Decision Date: 08 November 2024
Summary
Since receiving the first invoice for non-residential care in February 2023, Mr X repeatedly raised concerns on behalf of his mother, Mrs Y, that the cost of care had been inaccurately calculated. The Council apologised, made changes to its billing system, and offered a financial remedy in December 2023. But the Council’s calculations were still wrong.
The Ombudsman concluded that the Council was indeed at fault in its charging calculations and for its delays in resolving Mr X’s concerns and complaints.
What happened
In early November 2022, Mrs Y was assessed as having eligible needs for social care support, with a financial assessment being conducted later in the month.
In early April 2023, the Council completed a revised financial assessment, including in its assessment disability-related expenditure. In response to concerns from Mr X regarding charging, the Council reviewed Mrs Y’s financial assessments in June, August, September, October and December 2023. In December 2023, Mrs Y was sent a letter with the reviewed financial assessments.
In all the assessments, Mrs Y’s transport costs to the day centre were considered as disability-related expenditure.
Mr X was primarily concerned that the Council had charged for the home care time commissioned as opposed to the actual service delivery time. Mr X further reminded the Council that upon recalculating the invoice, the Council should consider that due to its invoicing mistakes, Mrs Y’s tariff income (income from savings) was higher than if the invoices had been correct and on time, because payments would have been made earlier.
Mr X contacted the Council to inform them that he had again received an incorrect invoice, and to ask when the Council would respond to his complaint.
The Council responded to confirm it would put the invoice on hold until the complaint was resolved. Despite this communication, a reminder was still sent to Mrs Y requesting payment, which caused her distress.
At the end of September 2023, the home care provider informed Mr X that it had indeed overcharged for 48 hours of care delivered to Mrs Y. It confirmed it would accordingly adjust its invoices to the council, and offered Mr X £350 to compensate for his time and trouble.
The Council also responded to his complaint in the third week of October 2023. However, Mr X remained unhappy, asserting that the Council was continuing to send incorrect invoices. Mr X received a bailiff’s letter for the unpaid invoice at the end of November 2023.
At the beginning of December, the Council responded to Mr X’s complaint. It apologised for the number of incorrect invoices issued and for the contact from the debt recovery agency. It further offered £300 to Mr X to remedy his distress and time and trouble. It further communicated changes it had set up to its invoicing system which should improve future service. It accordingly informed Mr X that the outstanding fees for Mrs Y’s care services since February 2023 amounted to £1248.
However, Mr X was concerned that the Council’s approach of calculating the total sum meant he could not verify the weekly charges. In mid-March 2024, the Council sent Mr X some explanation concerning the weekly care charge. Mr X disputed these figures, however, as they failed to account for the Care Provider’s corrections to Mrs Y’s invoices concerning undelivered service.
The Council said it could not recalculate Mrs Y’s invoices because of the way the Care Provider provided its credit information. However, it proposed instead to reduce the outstanding invoice charges by the amount that was charged for but not delivered (which it increased to 49 hours 16 minutes), as well as adjusting for disability-related expenditure. The remaining sum to pay would amount to £474 – an appreciable difference.
Mr X remained unhappy with this calculation as the final figure of outstanding fees did not appropriately account for the decrease in Mrs Y’s tariff income.
What was found
As the previous calculation mistakes had already been rectified in December 2023, the Ombudsman’s investigation of fault regarding calculations focused upon the outstanding amount requested by the Council. As alleged by Mr X, the Council was indeed at fault in calculating the outstanding invoiced charges by not properly accounting for Mrs Y’s tariff income. When the Council was reviewing Mrs Y’s charges no payments were made, which meant that Mrs Y’s tariff income was higher than if she had continued paying for her care services. The Council was, therefore, instructed to re-calculate Mrs Y’s outstanding care charges, this time appropriately making such adjustments.
Furthermore, fault was found in the Council’s continued delays in resolving Mr X’s concerns and complaints. This fault caused injustice to both Mrs Y, as she was charged more than she should have been, and to Mr X, due to the extensive time and effort he had to expend in attempting to resolve the charging issues for his mother. As a result, the Council was ordered to apologise to Mrs Y and Mr X for the injustice caused by the identified faults. Furthermore, the Council had to pay Mr X £150 to recognise the distress caused to him by the Council’s failings. This payment was additional to the £350 and £300 already offered by the care provider and Council respectively in December 2023, in recognition of the further delays in resolving his concerns.
Finally, the Ombudsman elected to not investigate another element of the complaint. Mr X had further complained that the Council’s financial assessments had failed to consider and allow certain disability-related expenditures. However, the Ombudsman had already considered how Mrs Y’s disability-related expenditure was calculated in a previous complaint and thus declined to re-investigate.
Furthermore, whilst the previous complaint had not considered the Council’s refusal to consider the costs of Mrs Y’s transport to a day centre as disability-related expenditure, the Ombudsman declined to investigate this refusal. This was because in its December 2023 charging review the Council had, in fact, included such costs. As such, it would have been disproportionate to investigate this matter as the Ombudsman could not have ordered any further remedy than already provided.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
It is interesting to note that the Ombudsman emphasises the limited ‘public money’ it has available in financing its investigations, thus underscoring that investigations will only be conducted where potential remedies will be ‘proportionate’ to investigatory costs. This problem limits its work to cases which may be practically significant for individual appellants, rather than any more widely doctrinally telling for those working in the sector.
The nature of the care service was care at home in this complaint, and the problem centred around the call monitoring times, which the Council’s commissioner put some effort into improving. The implication was that the provider was charging the Council only for the time that was used, not the time that was commissioned, which we would be surprised at if it were actually confirmed to be true. We’ve noticed that this sort of issue has arisen before and the Ombudsman has been of the view that people should not be charged for care which they have turned away; we think that as a matter of contract law, it is what is commissioned and on what terms, in the event of care being declined, that determines whether or not the Care Act charging system allows a charge to be levied, regardless.
We note that this investigator thought that it was correct that transport costs to day care should be regarded as DRE, whereas in more recent reports involving West Sussex, the investigator in those matters had treated that Council’s approach to transport costs not being able to be counted as DRE until someone had proved that they had no other way of getting to the service. This is a worry divergence of approach, we would suggest.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Leeds City Council (23 018 552) report. If you are affected by the issues in this report, please consider asking a free, one-off question, anonymously, at a level of principle, here. Our experts’ response will give you an opinion which may then help you and the broader community, when posted.
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