Summary: Ms X complained the Council billed her daughter for £20,000 in care charges for the time she spent in supported living from 2015 to 2022. Ms X says her daughter cannot manage her own finances and it failed to tell Ms X about the care charges. The Council has accepted fault for failing to complete a capacity assessment of Ms X’s daughter or keep either Ms X or her daughter suitably informed about care charges. The Council has offered to remove £15,339.64 worth of care charges from 2019 to December 2022. This is a suitable offer to reflect the fault. The Council also agreed to apologise to Ms X for delays in confirming the care charges owed from January 2023 to June 2023 and offer a payment arrangement to repay this balance owed.

The complaint

1. Ms X complained the Council billed her daughter, who I shall refer to as Ms Y, £20,000 for time she spent in supported living from 2015 to 2022.
2. Ms X says the Council failed to tell her about the supported living charges and Ms Y does not have the capacity to understand the charges.
3. Ms X also complained the Council gave Ms Y a Grant but because the Council did not make either her or her daughter aware of it, the Council has reclaimed the Grant as unused.

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The Ombudsman’s role and powers

4. 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)
5. 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

6. I have considered all the information Ms X provided. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
7. Ms X and the Council had opportunity to comment on my draft decision before I made my final decision.

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What I found

Rules and Regulations

8. Councils must assess anybody in their area who appears in need of care services. Following an assessment the Council must decide which needs are eligible for their support. If the Council provides support it must produce a written Care Plan.
9. Where a council assesses a person’s needs and agrees to provide care, it should set a personal budget in a care and support plan. A personal budget is a statement which specifies the cost to the local authority of meeting eligible needs, the amount a person must contribute and the amount the council must contribute.
10. Councils can charge people towards the cost of a care home placement. They complete a financial assessment, applying charging rules in regulations and guidance to determine how much a person pays.
11. Guidance requires councils to make sure there is information and advice available in an appropriate format to ensure residents and their representatives understand charges.
12. Direct payments are cash payments a council makes to a person with eligible care needs, instead of providing them with care services. They give people control and choice over their care arrangements, and let people have greater flexibility and independence.
13. The Mental Capacity Act 2005 sets out five principles:
• A person must be assumed to have capacity unless it is established that they lacks capacity.
• A person is not to be treated as unable to decide unless all practicable steps to help them to do so have been taken without success.
• A person is not to be treated as unable to decide merely because they make an unwise decision.
• A decision made on behalf of a person who lacks capacity must be made in their best interests.
• Before deciding, the decision maker must have regard to the option least restrictive of the person’s rights and freedom of action.
14. The Act also says the test of someone’s capacity to decide is on the balance of probabilities and is decision and time specific. When someone is making a decision on an incapacitated person’s behalf, and in their best interests, they must take into account the person’s wishes, feelings, beliefs and values and those of family and friends.

What happened

15. In August 2015, the Council completed a financial assessment for Ms Y’s Community Care Services. The Council wrote to Ms X and Ms Y to confirm Ms Y’s client care contributions.
16. In October 2015, a support worker for Ms Y in her supported accommodation set up a Standing Order for Ms Y so she could pay her client care contributions.
17. The Council completed reviews of Ms Y’s financial assessments in October 2015, March 2016, April 2017, May 2018 and April 2019. The Council sent the outcome of these financial assessments to Ms Y and her support worker.
18. In September 2019, the Council received a returned letter for charges. The Council queried this internally. The Council confirmed Ms Y’s address was still correct and its disability service said it considered Ms Y had capacity to manage her own finances. The Council did not carry out a capacity assessment to reach this decision.
19. On 4 October 2019, Ms Y moved to a new address. The Council was informed about this change of address and it updated its Adult Social Care system with the new address. The Council did not update its billing system.
20. Ms Y cancelled the Standing Order in November 2019. Up to this point, Ms Y had paid all client care contribution charges.
21. In April 2020, the Council completed a new financial assessment of Ms Y and sent this to Ms Y at her correct address. This confirmed Ms Y needed to pay £91.61 per week for her client care contributions for her care since March 2020.
22. The Council produced monthly bills for Ms Y’s care charges from April 2020 to June 2022. The Council sent this billing to Ms Y’s previous address.
23. The Council completed further financial assessments in March 2021 and March 2022 which it sent to Ms Y at her correct address.
24. In June 2022, the Council received a returned invoice from Ms Y’s previous address advising she did not live there. The Council updated its billing system with the correct address in July 2022.
25. From July 2022 to December 2022 the Council sent Ms Y invoices to her correct address.
26. On 21 December 2022, Ms Y agreed to direct payments for her Partnership for Independence service with the help of Ms X. Ms X signed a direct payment agreement on 20 February 2023. The Council completed a financial assessment of this on 27 February 2023 which it sent to Ms X and Ms Y.
27. On 16 March 2023, the Council confirmed Ms Y would need to pay £70.43 per week for her client care contributions to her direct payments account. The Council advised the amount owed so far was £895.47.
28. Ms X queried the financial assessment as it contained inaccuracies. The Council sent a financial assessment form to Ms X which she returned and asked for all future to contact with her about Ms Y’s financial matters. The Council updated Ms Y’s records to reflect this request.
29. In October 2023, the Council noted Ms Y had not used her direct payments since June 2023 as part of a the new financial assessment for Ms Y. The Council investigated the matter and confirmed Ms Y was no longer using her direct payments. In December 2023, the Council arranged to remove all client contribution costs since June 2023.
30. On 15 January 2024, the Council sent a revised invoice for Ms Y’s contributions to her Partnership for Independence direct payments following completion of the new financial assessment. The Council billed for a total of £1,852.42 for 6 January 2023 to 7 June 2023.
31. On 18 January 2024, the Council sent a first reminder to Ms X for all Ms Y’s unpaid client care charges from 7 May 2020 to December 2022.
32. Ms X made a complaint to the Council on 29 January 2024. Ms X said:
• Ms Y had been living in supported living until November 2022 before she moved back home.
• The Council has billed Ms Y for £17,000 of charges for her time in supported living which Ms X was unaware of.
• Ms Y is not capable of understanding letters about finances and money.
• The Council did not help her set up payments towards her care costs and the Council has allowed this debt to accrue.
• The Council has now charged £1,800 for Partnership for Independence payments but Ms X was not aware the Council would charge for this service.
• The Council provided a Grant for Ms Y but this went unused and the Council has now reclaimed this.
33. The Council provided a complaint response on 6 February 2024. The Council said:
• It assessed Ms Y as needing to pay client care contributions in 2015.
• Ms Y paid the client care contributions until 2019.
• The outstanding invoice of £15,339.64 covers Ms Y’s client care contributions for the period 9 March 2020 to 1 December 2022.
• The second invoice for £1,852.42 cover the period 6 January 2023 to 7 June 2023 for Ms Y’s Partnership for Independence contributions.
• It completed financial assessments for Ms Y’s contributions and sent notifications advising of the client care contributions owed.

Analysis

Initial period of charges

34. In 2015 the Council completed a financial assessment of Ms Y’s charges for her supported living care. The Council completed this financial assessment and sent it to both Ms X and Ms Y confirming Ms Y’s client care contributions. A council support worker also helped Ms Y set up a Standing Order to pay for her client care contributions. The Council acted correctly in 2015 and I do not find fault.
35. The result of the Council’s actions was that Ms Y paid for her client care contributions from 2015 to 2019 meaning there was no injustice to Ms Y.

Charges from March 2020 to December 2022

36. In November 2019, Ms Y stopped her Standing Order following moving out of her previous property. Ms Y did this because she was no longer receiving the care for which she was receiving the client care contributions. All outstanding balance was settled to this point. Neither Ms Y nor the Council took any action causing issue at this time.
37. While the Council did not act in fault in relation to any outstanding charges, it was at fault for failing to properly update Ms Y’s address on its billing system. The Council was aware in 2019 that Ms Y had moved but only updated its Adult Social Care system and not its billing system, this was fault. This fault meant the Council sent any future billing to Ms X’s previous address.
38. The Council also decided in 2019 that Ms Y had capacity to manage her own finances. A person must be assumed to have capacity unless there is reason to believe otherwise. The Council assumed Ms Y had capacity despite its records showing that Ms Y showed certain behaviours to question whether she could manage her own finances. Ms X also told the Council in 2019 that Ms Y does not understand charges, cannot budget and was reckless with money. An application was also made for a corporate appointee to help Ms Y manage her finances but this was withdrawn because it was unaffordable for Ms Y. The Council has accepted fault for failing to complete a mental capacity assessment of Ms Y to decide if she could manage her own finances in 2019.
39. The result of the Council using the incorrect billing address meant that Ms Y only received the financial assessment letters once per year in 2020, 2021 and 2022 but none of the billing. Given that Ms Y could not understand how to manage her own finances, these financial assessment letters would not have been useful information for her. The Council also failed to follow up the unpaid charges with Ms Y meaning she would have been unaware of money owed to the Council.
40. Following Ms X’s request in 2023 for the Council to send communication to her about Ms Y’s financial matters, the Council failed to make any contact until January 2024 to advise about the outstanding balance owed for the charges from March 2020 to December 2022. This was fault.
41. The Council has accepted fault for its actions in managing Ms Y’s client care contributions from 2019 to 2023. The Council has accepted fault not just for how it managed the charges from 2020 to 2022 but also in how it managed Ms X’s complaint about the charges in 2024. While Ms Y received the care, and, technically, would owe charges for the care she received, the Council has offered to waive the full charges from March 2020 to December 2022 totalling £15,339.64. I consider this a suitable offer given the fault by the Council.

Partnership for Independence charges

42. In December 2022, Ms Y agreed to direct payments for her Partnership for Independence care. Ms Y agreed to this care following her moving back home with Ms X. Ms X also signed a direct payment agreement for this care. The Council completed a financial assessment for this care and confirmed the cost of care to Ms X in February 2023.
43. The evidence shows Ms X was aware that Ms Y would need to contribute towards the cost of her direct payments through both signing the agreement and the Council issuing the financial assessment outcome letter. The Council made Ms X suitably aware of the costs for the Partnership for Independence direct payments and I do not find fault.
44. However, the Council delayed in completing the new financial assessment, which would have confirmed the exact cost. This was fault. While this was fault, the Council’s costs detailed in the February 2023 financial assessment are relatively in line with the final costs calculated by the Council. As such, the delays in completing the new financial assessment has not materially impacted on how much Ms Y needed to pay. The reason for the accrual of the outstanding balance is due to no payments being made to Ms Y’s direct payment account. I cannot find the Council at fault for this.
45. Since the Council made Ms X aware of these costs and Ms Y accessed the care from January 2023 to June 2023, the Council is entitled to bill for the cost of this care. It is not appropriate to remove the cost of these client care contributions.
46. The Council should provide an apology to Ms X for the delays in confirming the exact cost of this care and offer Ms X a payment arrangement to repay the outstanding balance owed of £1,852.42.

Grant

47. Ms X complained the Council gave Grant funding to Ms Y and reclaimed it. The Council has advised it did not give any Grant funding for Ms Y. There is no evidence of any Grant funding award to Ms Y and, therefore, cannot find fault with the Council on this matter.

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Agreed action

48. Within one month of the Ombudsman’s final decision the Council should:
• Waive the full outstanding balance owed by Ms Y totalling £15,339.64 for her client care contributions for the period March 2020 to December 2022.
• Provide an apology to Ms X for the delays in confirming the exact cost of the Partnership for Independence care for Ms Y and offer Ms X a payment arrangement to repay the outstanding balance owed of £1,852.42.
49. The Council should provide us with evidence it has complied with the above actions.

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Final decision

50. There was fault by the Council, as the Council has agreed to my recommendations, I have completed my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman