudsman’s role and powers

2. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
3. 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

4. I considered evidence provided by Mrs Y and the Council as well as relevant law, policy and guidance.
5. Mrs 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

Legal and administrative background

6. 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)
7. 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. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
8. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home. After charging, a person’s income must not reduce below a weekly amount known as the minimum income guarantee (MIG). This is set by national government and reviewed each year. A council can allow people to keep more than the MIG. (Care Act 2014)
9. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care. When doing so, a council should make an assessment to allow the person to keep enough benefit to pay for necessary disability-related expenditure (DRE) to meet any needs it is not meeting. The Care and Support Statutory Guidance sets out a list of examples of such expenditure. It says any reasonable additional costs directly related to a person's disability should be included. What counts as DRE should not be limited to what is necessary for care and support. For example, above average heating costs should be considered.

What happened

10. At the beginning of 2024, the Council assessed Miss Y’s care needs. The assessment determined Miss X had eligible care needs which required weekly, non-residential care.
11. Miss Y was made aware she may have to pay towards the cost of any social care she received. Miss Y signed an agreement which explained she would pay any assessed care contribution.
12. The Council referred Miss Y for a financial assessment in February 2024.
13. Miss Y’s package of care began in March 2024.
14. The Council wrote to Mrs X in April 2024 to ask her to complete an online statement to allow the Council to complete the financial assessment.
15. The Council issued a reminder to Mrs X in June 2024 to request she complete the online statement to allow the Council to complete the financial assessment. The reminder explained Miss Y may be charged the full cost of her care if the online statement was not completed.
16. The Council issued a second reminder letter to Mrs X in August 2024. The second remind asked Mrs X to complete the online statement. The reminder said if the statement was not completed, Miss Y may be charged the full cost of her care.
17. The Council issued a third reminder to Mrs X in November 2024. The reminder asked Mrs X to complete the online statement and explained Miss Y may be charged the full cost of her care if the statement was not completed.
18. Mrs X contacted the Council at the end of November 2024 to discuss the online statement. The Council responded to explain it needed to complete an assessment of Miss Y’s finances to calculate whether she was required to pay a contribution towards the cost of her care.
19. Mrs X completed the online statement in December 2024.
20. The Council wrote to Mrs X in March 2025 to explain it had completed the financial assessment and determined Miss Y was required to make a weekly contribution towards the cost of her care. The letter explained that certain costs were not included in the assessment as they are payable from the minimum income guarantee.
21. Mrs X contacted the Council the following day to explain Miss Y’s financial circumstances has changed and she had reduced her package of care. The Council requested evidence of Miss Y’s change in circumstances and updated financial information.
22. In April 2025 the Council issued an invoice for Miss Y’s weekly care contribution which was calculated and backdated to April 2024.

My findings

23. There is no evidence of fault in the Council’s actions in making Miss Y aware of the charges relating to her package of care. The Council has provided evidence Miss Y was aware that she may be required to pay a contribution towards her care once the financial assessment was completed.
24. There is no evidence of fault in the Council’s actions in completing Miss Y’s financial assessment and issuing the invoice for her care charges. Although there was a delay in the financial assessment being requested and completed, the evidence shows the Council requested the relevant information in April 2024 and sent three reminders between June and November 2024. The delay in completing the financial assessment was not caused by the Council.
25. There is no evidence of fault in the Council’s completion of Miss Y’s financial assessment. The Council considered the information provided, considered Miss Y’s DRE and allowed her the minimum income guarantee.

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Decision

26. I find no fault.

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Investigator's decision on behalf of the Ombudsman