Summary: We will not investigate Mr X’s complaint about the Council’s decision his mother, Mrs Y could return home with an increased care package in November 2023 and its discussion of finances when assessing her care needs. The complaint is late, and there is insufficient evidence of fault to justify our involvement.

The complaint

1. Mr X complained about the Council’s decision his mother, Mrs Y, could return home from hospital with an increased care package in November 2023. He also complained the Council discussed her finances before assessing her care needs.

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The Ombudsman’s role and powers

2. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
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. We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as hospitals and health bodies. (Local Government Act 1974, sections 25 and 34(1), as amended)
5. 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
• 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

6. I considered information provided by Mr X and the Council.
7. I considered the Ombudsman’s Assessment Code.

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My assessment

What happened

8. Mrs Y, who had been living on her own with a care package, was admitted to hospital in October 2023 after a fall. In early November, there were discussions between the Council and hospital staff about whether Mrs Y would be able to return home. The Council said Mrs Y may need a bed downstairs if she was not able to manage the stairs safely and requested a review by a physiotherapist.
9. Later in November, the Council discussed Mrs Y’s care needs with nursing staff, who confirmed Mrs Y did not need night-time care but would need continence pads. It also consulted with a physiotherapist, who confirmed Mrs Y was safe to return home. The Council spoke to Mr X, who said Mrs Y needed a longer care call in the morning and an extra call at bedtime. He also said he had installed a bed downstairs and a stair gate at the bottom of the stairs as a safety precaution. The Council recommended a wrist sensor alarm, in case of falls and Mr X said he had installed CCTV. The record of the call states Mr X said Mrs Y was declining in hospital and the sooner she returned home the better she would be.
10. The day before Mrs Y was due to return home, Mr X raised concerns about the Council’s assessment of her needs. He said the social worker had focused on her finances than her current needs. He spoke to a manager, who confirmed the Council had to explain the likely costs of Mrs Y’s care. Mr X said Mrs Y’s needs were primarily health needs and her care should be funded by NHS Continuing Healthcare (NHS CHC). The manager explained an NHS CHC checklist could be completed on the day of discharge. In this conversation, Mr X also raised concerns about Mrs Y’s cognitive impairment and about whether her overnight care needs could be met at home.
11. On the day of discharge, a Council offer completed a CHC checklist at a meeting with Mr X and Mrs Y. Four hours after returning home, Mrs Y had a fall and was readmitted to hospital. In 2024, she was discharged to an intermediate care unit and moved to a nursing home in early March. The health body said she was not eligible for NHS CHC funding, following an updated NHS CHC checklist.
12. In its complaint responses, the Council accepted a delay in submitting the NHS CHC checklist completed on 1 December 2023 until 18 December 2023.

My assessment

13. We usually expect people to complain to us within 12 months of the events they are complaining about. Mr X complained in March 2025 about events in late 2023, so the complaint is late. I note Mr X was pursuing a complaint with the Council until February 2024 and has since made a separate complaint to the hospital, but my view is that this is not sufficient to account for the delay in complaining to us. There are no good reasons for us to decide to investigate now.
14. Even if we did investigate, it is not our role to say whether the decision a council makes is correct. Unless there is fault in the decision-making process, we cannot comment on the decision reached. When making its decision that Mrs Y could return home, the Council considered relevant factors, including:
• consulting with health professionals caring for Mrs Y in hospital, including a physiotherapist who confirmed Mrs Y was safe to return home;
• considering how to minimise any risks due to falls and Mrs Y using the stairs; and
• arranging an increased package of care in light of a deterioration in her condition.
15. Based on this, there is insufficient evidence of fault to justify further investigation.
16. Councils are expected to discuss the likely costs of adult social care when arranging it, so it was not fault for the Council to discuss this as part of its needs assessment. Although there was a short delay in submitting the CHC checklist in December 2023, this did not cause an injustice because Mrs Y was readmitted to hospital, so the process had to be restarted in January 2024.
17. We cannot consider complaints about the actions or omissions of hospital staff as this is outside our remit, nor can we consider the decision Mrs Y was not eligible for NHS CHC funding because that is a decision for the health body.

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Final decision

18. We will not investigate Mr X’s complaint because it is late and, in any case, there is insufficient evidence of fault to justify our involvement.

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Investigator's decision on behalf of the Ombudsman