Summary: The Ombudsman will not investigate this complaint about care home charges for the complainant’s late husband. This is because it is a late complaint and because there is insufficient evidence of fault by the Council.

The complaint

1. The complainant, whom I refer to as Mrs X, says she accrued care home fee arrears due to poor communication from the Council after her husband’s NHS funding stopped. She says the Council gave her no information about charges after the NHS funding stopped. Mrs X says she has no money to pay the arrears.

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The Ombudsman’s role and powers

2. 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 an investigation if we believe it is unlikely we would find fault. (Local Government Act 1974, section 24A(6), as amended)
3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

4. I read the complaint and the Council’s responses. I considered correspondence with Mrs X’s MP and a copy of the financial assessment the Council completed in July 2018. I also considered comments Mrs X made in reply to a draft of this decision.

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What I found

What happened

5. Mr X was in a care home from May 2017. He died in October 2019. Mrs X was his attorney. The Council charged care home fees from May 2017 which Mrs X paid on behalf of Mr X.
6. The NHS funded Mr X’s care from April 2018 to July 2018. This meant Mr X did not have to make a financial contribution for this period.
7. In June 2018 Mrs X told the Council that the NHS was stopping in July. She said she was going to challenge the decision. The Council did a new financial assessment in July and notified Mrs X, in July and August 2018, that the charge would be about £339 a week. Mr X moved to a different care home in September 2018.
8. Mrs X says she received an invoice in September which showed a nil charge. On this basis she thought there were no charges. Mrs X then went on holiday and loaned money to her daughter. The Council says it had not sent an invoice but a statement showing a nil balance after Mrs X had made a payment. Mrs X received a bill in October.
9. I have seen notes that state Mrs X called the Council in December 2018 to say she would not pay the charges.
10. Mrs X complained that the Council had not told her that Mr X would have to make a contribution. The Council rejected her complaint in January 2019 and signposted her to the Ombudsman. Mrs X did not continue with the complaint but made an arrangement to pay £100 a month. The last payment she made was in September 2019.
11. In February 2019 the Council did another financial assessment. I have seen notes which state Mrs X called to ask why the charge was more than the amount stated in the 2018 assessment.
12. Mr X died in October 2019. The Council sent Mrs X a final bill for £4521. Mrs X told the Council she knew nothing about the charges and had no money to pay. In response the Council explained that it was her responsibility to pay the debt from the estate and that she had been aware of the charges since 2018. The Council invited Mrs X to make a payment plan.
13. Mrs X complained to the Ombudsman in June 2020. She says the Council did not tell her about the fees after the NHS funding stopped. She says she has no money and is only willing to pay for the final month.

Assessment

14. I will not start an investigation for the following reasons.
15. This is a late complaint. The Council signposted Mrs X to the Ombudsman in January 2019 but she waited until June 2020 to complain. Instead, rather than escalating her complaint, she made a payment arrangement. Mrs X says she was busy looking after her husband and appealing against the NHS decision. However, by January 2019, Mr X was living in a new home and Mrs X would have had many months to deal with the NHS appeal. In addition, Mrs X had another financial assessment in February 2019 which was another opportunity to complain if she was still dissatisfied. I have not seen any good reason to accept such a late complaint.
16. I also will not start an investigation because there is insufficient evidence of fault by the Council. The notes show Mrs X was aware that the NHS funded had stopped. Mrs X had to pay fees before getting the NHS funding, so it is reasonable to expect that Mrs X would have known that the fees would have resumed when the NHS funding ended. In addition, Mrs X had a financial assessment in July 2018 and the Council notified her of the charge in July, August and October 2018. There is nothing to suggest the Council did not notify Mrs X of the fees after the NHS funding stopped.

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Final decision

17. I will not start an investigation because this is a late complaint and because there is insufficient evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman