Summary: The Council accepts there were delays in financial assessments and reviews of Ms K’s care, errors in the transport provision, and a failure to carry out a carers’ assessment. It has apologised and reinstated transport. It will reimburse Mr X’s costs for the transport he provided and offer carers’ assessments to Mr and Mrs X. There was no fault in the calculation of Ms K’s contribution towards the cost of her care, however, and no reason why the Council should waive the outstanding contribution.

The complaint

1. Mr X (as I shall call him) complains the Council continued to charge his daughter Ms K the same contribution to the cost of her care even when it was reduced significantly because of Covid 19. He says the Council mistakenly assumed she had transport available when she did not, and he paid extra to take her to her day care.

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The Ombudsman’s role and powers

2. 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)
3. 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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How I considered this complaint

4. I considered the information provided by the Council and by Mr X. We spoke to Mr X. Both Mr X and the Council had an opportunity to comment on a draft of this statement and I considered their comments before I reached a final decision.

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What I found

Relevant law and guidance

5. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
6. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months.
7. 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)
8. 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. 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.
9. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment.

What happened

10. Ms K is an adult with learning disabilities. She lives at home with her parents. Before the Covid 19 pandemic, Ms K was assessed as requiring 24 hours a week care to meet her needs. She attended a daycare centre three days a week and the Council provided transport for her journey there and home. Ms K’s assessed contribution towards the cost of her care was £45 a week.
11. Mr X says during the pandemic Ms K was unable to attend the daycare centre, which closed during that time. He says when some services started to reopen, the Council offered Ms K four (3 hour) half days as a different provision but said Mr and Mrs X would have to take her there and collect her. Mr X says he reduced the service to three afternoons a week (a total of 9 hours) after a while.
12. In February 2022 the Council wrote to Ms K with a new financial assessment. The assessed contribution was now £50.98.
13. Mr X wrote to the Council. He said Ms K now had to pay more every week for fewer care hours, as well as paying for her own transport. He added that she had not had a review of her care or contact with a care manager for two years. He asked for a copy of her support plan and the financial assessment.
14. A service manager responded to Mr X’s complaint in March. She upheld his complaints that Ms K had not had a review of her care despite the changes to her care package, and that she had not had her finances assessed since 2019 despite changes in provision.
15. The manager apologised for the disruption in the provision of care to Ms K. She said a review manager would be appointed to “undertake the tasks required to understand the history of changes to the funded services as a result of the Covid-19 pandemic. This will be accompanied by a reassessment of financial contributions. During this intervention, the review manager will consider (Ms K’s) current needs and work with (Ms K) and those important to her to formulate a robust Support Plan.”
16. A social worker met Ms K and Mr X on 24 March to review Ms K’s care needs. She noted Mr X felt Ms K was still being charged for the number of hours care she had before the pandemic. Mr X said he would like the transport to be reinstated. The option of respite was discussed but neither Ms K nor her parents wished for it.
17. The social worker also contacted the daycare provider to see if full days were available for Ms K.
18. Mr X continued to express concern that the Council was sending him invoices as though Ms K received 24 hours care not 9 hours. A finance officer telephoned Mr X on 27 April. She explained that Ms K was paying an assessed contribution, not the whole cost of her care. She said the current contribution was the maximum Ms K would pay even if the costs of her care were higher.
19. The social worker emailed Mr X. She said she understood the finance officer had explained the contributions. She said as Ms K had a mobility vehicle she would have to use that instead of a taxi funded by the Council. She also said there was a further half day available on a temporary basis at the daycare centre if Ms K would like it.
20. Mr X complained about the continuing invoices and the failure of the Council to provide a taxi service. He said without transport he could not take up the offer of the extra half day. He confirmed that his car was not a mobility vehicle but was privately owned. He asked why transport was no longer available as it had been before the pandemic.
21. Mr X complained to the Ombudsman. He said the Council continued to send him invoices for Ms K’s contribution, but he was paying the amount he felt was proportionate given the reduction in services. He also said the Council had not carried out a carers assessment for himself or Mrs X.
22. The Council wrote to Mr X indicating it would take recovery action if the outstanding amount was not paid.
23. The Council says the daycare centre does not have spare provision at the moment, but it will be offered to Ms K when it does. It says it has increased the hours available from 9 hours at the point when services reopened to 16 hours now and understands the current arrangement of two and a half days is “working well” for Ms K.
24. The Council acknowledges there was an error in its records about the transport available to Ms K and it has now reinstated the taxi service available through a direct payment.
25. In terms of the contribution towards the cost of her care, the Council points out that it has conducted the financial assessment using the 2014 Care and Support (Charging and Assessment of Resources) Regulations. It says, “Using this calculation, a person’s minimum contribution would always remain the same despite any increase or reduction in the Local Authority funded package of care as long as the funded provision exceeds the personal contribution, or in the case where financial circumstances change and a further financial assessment is required.” It adds that the only time Ms K’s contribution would decrease would be where the funded care cost is less than the assessed contribution, at which point she would fund her own care entirely.
26. The Council has put recovery action on hold in acknowledgement of the ongoing complaint investigation.
27. The Council says its records show Mrs X received a carers assessment in 2017 but Mr X has not been offered one.
28. Mr X says the Council has not taken their living costs into account. He says the disability related expenses allowed do not reflect the actual expenditure.

Analysis

29. The Council was wrong to assume Ms K had a mobility vehicle. The consequence of that was the cost of transporting Ms K to and from her daycare centre and the associated time.
30. The Council delayed in reviewing Ms K’s needs and her financial assessment. In the circumstances of the pandemic there was no provision available and that was not the fault of the Council. However, there was a delay after services resumed before an annual review of needs took place. Although that did not lead to a change in services, the delay in the review of the finances led Mr X to believe Ms K was being charged more than was appropriate.
31. There has been a delay in offering a carers assessment. That is fault and may have led to a loss of service for Mr and Mrs X.
32. There is no evidence of fault in the way Ms K’s contribution to the cost of her care has been calculated.

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Agreed action

33. The Council has now reinstated the transport for Ms K. Within one month of my final decision, it will reimburse Mr X for the cost of the journeys undertaken in the meantime and offer an additional sum of £250 in recognition of the time taken by Mr X to provide transport.
34. Within one month of my final decision the Council will offer a carers assessment to both Mr and Mrs X. If there is a budgetary consequence it will backdate the payment of that for one year.
35. Mr X should not have had to remind the Council it had not carried out the appropriate annual reviews. Within one month of my final decision the Council will offer £250 to Mr X for the time and trouble he was put to in making the complaint.
36. There is no reason for the Council to waive the outstanding debt owed for Ms K’s contributions to the cost of her care.

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Final decision

37. Subject to further comments by Mr X and the Council, I intend to find there was some evidence of fault by the Council which the completion of the recommendations at paragraphs 33 – 35 will remedy.

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Investigator's decision on behalf of the Ombudsman