Summary: On behalf of Mrs A, Mr X complains the Council has not properly taken into account Mrs A’s financial and personal circumstances in deciding how much she should contribute to her care costs. The Ombudsman will not investigate the complaint because we are unlikely to find evidence of fault and an investigation is unlikely to lead to a different outcome.

The complaint

1. Mr X complains on behalf of his mother, Mrs A, that the Council’s assessment of the level of her contribution towards her care costs does not properly take into account her circumstances and expenses and leaves her with insufficient funds.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
3. 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 we would find fault, or
• it is unlikely we could add to any previous investigation by the Council, or
• it is unlikely further investigation will lead to a different outcome, or
• we cannot achieve the outcome someone wants. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

4. In considering the complaint I reviewed the information provided by Mr X, including the Council’s response to his complaint. I gave Mr X the opportunity to comment on my draft decision and considered what he said.

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What I found

5. Mrs A has health problems and receives benefits. Her income is taken into account by the Council in determining her contribution to the care package she receives.
6. In deciding what a person’s contribution will be to their care, councils must ensure that their income is not reduced below a specified level after charges have been deducted. This is called the Minimum Income Guarantee (MIG). The MIG amounts are set out by national government in the Care and Support (Charging and Assessment of Resources) Regulations. They are a minimum and councils have discretion to set a higher level if they wish.
7. Unhappy with the Council’s assessment of the amount of Mrs A’s contribution towards her care costs, Mr X appealed to the Council asking it to consider her particular circumstances and the costs she has each week, which, with the contribution level set by the Council, would leave her in a negative financial position. He made specific reference to Mrs A’s car expenses, two loans and her charity contributions.
8. The Council explained which car costs can be treated as disability related expenditure and that it could not take into account loans or charitable contributions in determining Mrs A’s contribution. It suggested Mr X seek debt advice for Mrs A from an advice agency.
9. In response to Mr X’s complaint that it had not taken into account Mrs A’s personal circumstances or mental welfare, the Council explained the costs it could take into account. It confirmed it would revise the assessment to cover cleaning costs Mrs A incurred. It noted that a mental health assessment was being pursued for Mrs A and advised Mr X to let it know if there were any changes to her financial circumstances since the last full financial assessment had taken place.

Assessment

10. Mr X has asked us to assess the personal and financial circumstances of Mrs A and define a fair amount that she is able to afford. However, this is not our role. We cannot review the merits of decisions properly made by councils no matter how strongly complainants may disagree with them.
11. In this case the Council assessed Mrs A and, using MIG figures, determined what her contribution to her care package should be. It found no exceptional circumstances which would lead to it changing the assessment but if Mr X has new information with regard to Mrs A’s financial situation or new evidence about her mental health, Mr X can submit this to the Council for consideration.
12. While I understand Mr X and Mrs A will be disappointed, I do not consider an investigation by the Ombudsman would be likely to find evidence of fault by the Council or lead to a different outcome.
13. In responding to my draft decision Mr X has asked us to look at Mrs A’s case on its individual merits. It is not our role to review the merits of Council decisions. The Council has looked at Mrs A’s case but it has decided there are no exceptional circumstances and that national MIG figures apply. Mr X says he believes Council policy here is aimed at old people which his mother is not, but the same process is used for adults of all ages.

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Final decision

14. The Ombudsman will not investigate this complaint. This is because we are unlikely to find evidence of fault and an investigation is unlikely to lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman