Heart to Heart Home Care Agency Ltd (18 019 042)

Category : Adult care services > Domiciliary care

Decision : Upheld

Decision date : 05 Aug 2019

The Ombudsman's final decision:

Summary: Mrs X complains Heart to Heart Home Care Agency failed to invoice her properly, cancelled her care without notice and did not respond to her complaint. Mrs X is correct on all three points. The Care Provider needs to apologise, cancel any outstanding charges, pay financial redress and consider what action to take to prevent similar problems from happening.

The complaint

  1. The complainant, whom I shall refer to as Mrs X, complains Heart to Heart Home Care Agency (the Care Provider) failed to invoice her properly and then cancelled her care.

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The Ombudsman’s role and powers

  1. We investigate complaints about adult social care providers. If there has been fault, we consider whether it has caused an injustice and, if it has, we may suggest a remedy. (Local Government Act 1974, sections 34B, 34C and 34H(4), as amended)

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How I considered this complaint

  1. I have:
    • considered the complaint and the documents provided by Mrs X;
    • discussed the complaint with Mrs X;
    • considered the comments and documents the Care Provider has provided;
    • shared a draft of this statement with Mrs X and the Care Provider, and taken account of the comments received.

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What I found

Key facts

  1. Mrs X’s contract with the Care Provider required four weeks’ notice to terminate it. It also provided for charges as follows:
    • Weekday hourly £16.50
    • Weekday 30 mins £10.50
    • Weekday 45 mins £14.00
    • Weekend hourly £17.50
    • Weekend 30 mins £11.50
    • Weekend 45 mins £15.00
    • Bank holiday hourly £33.00
    • Bank holiday 30 mins £21.00
    • Bank holiday 45 mins £28.00
  2. The contract says:
    • 3.1 “It is in the client / service user’s interests to ensure they sign a timesheet at the end of each visit. Failure to countersign the timesheet will not affect liability for payment. The timesheet acts as a record of the time worked and upon which an invoice is based. It is final and binding in any event whether countersigned or not”.
    • 5.1 “The provider may give notice of termination in the event that any of the following events occur:”

5.1.1 “The service user fails to pay any sum payable under this agreement on its due date (whether previously demanded or not)”

    • 5.2 “The provider may immediately terminate the contract if any of the following events occur:”
      1. “The service user exhibits behavior which the registered manager considers as persistently unsociable to such an extent that they seriously affect the well-being of staff of the agency.”
      2. “The service user exhibits violent behavior towards any employee of Heart to Heart Home Care Agency deemed by the registered manager.”
    • 7.1 “Any care visit cancelled such as hospital appointments, sociable events, etc. fees payable during the absence will be full fees. This agreement exempts; Christmas Day, New Years Day and Easter Sunday.”
    • 8.1 “Upon termination of this agreement by the service user, the service user shall forthwith pay to the provider all sums payable under this agreement.”
  1. On 1 February 2019 Mrs X received an invoice from the Care Provider for the care delivered in January, with payment due by 6 February. She e-mailed the Manager at 13.26 disputing these charges:
    • 1 January – charged £99.00 for 3 hours but delivered 2 ¾ hours £94.00;
    • 2-4 January – charged £115.50 for 7 hours but delivered 4 ½ hours £76.50;
    • 19-20 January – charged £70 for 4 hours but delivered 3 ¼ hours £58.25
  2. She said the Care Provider had overcharged by £55.75. Mrs X asked the Manager to issue an amended invoice so she could pay what she owed (£1,187.50 less £55.75 = £1,131.75).
  3. At 14.05 the Manager told Mrs X:
    • she had repeatedly pointed out that the contract says, “if you cancel a call or tell the carers to go its an hour”
    • she would not amend the invoice as it was correct; and
    • “I think it’s probably best if you find another agency as we are obviously not meeting your expectations”.
  4. At 14.36 the Manager e-mailed Mrs X saying she could not cover her call that evening as she was not feeling well and did not want to pass it to her. She said she had asked another carer to pick up the call. But that did not happen.
  5. At 14.38 Mrs X told the Manager the invoice was not correct as they had charged seven hours for four and a half hours.
  6. At 15.43 Mrs X told the Manager she had no intention of looking for another agency when the Care Provider was doing a “great job”. She asked the Manager to have a look at the invoice when she was felling better and said she would see the mistakes she had made. She said she had never asked the carers to leave but they had left when there was nothing more to do.
  7. At 16.26 the Manager told Mrs X she was not checking the invoice as the contract clearly said if the Care Provider cancelled there was no charge but if Mrs X cancelled there was a charge. She said the carers had confirmed that Mrs X had asked them to leave, so the invoice was correct and she would not be checking it.
  8. At 17.28 Mrs X said the invoice was wrong as they had charged seven hours for 2 to 4 January, which meant it had charged for three extra hours. She said she would pay the right amount if provided with a correct invoice.
  9. At 23.06 the Manager told Mrs X the invoice was correct as it had provided:
    • 1 January - 3 one-hour calls at £33.00 an hour = £99.00
    • 2 January – two-hour cleaning call, 1 hour in the evening
    • 3 January – 2 one-hour calls
    • 4 January – 2 one-hour calls
    • 19 January – 1 one-hour call
    • 20 January – 3 one-hour calls
  10. On 2 February at 01.48 Mrs X said they had not done any cleaning that week, as her Personal Assistant had done this for her.
  11. At 16.40 the Manager e-mailed Mrs X. She said as Mrs X had not paid the invoice or written again since she e-mailed Mrs X at 01.50, they would cancel her care “tonight”. She said, “I don’t know what game you are playing but I am not playing, I am much too busy”. She said Mrs X was normally the first to pay and she did not think she had any intention of paying.
  12. Mrs X replied shortly afterwards saying she had just woken up, having been awake most of the night. She said she had printed the invoice off and gone back to bed. She noted that the invoice was not yet due and asked how it could treat her in this way. She said she needed her care. The Manager told her care would resume when she paid the invoice.
  13. Mrs X replied at 07.37 on 3 February. She said she did not feel up to doing paperwork that day. She said she would contact Social Services or another care agency if she needed them but just needed to sleep. At 14.12 the Manager e‑mailed Mrs X. She said she had tried calling and left a message. She said she would call around 18.00 to pick up the care logs for January as she needed to send them to Mrs X’s Social Worker to check the times she was disputing. Mrs X replied at 17.09 saying she did want to see the Manager and would liaise with someone else the next day. The Manager said she would collect the care logs when Mrs X’s Personal Assistant was there the next day so Mrs X did not have to see her. Mrs X said her Personal Assistant did not want to see the Manager either so she would deal with someone else.
  14. Mrs X paid the Care Provider £1,131.75.
  15. On 6 February Mrs X wrote to the Care Provider complaining. She said:
    • its contract provided for invoices to be based on the time worked, as reflected in the timesheets, not contracted hours;
    • its invoices were regularly incorrect as it failed to comply with this, resulting in a lot of work for her identifying errors;
    • the Manager refused to issue a corrected invoice for January, saying it was correct;
    • the Manager did not attend in the evening of 1 February due to illness which meant it was not possible to cover the call;
    • the Manager cancelled her care the next day until she paid the “incorrect” invoice;
    • the Manager went to Mrs X’s home threatening to call the Police.
  16. On 8 February the Care Provider e-mailed Mrs X. It said it assumed “that you not replying to a question about continuing the care package means you no longer require our service”. It said it would send an invoice for February as she had to give a month’s notice. It sent Mrs X an invoice for £1,006.00. It said payment was due that day. The invoice included £33.00 for two hours of care on 1 February.
  17. On 9 February the Care Provider received an e-mail from Mr W, on behalf of Mrs X. He said she did not want it to “continue” care as it had already cancelled her care. He said she had paid for the care delivered. He referred to breaches of contract and safeguarding issues. He said this had caused a lot of stress to Mrs X, to whom his e-mail was copied. He said she did not want it to contact her directly again and all contact should be with him. He asked for a response to Mrs X’s complaint.
  18. Mrs X paid for the hour of care the Care Provider delivered on 1 February.
  19. On 13 February the Care Provider sent Mrs X an amended invoice for February for £903. It said it had taken the charge for the 1st off as she had paid £16.50. It said Mrs X had cancelled care by e-mail on 9 February and it required a month’s notice under the terms of its contract.
  20. Mrs X says she had to manage as best she could, making more use of her existing personal assistant until she could recruit a team to meet her care needs.
  21. The Care Provider did not respond to Mrs X’s complaint. It says it did not respond “because it would never come to an end”.
  22. The log sheets filled in by Mrs X’s carers say they stayed:
    • 1 January – morning 1 hour – lunchtime 1 hour – evening 40 mins
    • 2 January – evening 1 hour
    • 3 January – morning 1 hour – evening 1 hour
    • 4 January – morning 1 hour – evening 36 minutes
    • 19 January – morning 1 hour
    • 20 January – morning 1 hour – lunchtime 15 mins – evening 1 hour
  23. The timesheets for these visits say:
    • 1 January – 6.10-6.50 (40 mins) – no information for other 2 calls
    • 2 January – no information
    • 3 January – 6.55-7.55 – no information for 2nd call
    • 4 January – 7.00-8.00 – 6.00-6.30 (30 mins)
    • 19 January – 6.12-7.12
    • 20 January – 6.05-7.05 – 12.34-12.46 (12 mins) – no information for 3rd call

Did the care provider’s actions cause injustice?

  1. I understand why the Care Provider would want to charge for an hour when it had employed a carer for an hour, even if a client did not need that long on a particular visit. However, its contract clearly says it will base invoices on what it says on the timesheets. If the Care Provider wants to charge for the care it has scheduled to provide, rather than the care delivered, it needs to amend its contract.
  2. The time sheets are incomplete. However, those that exist, along with the log sheets filled in by the carers, confirm what Mrs X said about the visits she received in January. There is a discrepancy between the timesheet (30 mins) and the log (36 mins) for the evening visit on 4 January. However, the contract gives precedence to the timesheet.
  3. Mrs X was therefore right to question the January invoice. But the Care Provider refused to engage with her questions. That was fault by the Care Provider.
  4. When Mrs X persisted with her questions the Care Provider cancelled her care for the evening of 1 February and the next day cancelled all her care. That was fault. Mrs X had until 6 February to pay the invoice and her actions did not provide grounds to cancel her care with immediate effect.
  5. The Care Provider sought to charge Mrs X for February’s care, although it had been the one to cancel her care. That was fault.
  6. The Care Provider did not respond to Ms X’s complaint. That was also fault. There is no good reason not to respond to a complaint. I cannot criticise the Care Provider for not sending a response to Mr W, as it did not have Mrs X’s consent to do so. It should either have sent a response to Mrs X, or taken steps to obtain her consent to deal with Mr W.

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Recommended action

  1. I recommend the Care Provider:
    • within four weeks writes to Mrs X apologising for the inconvenience it caused her by cancelling care without notice and cancelling any outstanding charges, and pays her £250 for the distress and trouble it has put her to in pursuing her complaint;
    • within six weeks draws up an action plan identifying the action it needs to take to make sure it:
        1. charges its clients in line with their contracts;
        2. does not cancel care without notice; and
        3. responds to all complaints.
  2. The Care Provider has not agreed to take these actions and says it will not pay anything to Mrs X.
  3. Under the terms of our Memorandum of Understanding and information sharing protocol with the Care Quality Commission, I will send it a copy of my final decision statement.

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Final decision

  1. I have completed my investigation on the basis that the Care Provider will reconsider its position and take the action I have recommended.

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Investigator's decision on behalf of the Ombudsman

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