Summary: The Council is unable to evidence it clearly explained its charging policy for day services to Mr X.

The complaint

1. Mr X complains a social worker gave him inaccurate advice about the charging arrangements for a day service his adult daughter, Miss Y, attends. Mr X says a social worker visited the family at home and said the service was free.

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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 a council’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 have:

• considered the complaint and discussed it with Mr X;
• considered the correspondence between Mr X and the Council;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. The Care Act 2014 (the Act) is the legislation that sets out local authorities’ powers and duties in respect of adult social care services. The Department of Health and Social Care also produces statutory supplemental guidance for local authorities on how to discharge these duties. This is called the Care and support statutory guidance (the statutory guidance).
6. Section 14 of the Act gives a local authority the power, with certain exceptions, to charge for care and support it arranges to meet an adult’s needs.
7. Section 17 of the Act explains that, where a local authority decides to charge for care and support, it must assess the adult’s financial resources to calculate the amount (if any) the adult would be likely to be able to contribute towards the cost of the care and support.
8. In carrying out a financial assessment, the local authority must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 (the Charging Regulations). The Charging Regulations set out how local authorities should treat an adult’s income and capital for the purposes of calculating care contributions.

What happened

9. Miss Y is in her twenties. She has a learning disability. She lives at home with her family, who provide day to day support.
10. Miss Y has attended her current day service since July 2018. The Council also offered a direct payment for respite care, but Mr X has so far declined.
11. Mr X says the Council told him day services were free of charge. About three or four months after Miss Y began attending the service Mr X began receiving invoices for Miss Y’s contribution. Mr X could not understand why so he approached the day service, he says the staff told him they thought the service was free.
12. The Council says it sent Mr X a financial assessment form and a covering letter on 10 July 2018, when Miss Y began attending the day service. Mr X says he did not complete the assessment because he had been told the day service was free.
13. The Council completed the financial assessment without Mr X’s input. It allowed £12.50 for disability related expenditure and £10 for additional essential household expenditure. The outcome concluded Miss Y’s weekly contribution to be £10.57.
14. In its response to my enquiries the Council says the needs assessments of Miss Y completed on 12 June 2018 and 6 September 2018 record that charging information was given to Mr X. I have considered both undated documents. Neither document records any information relating to charging. The Council says, “Nothing was confirmed in writing”.
15. I have also had sight of Miss Y’s care and support plan dated 1 March 2018. It does not document information relating to charging.
16. The Council sent Mr X an email on 18 October 2018, reminding him to complete the financial assessment form. From the records it appears this relates to the proposed direct payment for respite care, not day services, “mail to [Mr X] to make him aware of the DP and to encourage completion of financial records in order for the DP to be put into place”.
17. Mr X refused to accept the direct payment until the dispute about charging for day services was resolved.
18. A council officer telephoned Mr X on 22 October 2018 to arrange a visit to discuss the direct payment for respite care. The officer recorded that Mr X wanted to discuss the invoices he was receiving for the day service and that he had been under the impression the service was free.
19. A social worker visited Mr X on 8 November 2018 to discuss the day service charge. Mr X reiterated his point, that he had been told the service was free, and said, paying the contribution would leave Miss Y short of funds. Mr X says the social worker telephoned the Council whilst in his home to ask if the service was chargeable, and the Council confirmed it was.
20. The records show the same social worker sent an internal email to the financial assessment team asking for clarification about the charge, saying “Are you able to shed some light on this so I am able to approach dad and give the exact reason/reasons to why there is a contribution”. The response from the financial assessment team confirmed there had been confusion and dispute over the financial contribution, and said, “I can see from the support plan the DP is for a one off respite payment for £810 for 10 days and if this was taken at home the charge would be £10.57 per week…”. The officer does not explain the charge for day services.
21. The records show an officer had contact with Mr X in February and March 2019, but this was about the proposed respite care for Miss Y.
22. Mr X submitted a formal complaint to the Council on 5 March 2019. He did not receive a response. He says this compounded his frustration.
23. In May 2019, an officer telephoned Mr X again about the proposed direct payment for respite care. The officer recorded that Mr X was “still waiting to be contacted about the charging issue so wants me to call back in 4-6 weeks to discuss the DP further”.
24. Mr X did not hear from the Council. He submitted a complaint to this office in October 2019.
25. In its response to my enquiries the Council said “Regrettably the complaint was overlooked and not picked up for investigation until 9th October 2019. The council wishes to apologise for this and to make a payment of £250 in recognition of its failure to keep the complainant informed of the progress of the complaint”.

Analysis

26. The Care and Support Statutory Guidance 2014 makes it clear that the approach to charging for care and support needs should be clear and transparent so people know what they will be charged.
27. The Council has accepted that it did not provide written information to Mr X about charging for day services. It says a social worker explained this to Mr X during assessments of Miss Y in June and September 2018, and this is evidenced in both documents. I have considered both documents and neither document records such information was given.
28. At the time Miss Y began attending the day service Mr X was in discussion with the Council about a direct payment for respite care. The records I have seen suggest the assessed financial contribution related to the proposed direct payment for respite care, not for day services. It appears council officers were also unclear. A social worker contacted the financial assessment team to clarify the charge for day services, this is the same social worker the Council says verbally explained the charges to Mr X. The financial team confirmed the weekly charge relates to proposed respite services, not day services.
29. I am not satisfied the Council explained its charging policy for day services clearly. Neither have I seen evidence which confirms the financial assessment the Council completed was for day services. Mr X’s confusion is understandable.
30. When Mr X raised the matter with the Council he did not receive a timely response. The Council acknowledges it did not deal with Mr X’s complaint as it should have done. It has offered to apologise to Mr X and make a payment to him to acknowledge his frustration and distress. This is an adequate remedy.

Agreed action

31. The Council will within six weeks:

• undertake a fresh financial assessment of Miss Y, with Mr X;
• waive all outstanding charges for day services to the date of the final decision;
• follow through its offer of an apology and a £250 goodwill payment to Mr X.
• ensure that it gives clear information about charging to all service users and their representatives. Written information about the Council’s charging policy should also be available for service users

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Final decision

32. There is evidence of fault in this complaint. The above recommendations represent a suitable remedy for the injustice caused.
33. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman