The Ombudsman's final decision
Summary: It is more probable than not that Mrs Y did not receive written confirmation of care charges from the Council. The Council’s proposal to amend the start date for charging is satisfactory.
The complaint
Mrs X complains the Council failed to inform her mother-in-law Mrs Y, that the care she was receiving was chargeable. She also complains the Council delayed in sending Mrs Y an invoice which resulted in a large, backdated bill.
The Ombudsman’s role and powers
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) 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)
How I considered this complaint
I have: considered the complaint and additional information Mrs X provided considered the correspondence between Mrs X and the Council, including the Council’s response to her complaint; made enquiries of the Council and considered the responses; taken account of relevant legislation; offered Mrs X and the Council an opportunity to comment on a draft of this document.
What I found
Relevant legislation The Care Act 2014 is the overarching legislation which sets out what councils can charge people who have an assessed need for care.
The Care and Support Statutory Guidance sets out in detail how councils must apply the requirements of the Care Act.
Councils have discretion to choose whether or not to charge for non-residential services. Where a council decides to charge it must do so in line with the Care and Support (Charging and Assessment of Resources) Regulations and have regard to the Care and Support Statutory Guidance.
Where the council has decided to charge, it must carry out a financial assessment of what a person can afford to pay.
Councils can take most benefits into account including employment and support allowance (ESA), attendance allowance and some components of disability living allowance.
Background
Mrs Y was discharged from hospital in August 2021 with domiciliary care services funded by the NHS. This service was free of charge for four weeks. It came to an end on 10 September 2021 and responsibility passed to the Council.
Mrs X says the Council failed to inform Mrs Y that care would be chargeable, so she was unable to make an informed decision about accepting the service.
I have had sight of a record of a telephone conversation between a social worker and Mrs Y on 24 August 2021. Mrs Y reported the NHS funded care was going well and that she was improving. The social worker reminded Mrs Y the care funded by the NHS would end, and responsibility would transfer over to social services. She also said a financial assessment would be completed to establish, what if, any, financial contribution would be required from Mrs Y.
The Council issued Mrs Y with a financial assessment form. Mrs Y confirmed she wanted to receive and deal with correspondence herself. Mrs Y is registered blind and Mrs X says she needs information/forms in an accessible format. The Council says Mrs Y did not request correspondence be in a large font, and it had no such adjustment recorded on its systems.
Mrs Y completed the financial assessment form and returned it to the Council.
Mrs Y received a large, backdated bill from the Council three months after the service began. She continued to accept the care and began paying the assessed charge, but she believed the backdated charges to be unfair.
Mrs X submitted a formal complaint on Mrs Y’s behalf and asked the Council to waive all care charges between 6 September 2021 & 4 January 2022.
The Council responded on 26 January 2022. It acknowledged a delay in generating an invoice for Mrs Y’s care and explained the delay was in part caused by the fact the Council had used outdated financial information to assess Mrs Y, which had been held on the system from a previous financial assessment. It refused to waive the charges.
In response to my enquiries, the Council says its “...system is configured to continue charging based on the previous financial assessment carried out whether this service is: Home care, day care (day centre) direct payments, residential and nursing home care. In order to remedy this, we have now referred this onto our IT department to implement a new ‘release’. This will enable re-configuration of the system, so that if there is a break in service for more than 12 months it won’t automatically continue to charge”.
The Council says when a person receives Covid funded care it provides written information confirming the date the care becomes chargeable. In Mrs Y’s case it is unable to confirm such information was sent.
The Council’s earliest record of providing Mrs Y with written confirmation of the charges is dated 8 December 2021. In light of this, the Council has offered to amend the date the charges started to 13 December 2021. (it initially charged from the 11 September 2021). It intends to write to Mrs Y to inform her of its decision.
Mrs Y continues to receive care commissioned by the Council. The Council confirms all current charges are being paid.
Analysis I am satisfied Mrs Y was aware that the care she receives would become chargeable on the cessation of the NHS funded care, but she was not aware of the exact cost. I am not persuaded this caused Mrs Y a significant injustice as she chose to continue receiving care after receiving notification of the cost and then began paying the assessed charge.
It is more probable than not, that Mrs Y did not receive written confirmation from the Council informing her of the charges. I consider the Council’s offer to amend the start date for charging to be satisfactory.
Final decision
It is more probable than not that Mrs Y did not receive written confirmation of care charges from the Council. The Council proposal to amend the start date for charging is satisfactory.
It is on this basis; the complaint will be closed.
Investigator's decision on behalf of the Ombudsman