Summary: There was a delay before the Council informed Miss X of charges for care, after she had said clearly she could not afford to pay. Miss X cancelled the care package immediately she found out about the charges. The Council agrees to acknowledge the delay by waiving the charges.

The complaint

1. Miss X (as I shall call her) complains the Council charged her for care after she told them she would not have the care package if it was chargeable as she could not afford it.

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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 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)
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 all the information provided by the Council and by Miss X. Both Miss X and the Council had the opportunity to comment on an earlier draft of this statement before I reached a final decision.

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What I found

Relevant law and guidance

5. 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)
6. 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.
7. Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently. Regulations require intermediate care and reablement to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support. Councils may charge where services are provided beyond the first six weeks but should consider continuing providing them without charge because of the preventive benefits. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)

What happened

8. Miss X was discharged from hospital in November 2022 and was assessed as needing a long-term care package to assist her with personal care, dressing and support with some meal preparation if needed.
9. The Council’s case recording shows a social worker visited Miss X on 7 December. Her notes say, “(Miss X) says that she has previously stopped care packages as she felt she could not afford the payments. We discussed the financial assessment, and that care is means tested. (Miss X) confirmed that she will still need the care even if she has to pay for it as she cannot manage without.”
10. The social worker telephoned Miss X on 14 December to tell her when the permanent care package would start. Her notes record Miss X said she would not pay for her care and asked how much it would be. The social worker said there would have to be an assessment, but based on previous assessments the charge was likely to be about £99 a week: “(Miss X) said again that she would not pay for any care and she would not allow any care to start before knowing the cost to her.” The social worker said she would check with the charging section and “get back to her” but it was likely there would be a charge. Miss X reiterated she would not pay for care.
11. The file note of the telephone call concludes “Plan: Postpone start of POC and make contact with Fairer Charging”. There is no record of any contact by the social worker with the charging section, or that the social worker contacted Miss X again as promised. The file shows the new care package was not postponed but started on 19 December.
12. The Council says its charging team tried to contact Miss X several times by telephone but there was no answer and no voicemail facility. It wrote to her on 17 March to say there would be a financial assessment by telephone on 29 March. The Council says when its officer called, Miss X said she had not received the letter and did not want to go ahead with the assessment as she was not prepared for it. The Council says, “As we had tried to book the assessment a few times and the citizen was not forthcoming with the information we then carried out a desktop review assessment as the citizen had been previously assessed by the team.”
13. On 11 April the Council wrote to Miss X to say her weekly contribution would be £135. On 20 April the Council sent an invoice for backdated charges for £1427.09.
14. Miss X cancelled her care when she received the invoice. The care agency told the Council Miss X had said she couldn’t afford the care and would ask her son or daughter for help if and when she needed it. An officer spoke to Miss X on 3 and 4 May and Miss X was adamant she did not want to continue with the care.
15. Miss X complained to the Ombudsman. She said the Council had told her she would not have to pay for care.
16. The Council says it has no record that Miss X would be eligible for intermediate (non-chargeable) care as she needed long-term services. It says however that she received non-chargeable reablement services which were arranged and funded by the NHS to enable her discharge from hospital between 10th November 2022 and 18th December 2022. The Council completed an assessment and arranged care services for her but did not charge for the period up to 13 January 2022.

Analysis

17. The Council’s records show clearly that Miss X had said she would refuse care if she had to pay. She cancelled the care with immediate effect when she received the invoice in April.
18. There is no record the social worker acted on her promise to contact Miss X once she had spoken to the charging section about Miss X’s likely contribution to the cost of care.
19. In effect, the first identifiable date Miss X knew of the charges was when she received the invoice in April.
20. Although I see no evidence to support Miss X’s statement that she was told she would not have to pay for care, the lack of promised contact from the social worker and the long delay before notification was fault on the part of the Council which might well have led her to believe the care was not chargeable. In the circumstances, the Council should in my view waive the charges for care.

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Agreed action

21. The Council has confirmed it will waive the care charges as set out in its invoice of 20 April.
22. The Council has provided us with evidence it has complied with the above actions.

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Final decision

23. I have completed this investigation. I find there was fault on the part of the Council which caused injustice: that was remedied by completion of the recommendation at paragraph 21.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman