Summary: Miss X complained about the Council’s decision backdate charges her care and support services. She also complained about how her complaint was considered. We do not find fault with the Council’s decision to backdate charges or its complaint handling.

The complaint

1. Miss X complains about the Council’s decision to backdate home care charges to August 2019. She says she should only have been charged from when the Council completed its financial assessment in July 2020.
2. She also complains about the lack of independent scrutiny within the Council’s complaints process.
3. She says this has caused distress, frustration and financial hardship.
4. Miss X is represented by her advocate (Advocate B) in making this complaint.

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The Ombudsman’s role and powers

5. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
6. If we are satisfied with a council’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 reviewed the information provided with the complaint.
8. I made enquiries with the Council and reviewed the relevant law and guidance.
9. Miss X and the Council had an opportunity to comment on my draft decision. I have considered their comments before making a final decision.

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What I found

Relevant law

10. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14)

What happened

11. Miss X lived in a residential care home (the Home) for several years. During this time she made a contribution to the Council towards the cost of her placement there.
12. In February 2019, Miss X’s then advocate (Advocate A), advised the Council the Home was going to be deregistered as a care home. Instead, it was going to be “supported living” arrangement. This meant Miss X would be paying separately for her accommodation and personal care costs.
13. In February 2019, the Council sent an email to the Advocate asking her to complete a financial assessment form on behalf of Miss X. This would assess what contribution Miss X would have to pay towards her personal care costs.
14. The Council did not receive a response, the advocacy service says this is because it did not receive this email.
15. The Council sent a reminder email in April 2019. This prompted an immediate response from Advocate A. She requested a delay in carrying out the financial assessment because there was an expected variation of Miss X’s benefits as a result of the Home’s deregistration. Advocate B then took over the case.
16. In December 2019, Advocate B told the Council the Home deregistered in August 2019. The Council says it did not receive this email.
17. Advocate B says she sent further emails about this in February and May 2020.
18. The Council responded in June 2020. It carried out a financial assessment. The Council backdated charges to August 2019. Advocate B said this was unfair and Miss X should only be charged from July 2020, when the Council completed its financial assessment.
19. Advocate B complained to the Council about this. It was not upheld for the following reasons:

• The April 2019 email from Advocate A demonstrated there was an awareness of the requirement to make a contribution towards Miss X’s personal care costs.
• Whilst there was delay in completing the financial assessment, this was not entirely down to the Council. The Council says it did not receive emails from Advocate B in December 2019 and February 2020.
• Once all the supporting documentation has been sent to the Council, the financial assessment was completed in 15 days. Prior to this, the advocacy service had not provided the required financial information.

20. Dissatisfied with this outcome, Advocate B complained to the Ombudsman on Miss X’s behalf. She says the Council should have been proactive in carrying out the financial assessment because its systems should have alerted the Council to the Home’s deregistration in August 2019. She also says she had provided all the relevant financial information in December 2019.
21. Advocate B also expressed her dissatisfaction with the Council’s handling of her complaint. She said the complaint should have been subject to an independent review, rather than by a manger from the financial assessment team.

Analysis

Financial assessment

22. The Care and Support Statutory Guidance 2014 makes it clear that the approach to charging for care and support needs should be clear and transparent so people know what they will be charged. 
23. In this case I am satisfied Miss X was aware that the support she received may be chargeable from the outset. The Council requested financial information in February 2019, and this was acknowledged by Advocate A in April 2019.
24. The Council acted on the request from Advocate A to delay the assessment process because the deregistration of the Home had not yet taken place and uncertainty about Miss X’s benefit entitlement.
25. No further action took place until December 2019, when Advocate B contacted the Council again. The Council says it did not receive this email, nor the follow up email in February 2020 and so the financial assessment was further delayed until June 2020. The email correspondence I have seen suggests there were some technical issues affecting the delivery of emails between the Advocate and the Council and vice versa. There was also delay in the Council being notified of the deregistration. I consider it was reasonable for the Council to await completion of the necessary forms and financial information before it was able to complete the assessment, particularly as Advocate A had told the Council of some uncertainty in April 2019.
26. I acknowledge these factors all contributed to the delay and inevitable frustration to Miss X.
27. While this is unfortunate, on balance, I cannot say this was due to fault by the Council. In any event, I have decided this would not have been a reason to waive the charges owed by Miss X for care services she had received at the Home.
28. Once all the relevant information has been provided, the Council carried out the financial assessment without delay.
29. Because Miss X was advised there would be a financial assessment carried out and it was likely she would need to contribute towards the costs of her care and support package I do not criticise the Council for its decision to backdate the charges.

Complaint handling

30. The Council’s complaints policy provides for a management review of the initial complaint response. This policy does not specify it will be someone independent of the department being complained about. I have considered both responses and am satisfied Miss X’s complaint was properly dealt with.

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Final decision

31. There was no fault by the Council when it backdated charges for care and support to August 2019 or the way it responded to her complaint. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman