Summary: We will not investigate this complaint about the care needs assessment completed for Mrs X’s mother and about the Council not providing financial assistance with paying for her mother’s care at a nursing home. This is because there is insufficient evidence of fault. In addition, an investigation would not lead to a different outcome.

The complaint

1. Mrs X complains about the care needs assessment completed for her mother. She says her mother nursing care, but the assessment only identified her mother needed residential care. She also complains the Council will not provide financial assistance with paying for her mother’s care at a nursing home.

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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 an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

3. I considered information provided by the complainant.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. The Council completed a care needs assessment for Mrs X’s mother, Mrs A, in February 2023. The outcome of the assessment was that Mrs A’s needs could be met in a residential care home.
6. Mrs X contacted the Council and advised her mother’s condition had changed. The Council said the care home could tell the Council if they were unable to meet Mrs A’s needs. At that point, it could review Mrs A’s needs.
7. Mid-March 2023, Mrs X decided to privately commission a nursing home for Mrs A. The Council offered to review Mrs A’s care needs, and this was arranged for mid-April as Mrs X was away.
8. Mrs X contacted the Council again end of March to advise her mother’s condition had declined again. The social worker offered to review Mrs A earlier, which was agreed.
9. Care assessments are completed based on the needs of the individual as presented at the time of the assessment. Where individuals have changing needs, it is appropriate for the Council to review the individual’s care needs. In this case, the evidence shows the Council appropriately followed this process. Therefore, an investigation is not justified as we are unlikely to find fault with the Council.
10. During its complaint investigation, the Council acknowledged Mrs A’s needs warranted a higher level of care than originally presented when she was assessed in February 2023. Therefore, the Council has authorised funding at the Council’s respite nursing rate of just over £816 per week, minus any assessed client contributions. The Council confirmed this covers the entire length of Mrs A’s stay at the nursing home.
11. Therefore, an investigation is not justified as it would not lead to a different outcome. The Council has already accepted Mrs A needed nursing care and has agreed to fund her stay at the nursing home at the Council’s rate. This action is appropriate and I do not consider any further recommendations are necessary in the circumstances.

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Final decision

12. We will not investigate Mrs X’s complaint because there is insufficient evidence of fault. In addition, an investigation would not lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman