The Ombudsman's final decision
Summary: We will not investigate this complaint about the Council’s calculation of charges for care and support or the information it has provided the complainant or her representative about the matter. This is because there is not enough evidence of fault by the Council, or of its actions causing Miss K significant injustice, or of us being likely to achieve a different result for her so the matter does not warrant investigation.
The complaint
Miss K and her representative from an advice centre say the Council has: failed properly to assess Miss K’s finances when deciding what contribution it should charge towards her care and support services; and to provide the representative with information about how a debt for unpaid care charges came about or what it consists of.
They say this means the Council is expecting Miss K to pay more than she can afford with consequent risk to her care and support and to her health and wellbeing.
Miss K wants the Council to reduce the charges to a level she says she can afford to pay.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide: there is not enough evidence of fault to justify investigating, or any injustice is not significant enough to justify our involvement, or we could not add to any previous investigation by the organisation, or further investigation would not lead to a different outcome, or we cannot achieve the outcome someone wants; or there is no worthwhile outcome achievable from us investigating.
(Local Government Act 1974, section 24A(6), as amended, section 34(B)) If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
How I considered this complaint
I considered information provided by the complainant and the Council.
I considered the Ombudsman’s Assessment Code.
My assessment
Under the Care Act 2014, related regulations, and government guidance, in brief: A council must assess the finances of someone eligible to receive care and support services according to an objective method, and decide what it should expect them to pay towards the cost of services, or of direct payments if they arrange services themselves.
Any charges must leave a person with enough to meet the cost of living, and not reduce their available income below the minimum guaranteed by government.
Councils must consider any specific spending related to a person’s disability and allow for what it considers reasonable in the person’s circumstances.
There is no requirement for councils to take personal debts or discretionary spending into account when assessing what charges or contribution the person should make.
The Council has assessed and re-assessed Miss K’s finances and set out in letters to her how it has calculated the contribution she should make towards her care and support. It has also allowed for some necessary spending related to Miss K’s disabilities, and explained its calculations to her in person.
The Council’s letters also explain how an unpaid debt for care charges arose between July 2023 and February 2024. In summary, the assessed charge was more than Miss K was paying each month, so there was a shortfall. At some point from November 2023 Miss K either paid even less each month than before or stopped paying, so the debt increased more quickly.
The Council has recently considered whether there is scope for it to reduce Miss K’s charges as she would like. It has decided there is not. To explain this it says Miss K receives benefits of £190 per week which are to help her towards the cost of care, but its maximum charge based on its detailed financial assessment is £140 per week. This would leave Miss K with £50 per week, on top of other benefits income, which she does not spend on care services and can use for something else.
If Miss K or her representative considers the Council’s calculations has used information which is wrong it is open to them to give the Council evidence of the correct information and ask it to reassess. Based on the information I have seen, however, there is not enough evidence of material fault in the Council’s charging decisions to warrant us investigating.
Miss K’s representative is unhappy the Council did not reply to their request for information about the debt for unpaid charges. We might consider the delay to be fault, but not all the reasons have been within its control, some of or all the information would have been in documents Miss K already had, and the overall result from the correspondence and complaint is no different from before. We could not achieve a different result by investigating now.
Final decision
We will not investigate Miss K’s complaint because there is not enough evidence of fault by the Council to warrant it, or of its actions causing Miss K significant injustice, or of us being likely to achieve a different result for her.
Investigator's decision on behalf of the Ombudsman