Summary: We will not investigate Mrs C’s complaint about the way the Council reviewed her late mother’s care arrangements because it is unlikely we would find fault. Mrs C’s complaint about the support provided by the Care Provider is late as she was aware of issues from late 2019 and could have complained to us sooner. Mrs C wanted the Care Provider to reimburse 50% of care fees paid. We will not investigate this complaint because it is unlikely we could achieve the outcome Mrs C wants.

The complaint

1. The complainant, who I shall refer to as Mrs C, complains about the care and support provided to her late mother, Mrs G, by the Crest Care Home (the Home) when her mother became a resident in August 2019. Mrs C says her mother privately paid for a service which did not meet expected standards. Mrs C also says North Yorkshire County Council (the Council) did not complete a care review within 12 months of the placement starting and this delayed a health authority considering her mother for healthcare funding. Mrs C wants the organisations to acknowledge fault and reimburse 50% of care fees paid.

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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 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 continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained, or
• we cannot achieve the outcome someone wants.

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

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/care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

4. I have considered information provided by the complainant and information from the Council in response to our enquiries. I have also considered the law and guidance relevant to this complaint.
5. Mrs C had an opportunity to respond to a draft of this decision.

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What I found

6. Mrs G lived in a different residential care home before moving to the Crest Care Home in August 2019. The Home is a residential home. Prior to the move the Council said it completed a financial assessment and this confirmed Mrs G would have been a full-cost payer for care fees and therefore not eligible for Council funding.
7. Mrs C was her mother’s attorney for health and welfare and said she arranged her mother’s placement in the Crest Care Home privately following the Council’s assessment. This was partly because the Crest Care Home was closer to where Mrs C and other family members lived than the previous care home.
8. Mrs C said she raised several concerns with the Home’s manager during her mother’s placement as she did not feel the home was meeting her mother’s needs. Her concerns included issues relating to care planning, medication monitoring and hydration. Mrs C said she did not formally complain to the Home.
9. The Council said it received a referral from the Home in March 2021 asking it to assess Mrs G’s needs. The Council’s assessment confirmed Mrs G’s needs had changed and she now needed dementia nursing care. It then worked with Mrs C to arrange Mrs G’s placement in a nursing home. Its financial assessment confirmed Mrs G as a full-cost payer.
10. The Council completed a care review in May 2021. Its officer also completed a checklist to determine if Mrs G should be considered for healthcare funding by the relevant health authority. The outcome of the checklist led to the relevant health health authority completing an assessment to determine whether Mrs G was eligible for healthcare funding. After completing several processes, the health authority decided Mrs G was eligible for healthcare funding.
11. Mrs C complained to the Council in April 2022 and complained to the Home in 2022. Her complaints related to the Council’s review process and the care and support provided by the Home. Mrs C then asked us to consider her complaints once the Council responded to her.

Findings

12. When the Council responded to Mrs C’s complaint it said it could not comment on the healthcare funding process and advised Mrs C to contact the relevant health authority. Mrs C has already done this. Any complaints about the healthcare funding process can be considered by the Parliamentary and Health Service Ombudsman.
13. The Council said it had not received any complaints from Mrs C or other professionals while Mrs G was in the Home. When dealing with her complaint in May 2022 it said the Home was responding to a complaint from Mrs C.
14. Mrs G’s placement in the Home was a private arrangement and the Council would not have had any duty to review her needs until asked to do so. The Council acted promptly to review Mrs G’s needs once the Home asked it to do this. An investigation is unlikely to uncover fault by the Council regarding this issue.
15. Mrs C complains about issues relating to her mother’s care arrangements dating back to August 2019. Although Mrs C did not complain to the Home until 2022, she was aware of issues from late 2019. She said she raised issues with the Home over the duration of the placement and it responded to her. Mrs C’s complaint about the Home is late and Mrs G has now died. We cannot investigate late complaints unless we decide there are good reasons. Mrs C could have complained to us sooner.
16. Where someone has died, we will not normally seek a remedy for injustice caused to that person in the same way as we might for someone who is still living. We would not expect a public or private body to make a payment to someone’s estate. Therefore, if the impact of a fault was on someone who has died, we will not recommend an organisation make a payment in recognition of, for example, the impact of poor care that person might have received while they were alive. This is because the person who received the poor care cannot benefit from such a payment. Therefore, we could not achieve the outcome Mrs C seeks.

Conclusion

17. We will not investigate Mrs C’s complaint about the Council as it is unlikely we would find fault. Mrs C’s complaint about the Home is late and it is unlikely we could achieve the outcome she wants.

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Final decision

18. We have decided not to investigate this complaint for the reasons set out in this decision statement. I have closed the complaint.

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Investigator's decision on behalf of the Ombudsman