Summary: There was no fault in the way the Council decided to invoice Mr B for backdated care charges and the way it communicated with him about the debt.

The complaint

1. Mr B complains about the Council’s decision to invoice him for backdated care charges and its communications with him about the debt.

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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. I discussed the complaint with Mr B and I considered the documents that he and the Council have sent and the relevant law, guidance and policies.

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What I found

Law and guidance

5. The Care Act 2014, the Care and Support Statutory Guidance and the Care and Support (Charging and Assessment of Resources) Regulations 2014 set out the council’s duties and rights in relation to charging for care and support.  
6. Where the council has decided to charge, it must carry out a financial assessment of what a person can afford to pay. The council must not charge more than the cost it incurs in meeting the assessed needs of the individual, and it must regularly reassess a person’s ability to meet the cost of their care to take account of any changes in their resources.  
7. Councils must ensure that a person’s income is not reduced below a specified level (the minimum income guarantee) after charges have been deducted. The amounts are set out in the regulations.

What happened

8. Mr B suffers from arthritis, mobility problems and mental health problems. Mr B started to receive support from the Council in August 2017. His support plan said he was entitled to two hours support to help him with his shopping, accessing the community and paying his bills.
9. The Council assessed Mr B’s finances in August 2017. Mr B was in receipt of the state pension and disability living allowance (DLA) and the Council calculated his weekly contribution to his care charges to be £4.76. The Council’s letter said Mr B should inform the Council if there were changes to his income or finances.
10. The Council carried out its annual review of Mr B’s finances in April 2018 and increased the charge to £10.56, in line with an increase in benefit income.
11. Mr B contacted the Council in April 2018 as he was very angry about the charge and did not accept that he had to pay any contribution. He threatened to stop the service if he had to pay for it. The officer suggested that a review financial assessment may be helpful and Mr B said he wanted a home visit to review the assessment. The officer asked an assessment officer to contact Mr B to arrange the review.
12. The assessment officer rang Mr B a few days later. The officer explained the charges to Mr B in detail. The officer advised Mr B that he may increase his benefits by applying for a personal independence payment (PIP) instead of DLA. She explained that this would increase his income but may also increase his contribution. Mr B said he would talk to someone about his finances and decide what to do.
13. The Council liaised with Mr B’s mental health worker during this time.
14. Mr B contacted the Council again on 29 November 2018 and said he had received a financial assessment form. He asked for a home visit to complete the form and wanted the Council to contact his mental health support worker.
15. The Council’s financial assessment officer contacted the mental health worker a couple of times in December but she was not available.
16. The Council officer checked Mr B’s benefits and noticed that Mr B had started to receive PIP instead of DLA in November 2017.
17. The Council officer discussed the case with Mr B’s mental health worker in January 2019 and explained that the Council would backdate the reassessed charge to the date of the PIP award. The mental health worker said Mr B would be very angry about this.
18. The Council officer spoke to Mr B’s community support worker to decide how to best proceed with the financial reassessment. The support worker said that a face to face meeting with the Council officer and the mental health worker would be the best way forward.
19. This assessment meeting took place on 12 February 2019. Mr B was advised that he was eligible for further benefits and he should apply for those. Mr B agreed to wait for the backdated invoice and would then decide to pay it off or ask for a repayment plan. The Council officer explained to Mr B that, although his contribution would increase, he would be better off financially overall as the increase to his income was higher than the increase of the contribution.
20. The Council wrote to Mr B after his meeting and said his weekly assessed charge was now £34.26 per week. Mr B rang the Council on 27 February 2019 as he was anxious about the backdated charges. The Council officer advised him to wait for the invoice and then to meet with his mental health worker to decide how to pay the debt. The Council sent the invoice for the backdated charges of £1,227 around the same time. The Council officer also contacted the mental health worker asking her to support Mr B with this issue.
21. The Council officer spoke to the mental health worker on 26 March 2019 as the mental health worker said Mr B wanted an explanation why he had received the invoice. The Council officer said that the issue had already been explained to Mr B numerous times, but Mr B was not happy about having to pay.
22. Mr B continued to ring the Council as he was unhappy about the charge and the service. Mr B stopped his care package in May 2019 and started to pay privately.
23. Mr B rang the Council several times in May 2019. He had received an invoice for the period from 29 April 2019 to 16 June 2019 but said it was incorrect as he stopped the care on 2 May 2019. The Council corrected the invoice.
24. Mr B’s community support worker spoke to Mr B on 6 June 2019 to discuss how Mr B would repay the debt. Mr B said he could manage to pay an extra £60 a month and the support worker agreed to speak to the Council to organise a repayment plan.
25. The support worker contacted the Council officer on the same day to put a repayment plan in place. The Council officer said that the Council could not agree a repayment plan until the account had been finalised and the Council was in the process of doing this. Once this was done, the Council could then consider the repayment plan.
26. Mr B contacted the Council on 24 June 2019. He agreed to repay £70 per month. The officer informed him that this was too low and Mr B would need to fill in a further form before the Council could agree a repayment plan beyond 12 months. The officer said Mr B had £4,000 savings in his account, but Mr B said he needed this for his daughter as she was very ill. The officer sent Mr B the form that he would have to fill in.
27. The Council finalised the account on 28 June 2019. It wrote to Mr B and informed him that the final debt was £1,237. Mr B paid back £1,000 on 1 July 2019 and the remainder by September 2019.
28. Mr B complained to the Council about his treatment and has come to the Ombudman. I have summarised his complaint and the Council’s response.
29. Mr B says the Council should not have sent him such a large invoice and should not have let the debt accumulate to the extent that it did. He said he had ‘a lot on his plate’ which is why he did not inform the Council of the increase in his income. He said the invoice and the debt had a very negative effect on his mental health. He says the Council officers did not consider his mental health in their communications with him and were abusive on the telephone.
30. The Council said the debt occurred because Mr B failed to inform the Council of the increase in his income. It said it used its discretion, as a gesture of goodwill not to backdate the debt to November 2017 (when the income increased), but only from April 2018. It said its officers supported Mr B to help with the paperwork and finances.

Analysis

31. Mr B is a vulnerable man with mental health problems. He described to me that he was worried sick and had sleepless nights after receiving the invoice. I have no doubt therefore that this debt caused Mr B a lot of mental anxiety as he described.
32. However, my investigation has focussed on whether there was any fault in the Council’s actions. Mr B’s vulnerability would not affect the debt that he owed, but the Council should take it into consideration in the way it pursued the debt and has discretion in writing off debt.
33. From the evidence that I have seen, I have not found fault in the Council’s actions.
34. The large invoice occurred because the Council had not been made aware that Mr B’s income had increased. I note that Mr B had opportunity to inform the Council of the increase. The Council carried out an annual review and also offered Mr B a further financial assessment in April 2018. The Council also informed Mr B in April 2018 that, if he were in receipt of PIP, it was likely that his contribution may increase.
35. There are no recordings of the communications between the Council and Mr B, but I have read the notes of the conversations. I accept that the evidence is limited, but on the evidence that I have seen I find no fault in the way the Council communicated with Mr B about the debt.
36. The Council officers in the finance department were aware of Mr B’s vulnerability and the possible impact of the debt on his mental health. There is a lot of evidence that the finance officers continued to liaise with Mr B’s mental health worker and his community support worker throughout. The finance officers contacted Mr B’s mental health worker and his community support worker frequently asking them to support Mr B and to speak to him.
37. I also note that the finance officers took advice from the community support worker on how to proceed with the financial reassessment. As a result of this discussion, the mental health worker was present during the financial assessment.
38. I also note that the Council was willing to negotiate a repayment plan with Mr B once the final invoice had been sent. Mr B then repaid £1,000 and any discussions about a repayment plan became unnecessary.
39. Finally, the Council exercised discretion and decided not to invoice Mr B for the entire debt which accrued from November 2017, but only for the debt from April 2018. That was a significant reduction of the debt by almost 6 months. This is a better outcome than anything the Ombudsman could achieve and I will therefore close the investigation.

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Final decision

40. I have completed my investigation and have not found fault by the Council.

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Investigator's decision on behalf of the Ombudsman