Summary: We will not investigate this complaint about Mrs Y’s package of care after a discharge from hospital. There is insufficient evidence of fault.

The complaint

1. Mr X complained the Council refused Mrs Y (his mother) a six-week intermediate care package. He said it put an unnecessary care package in place without telling them how much it would cost. Mr X said the Council was unresponsive when he tried to contact it to discuss the matter. He said this left Mrs Y with a large bill for care she did not need. He wanted the Council to make service improvements to ensure it assesses people properly.

Back to top

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

Back to top

How I considered this complaint

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

Back to top

My assessment

5. Mrs Y spent some time in hospital, and the Council assessed her eligibility for care and support when she was ready to return home. It noted in its assessment that the needs she had developed were long-term and not eligible for intermediate care, which is a short-term type of care which aims to support the person to regain skills to live independently.
6. Mrs Y discussed her needs and her financial position with the assessor and agreed to a package of four visits daily. She expressed a wish to reduce the impact on her family of her new level of support needs.
7. In a telephone call in the following days, Mrs Y asked the Council whether her first six weeks’ care would be free. The Council confirmed this was not the case, and confirmed the hourly cost for care for people who were full cost-payers. The Council had also sent an email to Mr X four days prior, which included the hourly rate for care and explained a financial assessment would be needed. It sent financial assessment forms to Mrs Y and Mr X, but did not receive a response.
8. The Council made Mrs Y and Mr X aware of the cost of care, and there is insufficient evidence to support Mr X’s concern a package of care was unnecessary. Mrs Y made a decision, with capacity, that she needed a package of four visits daily due to the needs she had developed while in hospital.
9. Mr X questions Mrs Y’s eligibility for six weeks’ free intermediate care. He says Mrs Y no longer needs a package of care, and says he had often carried out tasks before carers arrived. There is insufficient evidence Mrs X was expected to regain independence which would have led to her being eligible for free intermediate care. Mrs X continues to have care needs, albeit these are met by Mr X now rather than by a care agency. There is insufficient evidence of fault by the Council in its decision Mrs Y was not eligible for intermediate care.
10. The Council reviewed the package seven weeks after Mrs Y’s discharge. Her package of care was reduced to two calls daily, and ultimately finished several weeks later. There is no substantive evidence of Mrs Y expressing a wish to reduce her care before this date. There is insufficient evidence of fault by the Council and so we will not investigate the complaint.

Back to top

Final decision

11. We will not investigate Mr X’s complaint because there is insufficient evidence of fault by the Council.

Back to top

Investigator's decision on behalf of the Ombudsman