Summary: Mr C complains about the Council’s care charges and increases in care to his brother. The Council is at fault for making changes to a support plan without clarifying the services provided, and providing wrong and delayed invoices. These faults have caused frustration, time, and trouble. To remedy the complaint the Council has agreed to apologise to Mr C, make him a symbolic payment, and provide a detailed amended invoice. It will also make service improvements.

The complaint

1. Mr C complains the Council provided and charged for services, his brother Mr D, did not agree to. Mr C also complains about invoicing errors for support and telecare services.
2. As a result of these faults Mr D has an outstanding debt for care he did not agree to and Mr C has had time and trouble in checking bills to ensure they are correct.

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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 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)
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A) and 25(7), as amended).
5. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
6. 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

7. I spoke with Mr C and considered information he provided. I made enquiries of the Council and considered its response. I also considered:-
• Care Act 2014 and the associated Care and Support Statutory Guidance;
• Care and Support (Charging and Assessment of Resources) Regulations 2014;
• Council’s “Charging Policy for Non-Residential Services 2024”;
• complaint correspondence;
• case recording, invoices, financial assessments, and support plans.
8. Mr C and the Council could comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Background information

9. Mr D lives in his own home and has support from care workers, his brother, and his sister in law, Mrs C.

What should have happened

10. Regulations issued under the Care Act 2014, set the levels of capital that a person can have to be eligible for financial support from their local authority.
11. 8.16 Care and Support Statutory Guidance says “Where a local authority has decided to charge, except where a light touch assessment is permissible (see paragraph 8.22 below), it must carry out a financial assessment of what the person can afford to pay and, once complete, it must give a written record of that assessment to the person. This could be provided alongside a person’s care and support plan or separately, including via online means. It should explain how the assessment has been carried out, what the charge will be and how often it will be made, and if there is any fluctuation in charges, the reason. The local authority should ensure that this is provided in a manner that the person can easily understand, in line with its duties on providing information and advice.”
12. The Council’s “Charging Policy for Non-Residential Services 2024”; says “A provisional indication of the charge will be notified immediately. This will be confirmed in writing as soon as possible following the completion of the financial assessment and any checks that may be necessary”.
13. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. These should be used to check the care plan is still meeting the assessed care needs.

What happened

14. In March 2023 following a hospital admission, Mr D agreed for a telecare (emergency alarm) service. Both Mr C and Mr D were aware there was a charge for this service. However Mr C says he agreed to pay the instalments as Mr D did not want to set up a direct debit. Mr C says he made two payments.
15. Mr D left hospital and had care workers for 30 minutes, four times a day. After a Council review on 3 May Mr D reduced the calls to 20 minute calls, two times a day.
16. Mr D went back into hospital on 11 May. On 17 May Mrs C told the Council Mr D had over the threshold of savings and would have to pay for care services. The Council sent a letter out the same day saying Mr D would be a full cost payer, it outlined the hours received and the cost per week.
17. Shortly afterwards the Council reassessed Mr D as needing four calls per day. On 2 June an officer spoke to Mr D over the phone about increasing his care calls from two to four. Mr D could not speak directly to the officer as he is hearing impaired. A nurse spoke with Mr D on the officer’s behalf and Mr D agreed to an increase in the number of care calls. There is no record of the Council telling Mr D the length of these calls either in writing or over the phone. The Council also did not send Mr D an amended support plan setting out the new care package.
18. On 5 June during an officer phone call with Mrs C, she agreed to upgrade the telecare system to include a falls detector. Mr C says the Council told Mrs C this would be at a reduced rate because Mr D was leaving hospital.
19. The Council completed a telephone review with Mr D and Mrs C on 19 July, they raised no concerns about the care provided. On 29 August Mrs C contacted the Council as Mr D had not yet had an invoice. The Council sent an invoice which Mr C queried on 18 September. Mr C told the Council it had charged for 30 instead of 20 minute calls.
20. The Council reduced the care package following a review with Mr D on 20 September with a start date of 25 September. Mr D highlighted several other errors in the billing which included charging for periods Mr D did not receive services either because none were available or he was in hospital.
21. Mr D received a bill for telecare in April 2024 following an annual financial reassessment by the Council. Mr C says this invoice was nearly a year late and confusing as the telecare charges were added to the care charges. There was a separate statement for how much the telecare services were independently, but these included charges for both the falls detector and the emergency alarm.
22. The Council accepts the delay in this bill and says it was caused by its failure to record the extra service. However it disputes that it received two payments for the service. It says this is not possible as the telecare service did not start until June 2023 after Mr D left hospital. In response to a draft decision on this complaint Mr C has provided evidence of payments made and how the Council may have got confused.
23. In its complaint responses the Council has accepted several errors, this includes:-
• an initial failure to record Mr D as a full cost payer and the delay in sending out an initial invoice;
• charging for care Mr D has not received either because he was in hospital or care was not provided;
• delay in sending out an invoice for telecare services.
24. However the Council says it has now provided a correct invoice. It says Mr D agreed to an increase in his care and this was chargeable. The Council says it has amended the outstanding invoices to reflect the anomalies Mr C has pointed out and the balance remains outstanding.
25. Mr C is concerned other vulnerable people may be affected by the Council’s invoicing system. In particular that it relies on either the care provider or the service user to notify it of changes in care and invoices accordingly. Mr C says vulnerable people with no support may not be able to carry out these checks and will therefore be overcharged.
26. The Council says that through its monitoring system it spot checks care providers to ensure they are notifying the Council when for whatever reason care is not provided. The Council says it does not have the resources to check each invoice and the monitoring in place is sufficient to generally protect vulnerable service users.

Was there fault causing injustice?

27. The Council wrongly charged Mr D, provided wrong invoices, and delayed in both charging for services and providing an invoice. This is not in line with the Care Act and the Council’s own charging policy and is fault. The Council’s early acceptance of fault and apology is welcomed. However because of these faults Mr C had frustration, time, and trouble, in both pursuing the Council and checking invoices. I therefore consider an apology is inadequate to remedy Mr C’s personal injustice.
28. The Council says Mr D is liable to pay for care services he agreed. Mr D did agree to extra services however there is no record provided to Mr D in writing or in the form of a telephone conversation about the length of the calls he agreed to. On balance considering Mr D’s historical reluctance to have care and reducing his care; I consider it more likely than not he agreed to an extra two calls per day for 20 minutes not 30 minutes. I therefore do not consider Mr D should be liable to pay for care he did not and on balance would not have agreed to.
29. The Council was at fault for failing to provide Mr D with an updated care plan. There was a further missed opportunity to check the time periods when the Council reviewed the care package. This is not in line with the Care and Support Statutory Guidance and is fault.
30. The Council eventually provided invoices for telecare services but the whole invoicing process was confusing and unclear. There does not appear to have been a single letter which itemised what the charges were and the time periods they related to. It was therefore difficult for Mr C to decipher Mr D’s charges. I consider the failure to properly set out these charges is fault and Mr C has had time and trouble working out the charges. Mr C was however aware there was a charge for the telecare service and I therefore do not consider it is appropriate to waive these costs.
31. I appreciate the concerns Mr C has raised about other vulnerable people who may be similarly affected. It appears in this case there were several times when the Council was unaware of changes in care provision. It is unclear whether the fault for this lies with the care provider or the Council. I have included actions which will hopefully generally improve future services.

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Agreed action

32. I consider there was fault in the Council’s actions which caused Mr D and Mr C injustice. I consider the agreed actions below are suitable to remedy the personal injustice caused and to improve future services.
33. Within one month of the final decision the Council will:-
1. apologise to Mr C and Mr D for the time, trouble, frustration, and confusion caused by the invoicing errors and miscommunication;
2. pay Mr C £250 a symbolic payment to recognise his time, trouble, and frustration;
3. amend the outstanding invoice deducting charges for 20 minutes per day for the period 5 June 2023 to 24 September 2023. This is the date Mr C was aware the Council was providing care that neither Mr C nor Mr D had agreed to;
4. provide Mr C with an itemised invoice setting out the fees payable for both the Telecare Service and care and include any payments received between March 2023 to date. This should take into account the periods Mr C says there was no care provided. The Council should also consider additional evidence Mr C has about payments made for telecare services. It may be useful for an officer to talk with Mr C before creating the invoice;
34. Within three months of the final decision the Council will:
1. review the invoicing errors and delays that have occurred in this complaint and provide a plan about what the Council will do to prevent reoccurrence;
2. review how this service provider has been monitored and whether the spot checks currently in place for charging are sufficient to prevent future service failure;
3. review how the Council advises and invoices people for telecare services to ensure the information and charges are clear;
4. remind staff about the importance of recording changes in care packages and providing updated support plans to service users so that there is a clear written record of provided services;
5. remind staff about going through services provided when completing a review so that there is a record the person is receiving services both agreed to and paid for.
35. The Council should provide us with evidence it has complied with the above actions.

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Final decision

36. I have found fault in the actions of the Council which has caused Mr C and Mr D injustice. I consider the agreed actions above are suitable to remedy the complaint and improve future services. I have completed my investigation and closed the complaint on this basis.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman