Summary: We will not investigate Mr X’s complaint about the Council’s care needs assessment of his relative Mrs Y and it not offering a Deferred Payment Arrangement (DPA). There is not enough evidence of fault in the Council’s decision-making processes to warrant us investigating.

The complaint

1. Mr X is Mrs Y’s son-in-law. Mrs Y is elderly and has various physical health conditions. She was discharged from hospital in summer 2024 to a private care home which she has funded. Mrs Y and her family sought support from the Council several months later due to her reducing funds. The Council assessed Mrs Y’s care needs and finances.
2. Mr Y complains the Council:
1. failed to properly assess Mrs Y’s care needs;
2. failed to give the family chance to question and rebut its assessment;
3. refused the application for a Deferred Payment Agreement (DPA) to meet the care fees.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. 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. (Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

5. I considered information from Mr X, relevant government guidance on DPAs, and the Ombudsman’s Assessment Code.

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My assessment

6. We are not an appeal body. We may only criticise a council’s decision where there is evidence of fault in its decision-making process and but for that fault officers would have made a different decision. So we consider the processes councils have followed to make their decisions. We cannot replace a council’s decision with our own or someone else’s opinion if the decision was reached after following proper process.
7. In response to Mrs Y’s and her family’s request, the Council assessed her care needs and finances. Officers gathered information about Mrs Y’s needs from her and her current care home’s staff. They also sought from and took account of information about Mrs Y’s circumstances from two members of her family during the assessment. Officers recognised it was Mrs Y’s and her family’s preference for her to stay in the same residential care placement. But officers concluded Mrs Y did not have an assessed care need for the 24-hour provision she received at the home. Their assessment identified no night-time or other care needs which could not be met through support or provision in Mrs Y’s own property. Officers considered Mrs Y’s family’s responses to their assessment in replies to the complaint but were not persuaded to change their position.
8. Officers gathered relevant information about Mrs Y’s needs when making their decisions. It is unlikely we could find fault in the decision-making process here. There is not enough evidence of fault in the process followed by the Council to justify us going behind its decision and investigating. We recognise Mrs Y, Mr X and the wider family may disagree with the Council’s decision. But it is not fault for a council to properly make a decision with which someone disagrees.
9. Mr X has also complained the Council declined to enter into a DPA with Mrs Y to meet her ongoing care fees. Under ‘The Care and Support (Deferred Payment) Regulations 2014’, for a local authority to be required to enter into a DPA, it would have to be intending to meet the service user’s needs for care and support within a residential care home. The Council’s needs assessment for Mrs Y, that her needs can be met in her own property, means the DPA scheme would not apply here. There is not enough evidence of fault in the Council’s decision-making process on this issue to warrant us investigating.

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Final decision

10. We will not investigate Mr X’s complaint because there is not enough evidence of fault in the Council’s decision-making processes to warrant an investigation.

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Investigator's decision on behalf of the Ombudsman