Summary: The Ombudsman proposes to discontinue his investigation of this complaint, about the complainant’s contribution to his social care fees. This is because the Council has now offered to waive the outstanding balance, and this is the most an investigation by the Ombudsman could achieve.

The complaint

1. The complainant, to whom I will refer as Mr W, passed away in July 2018. He is represented here by his wife, Mrs W, and their daughter, Mrs C.
2. Mrs W and Mrs C complain the Council has miscalculated the amount they should repay from the late Mr W’s Direct Payment account.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. 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 further investigation will lead to a different outcome. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

4. I reviewed the correspondence between Mrs W, Mrs C and the Council.
5. I also shared a draft copy of this decision with each party for their comments.

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What I found

6. Mr W had a number of care needs. In January 2017, after a financial assessment, the Council find he was eligible for some local authority funding for his care. The Council agreed to deliver this via a Direct Payment DP arrangement.
7. In August 2017, Mr W was assessed as being eligible for NHS-funded Continuing Healthcare (CHC). However, for administrative reasons, this funding did not begin until June 2018.
8. In July 2018, Mr W was admitted to hospital, and died after a short stay. There was a significant amount of money left unspent in Mr W’s DP account.
9. The Council and Mrs W and Mrs B disagree what proportion of this should be repaid to the Council, and what proportion should be returned to Mr W’s estate.

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Legislative background

10. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14)
11. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. The scheme must comply with the principles in law and guidance, including that charges should not reduce a person’s income below Income Support plus 25%. The Council can take a person’s capital and savings into account subject to certain conditions. If a person incurs expenses directly related to any disability he or she has, the Council should take that into account when assessing his or her finances. (Care Act 2014 Department for Health, ‘Fairer Charging Guidance’ 2013, and ‘Fairer Contributions Guidance’ 2010)

Analysis

12. For non-residential care, the Council may agree to a Direct Payment arrangement. This is normally a bank account, into which both the Council and (if they are required to contribute) the service user will pay their respective contributions. The service user arranges their own care privately, and pays for it with the funds from the account.
13. Any unspent money left in the account when it is no longer needed – for example, because the service user passes away – is then returned to either the Council, the service user, or both, depending on their contributions, and what has actually been spent on care.
14. Mr W was receiving funded care for approximately 18 months. In this time, the arrangements became abnormally complex. For example, for a period of time he was receiving both Direct Payments, and also a separate care service funded directly by the Council. Since he passed away, the Council and Mr W’s family have been in dispute over what is owed to which party of the remaining balance, the Council considering it is due a repayment of several thousand pounds.
15. However, in the course of my enquiries with the Council, it said, due to the length of time the matter had been ongoing, and for the benefit of the complainant, it was now prepared to waive its outstanding invoices and draw the matter to a close.
16. As there is nothing more the Ombudsman could achieve in this case, it would be disproportionate to complete an investigation here. I have therefore discontinued my investigation, without making a finding on fault.

Final decision

17. I have discontinued my investigation.

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Investigator's decision on behalf of the Ombudsman