Summary: We will not investigate this complaint about the Council’s handling of care arrangements because there is not enough evidence of fault by the Council to warrant it, nor of the Council causing significant enough injustice to meet the tests in our Assessment Code, and we could not achieve a significantly different result so long after the original events.

The complaint

1. Mrs G complains when the Council had to arrange and manage the care of her father, Mr H, after he left hospital in December 2020 until he died in March 2023, it failed properly to:
1. assess and charge him for care or to resolve a dispute about the charges;
2. provide his family with affordable care options which did not require them to pay a top-up from February 2021;
3. provide information about social care charging;
4. review Mr H’s needs regularly or carry out an assessment in person;
5. address the family’s safeguarding concerns; and
6. since March 2023 to recognise and respond to their complaints about these matters.

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 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)

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. Mr H was ready for discharge from hospital in December 2020, so what happened was subject to special arrangements the government made during the Covid-19 pandemic to give priority to releasing hospital beds over the choices people and their families might normally have had about social care. Mr H moved to the first available care home, which was paid for under the Covid arrangements for six weeks. We would not criticise the Council for this decision under the exceptional circumstances which applied at the time.
6. By February 2021 the Council was clear Mr H had enough money to pay for his own care once his family could get a court deputyship to use his money to do so. The Council says its records show on more than one occasion his family wished him to stay at the same care home. The Council therefore continued to pay most of the cost of Mr H’s care and his family made top-up payments (which is what would have happened in the longer term if Mr H had not had his own money). I recognise it has taken time to resolve some discrepancies but I understand from the overall figures I have seen that has now happened. Investigating the point further could not achieve more.
7. The Council’s responses to the complaint and its timeline of events show it provided and discussed with Mr H’s family information and advice about the funding and charging position, so there is no reason to investigate this part of the complaint. This long after the original events it would not be possible to resolve areas of dispute about precisely what happened, so this part of the complaint does not meet the tests in our Assessment Code to warrant investigation.
8. In part d) of the complaint the information we have seen is clear Mrs G and her family strongly believed Mr H should have been entitled to Continuing Health Care (CHC) funding from the NHS, but the Council’s and Care Provider’s information shows he was not receiving any nursing care. On balance of probability we could not therefore say the Council had failed to review Mr H’s needs or refer Mr H for CHC funding. In any event, it was open to Mrs G to approach the relevant NHS body if she believed otherwise. We will not therefore investigate this.
9. Mrs G’s safeguarding concerns about Mr H appear to have been related to whether he was receiving adequate care, most likely informed by her belief about CHC funding and the type of care he needed rather than any neglect of his care by the Care Provider. I note the family appear to have wanted Mr H to remain at the same care home, so on balance I can only conclude they were satisfied with the standard of care he received. Nor have I seen any evidence to suggest Mr H suffered harm as a result of the care he was receiving. There is therefore no basis for us to investigate safeguarding matters now.
10. The Council has accepted it failed to pass Mrs G’s complaint for a second response in January 2024 because of a clerical mistake. It has offered Mrs G a payment of £150 to recognise the frustration caused by the delay until it provided a second response in August 2024. If we were to investigate it is unlikely we would seek a higher remedy. Although we will not therefore investigate, the Council may wish to consider whether its procedures comply with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. These say there should be an investigation of any Adult Social Care complaint the Council cannot resolve immediately, and a single response to the complaint which also signposts people to the Ombudsman if they remain unhappy, not to a further stage of the council’s procedures.

Back to top

Final decision

11. We will not investigate Mrs G’s complaint because there is not enough evidence of fault by the Council to warrant it, nor of the Council causing Mr H significant enough injustice to meet the tests in our Assessment Code, and we could not achieve a significantly different result now.

Back to top

Investigator's decision on behalf of the Ombudsman