Summary: The care provider’s information to Mr X was sufficiently clear, and the care provider agrees to make a refund to Mrs A’s estate in recognition of a letter which was sent late. There was one episode of a minor error in the fee quoted but that did not cause any injustice.

The complaint

1. Mr X (as I shall call the complainant) complains the care provider overcharged by £60 a week for the care of his late mother Mrs A.

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What I have investigated

2. I have investigated the complaint as set out above. Mr X has previously made related complaints about the actions of the local council, and we have completed those investigations.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)

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How I considered this complaint

4. I considered the information provided by Mr X and by the care provider. I spoke to Mr X. Both Mr X and the care provider had an opportunity to comment on an earlier 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. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve. The Care Quality Commission (CQC) has issued guidance on how to meet the fundamental standards below which care must never fall.
6. Regulation 19 says care providers should give timely and accurate information about the cost of their care and treatment to people who use their services. Providers must notify people of any changes to their terms and conditions including increases in fees and give them sufficient time to consider whether they wish to continue with the service.

What happened

7. The local council placed Mrs A at the CIC care home for a period of assessment. Members of Mrs A’s family challenged the placement through the Court of Protection and so the council explained to the care provider the placement could only be deemed temporary while proceedings were under way. The council told the care provider to charge Mrs A the local authority’s usual full cost fee (which was lower than the fee the care provider would normally charge someone who arranged their own placement).
8. In August 2018 after the Court had reached a decision, the council told the care provider Mrs A’s placement was now permanent. As a result, Mrs A would now fund her own care at the care provider’s usual fees for a residential placement for someone with dementia.
9. The care provider’s fees for self-funding residents were £800 a week at that time.
10. On 1 October 2018 the fees rose to £900 a week. The care provider wrote to Mr X on 17 October explaining the new rate. Mr X and his aunt jointly had power of attorney for Mrs A’s finances.
11. Mr X complained to the care provider about the fees. The care provider responded to him in December. The care provider said “It was explained to us that the placement was being challenged through court by the family and until this was resolved the placement must be considered temporary. This is why the rate was originally lower. The rate at the time your mother transferred from temporary to permanent was £900.00 per week.”
12. The care provider apologized that neither the council nor the care provider had explained this previously and said it would have expected the council to have explained it during the financial assessment.
13. The care provider says normally it asks for an Occupancy Care Agreement to be signed at the start of a placement but it says Mr X refused to sign it because of his challenge through the courts to his mother’s placement. Mr X agreed to sign the agreement in May 2019 but the agreement wrongly said the fees were £840 a month.
14. Mr X continued to refuse to make the payments. The care provider referred him to the Office of the Public Guardian as it said he was not fulfilling his responsibilities as power of attorney. It says Mr X’s aunt then ensured the fees were paid at the correct rate of £900.
15. Mr X complained again to the care provider in 2020 that there had been an overpayment of £60 a week. The care provider investigated the complaint again. The regional manager wrote to Mr X in December. He said the credit control team had written in October 2018 explaining the increase from £800 to £900; a breakdown of daily rates had been provided which clearly stated that from 01 October the rate was £900 a week; the fee of £900 had been paid consistently. The reference to £840 in the Occupancy Care Agreement was recognised to be an error. He added, “The issue was not raised as a concern until March 2020, some considerable time later and therefore I would have to say that this amounts to an agreement of the fee invoiced.”
16. Mr X complained to the Ombudsman.
17. The care provider acknowledges that ‘care fees being increased from the 1st and a letter confirming this only being sent on the 17th October could have and should have been communicated better’. It says in the light of this it will offer a refund in the amount of £242.85 to Mrs A’s estate: ‘This would amount to the difference in the increased care fees due for the 17 days from the 1st to the 17th October 2018’.
18. Mr X says he never received the letter of 17 October 2018. He says he did not receive any notification of the fee rate until Mrs A’s social worker gave him the occupancy care agreement in August 2019 which incorrectly said the fee was £840.

Analysis

19. The care provider clearly wrote to tell Mr X the fees would increase to £900. It was late in doing so but will now reimburse the estate the difference in the fees for that period.
20. There was an error in the Care Agreement which the care provider accepts: however, that did not make any difference to Mr X or Mrs A. The fees continued to be paid at £900 a week by Mrs A’s sister who also held power of attorney and took over responsibility for making the payments.
21. Neither Mr X nor Mrs A suffered any injustice in consequence of the administrative error.
22. Mr X says he did not receive the letter in October 2018 and was not told about the fee rate until August 2019. However, the care provider’s response to his complaint in December 2018 clearly states the fee was £900.

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Agreed action

23. The care provider has offered to refund the estate the difference in fees between 01 October 2018 and 17 October 2018 when it wrote to Mr X. It should do so within one month of my final decision.

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Final decision

24. I have now completed this investigation on the basis that the agreed refund to Mrs A’s estate of the amount identified in paragraph 17 will resolve any outstanding injustice.

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Investigator's decision on behalf of the Ombudsman