Summary: We do not find the Care Provider at fault for sending an invoice to the complainant for his late sister’s care. We accept the complainant did not know of the invoice until after his sister died. But we find the Care Provider had tried to make him aware sooner.

The complaint

1. Mr S complained the Care Provider delayed in issuing an invoice for care charges incurred by his late sister, Ms T.
2. Mr S said the unexpected invoice caused distress because if paid, it would reduce funds payable from Ms T’s estate to relatives. They would receive less than Mr S had previously advised they would receive.

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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. If they have caused a significant injustice or that could cause injustice to others in the future, we may suggest a remedy. (Local Government Act 1974, sections 34B, 34C and 34H (3 and 4) as amended)
4. 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

5. Before issuing this decision statement I considered Mr S’s correspondence to the Care Provider about the invoice at the crux of this complaint, and its replies.
6. I also gave Mr S and the Care Provider opportunity to comment on a draft version of the decision statement. I took account of any comments they made before completing the investigation and finalising the decision statement.

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What I found

The key facts

7. From June 2020 until August 2023, Ms T was resident in one of the Care Provider's care homes. Between May 2021 and early November 2022, Ms T’s local authority paid the cost of her care, while Mr S, acting with a Power of Attorney, sold Ms T’s house.
8. After Ms T’s house sold, Mr S settled with the Council the bill incurred for Ms T’s care which it had paid. Then, from February 2023 onward he paid monthly invoices sent to him by the Care Provider for Ms T’s care until she died in August 2023.
9. In November 2023, Mr S asked a finance officer from Ms T’s care home to send him a final invoice for Ms T’s care. When he received this the Care Provider said there were outstanding charges of around £9,000. This was for care Ms T received between early November 2022 and the end of January 2023.
10. Mr S then made a complaint the invoice related to charges that were twelve months old.
11. Mr S chased a reply to his complaint in December. When in January 2024 he had received no reply, he contacted this office. We asked the Care Provider to reply to Mr S’s complaint which it promised to do. However, it was not until late March 2024 that it did so. It apologised for not replying to Mr S sooner but offered no explanation for its delay.
12. In its reply, and in a later response sent to Mr S in May 2024, the Care Provider said:

• it first invoiced Mr S for the care charges in question in early January 2023;
• it then sent reminders for the outstanding amount in February, April and June 2023;
• the Post Office returned the June 2023 reminder and so it telephoned Mr S to confirm it used the correct address to send post; it then re-posted that reminder in July 2024;
• it had sent a final reminder to Mr S in November 2023, adjusting the amount outstanding to take account that it needed to refund care fees following Ms T’s death;
• it had no reason to think Mr S had not received the invoice or reminders. He had paid promptly in response to the monthly invoices it sent for Ms T’s care from February 2024 onward.

13. In his comments to this office Mr S said:

• no-one told him when Ms T’s local authority stopped paying her care fees;
• he had not received the January 2024 invoice or reminders;
• the amount the Care Provider billed Ms T was higher than that which it had agreed the Council would pay for the time she could not meet her care charges while he sold her house.

My findings

14. I did not uphold this complaint, as I found no fault in the Care Provider's actions.
15. I accepted Mr S was not aware in November 2022, when Ms T’s local authority stopped paying towards her care. It is possible either Ms T’s local authority or the Care Provider could have communicated better at that time, to let him know what had happened.
16. However, Mr S must have learnt the local authority payments had stopped soon afterwards and the period they covered. Because he settled the fees it had paid for Ms T’s care, following sale of her house. Mr S then went on, from the start of February, to pay the monthly invoices he received for Ms T’s care. I considered it possible he could therefore have identified the gap between November 2022 and January 2023 when no-one had paid care fees for Ms T.
17. But in addition, I accepted the Care Provider’s account that it had invoiced Mr S at the beginning of January 2023 for Ms T’s fees for this period. I had no reason to doubt that, nor that it went on to issue reminders. Mr S also did not dispute the Care Provider checked his address in July 2023.
18. I accepted that despite this, Mr S did not receive the original invoice or reminders, and the evidence showed at least one reminder went astray. But given Mr S paid all other invoices sent by the Care Provider it would have no reason to assume he did not receive its January 2023 invoice or reminders. There was also no reason for me to find that any invoices that went astray were due to fault by the Care Provider. I considered blame could equally lie with the post service. As the post service wrongly returned a reminder correctly addressed, this suggested it was more likely the cause of post going astray.
19. In addition, even if I found the Care Provider delayed significantly in issuing the invoice to Mr S, I could not recommend it write off the charges in whole or in part. While this would suggest poor administrative practice, Ms T still contracted for her care (or Mr S did so on her behalf) and benefited from the care provided. We would not seek a write-off in such circumstances as that would be disproportionate.
20. It was unfortunate these events left Mr S in a position where in administering Ms T’s estate he had to meet a significant, unanticipated bill. I accepted this resulted in awkwardness for Mr S, as he could no longer pay out the sums to relatives from the estate he had previously indicated. But I could not say this was an injustice arising because of any fault by the Care Provider. I had no grounds to recommend the Care Provider amend or cancel its invoice.
21. I noted Mr S’s comments on the fee for care paid by Ms T when she funded her own care, in contrast to the fee paid by her local authority for her care. I recognised this appeared unfair to Mr S. But it is not uncommon that local authorities, benefiting from their size and buying power, negotiate lower rates for care costs than private individuals. The law allows for this and we cannot interfere in the contract arrangements Care Providers make to provide care either in negotiation with councils or with private individuals.
22. Finally, I noted with some concern the Care Provider’s complaint handling in this case. It apologised to Mr S for the four-month delay in replying to his complaint made in November 2023. I did not consider it satisfactory that it provided no explanation for this. Especially as both Mr S and this office reminded it of the need to reply in between. The complaint was not complex and it should not have taken so long to reply.
23. However, I did not consider any injustice caused to Mr S by the delay justified further action by the Care Provider given it had apologised.

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Final decision

24. For reasons set out above I did not find the Care Provider’s actions caused Mr S an injustice. Consequently, I completed my investigation satisfied with its actions.

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Investigator's decision on behalf of the Ombudsman