Summary: We will not investigate this complaint about the Care Provider’s miscalculation of Mrs Y’s care charges and its subsequent contact several months later to pursue outstanding charges. The Care Provider has agreed to take suitable action to remedy the inconvenience, frustration and uncertainty the matter caused three of Mrs Y's children.

The complaint

1. Mr X complained about the care his mother (Mrs Y) received in a care home and the Care Provider's inconsistencies with calculating the fees owed after she had left its care. He said it issued a demand for nearly £15,000 shortly after Mrs Y's death, without explanation, after having previously said the account was settled. Mr X said the provider harassed the family for payment but continued to provide inconsistent figures.
2. Mr X said the matter has delayed the family's ability to grieve and caused significant distress. He wants the Care Provider to take responsibility for its accounting mistakes.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

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

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My assessment

Quality of care

7. Part of Mr X’s complaint is about the quality of care Mrs Y received while in the care home. The law says people must bring complaints to us within 12 months of becoming aware of the matter, unless there are good reasons.
8. The issues Mr X raises relate to a period between 2021 and 2023, and ended more than 12 months before Mr X brought his complaint to the Ombudsman. He was raising those issues with the Care Provider at the time and did not escalate those matters until the later issue relating to charges became evident.
9. There is not a good reason for us to consider the complaints about quality of care now, as Mr X could have brought those matters to us sooner.

Charges for care

10. If we were to investigate this complaint, it is likely we would find fault causing significant injustice to Mr X and two of his siblings.
11. The Care Provider duplicated two payments when it initially calculated the balance for Mrs Y’s care charges. This meant it wrongly told the family it owed Mrs Y a refund at the end of her stay. It issued this refund and the family believed the account was settled.
12. The Care Provider then identified its mistake several months later, after Mrs Y had died. When the Care Provider recalculated the balance, it found there was a debt due from Mrs Y’s estate. The Care Provider and Mrs Y’s children discussed the calculations and further changes were made to the amount the Care Provider considered outstanding. The Care Provider apologised for its mistake.
13. When we consider how an organisation should remedy injustice caused to a complainant, we consider what would have happened but for any fault in its actions. I have not found any evidence of fault that is of detriment to Mrs Y’s estate, in terms of how the Care Provider came to its more recent figures. The fault did not cause a quantifiable financial impact to Mrs Y. The fault in this case instead meant Mrs Y was actually charged significantly less for her care.
14. It is not the Ombudsman’s role to make recommendations that are of benefit to a complainant, and where care charges are rightly owed we would not ask that they are waived. The Care Provider is entitled to pursue the outstanding debt, should this be necessary.
15. The fault in this case caused inconvenience, frustration and uncertainty for
    Mrs Y’s children. This was substantively to three of her children, who took on the bulk of the actions in relation to discussing the matter further with the Care Provider.

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Agreed action

16. I invited the Care Provider to make a symbolic payment to the three children who were particularly affected, to recognise the impact the matter has had on them. To its credit, the Care Provider has agreed to pay them £150 each within a month of my decision. This is in line with the Ombudsman’s Guidance on Remedies (3.7, Symbolic Payments).
17. I am satisfied this is a suitable remedy for the impact of the fault in the Care Provider’s actions in this case. It would therefore not be proportionate for us to investigate the matter further, having regard to any remaining injustice from the alleged fault.

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Final decision

18. We will not investigate Mr X’s complaint because the Care Provider has agreed to take suitable action to remedy the impact of its actions on three of Mrs Y’s children.

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Investigator's decision on behalf of the Ombudsman