Summary: Ms C complained about the way in which the agency, who had arranged her parents’ homecare, had calculated her parents’ invoices. Furthermore, when Ms C raised this with the agency, it was reluctant to accept any fault. The Ombudsman has upheld Ms C’s complaint. The care provider has agreed to provide an apology and reimburse Ms C’s parents. It will also carry out an audit to determine if there are other clients who may have been overcharged.

The complaint

1. The complainant, whom I shall call Ms C, complained to us on behalf of her parents. Ms C complained that the agency, who arranged her parents’ homecare, overcharged them for the period March 2017 to April 2019.
2. Ms C says the care agency also failed to properly deal with her complaint. She says it failed to:
• Respond to the complaint / appeal within the timeframes set out.
• Provided plausible / accurate explanations about what had happened. It failed to thoroughly look into her concerns and only accepted further fault whenever she could provide more evidence.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)
4. If an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
5. If we are satisfied with a care provider’s actions or proposed actions, we can complete our investigation and issue a decision statement.

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How I considered this complaint

6. I considered the information I received from Ms C and the care agency. I shared a copy of my draft decision statement with Ms C and the care provider and considered any comments I received, before I made my final decision.

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What I found

7. Ms C’s parents have been with the care agency since February 2017. Patricia Whites (hereafter referred to as the “(care) agency”), is an “introductory care agency”. These type of care agencies identify and suggest domiciliary carers to customers. The customer then directly employs the carers. The person employing the carer is responsible for paying them their wages directly. They also pay the agency a one-off registration fee and an ongoing daily rate.
8. Ms C noticed an error in one of her parents’ invoices in 2019. She then decided to look more closely at how the care agency had calculated her parents’ invoices. As such, she asked the care agency on 25 April 2019 why her parents were being charged an agency rate of £43.20 per day, even though the new “Charging Structure April 2019” said this should be £31.20 per day.
9. Ms C received a response from the Accounts Team. The response said that the care agency had reduced its daily rate in April 2019, from £43.20 to £31.20 per day. However, due to a temporary problem with its invoicing system, this was not reflected in the invoice yet. This response was incorrect. There was no ‘reduction’, because (as later established) the daily agency rate for Ms C’s parents should have been £31.20 since March 2017.
10. Ms C subsequently looked further into this and found some information about charges in 2017 and 2018 (the “Christmas Schedule of Rates”). It mentioned that the agency rates in 2017 (during Christmas) were £31.20. However, her parents were charged £43.20 at the time. Furthermore, Ms C said that each time she had received a letter from the agency about its rates, it had mentioned the rates had not changed. As such, Ms C said it appeared that the agency rates for her parents should have been £31.20 since her parents joined in 2017. Ms C provided supporting evidence to the agency.
11. However, in response, the Head of Finance initially told Ms C that the care agency rates had been £31.20 during the Christmas period, because the care agency rates had been reduced during the festive season. This was incorrect. The care agency for customers such as Ms C’s parents, had merely remained at the same rate of £31.20 per day. However, Ms C’s parents were charged £43.20.
12. Ms C subsequently made an official complaint to the care agency about the fees her parents have had to pay since they joined. As such, I would have expected a thorough investigation into the rates they were charged, and to obtain sufficient internal evidence to be able to conclude how much they should have been charged. However, this did not happen.
13. Since then, the care agency said this investigation was difficult because:
• Some staff members had left
• Ms C did not provide sufficient documents
• Her parents care packages were complex
14. However:
• A care agency’s documentation / record-keeping should be such, that they should be able to determine what the care agency rate was, for a particular type of package, in the last three years.
• I did not see evidence to conclude the package was particularly complex (in terms of charging) and/or that this contributed to the charging error.
15. The care agency’s complaints policy is to respond to a complaint within 28 days. As such, Ms C chased the care agency for a response on 7 June 2019 (after four weeks).
16. The care agency provided its response four days later:
• The agency attached some documents about the pricing structure. It told Ms C that her parents should pay an agency rate of £43.20 a day and her parents have always been correctly invoiced at that rate.
• Ms C’s parents should have received the discounted rate of £31.20 during Christmas (in 2017 and 2018). The agency would adjust this.
• The agency concluded that, with the exception of these short festive periods, Ms C’s parents had been charged the correct agency rate throughout.
• The care agency reduced its agency rate in April 2019 to £31.20 a day.
17. Ms C appealed the care agency’s decision the same day. She provided further evidence (documents she had received from the care agency) and pointed out, amongst others, that:
• The cover letter she received in April 2018 said the agency would not increase her parents’ agency fees.
• The cover letter she received in April 2019 did not mention that there would be a reduction in her parents’ agency rate to £31.20, which suggests it would stay the same.
• This means that, if the care agency says her parents’ agency rate should be £31.20 (+VAT) since April 2019, it should have been this rate before April 2019 and before April 2018.
18. The care agency’s response to Ms C’s appeal, said that:
• The agency rate in February 2017 was £43.20. This had been the care agency’s rate in place since October 2016.
• There was no price change in April 2017.
• The agency reduced the care agency rate to £31.20 during the Christmas periods to make it more affordable for its clients.
• However, the rate (for the category ‘Companionship’) that should have been applied from April 2018 onwards, was set at £31.20. We apologise that the account was not adjusted at the time to this lower rate.
• The care agency apologised and reimbursed Ms C’s parents and waved the outstanding balance of £4,213.09 (the amount that was still owed to the care agency) to remedy Ms C’s frustration and the time it has taken the care agency to deal with her complaint.
19. Ms C wrote again to the care agency on 26 June 2019. She attached a document from the care agency called “Schedule of Fees of 3rd October 2016”. Ms C pointed out that the document explained everything that has happened, as it clearly stated that the care agency rates should reduce from £43.20 to £31.20 after 28 days. This did not happen.
20. The care agency did not consider this ‘new evidence’ and instead said Ms C had reached the end of its complaints process and it referred her to the Ombudsman, if she remained unhappy with its response.
21. The care provider says it carried out a comprehensive review of the account, as a result of my enquiries, and agreed it failed to reduce the agency fees of Ms C’s parents to £31.20 in 2017, after 28 days.
22. The care provider has already issued two credit notes:
• £559,20 issued on 2 May 2019, for the period 1 April 2019 to 21 April 2019
• £8,858 issued on 19 June 2019, for the period 1 April 2018 to 31 March 2019
23. The total refund value for the period from before 1 April 2018 is £8,574. The care provider says the outstanding balance it has previously waved as a goodwill gesture was £4,213.09. As such, it will issue for a credit note for the remaining balance of £4,360.91 (£8,574 - £4,213.09).
24. Ms C says the care provider should not deduct the £4,213.09 from the amount outstanding, because the care provider waved this as a remedy for her distress and the time and trouble she had to spend in sorting out the account.

Assessment

25. I agree with Ms C’s view that the document she sent on 26 June 2019 clearly shows that the care agency failed to reduce the daily agency fee to £31.20 after 28 days. The documents I have seen (all of which were documents provided to Ms C by the agency) also clearly show this £31.20 should have remained unchanged since then.
26. It also explains why the rates for Ms C’s parents were not ‘reduced’ during Christmas. As there was no reduction in its care agency rate for its customers during Christmas (it merely remained at £31.20), there was no need to go into the account of Ms C’s parents during Christmas to ‘apply a reduction’ in the agency rate.
27. It also shows it was not correct that the care agency said that its rate “had reduced to £31.20” for its customers in April 2019. It had merely remained at £31.20.
28. I agree with Ms C that the care provider did not properly deal with her concerns. It provided answers which were incorrect, and did not obtain sufficient records / evidence to be able to make sound conclusions. Whether or not some staff members had left in the interim, should not have been relevant.
29. As the period involved is more than six months, and the amount involved is more than £1,000, the care agency should pay Ms C’s parents interest over the amount it has had to repay.

Agreed action

30. I recommend that, within four weeks of my decision, the care agency should:
• Apologise for the way in which it has dealt with Ms C’s investigation, the distress this resulted in, and the time and trouble she had to spend in bringing the case to a close. It should also pay her £200.
• Ensure it has fully repaid all the appropriate amount(s) to Ms C’s parents. It should also calculate and pay interest on the total amount Ms C’s parents have overpaid since April 2017.
• Review its financial record-keeping system to ensure that it keeps sufficient records to be able to deal with complaints about what a client should have been charged.
31. The care agency should also, within eight weeks of my decision:
• Carry out an audit, by an audit company, to establish if the care agency also failed to reduce the care agency rate, after 28 days, for other clients in 2016 / 17. If it has, it should remedy this in line with the remedy provided for this case.

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Final decision

32. For reasons explained above, I have upheld Ms C’s complaint. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Investigator's decision on behalf of the Ombudsman