Summary: Mrs X complained the Council had not paid her the correct amount for her role as a Shared Lives carer. The Council has admitted fault and agreed Mrs X should be paid the amount she is claiming. To remedy the injustice caused, the Council has agreed to apologise, make a payment to Mrs X and carry out its suggested actions of streamlining some of its processes.

The complaint

1. Mrs X complains the Council has failed to provide her with adequate payment for her role as a Shared Lives carer from September 2020 until the date it ended her agreement to care for Mr Y, in April 2022.
2. Mrs X says this has caused her financial losses, frustration and distress.

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The Ombudsman’s role and powers

3. 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)
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. If we are satisfied with an organisation’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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What I have investigated

6. Paragraph four (above) applies to this complaint. I have exercised discretion to investigate Mrs X’s complaint back to September 2020 which is the date the Council was originally asked to back date Mrs X’s extra payment to. Mrs X complained to the Council in November 2022 following its inaction and brought her complaint to us as soon as it was clear the Council had exhausted its complaints process. I therefore consider it reasonable to investigate the issue from September 2020.

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How I considered this complaint

7. I have considered all the information Mrs X provided and discussed this complaint with her. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
8. Mrs X and the Council had the opportunity to comment on my draft decision. I have taken any comments received into consideration before reaching my final decision.

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What I found

Shared lives carers

9. Shared Lives schemes provide an alternative to traditional social care accommodation and support for adults.
10. Under Shared Lives schemes service users who cannot live independently receive care and support from ordinary family households called Shared Lives carers.
11. Shared Lives carers share their home and family life with an adult who needs care or support to help them live well. Carers can be individuals, couples or families.
12. Schemes are often managed by councils but they can also be managed by independent providers or health trusts.
13. Shared Lives carers are paid a fee to cover the rent, household costs and care and support they offer to service users. Most Shared Lives schemes allow carers to support a maximum of three service users at any one time.
14. There will be a financial agreement between the Shared Lives carer and the council. Some councils pay carers using a banding system which is based on the needs of the service user and/or the Shared Lives carer’s experience or level of training.

What happened

15. I have set out below a summary of the key events. This is not meant to show everything that happened.
16. Mrs X was the shared lives carer for an adult, Mr Y, for a number of years. He lived in Mrs X’s home with her and her husband.
17. Over time, Mr Y’s needs had increased. Mrs X therefore asked the Council to increase the band which she was paid to reflect the extra care and support she felt she was providing Mr Y with.
18. In December 2020, the Council’s shared lives team (SL) asked the Council’s adult social care team (ASC) to increase Mrs X’s weekly payment by an uplift of £73 as it agreed she was providing a higher level of care to Mr Y. SL never received a reply to this request. No request was logged on the Council’s ASC systems.
19. In January 2021, SL completed a banding assessment for Mr Y which confirmed the band Mrs X was paid should be increased by £73 per week. It passed this to ASC to progress the matter.
20. From January to May 2021, several more requests were made for the matter to be progressed. Mrs X’s payment increase was still not actioned.
21. In October 2021, SL again requested the banding be increased and Mrs X be paid £73 extra per week running from the beginning of September 2020 to the current time.
22. Around the same time, Mr Y was admitted to hospital and then later discharged to a nursing home. He never returned to Mrs X’s home, but the agreement between her and the Council remained in force.
23. The Council eventually decided to end Mr Y’s placement with Mrs X. It had decided that her home was no longer suitable to cater for Mr Y’s needs. At the end of March 2022, the Council sent Mr Y and Mrs X formal notification that the shared lives agreement would end on the last day of April 2022.
24. In November 2022, Mrs X complained to the Council about the situation with the payments.
25. In January 2023, the Council replied to Mrs X’s complaint. Its investigation had found that there were no records of the uplift requests on the ASC side. Using information provided by SL, the Council established a timeline. It agreed to pay the uplift from January 2021 (when the formal assessment had been carried out) until the time Mr Y was admitted to hospital in October 2021. The payment offered totalled £2920.
26. Further emails passed between Mrs X and the Council in the coming months. Mrs X was unhappy the Council would not pay the uplift from the date SL had originally asked for it to be started from, which was September 2020, until the agreement had formally ended on the last day of April 2022.
27. The Council took the stance that Mrs X had been paid for an empty room whilst Mr Y was not in her care but before it had decided to end the placement. It declined to pay the uplift for the period from October 2021 until the end of April 2022.
28. Mrs X asked to escalate her complaint. After further emails between her and the Council, at the end of March 2023, it signposted her to the Ombudsman for a second time and advised her she had exhausted its complaints process.
29. Mrs X then contacted the Ombudsman. She has not accepted any payments from the Council relating to the uplift amount of £73 per week.

Analysis

30. After speaking to Mrs X about her complaint, I sent enquiries to the Council to ask it to establish a timeline and explain any delays. I also asked it to explain its rationale for agreeing to pay Mrs X from January to October 2021 but not the periods of:

a) September 2020 to January 2021; and

b) October 2021 to April 2022 when the agreement ended.

31. I also asked the Council whether it wished to suggest a remedy for any injustice that may have been caused to Mrs X.
32. In response to my enquiries, the Council said new managers in the service had reviewed the situation and found it should pay Mrs X the additional £73 per week for periods a) and b) mentioned above. This would be in addition to the offer to pay from January to October 2021.
33. The Council clarified that this additional cost would bring the total payment owed to Mrs X to £6351 for the entirety of the period from September 2020 to April 2022. I calculate this payment to be correct.
34. In its responses, the Council also offered Mrs X a remedy payment of £200 for distress the issue had caused her and the time the Council took to respond to her issues.
35. The Council has recognised that it acted with fault and that this fault caused Mrs X avoidable frustration and distress as well as a loss of income she was due.
36. I am satisfied, that in the circumstances of this complaint, the Council’s suggested remedies are fair and proportionate. I have made a recommendation below to remedy the injustice caused by the fault.
37. The Council also said it recognised it needed a better way of communicating between departments. It said by the middle of September 2023, it would streamline its processes. Where there is a need for a shared lives review or reassessment, it has created a form to be filled out by users, carers or services. The form will be linked to the Council’s computer system so that a central record is available and teams can therefore liaise with one another about actions that need to be taken.

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Agreed action

38. To remedy the injustice caused by the faults identified, the Council has agreed to take the following action within four weeks of the date of my final decision:
• apologise to Mrs X for the confusion caused by not agreeing to pay her the required amount and for the time spent dealing with the issues concerned. The apology should be in accordance with our guidance Local Government and Social Care Ombudsman - making an effective apology;
• pay Mrs X £200 for the distress caused by having to challenge the Council’s stance on payments it owed to her;
• pay Mrs X £6351 for the period owed as shown in paragraph 33; and
• streamline the process for when a review/reassessment of a shared lives agreement is required as per paragraph 37.
39. The Council should provide us with evidence it has complied with the above actions.
40. Remedy payments are in line with the Ombudsman’s guidance on remedies.

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Final decision

41. I have now completed my investigation. I uphold this complaint with a finding of fault causing an injustice.

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Investigator's decision on behalf of the Ombudsman