Summary: We will not investigate this complaint about the Council bullying and harassing Mrs B, or the reasons why it informed the DWP in 2021 of financial abuse of Mrs B’s finances. We will not investigate the Council’s failure to ensure Mrs B was properly assessed for Continuing Health Care or Funded Nursing Care when she moved into the home in 2019. This is because we could not add to the Council’s response or make a different finding of the kind Ms C wants.

The complaint

1. Ms C, Mrs B’s daughter complained on her behalf. Ms C says the Council has bullied and harassed Mrs B, made false allegations about her finances to the DWP, wrongly assessed her, made threats, sent letters to her home and directly to her in the care home and continues the send threatening letters. Ms C says Mrs B has suffered upset and distress because of the Council’s actions and says Mrs B was not properly assessed for NHS Continuing Health Care (CHC), or Funded Nursing Care (FNC). Ms C wants the Council to stop harassing Mrs B for payment and admit to their failures.

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The Ombudsman’s role and powers

2. 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)
3. 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 do not start an investigation if we decide the tests set out in our Assessment Code are not met. (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.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. The Council explained the rationale for contacting the DWP. Ms C complained to the Council in 2021 about this matter. Ms C could have come to us at the time if she was unhappy with the Councill’s response. There is no good reason for us to disapply the law to investigate this point now.
7. The Council says a financial assessment has not been completed for Mrs B, despite its attempts to do so. It explained in the absence of a completed financial assessment form, a person is deemed liable to pay the full cost of their care. We could not say this is fault. If Ms C is concerned Mrs B should not pay the full cost she can complete the financial assessment form and return it to the Council to consider.
8. The Council has explained Mrs B does not meet the criteria for NHS funding.
9. It is not an administrative function of the Council to decide whether a person is eligible for CHC or FNC funding, nor can the Council decide not to provide CHC or FNC funding. In the absence of evidence from the NHS confirming Mrs B was eligible for funding from 2019, there is no fault with the Council for charging Mrs B for care it provided.
10. If Ms C has evidence that Mrs B would have been eligible for CHC funding from 2019 she can ask the NHS to consider a retrospective application.
11. Ms C as the applicant can tell the NHS why she disputes the Council’s view and say what nursing care Mrs B received. But it is up to CCG to get all information it needs to decide an application. Information about the NHS CHC funding can be found on the website below.

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

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Final decision

12. We will not investigate Ms C’s complaint because further investigation could not add to the Council’s response or make a different finding of the kind Ms C wants.

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Investigator's decision on behalf of the Ombudsman