Summary: Mrs B complains about the Council’s actions in respect of billing for home care after her father was discharged from hospital. She also complains about the time taken by the Council to respond to her complaint. The Ombudsman finds there was fault by the Council in these matters. As a result, Mrs B was put to considerable time and trouble in seeking to resolve the matter, and her father received an unexpected invoice for care costs followed by threats of formal recovery action when that invoice was disputed. A remedy has been agreed.

The complaint

1. The complainant, whom I shall call Mrs B, complains on behalf of her father Mr C that:

• he was wrongly advised that his care in 2017 would be free for the first six weeks;
• the Council billed him incorrectly, and has issued an invoice which does not relate to him; and
• there was considerable delay in dealing with the complaint, and compensation offered was derisory.

2. Mrs B also complained the homecare provider did not assist Mr C to mobilise, and twice left his properly unlocked.

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What I have investigated

3. I have investigated the actions of the Council in respect if the three points of complaint set out at paragraph 1 above. I have exercised discretion to do so despite the time which had passed since the events complained of took place, because in the interim Mrs B was waiting for the Council to provide its response to her complaint under the statutory process.

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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 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)
5. 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)
6. We may decide not to start or continue with an investigation if we believe for example that it is unlikely we could add to any previous investigation into the relevant matter. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

7. I considered all the information Mrs B provided about the complaint. I made written enquiries of the Council and took account of the information it provided in response. I provided Mrs B and the Council with a draft of this decision, and took into consideration the responses received.

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What I found

Legal and administrative information

8. Councils can make charges for care and support services they provide or arrange. (Care Act 2014, section 14)
9. Intermediate care and reablement support services are for people after they have left hospital or when they are at risk of having to go into hospital. They are time limited and aim to help a person to preserve or regain the ability to live independently. Regulations say local authorities must not charge for the first six weeks of intermediate care or reablement services. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)
10. Councils should have clear procedures for dealing with social care complaints. Regulations and guidance say they should investigate a complaint in a way which will resolve it speedily and efficiently. Regulations do not say how long a complaint investigation should take but expect this will be determined at the start of the procedure, usually in discussion with the complainant. During the investigation, the council must keep the complainant informed of progress ‘as far as reasonably practicable’. If the council has not provided a response after six months (or, after any previously agreed longer period), it must write to the complainant to explain why. (Regs 13 and 14, Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

What happened in this case

11. In early June 2017 Mr C was admitted to hospital following a fall. Mrs B reports that she was told by a hospital physiotherapist in August 2017 that the first six weeks of care on discharge would be free as ‘intermediate care’. On 3 October 2017, the day before Mr C was discharged home, Mrs B reports that nursing staff confirmed he would be receiving intermediary care.
12. The Council’s records include a referral from the hospital ward in July 2017 for a social care assessment, which noted that intermediate care ‘may be the appropriate supported discharge plan’. He was not ready for discharge at this time and so the social worker did not complete the social care assessment until 9 September. The assessment records noted that prior to this Mr C had been recommended for intermediate care, but enquiries had been made with the hospital ward physiotherapist to establish what potential Mr C had for rehabilitation after discharge. The social worker recorded that the physiotherapist had noted that Mr C would need two carers for transfers and mobility and had no rehabilitation potential, and that the intermediate care team had declined to support him.
13. The social worker completed an eligibility care and support plan, and this noted that Mr C’s care needs could be met by four care calls a day, each with two carers. The plan noted that Mr C would be self-funding and that the cost of the care package would be £486.67. The plan was not signed by Mr C and there is no evidence that it was shared with Mr C or his family.
14. Mr C was discharged home on 4 October and the care provider began the calls in accordance with the care and service delivery plans.
15. On 24 October the Council wrote to Mr C about him paying the full cost for his care. It stated the hourly rate for homecare was £15.44. The letter also stated that cost for day care can be up to £56.65 per day. This led to some confusion: I will return to this point later in this statement. A declaration was enclosed, requiring a signature giving agreement to pay for care.
16. On 25 October, on receipt of the letter, Mrs B telephoned the Council. She was advised that Mr C had not been discharged from hospital with a package of intermediate care. Mrs B says the officer told her that Mr C would probably have to pay for his care ‘after the first week’. I have not seen any evidence relating to that call.
17. Following this, Mrs B made her formal complaint to the Council on 30 October 2017. The Council acknowledged this on 1 November and said the statutory procedure allowed a maximum of six months for reply but it hoped to respond much sooner.
18. On 9 November the Council received the declaration form back from Mrs B and her father. Next to a declaration setting out that ‘financial and charging implications have been fully explained to me’, they had noted ‘No!’.
19. On 14 November the Council issued a letter which stated for the first time that the weekly cost of Mr C’s homecare would be £486.36, with effect from 4 October 2017.
20. On 24 November the Council issued the invoice for the first period of care, 4 October to 12 November 2017, at the hourly rate set out in the letter it had issued on 15 October 2017. Mrs B responded saying she had lodged a formal complaint because of her understanding that the first six weeks of her father’s care would be free of charge.
21. Internal email correspondence from the Council indicates that on 6 December the Council issued a repeat invoice in respect of the first period of care, followed by a reminder on 2 January 2018 and a final warning letter on 12 January 2018. Mrs B says that the correspondence threatened bailiff action for non-payment. She complained to the Council about this and action was then taken to put recovery of the disputed sum on hold while the complaint was under consideration.

The Council’s response to the complaint

22. The Council issued its response to Mrs B’s complaint on 10 January 2019, some 14 months after the complaint was made. I have seen no evidence that the Council made agreements with Mrs B to extend the timeframe beyond six months, as the Regulations prescribe. The delay and failure to keep Mrs B updated was fault. The Council acknowledged there had been delay. It apologised for it and offered Mrs B £100 in recognition of the time and trouble taken in pursuing her complaint.
23. On the substantive issue, the billing for the first six weeks of care after discharge form hospital, the Council said it could not explain why Mrs B might have been misadvised by staff at the hospital, but the assessment of Mr C’s care and support needs had been carried out by adult social care professionals and as such the decision in respect of maintenance care lay with them. The Council said its staff had not advised the care would be free, and it referred to the information obtained from the physiotherapist about Mr C’s lack of potential for rehabilitation. The Council did not uphold this part of the complaint.
24. The Council accepted there had been some fault in other matters Mrs B had brought to its attention. It accepted that there had been some failings in communication between the financial assessment team and Mrs B, and between a social worker and Mr C when his case was being closed to her after he was discharged from hospital and the care package was in place. The Council also accepted that recovery action in respect of the disputed sum from the initial invoice should have been placed on hold in line with its usual practice. It apologised for these failings and any distress caused by the letters about recovery action and said advice would be given to relevant teams.
25. The Council also addressed the query Mrs B had raised about the information in the letter of 24 October, referred to in paragraph 15 above. Mrs B had found the information confusing because of the reference to two different fee rates. But one of these related to day care, not home care. Mr C did not receive day care services and so that rate did not apply to him. The Council was able to clarify this for Mrs B. It apologised for any confusion caused and it has now changed the standard wording in these letters to aid clarity.

Analysis

26. There is no evidence in this case that the Council advised Mr C or his family that he would have free care, and the information provided by Mrs B suggests that any such information came from hospital staff. However, there is no evidence that the Council told Mr C or his family there would be a charge for care from the date of discharge, and how much it would be, prior to the letter of 14 November 2017. That was fault. The Council should ensure that service users have information about charges at an early stage and record that it has provided this information. Although a letter had been issued on 24 October, this gave only an hourly rate for homecare and did not specify that this was the cost per carer, and Mr C requires the assistance of two carers at all care calls.
27. I agree with the Council’s findings on those parts of the complaint it upheld. However, I consider that additional remedy is appropriate, and I shall set out my recommendations below.
28. The faults identified caused injustice. Mr C was presented with a cost for care which he had not been forewarned of; he was caused distress by the threat of recovery action including the use of bailiffs. In addition, his representative Mrs B was put to some considerable time and trouble trying to resolve the matter and there were communication failings and a long delay in that process which exacerbated this.

Agreed action

29. In recognition of the injustice set out above I recommended that within four weeks of the date of the decision on this complaint the Council:

• Waives the cost of care for the six-week period 4 October 2017 to 16 November 2017 (this being the period from the commencement of care to the date of receipt of notification of the charges) and issues a revised invoice reflecting this;
• Pays Mr C £100 in recognition of the distress caused by the letters issued warning about recovery action, when the invoice was known to be in dispute, with a complaint having been made and acknowledged; and
• Pays Mrs B £150 for the time and trouble taken in pursuing her complaint. If the Council has already paid the £100 it offered when it responded to her complaint, I recommend it pays a further £50.

30. I also recommended that within three months of the date of the decision on this complaint, the Council ensures that all relevant staff are reminded of the need to correctly advise new service users about any costs for care they will incur, and properly records what advice has been given in this regard.
31. The Council has agreed to my recommendations.
32. In making these recommendations I acknowledge the steps the Council has already taken to address issues arising from the aspects of this complaint which were upheld by its investigation, including apologising to Mrs B and offering some financial remedy; amending standard letters; and reminding revenues staff about placing recovery action on hold in relevant circumstances.

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Final decision

33. I have completed my investigation on the basis set out above.

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Parts of the complaint that I did not investigate

34. I did not investigate Mrs B’s complaint about the action of the homecare provider which took place in 2017. I decided not to exercise jurisdiction to include this in my investigation because it is unlikely we could add to what has previously been said by the care provider about what happened at that time.

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Investigator's decision on behalf of the Ombudsman