Decision Date: 7th March 2025
Summary
The complainant asserted that an invoice was issued without social care and financial assessments being fully completed for a gentleman since deceased, and that the Council failed to inform him of the liability charges.
What happened
Mr Y brought a complaint against the Council for invoicing his late father’s estate (Mr W) for fees incurred during Mr W’s stay at a residential placement.
After discharge from hospital in October 2023, Mr W was placed in a short-term residential placement funded by the NHS. He required further hospitalisation following a fall shortly after this. This lasted just under a month, after which he was placed into another residential placement, also initially funded by the NHS.
Two weeks after he moved into this placement, which we think was in late November or at the beginning of December at the latest, the Council visited Mr W and began the Care Act assessment process to determine his long-term care and support needs.
However, Mr W’s NHS funding, which paid for the residential placement, ended in mid-December from what one can tell from the report (12 December).
Mr Y claimed the Council did not inform him that after this point that Mr W was required to contribute financially.
In the meantime, Mr W was referred for a decision by the ICB as to whether he was eligible for long-term funding under the Continuing Health Care (CHC) scheme. This assessment concluded Mr W was not eligible. Shortly after this decision, in very early January, Mr W passed away.
On the 18th January 2024 the Council requested financial information about Mr W. The Council advised Mr Y failed to respond and so the Council completed a ‘light touch’ financial assessment a month later which determined Mr W should have contributed financially. The ‘light touch’ financial assessment found Mr W was required to pay £448.96 to cover care provided between 12th December 2023 to the 4th January 2024. An invoice was issued on the 27th March 2024, directed to the estate, which reflected this.
Mr Y questioned this charge with the Council on the grounds that the Council failed to advise Mr Y that Mr W was required to contribute financially to care received before the social care and financial assessments were completed. The Council considered waiving the charge at this time, but ultimately decided Mr Y needed to pay in full (on his late father’s behalf).
Mr Y brought a complaint to the Council and then to the Ombudsman about the Council’s decision in this instance. As far as he was concerned, his father was in a ‘discharge to assess’ placement and he had understood that fees would be triggered only after his father had been assessed and a suitable care home placement was found.
What was found
The Council reconsidered Mr W’s case after Mr Y made enquiries. The Council recognised here there was no record of a Care Act Assessment actually being completed in accordance with its policy. On these facts, the Council decided to waive the invoice.
The Council recognised the distress caused to Mr Y and suggested a payment of £400 alongside an unreserved apology that the errors were not corrected.
The Ombudsman found this was an appropriate remedy to the complaint, as the desired outcome (to Mr Y) of a waived invoice was met. The Council was required to provide the Ombudsman with evidence it cancelled the invoice and made the £400 within four weeks of the final decision.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
We’ve highlighted below, the areas of discretion that the LGSCO’s own founding legislative framework permits the organisation regarding investigations work. It has discretion to complete an investigation and issue a decision statement if its staff conclude that they are satisfied with an organisation’s actions or proposed actions (Local Government Act 1974, section 30(1B) and 34H(i), as amended). It is within the Ombudsman’s discretion as to whether it is necessary to continue any investigation.
In this case, the submitted enquiries to the Council prompted its own review of the complaint, and the outcome provided a suitable remedy in line with the wishes of Mr Y. This meant although the LGSCO carried out investigations, they did not find that it would be worthwhile to suggest any further compensation, as the Council effectively remedied the concern.
That being said, this scenario covers legal and procedural issues of the Council’s duties.
Section 9 of the Care Act 2014 requires councils to carry out an assessment for any adult with an appearance of need for care and support. It must then give the person a written record of the completed assessment.
Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay.
Here, NEITHER of these critical procedural steps had been done properly. We are astonished that the Council isn’t asked how that could have come about? If the Care Act assessment began before the NHS funding finished, why was it not concluded?
There is no explanation, either, as to why the Council rejected the complaint the first time around.
The issue here is that invoices were charged on fees for services which had not been completely assessed for. This led to confusing information being distributed by the social worker and Council, which led to the avoidable distress suffered by Mr Y.
The underlying issue is clearly the joint working as between the hospital discharge teams, and this is typical of a large number of complaints to the Ombudsman, not that the discharge is simply too fast and before the person is ready, but that the fog that descends over who is responsible for the first bedded setting after discharge makes it impossible to be sure whether one is going to receive a bill for it.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Norfolk County Council (24 008 978) 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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