Summary: We will not investigate this complaint about charges for adult social care. This is because there is not enough evidence of fault to justify investigating.

The complaint

1. Mr Y complained on behalf of his father, Mr X, who has dementia, that the Council has wrongly included various expenses to be paid as part of his Personal Expense Allowance (PEA). He also complained about the lack of response from the Council when he asked to appeal the assessment decision about his father’s finances.
2. Mr Y says this has caused him and his father distress and frustration. In particular Mr Y says his father is worried he will have to move out of his care home, as he is concerned he will be unable to pay the contribution required.

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The Ombudsman’s role and powers

3. The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6))

4. It is not a good use of public resources to investigate complaints about complaint procedures, if we are unable to deal with the substantive issue.

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How I considered this complaint

5. I considered the information Mr Y and the Council provided. I also considered the Ombudsman’s Assessment Code and Guidance on Remedies.

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My assessment

6. Following an assessment of Mr X’s finances, the Council informed him that he would need to pay towards the cost of his care. The Council explained that following these costs being paid, Mr X would have a PEA of £31.55 per week amounting to £136.71 per month.
7. Mr Y complained on behalf of his father in October 2022. He complained that the assessment had not included costs which Mr X was contractually obliged to pay, including a TV package, mobile phone contract and a funeral payment plan. With these costs, Mr Y said his father would have to pay £111 approximately a month for bills, leaving him with an allowance of £25 per month remaining. Mr Y said the allowance was insufficient for his father to be able to then be able to pay for any further costs.
8. Mr Y did not receive a response, so he complained again in November. Mr Y again did not receive a response. The Council later responded to the complaint in February 2023. Within its response it apologised for the failure for it to reply and offered £100 to recognise the time and trouble Mr Y had taken to raise his complaint and recognise the emotional impact. However, it denied fault in the financial assessment.

Analysis

9. PEA is the weekly amount that people receiving local authority-arranged care and support in a care home (residents) are assumed to need as a minimum for their personal expenses. It is intended to allow residents to have money for personal use. PEA should not be spent on aspects of care and support that have been contracted for by the local authority and/or assessed as necessary to meet the person’s eligible care and support needs by the local authority or the NHS. 
10. The costs Mr Y says should be paid for through his father’s PEA are not related to aspects of care and support needs. While Mr X may be contractually bound to pay the charges on a monthly basis, it is for him to either end these contracts, even if this incurs a fee, or keep the services and pay the costs for this, either through his PEA as they do not need to be excluded as they are not care services or through his savings. It is unlikely that we would find fault in the Council’s financial assessment to not include these charges within his care costs, so we will not investigate this complaint.
11. Mr Y has also complained about the way the Council dealt with his complaint. It is not a good use of public money to investigate how a complaint was dealt with where we are not investigating the substantive issue so we will not investigate this complaint.
12. Further, in this case, the Council has recognised fault, apologised to Mr Y and offered to pay £100 to recognise the emotional impact of this on him. This is an appropriate and proportionate offer to remedy the injustice caused. It is unlikely further investigation would lead to a different outcome, so we will not investigate.

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Final decision

13. We will not investigate Mr Y’s complaint because there is not enough evidence of fault to justify investigating.

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Investigator's decision on behalf of the Ombudsman