Summary: We will not investigate this complaint about charging for adult social care. There is not enough evidence of fault by the Council.

The complaint

1. Mr B says his mother, Ms C, believed care packages in place after hospital were free for six weeks. Mr B says although Ms C received invoices for the care, she did not understand them, and the Council had not discussed the charges with other family members. Mr B says the Council should waive the care charges.

Back to top

The Ombudsman’s role and powers

2. We may investigate a complaint on behalf of someone who has died. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

3. Ms C has died, the Ombudsman has accepted Mr B as suitable to raise this complaint.
4. We investigate 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 continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused significant injustice to the person who complained, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

Back to top

How I considered this complaint

5. I considered information provided by the complainant.
6. I considered the Ombudsman’s Assessment Code.

Back to top

My assessment

7. When someone receives care at home the Council can ask the person to pay towards the support. The Council must complete a financial assessment to decide how much, if anything, the person can afford to pay.
8. Ms C previously received packages of care at home after a period in hospital. On those occasions she received free care up to six weeks. The reasons were explained to her each time. Sometimes it was because it was during Covid and there was special funding in place at the time, and on other occasions it was because she was eligible for intermediate care.
9. Intermediate care is provided for a short time to help you recover and increase your independence. It is not the case that everyone leaving hospital gets this care, only if the NHS decides you need it.
10. In 2022 when Ms C was leaving hospital, the NHS did not decide Ms C needed intermediate care. It is recorded Ms C was at her baseline. It is therefore likely Ms C would not need intermediate care as there was no improvement to make.
11. The NHS decided Ms C had capacity to make decisions about her care support. Ms C agreed to a chargeable package of care support so she could remain living in her own home. Where someone has capacity to make their own decisions, there is no need for the Council to discuss the matter with anyone else unless the person using the service asks it to.
12. Previously Ms C had cancelled packages of care because of the costs, but she did not do so on this occasion. Therefore, it is likely she wanted this care and was happy to pay for it as shown in the Council’s records.
13. There may be some delay in the Council sending invoices after Ms C’s death, but the care is still chargeable, and the debt is due from Ms C’s estate.
14. Because of earlier hospital discharges where Ms C received up to six weeks of free care, it is easy to see why Mr B may assume that would always be the case. But the evidence supports Ms C was not eligible on the last couple of hospital discharges, and that she agreed to a chargeable care package.

Back to top

Final decision

15. We will not investigate Mr B’s complaint because there is not enough evidence of fault. The Council gave a detailed response to Mr B’s complaint, including evidence. It is unlikely we could add to that or that further investigation would lead to a different outcome.

Back to top

Investigator's decision on behalf of the Ombudsman