Summary: We will not investigate these complaints relating to assessments of a person’s entitlement to s117 funding. Some of the issues were considered by a previous investigation. The Council and the ICB will undertake a new review which will provide a suitable remedy to other issues. And, it is unlikely an investigation would find a significant outstanding injustice in relation to the remaining issues.

The complaint

1. Mrs X is eligible to receive aftercare under section 117 (s117) of the Mental Health Act 1983 (the MHA). The London Borough of Islington (the Council) and North Central London Integrated Care Board (the ICB) share the responsibility to assess and meet any needs Mrs X has which are entitled to support under s117.
2. Mrs X’s daughter, Ms G, and Ms G’s partner, Mr H, complain:
1. The Council unlawfully ended Mrs X’s s117 funding in September 2023.
2. The Council failed to recognise, or misrepresented, its responsibility for Mrs X’s s117 aftercare from September 2023 until April 2024.
3. The Council unreasonably withheld information about who authorised key decisions about Mrs X’s s117 aftercare.
4. The Council unreasonably skewed assessments another council completed of Mrs X’s needs.
5. The Council unreasonably used a ‘split funding tool’ to consider the extent of its responsibility for meeting Mrs X’s needs.
6. The Council failed to tell Mrs X, Ms G or Mr H of its plans to consider its responsibility for funding a respite placement for Mrs X at a panel in April 2025.
7. The Council failed to invite Mrs X, Ms G or Mr H to participate in the panel process in April 2025, and failed to follow an acceptable process.
8. The Council appointed officers with a conflict of interest to oversee Mrs X’s case.
9. Council officers misrepresented information and were guilty of professional misconduct.
10. The Council unfairly decided to stop communicating with Ms G and Mr H in April 2025.
3. Ms G and Mr H said that, because of the procedural and administrative failings, Mrs X had been denied fair representation. Ms G and Mr H said this, in turn, meant Mrs X remained without s117 funding she was entitled to which caused her a financial hardship. In addition, Ms G and Mr H said the Council’s actions caused avoidable stress.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

6. If we are satisfied with the actions or proposed actions of the organisations that are the subject of the complaint, we can complete our investigation and issue a decision statement. (Health Service Commissioners Act 1993, section 18ZA and Local Government Act 1974, section 30(1B) and 34H(1), as amended)

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How I considered this complaint

7. I considered evidence provided by Ms G and Mr H and by the Council, as well as relevant law, policy and guidance.
8. Ms G and Mr H had an opportunity to comment on my draft decision. I considered the comments they made before making a final decision.

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What I found

Legislation and guidance

9. The ICB previously advised us it delegated its responsibility for providing s117 aftercare for people in Islington to the Council via formal agreement. As such, the ICB said that throughout the period complained about it was never advised of Mrs X’s eligibility for s117 aftercare. And it said it did not engage in any discussions about her identified needs or whether they were entitled to support under s117.
10. I have, however, still included the ICB as an organisation under investigation. This does not reflect a provisional view about possible fault. Rather, it relates to the legal landscape and the Ombudsmen’s usual process in most complaints about the provision of s117 aftercare. Namely, to always include the NHS organisation and local authority which hold shared responsibility for the provision of the s117 aftercare package. Regardless of the day-to-day, frontline management of the process, the overarching responsibilities cannot be delegated.

Background

11. In the late summer of 2023 Mrs X left a care home and moved to private accommodation in another part of the country. Ms G and Mr H began supporting Mrs X in her home. The Council and the ICB retained responsibility to meet any support Mrs X was entitled to receive under s117. However, if Mrs X had any additional needs which did not meet the criteria for support under s117, the council in Mrs X’s local area would be responsible for assessing her eligibility for support under the Care Act 2014 (the Care Act). The Council asked the council in Mrs X’s local area to assess her needs. In the spring of 2024 the Council also began its own assessment of her needs.
12. In the summer of 2024 Mrs X stayed in a care home for four weeks to give Ms G and Mr H some respite from their caring roles. The local council paid for this and later asked the Council (and, by extension, the ICB through its shared responsibility for Mrs X’s s117 aftercare) to pay for it, or a contribution toward the costs. Both the Council and the local council continued to complete assessments of Mrs X’s needs. These presented differing views about the extent to which Mrs X’s needs were entitled to support under s117. The Council began using a ‘split funding tool’ to help decide what support it would provide through s117.
13. In April 2025 the Council decided it was responsible for ten percent of the cost of Mrs X's respite placement. This meant the local council was responsible for the remainder of the cost, under the Care Act. And, as such, 90% of the cost of Mrs X’s respite placement would be subject to a financial assessment.

Analysis

Complaints (a) to (d)

14. These complaints effectively mirror, or are interwoven with, issues we have already considered during a previous investigation. We have already investigated and reached a decision about how the Council (and ICB) considered Mrs X’s entitlement to support through s117 during this period. Because of this, we will not consider these issues again.
15. In terms of the concerns about withheld information, I understand Ms G and Mr H wanted staff details so they could challenge the Council’s decisions and pursue concerns about the Council’s actions. Ms G and Mr H have been able to pursue these core concerns with the Ombudsmen. While the earlier investigation did not investigate or comment on the issue of transparency it would not be proportionate to consider this as a standalone issue, given the underlying fault and injustice has already been addressed. This is because any outstanding frustration related to these events would not warrant a significant enough injustice to justify the Ombudsman’s involvement.
16. Similarly, in terms of the concerns about the Council having unduly influenced the other council’s assessments, our earlier investigation found that the Council did not have an adequate assessment of Mrs X’s needs. We recommended the Council (and the ICB) produce one. As such, it would not be appropriate to revisit this issue.

Complaints (e) to (g)

17. During our assessment of this complaint we spoke to representatives of the Council about the outcome of its panel in April 2025. We noted our view that the panel, and the Council’s use of the ‘split funding tool’, had ultimately relied on a flawed assessment. We shared our view that, in these circumstances, it would be appropriate to revisit the Council’s decision about its (and the ICB’s) partial or full responsibility for Mrs X’s respite stay.
18. The Council confirmed it would revisit the decision it made in April 2025, about the proportion of Mrs X’s respite provision which was entitled to s117 funding. The Council said this work will involve a thorough review of all the evidence held on Mrs X’s file, including the correspondence received from Ms G and Mr H. The Council said the review will consider whether the decision previously made about Mrs X’s care and support needs was reasonable and accurate based on the information available at the time. The Council said the review will be undertaken jointly with the ICB to ensure a shared and consistent view
19. This effectively provides a suitable remedy for the issues Ms G and Mr H complained to the Ombudsmen about. As such, we will end our involvement.

Complaints (h) to (j)

20. These issues ultimately relate to the substantive decisions the Council reached during its consideration of Mrs X’s case. Most significantly, in terms of events since the period reviewed by our last investigation, this relates to the Council’s decision about funding responsibility for Mrs X’s respite care. That is, the claimed injustice stemming from these issues relates to decisions about Mrs X’s eligibility for s117 funding.
21. As detailed in paragraphs 18 and 19, the Council is going to complete work that will address the underlying claimed fault and injustice.
22. In addition, during the complaints process the Council:

• Acknowledged that the involvement of a specific member of staff “gave rise to a perception of partiality”. The Council accepted it should have been more sensitive to how this appointment might be perceived and should have done more to ensure greater independence. The Council said that, in the interests of impartiality, it had allocated Mrs X’s case to someone else. It also said it would adjust its oversight arrangements to ensure there was no actual or perceived conflict of interest.
• Acknowledged that “aspects of communication and case management may not have met the expected standards”. Specifically, the Council said some communication was defensive and inconsistent and did not always provide the clarity Ms G and Mr H wanted. The Council said it would complete a review of the case to identify areas for improvement – in terms of transparency, documentation and engagement with family representatives. In addition, the Council said that, from now on, it would arrange for written summaries of meeting outcomes and care planning agreements to be provided to all participants.
• Said it would continue to involve Ms G and Mr H in any decision-making related to Mrs X’s s117 aftercare.

23. In summary, the Council has already acknowledged failings and taken steps to address them. In this context it does not seem likely an investigation of these issues would have a good chance of finding fault which could be linked to an outstanding injustice significant enough to warrant the Ombudsmen’s involvement. As such, we will not consider these heads of complaint any further.

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Decision

24. We will investigate this complaint because: parts of the complaint have already been considered by a previous investigation; new actions by the Council will provide a remedy for other claimed failings; and, for the remainder, it is unlikely an investigation would be able to find evidence of an unremedied injustice significant enough to warrant the Ombudsmen’s involvement.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman