Summary: There was fault by the Council. It failed to deal with two requests to increase the fee paid to a care provider. The Council also did not always keep the provider informed of its progress. The Council should apologise to the provider, make a decision, and backdate the payment.

The complaint

1. Mr B is the manager of a residential care home owned by a charity. The Council placed a young man in the home. After some time , Mr B asked the Council to increase the amount it paid for the resident’s care provision. This is referred to as a fee uplift.
2. Mr B complains on behalf of the charity, that the Council has failed to deal with his request for a fee uplift. He also says the Council failed to keep him informed of progress on his request.
3. As a result, the charity has potentially missed out on income and Mr B has been put to time and trouble in pursuing the matter with the Council.

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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)

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How I considered this complaint

6. I considered the information provided by Mr B and discussed the issues with him. I considered the information provided by the Council and the file documents. Both parties had the opportunity to comment on a draft of this statement. I have considered the comments made before reaching a final decision.

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What I found

What happened

7. The Council placed a young man, Mr Y, in the care home managed by Mr B. The care home is not in the Council’s own area, but the Council remained responsible for funding Mr Y’s care. This is called an out-of-area placement.
8. Mr B sent wrote to the Council March 2019. He requested a fee uplift of 3%. The Council responded in April 2019 asking Mr B for detailed information about the finances of the services involved in providing Mr Y’s care. It provided Mr B with a template to do this. Mr B asked the Council if it would accept that his local authority is supporting an increase as evidence that this is needed. He pointed out that other authorities in the country do so when reviewing out of area placements.
9. The Council agreed it would consider this and later that month, Mr B sent details from his local authority that it has agreed an increase. The Council asked for more information about what services the uplift from the local authority covered, and Mr B replied.
10. The Council contacted Mr B’s local authority because it needed more clarification about the services it had increased funding for. The Council got no response from the local authority until July 2019. The Council says the local authority confirmed it had increased the funding to all its placements by £19.11 and not 3% as Mr B had requested.
11. The Council decided it would review the funding of its placements. It started this in July 2019 and had reviewed funding for placements for people in the London borough of Newham by the end of October. The Council told Mr B that it had put out-of-area uplift requests on hold until October.
12. The Council then started its review of funding for out-of-area placements. The Council says this review was reported to the relevant Management Team a number of times, but the review was not complete and the Council had not decided the amount of any uplift. Mr B complained to the Council. In its response dated 27 February 2020, it acknowledged that there had been ‘an unacceptable level of delay’, and said it would make an offer to providers by the end of March.
13. The Council’s management team was due to consider the review again at the end of February 2020, but this was cancelled because the Council had to prioritise its response to COVID-19 in its local area.
14. Mr B submitted another request for an increase in the 2020/21 fees, in March 2020. The Council says both requests are pending but the review of fees is not complete as the Council has still diverted staff to respond to COVID-19.
15. Mr Y left the care home during late 2020 for reasons unrelated to the level of funding.
16. The Council has no set process for reviewing out of area fees but it does have a working practice and templates to capture information about the request and the cost of providing services.
17. The Council up until 2020 had not comprehensively reviewed fees for out-of-area placements for some years. In previous years, requests had been considered separately or together with other similar requests. The Council says it can backdate fees where this is warranted.

Was there fault by the Council causing injustice?

18. I am unable to decide how much any uplift should be. This is a decision for the Council and in the event of a dispute, the charity can consider court action in line with its contract with the Council. However, I have investigated whether the Council took too long to deal with Mr B's request for an uplift, and whether it kept him informed.
19. The Council acted in good time on Mr B’s original request in 2019 to increase the fee. It considered using the local council’s decision making to inform its own decision and this meant it needed information from the local Council.
20. The Council says the delay from March 2019 to July 2019 was attributable to the local council as it took some time to give enough information. I have asked the Council for its records showing its contact with the local council but it has not given me these. This means that I cannot be sure of the reasons for the delay from March to July 2019. Although, it is fault that the Council has not responded to my enquiry to establish this the cause of the delay here is not at the crux of this complaint and and does not alter the remedy.
21. It is clear that there is fault by the Council in avoidable delay from July 2019 to date. The Council should have been able to make a decision before it was forced to divert resources and pause the review of funding, in February 2020, particularly as Mr B’s request had already been outstanding for some months. This delay was fault by the Council and meant that Mr B still had no decision nearly a year after his first request. I appreciate that the Council had not thoroughly reviewed out of area funding in recent years, but an annual review should not be outstanding after 11 or 12 months.
22. I also appreciate that the Council has had to divert its resources and prioritise its response to COVID-19 and the extra support needed by its residents during this time. It is inevitable that this would impact on the normal administration of the Council, and that normal services may be impacted with little warning. But again, I would expect the Council in time, to give consideration to the impact of not reviewing funding of out of area placements and take into account that Mr B’s request was already a year old at the time it had to suspend its review. Over the course of the last 12 months, I would expect it to consider how it will progress the out-of-area funding review.
23. Although I accept the Council has to prioritise and the review is lower priority than some other Council responsibilities, there should be some expectation that it will restart this work.
24. The Council did not always keep Mr B informed of the progress of his requests.
25. The Council’s delay means that the charity is unlikely to have received the correct level of funding. This also put Mr B to time and trouble in pursuing the Council and in bringing the matter to the Ombudsman.

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Agreed action

26. Within one month of this decision, the Council will show the Ombudsman it has written to Mr B to apologise for the continued delay, and that it did not always keep him informed of its actions.
27. Within two months of this decision, the Council will show the Ombudsman it has written to Mr B with a decision on his two outstanding uplift requests. It should make any payment backdated to 1 September 2019, within a month of that decision.

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Final decision

28. I have completed my investigation. There was fault by the Council causing injustice.

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Investigator's decision on behalf of the Ombudsman