Summary: Mr X complained the Council issued a backdated invoice in February 2022 for Direct Payments related to his care charges. We did not find fault with the Council backdating Mr X’s care charges.

The complaint

1. Mr X complained the Council issued a backdated invoice in February 2022 for Direct Payments related to this care charges. Mr X says the Council caused this backdated invoice by failing to complete financial reassessments when he provided it with updated information and failing to complete annual financial assessments.

Back to top

What I have and have not investigated

2. I have not investigated Mr X’s complaint about a reduction in his care package since 2017.
3. 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)
4. I have not investigated Mr X’s complaint about this matter since he has been aware of this matter since 2018. The Council responded to Mr X’s complaint about his care package in 2018 and directed Mr X to the Ombudsman. Mr X did not contact the Ombudsman until 2023. There is no good reason Mr X took so long to bring this matter to the attention of the Ombudsman.

Back to top

The Ombudsman’s role and powers

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’. 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)
6. 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(i), as amended)

Back to top

How I considered this complaint

7. I have considered all the information Mr X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
8. Mr X provided comment on my draft decision which I considered before making my final decision.

Back to top

What I found

Care needs and assessments

9. 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)
10. 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. Councils may exercise discretion to disregard some sources of income, set maximum charges or charge a percentage of the person’s disposable income. How such discretion is to be applied should be set out in the Council’s policy. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
11. 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 family home. If a person has capital (other than their own home) and savings of £23,250 or more, they will be expected to pay all of the care fees until their savings drop below this amount.

2018 financial assessment

What happened

12. The Council provided Mr X with financial assessment forms. These explained that if Mr X did not complete the forms, it would assume he had capital in excess of £23,250 and would be a self-funder for his care. The financial assessment form advised the information Mr X provided would be used to decide on what services Mr X would receive and provision of false information to avoid payment is a criminal offence.
13. In February 2018, Mr X completed the financial assessment forms. Mr X confirmed with the Council he did not own any other property than his main residence on this form.
14. The Council completed a financial assessment of Mr X on 6 May 2018 based on the information he provided and said Mr X did not need to make any contribution to his care costs.

Analysis

15. When Mr X first completed his financial assessment forms, he provided accurate information about only owning his main residence. Mr X returned the forms to the Council with the required information which enabled the Council to complete the financial assessment. This financial assessment determined that Mr X did not have capital or savings above the £23,250 threshold. The Council also determined that based on his income, Mr X would not need to contribute towards his care costs.
16. The Council completed an assessment of Mr X’s finances on the information provided and reached the correct decision on his contributions. I do not find fault with the Council’s 2018 assessment.

2018 complaint and purchase of second property

What happened

17. Mr X complained to the Council in 2018. Mr X and the Council continued to communicate until the end of October 2018.
18. In November 2018, Mr X purchased a second property and rented this property out the following day.
19. Mr X says he told his social worker about the purchase of this property. The Council has no record of Mr X confirming this with it.

Analysis

20. While Mr X had contacted with the Council in 2018 before November, this complaint contact did not refer to Mr X’s plan to purchase a second property.
21. Following Mr X purchasing the second property, he says he told the Council about this purchase. Mr X has provided no evidence to support he told the Council about the purchase and the Council has no evidence of contact.
22. Without evidence Mr X told the Council about the second property, I cannot find fault with the Council being unaware that Mr X had purchased the second property in November 2018.

2019 financial assessment and contacts

What happened

23. The Council completed an annual reassessment of Mr X’s care contributions in April 2019. The Council confirmed Mr X did not need to contribute to his care costs based on the information it held. The Council asked Mr X to check figures used in the assessment and to advise it if it held incorrect information. The information contained in this financial assessment made no reference to Mr X’s second property.
24. The Council completed a revised financial assessment in July 2019 and again confirmed Mr X did not need to contribute and asked him to advise of any incorrect information.
25. In the summer of 2019, Mr X contacted the Council about a change to his care package. Mr X continued to liaise with his local councillor and social worker about changes to his care package until February 2020.

Analysis

26. When the Council completed the second financial assessment of Mr X in April 2019, it provided Mr X with a breakdown of its assessment. This assessment did not provide any details of Mr X’s second property. The Council invited Mr X to advise if it held incorrect information within its financial assessment. The Council completed a further assessment in July 2019 confirming similar.
27. The Council can only complete a financial assessment on the information it has available. There is nothing to show Mr X told the Council about his second property so the Council could not include this within its financial assessment. The Council also invited Mr X to provide information if he thought a mistake had been made; Mr X did not provide evidence of his purchase of a second property. I do not find fault with the Council.
28. Mr X had further contact with the Council in 2019 and up to February 2020. None of the contacts between Mr X and the Council include reference to Mr X having purchased a second property. I again cannot find fault with the Council for being unaware Mr X had purchased a second property.

2021 financial assessment, investigation and backdated billing

What happened

29. The Council completed an annual reassessment of Mr X’s care contributions in April 2021. The Council again confirmed a nil contribution from Mr X and asked him to check the information in the assessment.
30. Following the financial assessment, the Council discovered Mr X owned a second property. The Council wrote to Mr X to advise it had completed its financial assessments of him without knowledge of this second property. The Council said it would be investigating this second property and asked Mr X for an explanation of how he funded the purchase and for details about outstanding mortgage costs and rental income.
31. Mr X responded to the Council to advise he told the Council about the purchase of the second property in November 2018 and in 2019.
32. The Council told Mr X it had records of social worker visits to him and could locate no notes about a discussion over a second property. The Council said the financial assessments forms it sent to Mr X also made no reference to the second property. The Council reiterated its request for information from Mr X.
33. Mr X responded to advise he told social workers about the second property.
34. In June 2021, the Council told Mr X it had no record of Mr X telling it about his second property. The Council said it had also not received the information it had requested about this second property since April 2021. The Council said it needed to reassess Mr X’s client contributions based on evidence it had. The Council decided from the evidence it had, Mr X had equity in the property amounting to £70,000 which when split between him and his wife still exceeded the £23,250 threshold. The Council also said it had evidence of Mr X’s rental income. The Council asked Mr X to provide information as based on the information it held Mr X would be liable for his full costs since November 2018.
35. Mr X responded to reiterate he had told the Council many times about the second property.
36. The Council provided a Stage 1 complaint response in August 2021. The Council said:
• It must ensure that residents take responsibility for any liabilities they are legally responsible for.
• It requested information from Mr X in April 2021, May 2021 and June 2021 but this has not been provided.
• The evidence it has shows Mr X is responsible for his care charges since November 2018.
• It had responded to Mr X’s previous complaint in 2018 about his care package and directed him to the Ombudsman with this complaint.
37. Mr X responded to the Stage 1 complaint in September 2021. Mr X said he had told the Council about the purchase of the property. Mr X said if he knew the Council had not recorded the information he would have stopped the care package.
38. The Council asked Mr X for the information previously requested so it could complete an updated financial assessment. Mr X did not provide this information and continued to dispute being responsible for the charges. The Council directed Mr X to the Ombudsman.
39. Mr X and the Council continued to liaise over the complaint with the Council referring Mr X to the Ombudsman two further times.
40. On 3 November 2021, the Council wrote to Mr X to confirm that following its investigation it would be holding Mr X liable for his care charges from 2 November 2018.
41. The Council sent Mr X a bill for in excess of £27,000 in February 2022 for the backdated care charges.

Analysis

42. When the Council became aware, in April 2021, that Mr X had purchased a second property it started an investigation into this and advised Mr X of this. The Council asked Mr X for information about the purchase of his second property to find out how to calculate this within a financial assessment. The Council took suitable steps to investigate Mr X’s situation based on the new information it obtained. I do not find fault with the Council.
43. By November 2021, the Council had confirmed Mr X’s purchase of his second property meant he needed to contribute towards his care costs. The Council’s investigation determined that Mr X would have needed to contribute to these costs since he bought the property in November 2018. The Council has explained its rationale for this which stands up to scrutiny given Mr X’s capital in excess of the threshold and receipt of rental income.
44. While Mr X says he told the Council before April 2021 about this second property, I have received no evidence to support this. The financial assessment letters the Council sent to Mr X invited Mr X to provide it with any missing evidence which Mr X failed to provide.
45. Even if Mr X could evidence he told the Council, he was still liable for his care costs since November 2018 because of his capital and income. The Council is not at fault for requesting repayment of the care contributions that Mr X should have paid. I do not find fault with the Council producing the backdated bill for Mr X.

Back to top

Final decision

46. I have completed my investigation as there was no fault by the Council.

Back to top

Investigator's decision on behalf of the Ombudsman