Summary: We will not investigate Mrs X’s complaint that the Council refused to pay the full cost of her mother, Mrs M’s, care. There is not enough evidence of fault to justify an investigation and in any case, Mrs M has not experienced an injustice.

The complaint

1. Mrs X complains the Council will not pay for the full cost of her mother, Mrs M’s, domiciliary care. Instead it will only pay for the equivalent cost of a nursing home.
2. Mrs X says that as a result, Mrs M is not getting the best outcome for her finances.

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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
• any fault has not caused injustice to the person who complained.

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

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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. Mrs M has a number of significant health conditions as well as dementia. The Council assessed her and found she needed 24 hour support, including ‘awake night support’ (when the carer must stay awake in case the service user needs help). The Council said Mrs M’s needs could be met within a dementia-specialist nursing home.
7. Mrs M wanted to stay at home with live-in carers at a cost of around £2,100 a week. The Council provided a direct payment of £1,000 a week which was the equivalent of the average costs of a nursing placement in a care home. After carrying out a financial assessment, the Council calculated Mrs M could afford to contribute around £250 weekly towards the costs of her care.
8. The Council explained to Mrs X during the complaints process that it needed to consider best value and the different options available to meet Mrs M’s needs. It said her needs were likely to increase and recommended they consider the Council’s offer of a dementia registered nursing placement.
9. We will not investigate this complaint. Mrs M is receiving the care she wants and it is likely she will be able to continue to afford to pay for this. Therefore, she has not experienced any injustice.
10. Furthermore, the Care and Support Statutory Guidance 2014 states councils are entitled to take reasonable consideration of their own finances and budgetary position and can balance these with its duty to meet the needs of someone requiring support.
11. The Council demonstrated it considered Mrs M’s wishes and weighed them against its own financial duties to the wider population. It offered an alternative care option which is affordable and meets Mrs M’s care needs. It is satisfied Mrs M’s needs are currently being met because she paying the additional costs of her care. Therefore, there is no evidence of fault to justify an investigation.

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Final decision

12. We will not investigate this complaint because there is no evidence of fault or injustice to the complainant.

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Investigator's decision on behalf of the Ombudsman