Summary: We will not investigate the Council’s handling of Mr X’s request the Council should reimburse him for the care arranged for his late relative. This is because we could not add to the investigation already carried out by the Council.

The complaint

1. Mr X complains the Council failed to reimburse his family for the 24 hours care his late relative, Mrs Y, needed from July 2022 to December 2022. He would like to be reimbursed £39,592.23.

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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 or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation

(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 which includes the Council’s responses.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

6. The Council completed a ‘discretionary’ safeguarding adults review this year into Mrs Y’s case. (This is different to a ‘mandatory’ safeguarding adults review undertaken when someone is known to have suffered significant harm or abuse). The Council said it decided to carry out the review to look at the systems and practice occurring in Mrs Y’s case.
7. The Council’s review found Mrs Y died of natural causes due to complex health conditions. It also found the Council could have communicated with the family better, could have organised independent advocacy due to the family lacking faith in the Council and, that the different agencies involved in Mrs Y’s case could have liaised with each other more effectively.
8. I shall not repeat the chronology of actions here undertaken by the Council during the assessment process to avoid duplication. These are clearly laid out in the Council’s complaints response sent in June 2024.
9. Overall, the Council’s complaints response highlights that Mrs Y’s needs assessment process took longer than it should have starting from June 2022 when the Council first tried to arrange an assessment/review with Mr X. But this was not due to it not making sufficient effort.
10. The outcome of the care plan finalised in October 2022 was to increase Mrs Y’s care hours provision to 33 hours.
11. The Council turned down Mr X’s request to reimburse him £39,592.23. It found it could not justify this without a Care Act compliant assessment identifying Mrs Y as having eligible needs to support a care package of 24-hour care. It also said that having checked its records, Mr X failed to make this request to it explicitly at the time.
12. I note Mrs Y had involvement with health services in the form of the Occupational Therapy service, the GP and also NHS staff who had started the Continuing Health Care (CHC) application process for health funding. It seems that the CHC application was not completed. The Council has advised Mr X he may be able to make a retrospective application for health funding.
13. In these circumstances we are unlikely to be able to add to the Council’s investigation so we will not investigate.

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Final decision

14. We will not investigate Mr X’s complaint because we could not add to the Council’s investigation.

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Investigator's decision on behalf of the Ombudsman