Summary: There is no fault by the Council in its financial assessment for Ms X’s care and support. The Council applied charging rules when carrying out the assessment and any delay was due to Mr X not providing information the Council required. We are satisfied the Council provided general information about charging at the time care and support started.

The complaint

1. Mr X complained for his relative Ms Y about the Council’s financial assessment of Ms Y’s care charge. He said it
1. Discriminated against Ms Y when calculating her care contribution, in breach of the Equality Act;
2. Put Ms Y into debt without warning and is unfairly pursuing the debt;
3. Charged Ms Y for her care before she had been financially assessed;
4. Sometimes charged Ms Y more for her care from her contribution than it cost them to provide; and
5. Hid some of Ms Y’s care funds from the government.
2. Mr X said the Council’s fault caused Ms Y avoidable distress and a debt.

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The Ombudsman’s role and powers

3. The law says we cannot normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. However, we may decide to investigate if we consider it would be unreasonable to notify the organisation of the complaint and give it an opportunity to investigate and reply. We call these complaints ‘premature.’ (Local Government Act 1974, section 26(5), section 34(B)6)
4. Our service is free, and we use public money carefully. We do not start or continue an investigation if we decide there is no or insignificant injustice. (Local Government Act 1974, section 24A(6), as amended, section 34(B))
5. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. 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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What I have and have not investigated

6. I have investigated complaints (a) to (c). I did not investigate complaint (d) because it is premature. I did not investigate complaint (e) because there is no injustice to Mr X or Ms Y.

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How I considered this complaint

7. I considered the complaint to us, the Council’s response and documents described in this statement
8. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

9. Councils have the legal power to charge for care and support. If so, they must carry out a financial assessment (FA) to determine how much the adult needs to pay, following the Care and Support (Charging and Assessment of Resources) Regulations 2014 and Care and Support Statutory Guidance. Councils can take into account most types of income, including benefits when calculating care charges.
10. Some types of income are not taken into account in an FA. This is called ‘disregarded income’ and includes some benefits, earnings and some tax credits.
11. Disability Related Expenditure (DRE) are expenses that a person has to pay connected to their disability. They are disregarded in a person’s financial assessment and so reduce their weekly charge. DRE can include specialist items and services such as wheelchairs. They can include extra heating or laundry costs, equipment and aids and regular payments such as wheelchair insurance and gardening costs.
12. The Minimum Income Guarantee (MIG) is the basic amount the government says a person needs to live on. It is set by the government (not councils.) For 2023/2024, the MIG is:
• £82.15 (for a single person aged 18 to 24.) A higher amount applies for adults over 25 and a higher amount for pensioners.
• £45.75 (disability premium)
• £22.35 (enhanced disability premium).
13. When calculating a person’s charge, the FA must not leave the person with an income below the MIG for the relevant category.

What happened

2023

14. A social care officer carried out a social care assessment for Ms Y in May 2023 and decided she was eligible for care and support.
15. Ms Y started getting a direct payment for the cost of six hours of care and support in August 2023. A direct payment is money a council gives to a person to arrange and pay for their care and support.
16. The Council’s finance team sent a paper financial assessment form to Ms Y’s home address at the end of August and the factsheet about paying for care and support. The factsheet said:
• There are no set timescales for completing a financial assessment (FA). But it aims to complete one as soon as reasonably practical after receiving all the required information and proofs.
• If the FA is not completed when care starts, the Council will backdate outstanding charges. A payment plan is an option for any debt.
17. An officer from the finance team left Ms Y a voicemail message at the end of November about returning the financial assessment form. Mr X called the finance team the following day and said he dealt with Ms Y’s post. He said he did not want the Council to change the address it sent letters out to Ms Y. Mr X was reportedly unhappy about the direct payment being in payment before Ms Y’s charge was calculated.
18. Ms Y’s social worker spoke to Mr X in the middle of December. He said they had not received the financial form. So the social worker requested another one to be sent out.

2024

19. Another relative of Ms Y rang the finance team at the second week of January saying they were having trouble completing the on-line FA form. The officer posted a paper form out. The following day, the finance team received the completed on-line FA form. The finance team calculated Ms Y’s charge at the end of January.
20. The FA calculation includes Ms Y’s income from benefits and her expenditure including DRE of £15. It included other expenses including rent and council tax.
21. The finance team sent Ms Y a letter at the start of February informing her of the outcome of the financial assessment. The letter said:
• Her maximum weekly charge was £37.99 from 28 August 2023. If her care cost less than this, she has to pay the full cost.
• She has to pay maximum charge for any week where she receives care of the same or higher value.
• There was a backdated charge from 28 August to 18 February.
• She could have a payment plan for the arrears.
22. Mr X sent the finance team additional information about Ms Y’s rent and the Council revised the FA and reduced the weekly charge to £30.99 to take account of this.
23. In February, Mr X spoke with a social care officer and said they were going to cancel Ms Y’s care as she could not afford to pay.
24. A social care officer spoke to Mr X about the invoice and said that the Council would arrange a payment plan for repayment. Mr X said he would be making a complaint that the FA was not done before care started. The social worker said Mr X was aware of the FA and that care was chargeable as they had spoken about it during the care assessment in 2023 and the social worker had sent out information about the charging process beforehand.
25. Mr X told the social worker in the middle of February that they had cancelled Ms Y’s care.
26. The finance team sent Ms Y an invoice for care charges from August 2023.
27. The finance team carried out a review of the FA. They wrote to Mr X explaining he had asked for the carer’s premium to be included in Ms Y’s MIG. The Council refused to do this because Ms Y was not eligible for carer’s allowance or carer’s premium as she was not a carer.
28. Mr X complained to the Council raising points (a) to (c.) The Council responded to Mr X’s complaint and to correspondence from his MP about the FA. It explained how the charge was calculated and gave some information about the charging rules. The Council did not uphold the complaint.

Was there fault?

(a)The Council discriminated against Ms Y when calculating her care contribution, in breach of the Equality Act

29. Mr X alleges the effect of the FA is discriminatory on age grounds: as Ms Y is under 25, her MIG is lower. This isn’t fault by the Council as it is applying the rules set by the government. I do not uphold this complaint

(b) The Council put Ms Y into debt without warning and is unfairly pursuing the debt

30. Mr X received information about charging at the time of Ms Y’s social care assessment, which was before her care started. And Ms Y received a factsheet about paying for care in August, which was when the direct payment started. So they had information about charging for social care and were aware the charge would be backdated to the date care started. I do not uphold this complaint.
31. The Council is entitled to recover money owed. It has offered a repayment plan. This is appropriate and there is no fault.

(c) The Council charged Ms Y for her care before she had been financially assessed

32. The records indicate Ms Y received an FA form in August 2023 which was not returned, meaning the Council could not complete the FA or work out the charge. So the finance team contacted her in November to chase the paperwork it needed. The Council carried out the FA within two weeks of receiving the completed paperwork. I do not regard this as delay by the Council. The evidence indicates the delay was due to Mr X and Ms Y not providing the information the Council needed to calculate the charge. So there is no fault by the Council.

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Final decision

33. There is no fault by the Council in its financial assessment for Ms X’s care and support. The Council applied charging rules when carrying out the assessment and any delay was due to Mr X and Ms Y not providing information the Council required. We are satisfied the Council provided general information about charging at the time care and support started.
34. I completed the investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman