Council ‘failed to do enough’ to inform service user of care contributions, ombudsman finds

A council has reimbursed a service user for two months of domiciliary care after it “failed to do enough” to inform her she would have to pay a contribution towards her care.

An ombudsman investigation found there was “no evidence” Richmond council informed Mrs K, the service user, about its charging policy when a social worker first assessed her needs.

It also said the council took “too long” to inform Mrs K she would have to pay a contribution to the care she received, leaving her no time to find alternative care.

Mrs K complained the council did not tell her it expected her to contribute to care charges, after it arranged home care services from February 2017. This meant she was sent invoices for two months’ worth of care charges, which she was not expecting.

The council has since agreed to make sure financial assessments are completed in good time.

Zero contribution listed

Richmond council assessed Mrs K’s care needs in December 2016 and commissioned a care agency to arrange for carers to visit her at home five times a week for two hours a day. This was set out in a care and support plan, which, along with the needs assessment, was dated around a month after the council social worker visited Mrs K.

The needs assessment referred to an indicative budget for the cost of care of £174 a week. Meanwhile, the care and support plan described the same amount as the personal budget. Mrs K’s contribution was listed as zero.

Per the ombudsman’s report, there were no comments in the council’s assessment paperwork or case notes that said if it provided the service user any information about its charging policy or the need for a financial assessment.

It also found the council document had no record of the social worker writing to Mrs K or sending her a copy of the documents after they visited her.

An officer from the financial assessment team spoke to Mrs K on 6 February 2017. They recorded Mrs K did not know about the charging policy and had not received any form for a financial assessment. The officer sent Mrs K a form to assess her contribution to care costs. However, the home care service had already come into effect at the beginning of the month, meaning she was responsible to pay charges.

On 20 February, Mrs K spoke to a duty social worker, who reported Mrs K was “unaware” no financial assessment had been completed and was “very concerned” at the prospect of paying backdated charges for care.

The council wrote to Mrs K saying she should pay around £110 a week towards her care. It sent a first invoice to her 15 days later, requesting a payment of around £440 (four weeks charge).

Complaint to council

During this time, Mrs K, supported also by her son, complained about the charges to the council. She said the social worker failed to inform her that she would have to pay towards her care, with the service user understanding there would be no cost.

On 9 March, Mrs K asked to reduce her package of care as she said she could not afford the contribution, requesting two days of care a week. The council agreed and re-calculated her contribution at £69 a week.

A second invoice followed in April 2017, asking Mrs K to pay around £360. Shortly after, Mrs K cancelled her care.

The council visited Mrs K during this month to discuss the care charging policy with her, but considered it had no grounds to change its assessment. In June, a different social worker met with Mrs K but decided there was no further assessment of need given Mrs K did not want the council to arrange a care package for her.

Replying to Mrs K’s complaint, the council noted it assessed her care in 2013 and offered to provide services but cancelled those because Mrs K did not want to pay costs.

The council said little had changed in Mrs K’s financial circumstances between 2013 and 2017 so, it considered she would have realised it would make a charge on the second occasion.

‘Well short’ of expectation

The ombudsman “considered it likely on a balance of probabilities” there was some reference to the council charging policy when the social worker first met with Mrs K. It notes the social worker reported knowing Mrs K received benefit income, which would have “likely” been in context of a discussion around charging.

However, it considered this “inadequate to show that Mrs K knew for sure” whether the council could charge for her care.

The ombudsman added the council’s action fell “well short” of the expectation set out in government guidance, which says councils should tell those receiving care what they will have to pay towards it, before care begins. It said there was “no evidence” Mrs K received such information.

The ombudsman continued to say it could find “no mitigation” for the council, which failed to evidence whether it gave Mrs K financial assessment forms when it visited her in December.

It also said the council took “too long” in informing Mrs K about the charges. “Mrs K did not have the opportunity to make this choice sooner. She also had the distress of receiving an unexpected demand for money”.

Agreed action

Richmond council has agreed to apologise to Mrs K and has written off the care charges for February and March 2017.

The council agreed to learn lessons from the complaint submitted by Mrs K and her son, agreeing that within three months it would complete a review of its practice of undertaking financial assessments.

The local authority also agreed to make sure service users know their assessed contribution before care begins by ensuring financial assessments happen around the same time as assessments of need and making sure financial assessments are completed in good time.