Summary: The Council was not at fault for the way it sent invoices to Mr Y for care charges or for how it responded to his concerns. However, the Council was at fault for not explaining why it was charging Mr Y weekly for a service when he attended fortnightly. The Council has agreed to remedy the injustice caused.

The complaint

1. Ms X complains on behalf of Mr Y about how the Council has charged him for care costs, namely:
• The Council sent Mr Y an invoice for the outstanding balance which was incorrect.
• The Council did not properly investigate Mr Y’s concerns about his care costs and amount he had to pay.
• The Council took too long to resolve the issue.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
3. 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)

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How I considered this complaint

4. As part of this investigation I considered the complaint made and response from the Council. I made enquiries with the Council and considered the response received. I send a draft of this decision to Ms X and the Council for comments.

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What I found

Law and guidance

5. The Care Act 2014, the Care and Support Statutory Guidance 2014 (CASS) and the Care and Support (Charging and Assessment of Resources) Regulations 2014 set out the Council’s powers to charge for care and support it provides.
6. The CASS Guidance says the approach to charging should (among other things):
• ensure that people are not charged more than it is reasonably practicable for them to pay;
• be clear and transparent, so people know what they will be charged;
• Councils must carry out a financial assessment to decide about the charges. This will assess the person’s capital and income.
7. Councils must explain how it carried out a financial assessment, and how much a person must pay towards their care. A council must also say how often a person must pay and explain the reason for any fluctuation in charges. Councils should ensure this is provided in a manner the person can easily understand.
8. The Council’s leaflet for Council managed direct payments accounts says the Council will pay the gross amount due for a person’s care into their direct payment account. The Council manages this account and pays the relevant care providers. The Council then sends an invoice to the individual receiving care for their contribution. Invoices are sent four weekly. The leaflet says individuals should check invoices to ensure they are correct. If invoices do not show the services used the individual should contact the Council.

What happened

9. Mr Y requires care and support. He also has difficulty reading and writing. In May 2018 he started using his direct payment account to pay for attending an arts based project (the Provider) on a weekly basis. The Council wrote to Mr Y to confirm this and sent him a copy of its leaflet on managed direct payment accounts.
10. In July 2018 the Council reviewed Mr Y’s care costs and wrote to him setting out his personal budget and maximum financial contribution.
11. In August 2018 Mr Y stopped attending the Provider on a weekly basis and only attended every fortnight. He did not inform the Council of this change.
12. Mr Y telephoned the Council in October 2018 as he received an invoice for £360 which amounted to 8 sessions at the Provider. He also had received letters telling him he was in arrears. Mr Y told the Council he only attended the Provider on a fortnightly basis, not weekly and had been doing so since 1 August 2018. The Council confirmed Mr Y’s attendance with the Provider and agreed to update his support plan and invoices to reflect his fortnightly attendance since 1 August 2018.
13. The Council continued to send invoices to Mr Y which he found difficult to understand. In May 2019 Mr Y contacted the Council to say he wanted to pay the Provider directly for sessions he attended rather than have the Council pay the charges and send invoices to him. The Council agreed to Mr Y’s request and told him he should receive one final invoice. The Council cancelled Mr Y’s direct payment account and updated his support plan to reflect the changes.
14. In July 2019 Ms X contacted the Council about Mr Y’s outstanding invoices for the sessions he attended at the Provider. Ms X thought the Council overcharged Mr X. She provided the Council with a list of dates Mr Y did not attend the Provider but had been charged.
15. The Council contacted the Provider to check whether Mr X attended the sessions. After speaking with the Provider the Council issued a credit note, on 13 August 2019, to amend the outstanding charges Mr Y owed. The Council issued a further credit note to Mr Y’s account in September 2019 after speaking with Ms X. This left the outstanding balance Mr Y owed the Council at £225.
16. On 24 October 2019 Ms X raised a complaint with the Council on behalf of Mr Y. Ms X said:
• Mr Y reduced his art classes from weekly to fortnightly, but his invoices did not reflect this change.
• The Council has charged Mr Y for attending the Provider on days when it was closed and for days he did not attend.
• She been working with the Direct Payment Team to unravel what happened but has been unable to come to a conclusion.
• She found the Council charged Mr Y twice for attendance on 11 June 2019.
17. The Council responded to Ms X’s complaint in November 2019. The Council said:
• It changed Mr Y’s support plan to reflect fortnightly sessions at the Provider from August 2018. The Council’s system cannot reflect a fortnightly service so charged Mr Y for a half session each week. The invoices showed a half session each week not one session each fortnight. The Council apologised for not explaining this to Mr Y at the time and told Ms X it has discussed this with staff to ensure similar decisions are communicated in the future.
• It did not know Mr Y had changed his attendance at the Provider and only knew once he told the Council. This made some invoices sent to Mr Y incorrect as it thought he was attending more often. Once Mr Y made the Council aware, it contacted the Provider and raised credit notes accordingly to his account.
• After sending a letter to Mr Y in August 2019 detailing the outstanding invoice the Council spoke with Ms X and identified two sessions Mr Y did not attend in April and May 2019. The Council explained it had raised credits for both sessions. Therefore the amount Mr Y owed was £225.70.
• There was an overcharge on Mr Y’s account as it though he attended sessions at the Provider weekly, not fortnightly. The Council confirmed with the Provider and noted it had overcharged Mr Y £134 and removed this from his account.
18. In December 2019 the Council sent Ms X a breakdown of its charges for Mr Y.
19. Ms X remained dissatisfied and complained to the Ombudsman. She said both she and Mr Y were confused by the Council’s invoices and she is unsure whether the charges Mr Y owes are correct.

Analysis

20. Ms X complains the Council sent Mr Y invoices for his care costs where the balances were incorrect. While I accept the Council did send incorrect invoices to Mr Y, I do not find it at fault. I am satisfied the reason for the incorrect invoices was the Council was not aware Mr Y had changed his attendance at the Provider from weekly to a fortnightly basis. The Council’s leaflet on managed direct payments, which it sent to Mr Y, tells service users they should contact the Council if they feel any invoices are incorrect.
21. When Mr Y made the Council aware it had charged him for sessions he had not attended, the Council confirmed with the Provider which sessions Mr Y attended and adjusted the outstanding invoice to reflect this.
22. When Mr Y’s direct payment account ended, again he received invoices for sessions he did not attend at the Provider. Again this was due to the Council not being told Mr Y had not attended certain sessions. Once the Council was able to confirm which sessions Mr Y attended at the Provider it adjusted his invoices and issued him with a final invoice.
23. I have found the Council at fault for not explaining its invoices and charging method to Mr Y. When Mr Y contacted the Council in October 2018 to say he was only attending the provider every fortnight, the Council amended his support plan to reflect this. In response to enquiries from the Ombudsman the Council said its system could not process fortnightly charges so it charged Mr Y for half a session each week. Mr Y could not understand the Council’s invoices which ultimately led him to cancel his direct payment account.
24. The Council did explain why it could make fortnightly charges to Mr Y in its complaint response in November 2019, however it could have done this at a much earlier stage, particularly as it was aware Mr Y had difficulties reading and writing. I can see no record the Council told Mr Y it would charge him for half sessions each week when he telephoned in October 2018.
25. The Council has acknowledged it should have explained its invoicing method to Mr Y earlier and has apologised. It has also discussed this with staff to ensure such decisions are better communicated to people in the future. I do not think this goes far enough and the Council should make a payment to Mr Y to reflect the time and trouble he spent pursuing this. Had the Council explained why it had charged Mr Y a weekly amount he may have better understood his invoices and may not have pursued a complaint with the Council following the closure of his direct payment account.

Agreed action

26. Within 4 weeks of my final decision the Council agreed to carry out the following and provide evidence to the Ombudsman it has done so.
• Pay Mr Y £100 for not explaining its invoicing method to him earlier and to recognise the time and trouble he and Ms X spent pursuing this.
27. In line with our guidance on remedies, the Council may choose to offset this amount against Mr X’s outstanding debt of £225.70. Should the Council decide to do this it should send Mr X a revised invoice within the above timeframe.

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Final decision

28. I have completed my investigation and found fault by the Council as it did not fully explain to Mr Y why it was invoicing him for half sessions each week. The Council has agreed to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman