Summary: The Ombudsman will not investigate Mrs X’s complaint about her backdated and ongoing care charges. This is because the Council has taken proportionate action to remedy the injustice to Mrs X for to the backdated care charges. It is unlikely that an investigation will lead to a different outcome. It is also unlikely the Ombudsman would find fault with the Council over the ongoing care charges.

The complaint

1. Mrs X complains that in September 2019 the Council sent her an £8,000 bill for her care charges going back to October 2017.
2. Mrs X says she cannot afford to pay the bill and wants the Council to waive all outstanding care fees.
3. Mrs X says she also cannot afford to pay for her ongoing care charges.

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The Ombudsman’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we are satisfied with the actions a council has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)
5. 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’. 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
• it is unlikely we could add to any previous investigation by the Council, or
• it is unlikely further investigation will lead to a different outcome, or
• we cannot achieve the outcome someone wants.

(Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

6. I have considered Mrs X’s complaint to the Ombudsman and the information she provided. I have written to Mrs X with my draft decision and given her an opportunity to comment.

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What I found

7. Councils have a duty to arrange care and support for people with eligible needs. They can charge for most of the care and support they provide or arrange, but the amount someone needs to pay will depend on their financial circumstances. Councils must complete a financial assessment to decide how much a person can afford to pay towards their personal budget for care and can take a person’s income and savings into account subject to certain conditions. If a person incurs expenses that are directly related to a disability they have, the Council should take this into account when assessing their finances.

What Happened

8. Mrs X had a change in circumstances in October 2017 which resulted in her being liable for care charges.
9. Mrs X told her care manager of her change in circumstances in October 2017, but the Council did not amend the care charges.
10. In April 2019, the Council completed a financial assessment to calculate Mrs X’s care charges. The Council calculated Mrs X’s weekly care charges at £84.55 after taking into consideration her Minimum Income Guarantee. The Council did not raise these care charges with Mrs X.
11. In September 2019, the Council invoiced Mrs X £8,000 for care fees it calculated she had underpaid since September 2017.
12. In October 2019, the Council completed a Disability Related Expenditure Assessment (DREA). In light of the DREA and financial assessment the Council advised that Mrs X would be liable for charges at £65.30 per week moving forwards.

Backdated Charges

13. Councils have the power to backdate care fees when they establish someone is liable.
14. Following Mrs X’s complaint, the Council recognised it was at fault for not charging Mrs X care fees from October 2017 and removed all care charges until September 2019, amounting to £7,722.
15. In doing so the Council has taken proportionate action to address its fault for failing to raise the charges before September 2019. This is the time the Council made Mrs X aware that she should be paying for her care. It is unlikely a further investigation would lead to any further charges being removed.

Ongoing Charges

16. Mrs X disagrees with the amount the Council says she must pay towards the cost of her care. But the Council assessed Mrs X’s finances in line with the requirements of the Care Act.
17. Mrs X is liable for her care charges from September 2019. From the evidence I have seen, there is no evidence of fault in the Council’s financial assessment and DREA. The change in Mrs X’s personal circumstances in October 2017 would mean Mrs X would need to start paying towards her care.
18. The Council offered a payment arrangement for Mrs X’s current care fees and repayment of any charges accrued since September 2019.
19. It is unlikely an investigation by the Ombudsman would find fault with the Council’s assessment of Mrs X’s care costs.

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Final decision

20. The Ombudsman will not investigate Mrs X’s complaint about her backdated and ongoing care charges. This is because the Council has taken proportionate action to remedy the injustice to Mrs X for to the backdated care charges. It is unlikely that an investigation will lead to a different outcome. It is also unlikely the Ombudsman would find fault with the Council over the ongoing care charges.

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Investigator's decision on behalf of the Ombudsman