Summary: We will not investigate this complaint about the Care Provider’s decision to charge backdated fees to Miss Y. I am satisfied with the action the Care Provider has taken to remedy the impact of any fault in its actions, as it waived £10,000 in care fees. Investigation by the Ombudsman would not achieve a better outcome.

The complaint

1. Mrs X complained, on behalf of her aunt Miss Y, that the Care Provider requested £60,000 in backdated fees after identifying it had been undercharging Miss Y for over three years. Mrs X said the Care Provider agreed to reduce the amount by £10,000 but she did not feel this was sufficient. She said the matter caused her distress and she received threats of court action. She wanted the Care Provider to reduce the invoice further.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• the action has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• we cannot achieve the outcome someone wants, or
• it is unlikely further investigation will lead to a different outcome.

(Local Government Act 1974, sections 34B(8) and (9))

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I considered information provided by the complainant and the Care Provider.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Miss Y moved into a care home several years ago. The Care Provider became aware, following a financial assessment carried out by the Council, that Miss Y was responsible for the full cost of her care due to having sufficient capital. The Care Provider says the Council’s financial assessment had been delayed significantly, so the Council had partly paid Miss Y’s fees in the interim, pending the outcome. The Council recouped the fees it had paid to the Care Provider, and the Care Provider therefore in turn sought to recover the fees from Miss Y, via Mrs X who was appointed as her Lasting Power of Attorney.
7. The Care Provider accepted, in response to Mrs X’s complaint, it had been at fault due to delays and issues with communication. It reduced Miss Y’s backdated fees, reducing the invoice by £10,000. Mrs X then complained to us as she did not believe this was a sufficient remedy in the circumstances.
8. Any remedies we recommend are aimed at putting the person back in the position they would have been in, but for fault. In this case, had there been no delay or miscommunication, Miss Y would have paid more for her care from an earlier date. Miss Y has not experienced a quantifiable financial loss due to the identified fault. It is not the role of the Ombudsman to recommend actions that place people at an advantage. Investigation by us would not therefore result in any further reduction of the invoice, as the fees are properly owed for care Miss Y received.
9. Any injustice in this case is, instead, linked to Mrs X’s distress and inconvenience. We will normally only investigate a complaint where the complainant has suffered serious loss, harm, or distress as a direct result of faults or failures by the service provider. The impact on Mrs X was not so significant as to meet this threshold.
10. I am therefore satisfied the Care Provider has already provided a suitable remedy, and investigation by us would not achieve anything further.

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Final decision

11. We will not investigate Mrs X’s complaint because I am satisfied with the action the Care Provider has taken in response to the impact of its faults.

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Investigator's decision on behalf of the Ombudsman