Summary: We will not investigate this complaint about assessment of adult social care needs. The Council has accepted failures in process and apologised for it. We are satisfied with this action and could not say these errors caused the NHS decision to stop arranging the person’s care.

The complaint

1. Ms B says the Council failed to follow process, which led to mistakes in its assessment, and the removal of continuing healthcare funding for their relative, Ms C. The Council then delayed responding to the complaint. This has been upsetting and stressful for Ms B.

Back to top

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:

• any fault has not caused significant enough injustice to the person who complained to justify our involvement, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

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

3. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

Back to top

How I considered this complaint

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

Back to top

My assessment

6. Ms C lived in a care home arranged by the NHS and funded by continuing healthcare (CHC). The NHS wanted to review this arrangement and so the Council completed an assessment of Ms C’s care and support needs as part of the review process.
7. The Council accepts it failed to involve Ms B in its assessment and failed to send her a copy of the completed assessment. The Council also accepts delay in its complaint handling. The Council has apologised to Ms B for the fault and to acknowledge the impact that had on Ms B.
8. At the review the NHS decided Ms C was no longer eligible for CHC funded care. The Ombudsman could not say the NHS would have made a different decision but for the Council’s actions. The Council’s assessment was only one piece of evidence the NHS will have considered in making its decision. There is a process for appealing the NHS decision.
9. The removal of CHC funding is caused by the actions of the NHS, which we have no powers to consider.

Back to top

Final decision

10. We will not investigate Ms B’s complaint because it is unlikely we would add to the Council’s investigation or reach a different outcome. I am satisfied with the actions the Council has taken to accept fault and apologise for it.

Back to top

Investigator's decision on behalf of the Ombudsman