Summary: We will not investigate Ms B’s complaint that they were given wrong information about paying for her father’s, Mr D’s, care. This is because we are satisfied with the remedy implemented by the Council.

The complaint

1. Ms B complained her father’s, Mr D’s, family were not given appropriate advice about paying for his care and were told the health service would pay for his care. Ms B says Mr D’s Power of Attorney, her brother, should not have received invoices for care they believed would be free of charge.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
3. We normally expect someone to refer the matter to the Information Commissioner if they have a complaint about data protection. However, we may decide to investigate if we think there are good reasons. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

4. I considered information provided by the complainant and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Ms B says Mr D’s family were told because he had capital over the threshold for full funding he should pay for his own care until his capital reached the threshold for him to pay a full contribution which is £23, 250. The Council says following Mr D’s discharge from hospital to a nursing home under a private arrangement, his family were advised on 18 May he should become eligible for Council funding from 7 January 2021.
7. The Council apologised that a Continuing Health Care checklist was not sent to the CCG at the time and that Mr D’s attorney was given conflicting information by a student Social Worker about NHS funding. It explained a CHC checklist is to determine whether a person is eligible for a full CHC assessment. The Council says although because of the short notice, Ms B could not attend the meeting to undertake a further CHC checklist for Mr D, it discussed this with her and included her views in the checklist. The Council says no initial information was sent to the CCG so no personal information about Mr D was lost. However, Ms B says the checklist was completed and is concerned personal information about Mr D has been mislaid. Ms B can ask the Information Commissioner’s Office (ICO) to consider whether there has been a breach of data and it would be reasonable for her to do so. Information about the ICO can be found on the website below:

Your personal information concerns | ICO

8. It is not an administrative function of the Council to decide whether a person is eligible for CHC funding, nor can the Council decide not to provide CHC funding. Even though Mr D’s family may have initially been given wrong information about charging, in the absence of evidence from the NHS confirming Mr D was eligible for CHC funding there is no fault with the Council for charging for care it provided during this period.
9. If Ms B has evidence that Mr D would have been eligible for CHC funding if a checklist had been completed sooner, she can ask the NHS to consider a retrospective application. Information about NHS health care can be found on the website below:

https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

10. The Council says it found several learning points from investigating Ms B’s complaint and will ensure this is passed onto staff. It says although the student involved in Mr D’s assessment is no longer working for it, it will also ensure this is passed onto student Social Workers. The Council apologised to Ms B for any distress caused. We could achieve no more even if we investigated and are satisfied the actions taken by the Council remedies the injustice caused by the fault.

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Final decision

11. We will not investigate Ms B’s complaint because we are satisfied with the remedy provided by the Council.

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Investigator's decision on behalf of the Ombudsman