Call for action on care charges, after woman’s suicide was linked to council’s invoices

Disabled activists are calling for local authorities to take urgent action, following an ombudsman ruling that a disabled woman took her own life after being wrongly sent a string of invoices demanding payment of care charges she did not owe.

The Local Government and Social Care Ombudsman ruled earlier this year that the invoices sent to Mrs C by Essex County Council caused her unnecessary distress.

Her son had complained to the ombudsman that the invoices contributed to his mother’s decision to take her own life in January 2021.

The ruling in February came as freedom of information requests submitted by campaigners were beginning to show that tens of thousands of disabled people across the country were having debt collection action taken against them every year by their local authorities over unpaid care charges.

As a result of that information, Cheshire Disabled People Against Cuts (CDPAC) called on councils to “urgently review their debt recovery codes of practice” and clarify how pursuing disabled people with support needs for care charge arrears upheld the Care Act’s “wellbeing principle”.

This week, a freedom of information response from Essex County Council, obtained by CDPAC, showed that more than 3,000 individuals in the county had debt management procedures started against them by the council in 2020-21 for failing to pay non-residential care charges.

Now CDPAC has called on senior figures in local government to learn from the ombudsman’s ruling and assess the impact of such debt recovery actions on disabled residents, particularly in the light of the “intensifying cost of living crisis that disproportionately affects disabled people on low incomes” (see separate story).

Mrs C, who had a history of mental distress, had been discharged from hospital in May 2020 into a care home following a “physical illness” – with those three weeks paid for from government pandemic funding – and was then returned to her own home the following month.

She began receiving support from a care agency, but in October the council started sending her invoices for her care, which her family said they had been told she would not be charged for.

By December, the council had still not completed a financial assessment, but had sent her a bill for outstanding charges of £4,400.

When the assessment was finally completed the following month, Mrs C was told she would have to contribute to her charges, and that she owed the council £3,300.

Around 10 days later, Mrs C paid the bill via an automated payment service. Later that day she took her own life.

Her son said later: “In my opinion she took her own life because she became obsessed with this large outstanding payment of £4k that the council were hounding her for (incorrectly).

“She felt she had deceived the council for non-payment….”

In March 2021, the council realised it should not have been charging Mrs C for care, and that the cost should have been met from the funding provided by the government in March 2020 to meet extra social care costs arising from the pandemic.

It refunded the charges to Mrs C’s estate but did not offer any explanation or apology to her family, although it later “expressed regret for its actions”.

It has since reviewed all cases where care charges should have been covered by the government funding, issued a new charging policy, and introduced a training programme on financial assessments and charging for all frontline staff.

The ombudsman was critical of the council’s failure to follow “good administrative practice” by not keeping a record for staff of how to use the government Covid funding, and in missing repeated opportunities to correct its failure to use the funding to cover Mrs C’s care charges.

The ombudsman said the council was also at fault for failing to realise the further distress it would cause Mrs C to receive the revised bill for more than £3,000 in January.

The ombudsman said it was concerned that the council knew in January 2021 that Mrs C “had been distressed by its earlier invoices and expressed concerns about their affordability” and “knew of her mental health illness and vulnerability” but took no steps to warn Mrs C or her son about the “substantial invoice” it was sending.

The council was also at fault, says the ombudsman’s report, for failing to have a policy that contained advice on dealing with “potentially vulnerable” service-users it charges for care.

Although the ombudsman said it would not be appropriate to say if the council’s invoices caused Mrs C to take her own life, it said there was “no doubt” the invoices sent to Mrs C “caused her distress”.

The council has agreed to issue a further apology to Mrs C’s son and pay him £500 for the distress caused by its actions, and to revise its policy on care charges.

A CDPAC spokesperson said: “The ombudsman has made very important recommendations in response to this distressing case.

“It is critical that directors of adult social care and chief executives consider those recommendations carefully and urgently.

“That work must involve councils inviting disabled people-led organisations to work in partnership with officers to properly assess the impact of social care charge debt recovery actions on disabled residents, in acknowledgment of an intensifying cost-of-living crisis that disproportionately affects disabled people on low incomes.”

She called on council officers to receive “urgent training” on the implications of the case, which should include that financial officers must identify cases where a financial assessment has been delayed.

She said that such delays “run the risk of placing the disabled resident with care needs at heightened risk of care charge-related poverty, and lowered wellbeing outcomes”.

CDPAC called on the Local Government Association, the Association of Directors of Adult Social Services and the National Association of Financial Assessment Officers to “work collaboratively to ensure disabled people being charged for their care are better protected from the acute distress associated with poverty and debt”.

An Essex County Council spokesperson refused to say if it accepted the dangers caused by debt collection of care charge arrears, and that debt recoveries were undermining the Care Act’s well-being principle; whether it accepted that all care charges should be scrapped; and what action it would take to ensure that its care charging policy did not cause other service-users the kind of distress caused to Mrs C.

But she said in a statement: “We have acknowledged and accepted the findings of the Local Government and Social Care Ombudsman and the recommendations contained in the report.

“We remain dedicated to ensuring all our residents receive the highest quality of care and are committed to learning to improve.”

She also refused to say if the council’s freedom of information response showed the urgency of taking action on debt collection of care charge arrears.

But she said in a further statement: “Where Essex County Council does undertake debt recovery for adult social care charges, it does so in accordance with Annex D of the [Department of Health and Social Care’s] Care and Support Guidance (PDF).”

Picture: Essex County Council offices in Chelmsford. Picture by Google

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