The Ombudsman's final decision
Summary: The Council acknowledges there was a failure of communication and has amended its system as a result. It now apologises to Mrs X and will waive the invoice for Mrs X’s care charges.
The complaint
Mr A and Ms B (as I shall call them), Mrs X’s son and daughter, complain the Council did not give them information soon enough about care charges. They say if the Council had told them earlier there would be a charge, they would have acted differently in respect of the care needed by Mrs X.
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 considered the information provided by Mr A and Ms B, and by the Council. All parties had opportunity to comment on an earlier draft of this statement before I reached a final decision.
What I found
Relevant law and guidance A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17) Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. Councils have no power to assess couples according to their joint financial resources. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently.
Regulations require intermediate care and reablement to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support. Councils may charge where services are provided beyond the first six weeks but should consider continuing providing them without charge because of the preventive benefits. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014) What happened Mrs X had a series of hospital admissions at the end of 2021 and beginning of 2022. After discharge she was provided with periods of reablement care, free of charge.
In April 2022 a social worker visited Mrs X to assess her needs. The social worker explained that at some point there would be a financial assessment to see whether Mrs X had to make a minimum contribution towards the cost of her ongoing care.
The Council’s records show that Mrs X called the Council on 27 April because she was concerned about paying for her care. The Council says a message was sent to other social work team members (as the initial social worker was absent) but there was no record the call was followed up.
In June 2022 another officer from the Council telephoned Mrs X and said she owed £1160 for the care she had already received.
Ms B complained to the Council. The Council replied on 12 July. It said the social worker had recorded in her notes she had read a statement to Mrs X which said almost everyone contributed towards the cost of their care, a financial assessment would be undertaken and “the cost will commence from the start of the service”.
The Council’s records showed it had sent a leaflet to Mrs X explaining about the financial assessment and the charges which might be payable. It said it was not possible to assess finances before care began, in many cases, and it had a duty to provide the services required to meet the assessed need whether or not the financial assessment was complete. It apologised that no-one had contacted Mrs X but said the correct procedures had been followed in terms of the charging.
The complaint and response Mr A and Ms B complained to the Ombudsman.
The Council has now reviewed the complaint and accepts there were shortcomings in the service it provided. It says although the social worker did alert Mrs X there might be charges, she was not in a position to say what the amount of contribution might be.
It says when Mrs X called the Council to ask about her contributions, the Council did not keep its commitment to call her back: it has since reviewed its service and put in place a system which generates an alert seen by all key workers involved in a client’s care. It says the notification function will also include any time constraints and the level of urgency. The system was put in place on 5 October.
The Council apologises to Mrs X for the shortcomings in its system and will waive the invoice for the home care package.
Analysis The Council acknowledges there were faults in the way it communicated with Mrs X about the level of care charges.
Agreed action
The Council has already put in place an improved system to ensure better responses to call back requests, so I do not make any further recommendations there.
The Council’s apology to Mrs X and offer to waive the home care charges will remedy any outstanding injustice to Mrs X.
Final decision
I have completed this investigation on the basis there was fault on the part of the Council which its actions will remedy.
Investigator's decision on behalf of the Ombudsman