Summary: The Ombudsman will not investigate this complaint about the Council’s involvement in an assessment for Continuing Healthcare funding. The Parliamentary and Health Service Ombudsman is better placed to consider the complaint.

The complaint

1. The complainant, who I have called Ms Q, complained on behalf of her mother, Mrs M. She said Salford City Council did not properly complete a checklist for Mrs M’s Continuing Healthcare funding assessment.

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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 there is another body better placed to consider this complaint. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

3. I considered the information Ms Q provided. I invited Ms Q to comment on a draft of this decision.

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What I found

Background

4. The NHS assesses and decides whether someone is entitled to Continuing Healthcare (CHC) funding to pay for all or some of their care needs.
5. It is possible to appeal a decision about a person’s eligibility for CHC funding. It is also possible to complain to the Parliamentary and Health Service Ombudsman (PHSO) about the matter.

What happened

6. Ms Q’s mother, Mrs M, has dementia and spent some time in a care home when she came out of hospital. However, following a number of falls, the Council decided Mrs M should remain in a care home. It completed a checklist to screen Mrs M for CHC funding and sent this to the NHS’s Clinical Commissioning Group (CCG). The CCG decided Mrs M was not eligible for CHC funding.
7. Ms Q is unhappy with the way the Council completed the checklist. She said it did not follow guidelines for completing the checklist and ignored a consultant psychiatrist’s report. Ms Q believes her mother is eligible for CHC funding because she has dementia.

Analysis

8. We will not investigate this complaint.
9. The NHS decides whether someone is eligible for CHC, not the Council. An investigation by us into the actions of the Council will not change the NHS’s decision not to award CHC funding. Ms Q may appeal this decision. And, if she is unhappy with the outcome of the appeal, she may complain to the PHSO. It is better placed to consider Ms Q’s complaint about the matter.

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Final decision

10. We will not investigate this complaint. This is because the PHSO is better placed to consider it.

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Investigator's decision on behalf of the Ombudsman