Summary: We will not investigate this complaint about delay in refunding overpaid care fees. The interest claimed on a one-month delay would not be significant to justify the Ombudsman investigating.

The complaint

1. Ms E says it took the Care Provider too long to refund care fees overpaid following the death of her father, Mr F. Ms E says the Care Provider’s process is unfair and does not meet guidance issued by the Competition and Markets Authority (CMA). Ms E wants the Care Provider to pay interest.

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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 significant enough injustice to the person who complained to justify our involvement.

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

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How I considered this complaint

3. I considered information provided by the complainant.
4. I considered the Ombudsman’s Assessment Code.
5. I considered guidance issued by the Competition & Markets Authority called ‘UK care home providers for older people – advice on consumer law.’

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My assessment

6. After Mr F died the Care Provider took the monthly direct debit for his care fees, so owed money back to Mr F’s estate. The Care Provider told Ms E it could take up to six months to refund.
7. The CMA guidance says refunds after a resident’s death should be timely, and concerns are likely to be raised if refunds take longer than 28 days from the date the provider has identified those who are entitled to receive the refund.
8. After Mr F’s death the Care Provider asked for information and evidence to support where it should make the refund. Ms E provided this information, and the Care Provider issued the refund two months later. Therefore, the Provider gave the refund around a month later than the CMA would expect.
9. Ms E says this caused her time and trouble chasing the matter and says the Care Provider should pay interest. The overpayment was not caused by any fault, there would be the need for some correspondence to resolve the issues, and I do not consider there is evidence of significant unnecessary time and trouble. The amount of interest on the month delay would not be significant enough to justify the Ombudsman’s resource to pursue.
10. The Care Quality Commission (CQC) is the independent regulator of health and social care in England. The CQC has fundamental standards below which a person’s care should never fall. The Care Provider should seek and act on feedback to continually evaluate and improve services, including bodies who provide best practice guidance relevant to the service provided. Ms E has highlighted the CMA guidance to the Care Provider. The refund process taking up to six months is well short of the identified best practice guidance. Its failure in this area may be a breach of the fundamental standard for good governance.

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Final decision

11. We will not investigate Ms E’s complaint because there is not a significant outstanding injustice to justify an investigation. The Care Provider has refunded the money owed, and the amount of interest claimed would not be significant to justify our resource.
12. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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Investigator's decision on behalf of the Ombudsman