A local authority billed a woman for care she did not receive by charging her by the hour rather than for tasks completed, a local government and social care ombudsman investigation has found.
The watchdog found Suffolk council failed to deliver its duties under the Care Act 2014 when it did not review a support plan for the woman, ‘Mrs X’, after her daughter ‘Mrs Y’ complained visits were too short.
The council also failed to provide the ombudsman with evidence to back its claims that the two women were told care visits would be charged for a minimum time of 30 minutes. Had it done so, Mrs X as a self-funder could have made alternative arrangements with a private provider.
The ombudsman recommended the local authority reimburse Mrs X for any overpayment, pay £250 for time and trouble and demonstrate that it had taken steps to ensure service users were better informed about care costs.
Falsified records
Mrs X’s agreement with the council-commissioned care agency was that it would provide 12 hours 15 minutes of support per week, including one daily 45-minute morning visit and two further 30-minute visits.
The weekly cost was £183.38, based on a £14.97 hourly rate, which Mrs X was expected to fund entirely.
Mrs Y’s complaints began in July 2016, one month after the care plan commenced, when she told Suffolk council that one carer was falsifying arrival and departure times. She “did not therefore consider that Mrs X should have to pay the full amount”, the ombudsman said.
In August 2016, Mrs Y complained again, saying that the agency was cutting its visits down to 20 minutes – something that she later backed up with documents.
She wanted carers to perform additional tasks in order to make up the time, something that the care agency argued it was under no obligation to do provided Mrs X’s agreed support had been delivered.
‘Inaccurate’ care plan
The ombudsman said that it was “clear” that carers had been completing their duties in less time than had been agreed in Mrs X’s care plan.
“If this was routinely the case, the plan was not accurately setting out the support she needed and it would have been appropriate for the council to have looked into this further,” the ombudsman’s report said.
“The most appropriate way to have done this would have been to arrange a review of the care and support plan [as provided for under the Care Act] and there is no evidence of this.”
Suffolk council told the ombudsman’s investigation that the care agency had an agreed minimum visit time of 30 minutes and that Mrs X and Mrs Y had been informed of this. It also said that it routinely informs self-funding service users that they may be able to initiate more flexible care by entering into a private arrangement with a provider.
But there was nothing in its service agreement with the agency reflecting the minimum 30-minute time slot; nor was the council able to produce notes evidencing its conversations with Mrs X and Mrs Y.
Informed choices
Michael King, the local government and social care ombudsman, said the case highlighted that people could only make informed choices if they were given complete information from the outset.
“Had the council managed the woman’s expectations by telling her about the provider’s minimum charge policy, she could have chosen to make alternative arrangements; something which she has since done,” King said.
A Suffolk council spokesman said the authority fully accepted the ombudsman’s recommendations.
“We would like to offer our sincere apology to our customer for not informing her of her care provider’s charging rules and reviewing the case properly,” the spokesman said.
“We’re constantly improving how we support people, so will ensure that we learn from this case.”
Unfortunately reports such as this barely scratch the surface and are likely to cause a shift towards T&C tweaking, rather than affect any sort of positive change.
In my 13 years as a support worker I have seen service after service encouraging the misreporting of visit times whilst leaving workers with no option but to meet minimum requirements and leave.
I would even suggest that the situation has become the accepted norm.
I know that some people justify false recording by suggesting that service users will have entitlement removed if they are not considered to need it, and others feel that increasing revenue with ‘a little deception’ will help to secure jobs in an industry that is struggling to find funding streams, but the bottom line is that service users suffer.
It just makes me sick.