Summary: The complainant’s representative (Mr X) complained about the way the Council charged for the care services provided to his mother (Mrs Y). The Council has accepted it failed when charging for Mrs Y’s non-residential care services and offered some remedies. The Council has made some service improvements. The Council agreed to apologise following our guidance on remedies, to pay more for Mr X’s distress and to re-calculate Mrs Y’s care charges. We will not investigate the part of Mr X’s complaint about disability related expenditure. We have already considered some disability related expenditure in Mr X’s previous complaint and for others we could not achieve more than the Council has already offered.

The complaint

1. Mr X says the Council failed in the way it charged for the care services provided for Mrs Y by My Homecare (the Care Provider). He also says the Council’s financial assessments were flawed as they failed to consider and allow certain disability related expenditure.
2. Mr X says the Council’s failings caused him uncertainty and distress and he spent much time communicating with the Council about Mrs Y’s financial assessments and charges. They also, he says, had a negative impact on his mother’s finances.

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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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We provide a free service but must use public money carefully. We do not start or continue an investigation if we decide further investigation would not lead to a different outcome. (Local Government Act 1974, section 24A(6), as amended, section 34(B))
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 and have not investigated

6. I have not investigated how the Council calculated Mrs Y’s disability related expenditure as this matter was dealt by us when investigating Mr X’s previous complaint 23 000 806.
7. Although not included in Mr X’s previous complaint, I decided not to investigate the Council’s refusal to consider costs of Mrs Y’s transport to the day centre as disability related expenditure. This is because in its letter to Mrs Y of 5 December 2023 the Council reviewed its charging for Mrs Y’s care services and included transport costs in Mrs Y’s financial assessments as disability related expenditure. It would not be proportionate to investigate this matter as there is nothing else we could achieve for Mrs Y.

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How I considered this complaint

8. I spoke with Mr X and considered the information he provided.
9. I made enquiries with the Council and considered the information it provided.
10. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Legislative and administrative framework

11. 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)
12. 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.
13. When making decisions on charging local authorities should be clear and transparent so people know what they will be charged. Where a local authority has decided to charge it should explain in the financial assessment how the assessment has been carried out, what the charge will be and how often it will be made. The local authority should ensure this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice. (Care and Support statutory guidance paragraph 8.2 & 8.16)

What happened

14. At the beginning of November 2022 the Council decided Mrs Y had eligible needs for social care support. Later in the month the Council carried out a financial assessment for her.
15. At the beginning of April 2023 the Council issued a revised financial assessment, which included disability related expenditure. Responding to Mr X’s concerns about charging the Council reviewed Mrs Y’s financial assessments in June, August, September, October and at the beginning of December 2023.
16. In the second week of August 2023 Mr X told the Council he had been raising concerns about the Council’s invoices for the non-residential care services provided to his mother from the date of receiving the first invoice issued in February 2023. The main concern was that the Council charged for the time commissioned rather than for the actual services delivered to Mrs Y. Mr X told the Council when re-calculating the invoiced it should consider the impact on tariff income of the payments which would have been made in time if not for the Council’s wrong invoicing. Mr X confirmed he would pay once he received corrected invoices.
17. A week later Mr X contacted the Council again stating he received another wrong invoice. He also asked when the Council would respond to his complaint.
18. The Council said it was putting Mrs Y’s invoice on hold until it resolved Mr X’s complaint. Despite this communication the Council sent Mrs Y a reminder requesting a payment for her care services which caused her distress.
19. At the end of September 2023 the Care Provider told Mr X it had charged for 48 hours more than it had delivered to Mrs Y. It confirmed it would adjust the invoices and offered a payment of £350 for Mr X’s time and trouble.
20. The Council responded to Mr X’s complaint in the third week of October 2023. Mr X was not happy with the Council’s response. He said the Council was still sending him wrong invoices.
21. At the end of November 2023 Mr X received a bailiff’s letter for the unpaid invoice.
22. At the beginning of December 2023 the Council sent Mrs Y a letter with the reviewed financial assessments from October 2022. In all the assessments Mrs Y’s transport costs to the day centre were considered as disability related expenditure.
23. A few days later the Council responded to Mr X’s complaint at stage two of its complaint procedure. The Council apologised for the number of invoices issued and that they were wrong. It also apologised for the recent contact from the debt recovery agency. The Council offered Mr X £250 for his distress and time and trouble. The Council explained changes that it had set up in the billing system which should improve its services in the future. The Council told Mr X the outstanding fees for the care services provided to Mrs Y in the period from the end of February 2023 amounted to £1,248.
24. Mr X was not satisfied with the Council’s approach of calculating the total sum as this meant he could not verify weekly charges.
25. In mid-March 2024 the Council sent Mr X some explanation about weekly care charges for the services provided to his mother. Mr X disputed the figures included in this correspondence as they did not account for the Care Provider’s corrections to Mrs Y’s invoices.
26. The Council said it could not recalculate Mrs Y’s invoices because of the way the Care Provider provided its credit information. The Council increased the amount of time charged for by the Care Provider when it did not deliver care to 49 hours 16 minutes. The Council proposed to reduce outstanding fees by the fees for the services that were charged for but not delivered and adjustment for disability related expenditure. The remaining sum to pay would amount to £474.
27. Mr X remained unhappy with this calculation as the final figure of outstanding fees did not take account of the decrease in Mrs Y’s tariff income which the Council should have considered when calculating care charges due from her.

Analysis

28. In its stage two of the complaint response the Council accepted its failings with Mrs Y’s care charges and offered to reduce outstanding fees. The correspondence with Mr X which followed concerned the calculations of the amount that the outstanding fees should be reduced by. Therefore my investigation focused on checking whether the Council’s calculation was correct and whether the remedies offered by the Council were enough.
29. Having reviewed the evidence I found the Council’s failings when calculating charges due for Mrs Y’s care services and delays with resolving Mr X’s concerns must have affected the financial basis of the Council’s assessments. When the Council was reviewing Mrs Y’s charges no payments were made which meant that Mrs Y’s tariff income was higher than if she had continued paying for her care services.
30. The Council’s failings with charging for the Care Provider’s services for Mrs Y and delays with resolving Mr X’s concerns, including during the Council’s complaint handling process, are fault. This fault caused injustice to Mrs Y as she was charged more than she would have been if not for the Council’s failings. The Council’s fault also caused injustice to Mr X due to the time and effort he spent trying to get the resolution of the charging issues for his mother. Since February 2023 Mr X had continuously queried the invoices received for the care provided to Mrs Y. He spent much time contacting the Council and was increasingly frustrated by the lack of resolution.
31. In its response to my enquiries the Council said it had improved some of its processes:
• In April 2024 the Care Provider joined the Council’s Interim Homecare Contract which requires them to analyse their call monitoring data to identify any issues and to send four-weekly Electronic Call Monitoring data to the Council. This included start and end times of calls for all clients funded by the Council.
• The information from home care provider call monitoring can also be reviewed against the information received by the invoicing team to ensure invoices reflect the care delivered.
• The Council has implemented an automated system for invoicing.

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Agreed action

32. To remedy the injustice caused by the faults identified, we recommend the Council complete within four weeks of the final decision the following:
• apologise to Mrs Y and Mr X for the injustice caused to them by the faults identified. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended;
• re-calculate the outstanding care charges due from Mrs Y by applying an estimate of how much the outstanding charges would have been likely to be reduced if Mrs Y’s tariff income had been adjusted at each stage of the assessment process. The Council will work out the estimate by using the capital level at the time it completed the first financial assessment. The Council will complete a new assessment every time Mrs Y’s capital would have dropped by £250 based on the tariff income amount used in the assessment. The Council will then calculate the difference between its new calculations and the original assessments;
• pay Mr X £150 to recognise the distress caused to him by the Council’s failings. This payment should be in addition to £350 offered by the Care Provider and £250 offered to Mr X by the Council in December 2023, in recognition of the further delays in resolving Mr X’s concerns.

The Council will provide the evidence that this has happened.

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Final decision

33. I uphold this complaint. The Council has accepted its fault but the remedies offered are not enough. The Council has now accepted my extra remedies, so this investigation is at an end. I will not investigate the part of Mr X’s complaint about disability related expenditure. Some disability related expenditure have already been considered in Mr X’s previous complaint and for others we could not achieve more than the Council has already offered.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman