Summary: We will not investigate Mr X’s complaint about the Council’s actions in 2022 and 2023 related to its assessment of his relative, Ms Y’s needs and an NHS Continuing Healthcare referral. We have already considered the Council’s assessment of Ms Y’s needs in a previous investigation and any injustice caused by its actions related to the Continuing Healthcare referral is not significant enough to justify our involvement.

The complaint

1. Mr X complains the Council’s assessment of his relative, Ms Y’s, needs in 2023 did not comply with the Care Act 2014.
2. He also complains about the Council’s actions in 2022 and 2023 related to a referral for NHS Continuing Health Care (CHC) funding for his relative, Ms Y. He says the Council’s actions have caused distress and it has failed to respond to him about this matter. He says he only became aware of the matter in 2024 when he obtained emails between the Council and the NHS following a Subject Access Request.

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The Ombudsman’s role and powers

3. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
4. We cannot investigate complaints about matters we have previously considered and decided.
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 any injustice is not significant enough to justify our involvement.

(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 the complainant.
7. I considered the Ombudsman’s Assessment Code.

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My assessment

8. We cannot investigate Mr X’s complaint about its assessment of his mother’s needs. We have previously considered and decided a complaint about this in 2023 so cannot investigate this again.
9. Following a subject access request in 2024, Mr X became aware of emails between the Council and the NHS in 2022 and 2023. He says the emails show the Council wrongly withdrew the CHC checklist in 2022 and failed to follow this up or inform the family. He says this has caused distress and the Council has never fully responded to his complaint about this matter.
10. We will not investigate this complaint. The NHS considered a CHC referral for Ms Y in 2023. Any correspondence between the NHS and the Council prior to this about when to submit the checklist has not caused a significant injustice, as the NHS did receive a referral and did consider Ms Y’s eligibility for CHC funding.
11. The NHS is the decision maker for CHC funding. If it decides a person is eligible, it will determine when the funding should start from. The Council was not the decision maker, so any injustice caused by the Council’s actions prior to the NHS decision is not enough to warrant out involvement.

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Final decision

12. We will not investigate Mr X’s complaint because we have previously considered and decided part of the complaint and any injustice is not significant enough to warrant our involvement.

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Investigator's decision on behalf of the Ombudsman