Shocked family of elderly woman handed huge bill after council staff failed to explain care charges

The woman’s family had chosen to place her in a more expensive care home, believing that they would only have to pay a £400-a-week ‘top up’, with Staffordshire County Council covering the rest of the cost.

But several months later the family were sent a bill by the council for £3,700, to cover the woman’s contribution to her care fees.

The family complained to the council, saying it was never explained to them that there would be additional payments and claimed they would not have chosen a more expensive care home if they had known.

They also complained that the council took too long to complete a financial assessment – eight months, as opposed to a typical wait of six to eight weeks. The Local Government and Social Care Ombudsman has now upheld both these complaints, finding that there was fault by the council.

But the ombudsman also found that there was no fault with the billing process apart from the delay, and the contribution would have been ‘the same regardless of the cheaper care home’.

The council has therefore been toldnot to write off the invoice, but instead make a ‘symbolic’ £300 payment to the family ‘to recognise the distress and frustration caused’.

According to the ombudsman’s report, the elderly woman – named as Mrs X – moved to a care home in October 2022, after a stay in hospital, initially on a temporary basis.

Her daughter-in-law, Mrs D, had considered the costs and believed the more expensive home would better suit Mrs X’s needs. Mrs D was asked to complete a questionnaire about Mrs X’s finances, which would be used for her financial assessment.

In April 2023 Mrs X became a permanent resident of the home, and became self-funding. The council told the family that it still needed to do a financial assessment to find out what Mrs X should have been contributing towards her care home fees since October 2022.

The financial assessment was finally completed in June 2023 and the family was sent the invoice for £3,700.

Mrs D said she ‘knew nothing about these care charges’, which Mrs X could not afford, and that ‘they would not have chosen that home for her had they realised the full charges’. Mrs D said she had never received correspondence from the council setting out the charges, and had only ever agreed to pay the top-up fees.

Following Mrs D’s complaint, the ombudsman found that while the case notes showed that finances were discussed with the family, they did not show that the council ‘properly and clearly made sure that Mrs D or any of Mrs X’s family understood that she would need to contribute to the care home charges’.

The ombudsman’s report states: “The council also cannot show that it sent the resident’s agreement which might have also alerted Mrs D to the fact that Mrs X would need to pay a contribution too. This was fault by the council.

“The council also took too long to complete the financial assessment. We expect an assessment to take around six to eight weeks.

"The council took eight months, from October 2022 to June 2023, to complete the assessment. Although we cannot say that Mrs X would have moved had she been alerted to the charges sooner, the delay compounded the misunderstanding of the care charges. It also added to the distress and frustration caused to Mrs D.”

Along with the £300 payment, the ombudsman told the council to apologise to Mrs D ‘for the impact on her’.

Mike Wilcox, cabinet member for health and care at the county council, said: “We fully accept the ombudsman’s ruling, and wish to offer our apologies to Mrs X and her family for the inconvenience caused to them.

"We recognise that there have been delays with financial assessments, and have a plan to improve this process so we can offer a better and more timely customer experience.”

Report by Local Democracy Reporter Phil Corrigan