Summary: We will not investigate Mrs X’s complaint about her care charge contributions. The complaint is late and there are no good reasons for us to investigate it now. There is not enough evidence of fault by the Council in its backdating decision to justify us investigating.

The complaint

1. Mrs X receives care in her own home, partly funded by the Council. She is represented by her sister, Mrs Y. Mrs Y complains the Council:
1. failed to do a financial assessment on Mrs X in 2019;
2. has refused to backdate a care fee refund for Mrs X to earlier than April 2021.
2. Mrs Y says Mrs X has been charged a lot of money for care between 2019 and 2021, which she would not have had to pay if the Council had done the requested assessment in 2019.

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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. The Ombudsman investigates 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 may decide not to continue with an investigation if we decide there is not enough evidence of fault to justify investigating. (Local Government Act 1974, section 24A(6))

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How I considered this complaint

5. I considered information provided by Mrs Y, and the Ombudsman’s Assessment Code.

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My assessment

6. Mrs Y first complained to the Council about Mrs X’s financial contributions to her care in 2019. The Council gave its final response in September 2019 and advised Mrs Y to complain to the Ombudsman if she was not satisfied with the outcome. Mrs Y did not do this because she says she was ill at the time. Mrs X’s family decided to look after her without help from the Council.
7. In 2021, Mrs X had an accident. Her family approached the Council again for support. The Council agreed a package of care and calculated Mrs X’s financial contribution. The family queried this and the Council asked for evidence of Mrs X’s finances for an assessment. The result was that Mrs X was not required to pay towards her care. Mrs Y complained to the Council again in 2021 because she believes that if officers had done a similar assessment in 2019, Mrs X would not have had to pay for her care between 2019 and 2021.
8. We expect people to complain to us within 12 months of their being aware of the matter complained of. Mrs X and Mrs Y knew about the decision on Mrs X’s care charge contributions in April 2019. The Council invited Mrs Y to complain to the Ombudsman about the charges at the end of the complaint process. Mrs Y complained to us in January 2022, so the complaint is late.
9. There are no good reasons for us to investigate it now. I have taken into account that Mrs Y says she could not proceed with the complaint at that time because of illness. But the Council considered the complaint and referred her to the Ombudsman, and if she was unhappy with the outcome, we would have expected her to raise the complaint with us in time.
10. I also take into account that even if we did investigate this late complaint, it is unlikely we could now say an assessment of Mrs X’s finances in 2019 would have reached the same result reached in 2021. Her circumstances will have changed, and so would the information available to assessments done two years apart.
11. The Council was not involved with Mrs X’s care from 2019 to 2021. It was Mrs X’s and her family’s decision to decline support from the Council in 2019, up until 2021. On the findings of the 2021 assessment, the Council backdated the care fee refund to April 2021, which is when the Council again became involved in providing care. There is not enough evidence of fault by the Council in that backdating decision to warrant us investigating.

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Final decision

12. We will not investigate Mrs X’s complaint because:
• the complaint about Mrs X’s care charge contributions is late and there are no good reasons for us to investigate it now;
• there is not enough evidence of fault by the Council in its backdating decision to justify us investigating.

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Investigator's decision on behalf of the Ombudsman