Summary: We will not investigate this complaint about failure to complete a Care Act assessment of adult social care needs. This does not cause enough injustice because the persons needs were already met by a nursing home placement, so it is unlikely the outcome would be any different. Any complaints about the standard of the privately arranged care would be a separate complaint to the care provider.

The complaint

1. Ms B says the Council failed to complete a Care Act assessment in 2024, meaning her relative, Ms C, did not get timely support when her health was deteriorating. Ms B says the Council did not follow statutory guidance about its responsibilities in the Continuing Healthcare process. Ms B says the Council delayed responding to her complaint. Ms B would like an apology, financial payment, and procedural improvements.

Back to top

The Ombudsman’s role and powers

2. We may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

3. Ms C has died; we have accepted Ms B as a suitable representative.
4. 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 injustice is not significant enough 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, or
• there is no worthwhile outcome achievable by our investigation.

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

Back to top

How I considered this complaint

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

Back to top

My assessment

7. Ms C lived in a nursing home which she privately arranged and funded. In 2024 Ms B asked the Council to complete an assessment of Ms C’s care and support needs under the Care Act 2014. There was a delay in the Council arranging to visit Ms C due to the demand on its resource, this is a service failure which it has apologised for.
8. The Council did not complete an assessment of needs due to miscommunication with Ms B. Instead, the Council completed the checklist for Continuing Healthcare (CHC) which is NHS arranged and funded care. Ms B had asked for and was expecting an assessment, so was frustrated when this did not happen.
9. Ms B says the failure to complete an assessment means Ms C did not receive adequate support. However, the nursing home where Ms C lived would have a care plan which it should keep under review, especially if there was any change in Ms C’s presenting needs. If Ms B is not happy with the service the nursing home was providing, she can make a complaint to the care provider and if not satisfied can make a separate complaint to the Ombudsman about that privately arranged care. I cannot see how the Council’s failure to complete an assessment caused any significant injustice to how the care provider met Ms C’s needs. The Council later offered to complete an assessment and support Ms B with looking at alternative provision, but Ms B declined this as did not wish to move Ms C. The Council also said it would discuss concerns with the care provider. The concerns likely should have triggered consideration of safeguarding, but it is too late to now complete that work.
10. The outcome of the CHC checklist was that Ms C did not meet the criteria for a full assessment for NHS funding. Ms B says the Council did not tell her how to dispute this, and Ms C was denied a full NHS assessment. However, Ms C has had full assessments since then and the NHS did not find she had a primary health need and has not awarded CHC. So, any fault by the Council has not caused a significant injustice. If the NHS felt it needed a more recent care needs assessment, or a different social worker with better knowledge of Ms C, then it could have postponed the meeting until the Council completed that work. The NHS must have been satisfied it had enough information to make its decision. Ms B is challenging the NHS decision, and if the NHS awards CHC it can backdate to when it considers appropriate. We have no powers to consider the actions of the NHS.
11. Ms B is also unhappy with the way the Council dealt with her complaint. But it is not a good use of public resources to look at the Council’s complaints handling if we are not going to look at the substantive issue complained about. We will not therefore investigate this issue separately.

Back to top

Final decision

12. We will not investigate Ms B’s complaint because the Council fault did not cause a significant enough injustice to justify an Ombudsman investigation. Although the Council’s delay and failure to complete a Care Act assessment caused Ms B frustration, this is not enough to justify our resource. Any failures in Ms C’s care support is a separate complaint to the care provider as it was privately arranged care, but we could no longer provide Ms C with a remedy for any impact on her. Ms B is correctly taking her concerns about the CHC process and funding decisions to the NHS, which is not within our powers to consider.

Back to top

Investigator's decision on behalf of the Ombudsman