Summary: Mr X complains the Council has failed to deal properly with his mother-in-law’s financial assessment by not backdating its funding for her care home fees. There is no requirement for the council to backdate its funding for care before the date someone first asks it for help. We will discontinue the investigation as we cannot achieve the outcome Mr X wants and get the Council to backdate its funding.

The complaint

1. The complainant, whom I shall refer to as Mr X, complains the Council has failed to deal properly with his mother-in-law’s financial assessment by not backdating its funding for her care home fees.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe we cannot achieve the outcome someone wants.

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

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How I considered this complaint

3. I have:
• considered the complaint and the documents provided by Mr X;
• discussed the complaint with Mr X; and
• shared a draft of this statement with X and the Council, and invited comments for me to consider before making my final decision.

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What I found

4. Mr X’s mother-in-law, Mrs Y, lived in a care home for over 10 years before she died in February 2017. The NHS funded her placement until April 2014, when it decided she was no longer eligible for Continuing Healthcare. Mr X appealed that decision. This took a long time and the appeal was unsuccessful.
5. Meanwhile, no one paid the fees, so a debt accrued with the care home. Mr X says he paid £45,000 towards the debt in June 2016, after consulting a Solicitor. As Mrs Y’s capital had reduced significantly, Mr X contacted the Council in September 2016 for help in funding her placement. Shortly afterwards the care home sent Mr X a bill for £30,000 but Mrs Y no longer had enough money to pay this. After she died in February 2017, Mr X gave her remaining assets to members of her family in line with her wishes. The care home’s bill has increased to £34,600 with the addition of interest due to late payment. It remains unpaid.
6. Anyone with capital over £23,250 can be expected to pay for their own care. Under that amount people can be eligible for financial support from their local authority. Mr X wants the Council to backdate its funding for Mrs Y’s care to when her capital would have fallen to £23,250 if she had started paying for it when the NHS funding stopped.
7. The Council has not agreed to do this and has based its funding for Mrs Y’s placement on the information provided in September 2016.
8. There is nothing in the Care Act 2014, the Care and Support (Charging and Assessment of Resources) Regulations 2014, or the Care and Support Statutory Guidance which says councils must backdate funding for care before the date someone asks for help. There is therefore no prospect of my being able to recommend the Council backdate its funding for Mrs Y’s care. I will discontinue the investigation, as it is not possible to achieve the outcome Mr X wants.

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Final decision

9. I have discontinued the investigation as we cannot achieve the outcome Mr X is looking for.

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Investigator's decision on behalf of the Ombudsman