Summary: Ms X complains that the Council did not tell her for a year that she should have been contributing to her care costs. She says the Council is now threatening legal action to recover the outstanding contributions. Ms X says this has caused stress, anxiety and worry. The Ombudsman finds the Council at fault for failing to send reminders or follow up with Ms X about her missed payments. The Ombudsman also finds fault because the Council delayed responding to Ms X about this matter. We find the fault caused Ms X injustice. The Council will apologise to Ms X and make a payment to her to remedy the injustice. The Ombudsman is satisfied that the Council is taking appropriate action to prevent a recurrence.

The complaint

1. The complainant, who I refer to here as Ms X, complains that the Council did not tell her for a year that she should have been contributing to her care costs. She says the Council is now threatening legal action to recover the outstanding contributions.
2. Ms X says this has caused stress, anxiety and worry.

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What I have investigated

3. The Ombudsman cannot investigate complaints that are more than 12 months after the complainant first had knowledge of the problem, unless there are good reasons to do so.
4. In this case, Ms X first had knowledge of the problem in October 2016. However, she has been in contact with the Council about it since then, trying to resolve it without success.
5. Overall, I have decided there are good reasons to exercise our discretion and investigate this complaint.

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The Ombudsman’s role and powers

6. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
7. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)
8. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
9. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

10. I considered the information and documents provided by Ms X and the Council. I spoke to Ms X about her complaint. Ms X and the Council had an opportunity to comment on an earlier draft of this statement. I considered all comments received before I reached a final decision.
11. I considered the relevant legislation and statutory guidance, outlined below.

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What I found

What should have happened

12. Councils can charge for care and support services they provide or arrange. (Care Act 2014, section 14)
13. Councils must assess a person’s finances to decide what contribution they should make. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)
14. The Care and Support statutory guidance (‘the guidance’) sets out principles for charging for care and support. One of these principles is that the approach to charging should be clear and transparent so people know what they will be charged.
15. The guidance says it is important that people pay their fair contribution towards their care and support costs.

What happened

16. Ms X receives care. Until October 2015, Ms X was not charged for these care services.
17. In October 2015, the Council reviewed Ms X’s situation and did a financial assessment. The outcome of this assessment was that Ms X should make a weekly contribution to her care costs. In November 2015, the Council sent Ms X a letter telling her this.
18. Ms X says she did not get this letter.
19. In October 2016, Ms X found out that she should have been making contributions for a year. She spoke to her Social Worker about this. The Social Worker wrote to Ms X that month, saying she had asked that Ms X’s financial assessment was looked at again to confirm the contributions were the right amount.
20. The Social Worker assured Ms X in this letter that the Council would investigate the backlog of outstanding contributions and someone would contact Ms X as soon as possible. The Social Worker advised Ms X to begin making weekly contributions.
21. Ms X began to make weekly contributions to her care costs.
22. In August 2017, the Council wrote to Ms X. It confirmed that Ms X’s financial assessment in October 2015 showed that she needed to make weekly contributions to her care costs, and confirmed the amount was correct. It noted that Ms X had discussed this with her Social Worker “some months ago”.
23. The letter said the intention of Ms X’s meeting with the Social Worker in October 2016 was to discuss the matter and come to an arrangement of how to deal with the outstanding amount. It said no final decision had been made. The Council asked how Ms X intended to repay the amount owed. The Council offered to discuss repayments with Ms X.
24. The Council says Ms X did not reply to this letter.
25. In January 2018, the Council put enforcement action to recover this debt on hold because Ms X said she was going to submit a complaint in February.
26. In September 2018, the Council took the hold off the account because Ms X had not submitted a complaint.
27. In November 2018, Ms X’s father spoke to the Council and said Ms X was going to dispute the outstanding amount. The Council put a hold on Ms X’s account again.
28. In February 2019, the Council wrote to Ms X. It said it had twice put her account on hold but had not received a complaint from her. It said the hold would be taken off, and it would continue to recover this debt. It urged Ms X to contact the Council and set up a repayment plan.
29. In March 2019, Ms X complained to the Council. She said she did not know she had to pay weekly contributions until October 2016.
30. In May 2019, the Council responded to Ms X’s complaint. The Council said it did not know why Ms X did not receive the letter in November 2015 which told her she had to contribute to her care costs.
31. The Council said regrettably there seemed to have been some misunderstanding about payment following Ms X’s conversation with the financial assessment officer in 2015. There is no record of that conversation, but the Council apologised if this was the case. The Council said it was not possible to say how much a contribution will be until a full assessment is carried out.
32. The Council said it wrote to Ms X in August and September 2017 asking how she intended to repay but had received no reply from her. It said it could not write off the debt, and if Ms X had difficulty repaying, she could set up a repayment plan.
33. In September 2019, Ms X complained to the Ombudsman.

Analysis

Outstanding bill for care costs

34. Ms X complains that the Council did not tell her for a year that she should have been contributing to her care costs.
35. Ms X acknowledges that the Council told her she may have to contribute to her care costs. She said the financial assessor told her that she would only be contacted if she was assessed as eligible to make contributions. She says that she did not receive the Council’s letter so she thought she had been assessed as not having to contribute.
36. So, the Council told Ms X at that time that she may have to contribute to her care costs in the future. Ms X could have contacted the Council to confirm the outcome of the assessment. She chose not to. The Council is not at fault for Ms X not receiving the letter.
37. The Council says when payments are missed, it will write to the person. It says in this case, the officer assigned to Ms X’s case was on secondment and had not been replaced. For this reason, the Council says it could only do “minimal checks”.
38. This is fault. The Council did not send any reminders to Ms X or chase her for missed payments for a year. This poor communication caused Ms X injustice because it caused uncertainty and she now faces a large bill. I must add, though, that this is a valid bill for care that Ms X received.

Outcome of the Council’s investigation

39. The Social Worker told Ms X in October 2016 that the Council would investigate this matter and get back to her “as soon as possible”. The Council did not tell Ms X the outcome of its investigation. The Council wrote to Ms X about the investigation in August 2017, ten months later, but did not explain the reason it had not chased up the missed payments.
40. I find that this delay of ten months, and the failure to explain the outcome of the investigation, is fault. This caused Ms X injustice because it caused her uncertainty about whether the amount she owed was correct.

Agreed action

41. Within four weeks of this decision, the Council has agreed to apologise to Ms X in writing for the uncertainty caused by failing to send reminders or follow up with her about her missed payments for a year. The Council will also apologise to Ms X for the uncertainty caused by the ten-month delay in responding to her about its investigation into the matter.
42. Within four weeks of this decision, the Council has agreed to make a payment to Ms X of £400. This is made up of £250 to reflect the injustice caused by failing to send reminders or follow up the missed payments, and £150 for the delay in responding to Ms X. This is in line with the Ombudsman’s published guidance on remedies.
43. The Ombudsman will need to see evidence that these actions have been completed.
44. The Council is currently reviewing its processes to make sure that the process for following up missed payments is consistently applied and prevents a recurrence. It is part-way through moving clients onto an online card which will allow the Council to respond more quickly when contributions are not being paid.
45. The Council is also going through a restructure which means there will be greater support to cover any long-term staffing absences.
46. These actions are positive. I am satisfied that these actions are taking place and will significantly reduce the risk of a future recurrence.

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Final decision

47. I have completed my investigation. I uphold Ms X’s complaint because I find fault causing injustice. The Council has already taken some action to prevent a recurrence, and it will take action to remedy the injustice to Ms X.

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Investigator's decision on behalf of the Ombudsman