Summary: The Council accepted it was at fault for not reviewing Mr Y’s care and support plan earlier given that his support services stopped due to the COVID-19 pandemic. It will apologise, refund the contributions Mr Y paid to the cost of his care in that period and waive the invoices that remain outstanding. It will also pay Mr X £200 for his time and trouble pursuing the matter on Mr X’s behalf.

The complaint

1. Mr X complained the Council required his son, Mr Y, to continue to pay his assessed contribution during the COVID-19 pandemic, even though the Council was not able to provide support services from late March 2020 to March 2021.
2. Mr X considers Mr Y has been over-charged. He was also put to the time and trouble of pursuing the matter.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. This complaint involves events that occurred during the COVID-19 pandemic. The Government introduced a range of new and frequently updated rules and guidance during this time. We can consider whether the council followed the relevant legislation, guidance and our published “Good Administrative Practice during the response to COVID-19”.
5. 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

6. I considered the information Mr X provided and spoke to him about the complaint. I considered information the Council provided, and relevant law and guidance, as set out below.
7. 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

Background

Charging for adult social care

8. Where an adult needs care and support, the Council will carry out an assessment to determine whether they have “eligible needs”. If they do have “eligible needs”, the support they need to meet those needs will be set out in a care and support plan. The care and support plan will usually include a personal budget, which is the expected cost of providing that care.
9. Councils can charge for care and support services they provide or arrange. Charges may only cover the cost the council incurs (Care Act 2014, section 14).
10. Councils will carry out a financial assessment to determine what contribution they should make towards their care costs. For care provided to people who live in their own home, this should not reduce a person’s income below Income Support plus 25%.(Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)

This Council’s policy

11. The Council calculates the person’s assessed contribution based on the expected costs for a 12 month period and invoices them for the contribution on a monthly basis. At the end of the year it carries out a reconciliation. Where the actual costs are lower than planned, and lower than the contributions charged, it will apply a credit to the person’s account. Where the costs are greater, additional costs up to the maximum assessed contribution will be charged.

What happened

12. Mr Y lives with his parents, Mr and Mrs X. Mr X manages Mr Y’s finances on his behalf.
13. Prior to March 2020, The Council assessed Mr Y and decided he needed support, including access to a day centre and overnight respite. The Council calls this support “short breaks” provision. Mr Y paid an assessed contribution each month, based on the expected costs of the support set out in his care and support plan.
14. In March 2020, both the day centre and respite support stopped due to the COVID-19 pandemic. There is no complaint about this: the family understand it was not possible for those services to continue during the first national lockdown. Mr X paid the invoices for the assessed contribution in April 2020 (£91.42) and May 2020 (£94.46) on behalf of Mr Y.
15. The Council continued to invoice Mr Y for the assessed contribution throughout 2020 and into 2021. Mr Y did not start receiving the day centre and respite support again until April 2021. Mr X complained. He said it was unfair for the Council to continue to invoice Mr Y for the assessed contribution when Mr Y was not accessing a service. The Council said it had invoiced in line with its charging policy. Mr X complained to us.

Was there fault causing injustice?

16. In response to my enquiries, the Council reviewed the case. It said its records showed it had agreed to cancel the care and support plan and completed another plan without the short breaks provision. However, it accepted it should have done this sooner and that the failure to review the plan in light of services stopping due to the COVID-19 pandemic was fault. It also accepted that if it had done this earlier Mr Y would not have been charged the assessed contribution during the period he was not receiving services.
17. As a result, the Council offered to apologise, refund the £185.88 Mr Y paid towards his care in April and May 2020, waive the outstanding invoices from June 2020 to March 2021, and make a payment to Mr X for the time and troubled he was put to.

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Agreed action

18. The Council will, within one month of the date of the final decision:
• apologise to Mr X and Mr Y for its failure to review Mr Y’s care and support plan earlier and for any distress caused;
• refund the assessed contributions Mr Y paid in March, April and May 2020 (totalling £280.34);
• waive the outstanding invoices for the assessed contribution for the period June 2020 to March 2021 (totalling £1033.43); and
• pay Mr X £200 for his time and trouble pursuing the matter.

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Final decision

19. I have completed my investigation. The Council has accepted it was at fault and has agreed appropriate action to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman