Summary: The Ombudsman will not investigate Mr X’s complaint that his father, between 2010 and 2012, paid care home fees and was refused continuing health care funding.

The complaint

1. Mr X complains that the Council failed from 2010 to inform his father, Mr Y, that he could have been cared for in his own home on his discharge from hospital. Mr X says the family was always told Mr Y must be in a care home and no other options were mentioned. Mr X says the health service’s clinical commissioning group refused to fund continuing health care. In 2016, it told him his father’s needs could be provided by Council support. Mr X says his father would have preferred to live at home and he paid £60,000 in care home fees until his death in 2012. Mr X says this was a loss to his father and his estate. The Council has caused inconvenience, upset and distress. Mr X wants the Council to refund the money paid above the cost of care at home.

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The Ombudsman’s role and powers

2. 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)

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How I considered this complaint

3. I have considered Mr X’s information, comments, and reply to my draft decision statement. I have considered the health letter of 12 February 2016 to Mr X. I have read the health ombudsman’s report dated 28 March 2018 on Mr X’s complaint about the refusal of continuing health care.

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What I found

4. In 2010 Mr X’s father was discharged from hospital to a care home. He did not return home and died in the summer of 2012. In 2016 the local care commissioning group rejected Mr X’s challenges requesting funding.
5. On 28 March 2018, the health service ombudsman issued a report rejecting Mr X’s complaint. Mr Y was not eligible for continuing health care. The investigation included consideration of the 2009 continuing health care guidance and checklist, Mr Y’s medical and care home records, and input from an independent continuing health care adviser.

Analysis

6. I will not investigate Mr X’s complaint for the following reasons:
7. The complaint is outside the Ombudsman’s jurisdiction because Mr X complains late, outside the permitted period of 12 months (see paragraph 2 above). Mr X’s complaint to the health service ombudsman says he knew about the matter in April 2011.
8. I do not propose exercising discretion to investigate because Mr X could have complained much sooner. Investigation is not likely to result in the outcome Mr X wants given the health service ombudsman’s finding that his father was not eligible for continuing health care.

Final decision

9. The Ombudsman will not investigate Mr X’s complaint

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Investigator's decision on behalf of the Ombudsman