Summary: We will not investigate Mr B’s complaint about inaccuracies contained in a Deprivation of Liberty Safeguards (DoLS) report. This is because the Council’s actions have not caused either Mr B or his mother, Mrs C, a significant enough injustice to warrant an Ombudsman investigation.

The complaint

1. Mr B says inaccuracies contained in a Deprivation of Liberty Safeguards (DoLS) assessment resulted in his mother, Mrs C, being refused NHS Continuing Health Care funding. Mr B says he has been put him to a lot of inconvenience, time and distress and says the Council should check and acknowledge the inaccuracies in the assessment and apologise to him.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
3. We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as the NHS. (Local Government Act 1974, sections 25 and 34A, as amended

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How I considered this complaint

4. I considered information provided by the complainant and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Continuing Healthcare (CHC) is an NHS funding stream for service users who are considered to have a ‘primary health need’. If a service user is assessed as having a primary health need, the NHS will pay for their care (including any social care provision and, sometimes, accommodation) in its entirety. Even if somebody is found not to have a primary health need, the NHS may still contribute towards the cost of that person’s nursing care. This is known as NHS-funded Nursing Care (FNC).
7. The National framework for NHS continuing healthcare and NHS-funded nursing care (the Framework) is the key guidance relating to CHC/FNC. This sets out that the local CCG is responsible for (among other things):

• Ensuring compliance with the Framework
• Making decisions on eligibility for CHC/FNC
• Recording assessments/outcomes
• Commissioning arrangements (on an individual and strategic basis)

8. Mr B says Mrs C needs nursing care and says she was refused this because of the Council’s DoLS assessment.
9. It is the CCG’s decision whether to award CHC funding, so Mr B can apply for a retrospective assessment, tell the CCG why he disputes the Council’s view and say what nursing care Mrs C received. But it is up to CCG to get all information it needs to decide an application. Information about the NHS CHC funding can be found on the website below.

https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

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Final decision

10. We will not investigate Mr B’s complaint because the Council’s actions have not caused either Mr B or Mrs C a significant enough injustice to warrant an Ombudsman investigation.

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Investigator's decision on behalf of the Ombudsman