Summary: We will not investigate this complaint regarding the Council’s failure to assess Mr X’s needs for several years or its decision to request Mr X return overpayments he received. This is because the complaint relates to events that took place more than 12 months ago and it would have been reasonable for Mr X to bring them to us at the time. Further, an investigation would be unlikely to find fault on the Council’s part.

The complaint

1. Mr X complained the Council failed to assess his needs for several years and is requesting that he return over payments he received from the Council in the form of direct payments.
2. Mr X said he has been caused distress by the Council’s actions.

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The Ombudsman’s role and powers

3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
4. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

5. I considered information provided by Mr X and the Council.
6. I considered the Ombudsman’s Assessment Code.

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My assessment

7. Between January 2011 and December 2018, Mr X was in receipt of direct payments from the Council to enable his assessed care needs to be met.
8. In December 2018, Mr X became eligible for CHC funding and transferred to another care package. However, the Council continued to provide Mr X with direct payments for several months.
9. In 2022, the Council became aware Mr X had been receiving direct payments when he should not have been, and it wrote to Mr X to ask that he return the over payments.
10. Mr X complained the Council failed to carry out a review of his needs between 2015 and 2018. Mr X said if the Council had assessed him, it would likely have increased the direct payments he was receiving. Mr X said he used the additional payments to fund his care and it was unfair for the Council to request the overpayments back after so much time had passed.
11. Mr X remains of the opinion that he should not have to return the overpayments because the Council failed to carry out assessments in line with its responsibilities. The evidence shows the Council neglected to assess Mr X’s needs for several years. The Ombudsman will not usually exercise discretion to investigate complaints that concern events that took place more than 12 months before the complainant became aware of them unless there are good reasons to do so. It would have been reasonable for Mr X to complain about the lack of assessments at the time if this caused him an injustice.
12. Mr X has received payments he was not entitled to; the Council is entitled to request that those payments be returned. It is unlikely we would find fault in the Council’s actions with regards to this part of the complaint. An investigation will not change that fact.

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Final decision

13. We will not investigate Mr X’s complaint because the complaint relates to events that took place more than 12 months ago and it would have been reasonable for Mr X to bring them to us at the time. Further, an investigation would be unlikely to find fault on the Council’s part.

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Investigator's decision on behalf of the Ombudsman