Summary: We have decided not to investigate Mr X’s complaint about the Council’s delay in carrying out a financial assessment. The Council has upheld the complaint and agreed to refund part of the care costs, which is an appropriate remedy for the injustice caused by the lack of initial costs information and its delay in completing the financial assessment. It will also share the learning from this complaint with relevant staff to prevent recurrence of the fault.

The complaint

1. Mr X complained about the Council’s delay in carrying out a financial assessment to determine how much he needed to contribute towards the cost of his care. He said he had no information about the likely cost until he received an invoice for £1,643 fifteen weeks after agreeing to the care package. Mr X said the unexpected invoice caused him worry and stress as well as financial hardship.

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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 provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

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How I considered this complaint

3. I considered information provided by Mr X and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

What happened

5. Mr X said he was offered support after his wife died. In November 2023, the Council assessed him as needing two 30 minute calls per day, which Mr X agreed to. Mr X said he was given no information about the cost of the care and assumed it would be no more than his wife had paid for a more substantial package. Council records state Mr X agreed to it carrying out a financial assessment to decide how much he would need to pay towards the cost of his care. There is no record it gave him any indication of the cost of the care or how much he might need to contribute towards it, nor any information about how the contribution would be calculated.
6. Mr X said he was asked to complete a financial assessment form in December. Council records show it received a completed form on 8 December. On 30 January 2024, the Council asked Mr X to provide supporting evidence. Mr X said he provided that within two days. The Council completed the financial assessment and wrote to him with the outcome on 16 February. It said he would need to pay £127.93 per week towards the cost of his care from November 2023. When Mr X queried the contribution, which he said was much more than his wife paid for a more substantial care package, the Council explained how it was calculated. Mr X cancelled the care straightaway because he said he could not afford it.
7. In early March, Mr X received an invoice for £1643, which he paid using savings he had set aside for his funeral costs.
8. In its complaint responses, the Council said:
• there was no legal timeframe in which a financial assessment must be completed, although it accepted it had taken longer than usual to ask him for additional information;
• there was no fault in the way the financial assessment was carried out and it had explained how his contribution was calculated;
• although it did not uphold his complaint, it would reimburse £400 to reflect the stress Mr X was caused and the exceptional circumstances of the case; and
• it would review the financial assessment process to see how long it was taking, on average, and whether it could resolve any issues more promptly.

My assessment

9. Mr X received the care and there is no complaint about the level of care provided. Therefore, the Council was entitled to charge him for it.
10. That said, although the Council told Mr X it would need to carry out a financial assessment when it agreed he needed a care package, it did not give him any information about the cost of that care or about how his contribution to the cost of that care would be calculated when it arranged the care.
11. The Care Act 2014 and associated regulations and guidance do not set out a timeframe for completing a financial assessment because the expectation is that the financial assessment will be completed around the time the care is arranged.
12. In this case, the Council asked Mr X for relevant information without undue delay and a completed form was received on 8 December 2023. There was then a delay on seven weeks before the Council asked Mr X for the additional evidence it needed to complete the financial assessment. There was no undue delay in completing the financial assessment when the further information was received.
13. If we investigated this complaint, it is likely we would find the Council at fault for not providing sufficient information about the likely cost of the care when it arranged it and for a delay in completing the financial assessment. This meant Mr X was not able to make an informed decision about receiving care and, by the time the Council told him about the costs, significant back-dated charges had been incurred, which caused him worry and stress.
14. We asked the Council, and it agreed, to carry out the following action within one month of the date of this decision:
• apologise to Mr X in line with our Guidance on remedies about making a meaningful apology;
• refund £550 to Mr X. (This is slightly higher than the £400 the Council initially offered, which Mr X refused and is in line with our guidance on remedies, available on our website);
• remind relevant officers that, at the time they arrange care, they should provide information about the likely cost of that care and how the person’s contribution to the cost of that care will be calculated. (This could be by providing a leaflet that explains this); and
• provide us with evidence about its review of the timescales in which it carries out financial assessments referred to in its complaint response and the changes it has made to improve its timeliness.

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Final decision

15. We have upheld this complaint because the Council has agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused to Mr X and improving its service for others.

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Investigator's decision on behalf of the Ombudsman