Summary: We will not investigate this complaint about the Council failing to provide a refund of a particular amount for care costs. This is because there is insufficient evidence of fault that a refund of this amount was actually owed.

The complaint

1. The complainant (Mr X) complains in relation to his late mother’s (Ms Z) care costs which were part funded by the Council. In particular, Mr X says he received an invoice from the Council which showed Ms Z had overpaid the amount she was required to contribute towards the cost of her care. He explains the invoice was sent to him as the executor of his Ms Z’s estate and this showed the Council owed a refund to the estate of around £13,000.
2. However, Mr X says the Council later amended the invoice in response to his requests for payment and reduced the amount of the refund to around £700. In summary, he says this has been very traumatic for him due to having to deal with the Council over this issue and not getting an adequate response. As a desired outcome, Mr X wants the Council to comply with the invoice showing a larger refund entitlement and make settlement of this.

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The Ombudsman’s role and powers

3. 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 per-son 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.
• any injustice is not significant enough to justify our involvement.
• we cannot achieve the outcome someone wants.

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

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How I considered this complaint

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

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My assessment

5. In its final complaint response to Mr X, the Council explained to him why the first invoice issued was inaccurate and gave reasons why the credit of the first amount shown was not actually due. In particular, the Council says it carried out a financial assessment in late 2018 under the Care Act 2014 to determine Ms Z’s level of contribution towards her care. The Council says it did not receive information it had requested from Ms Z which it needed for this purpose. The Council therefore based its assessment on Ms Z needing to pay for the full cost of her care for a period of 9 months.
6. This had the effect of creating a debit balance for Ms Z’s account. When the Council later received the information it had requested however, it reassessed Ms Z’s contribution level in late 2023 and determined this to be around £50 per week for the same 9 month period referred to earlier. This reassessment resulted in a credit balance of approximately £13,000 and this led to an invoice being posted which led to expectations being created that the credit amount would be refunded.
7. However, as the Council has explained, this credit balance had not been offset against the earlier debit balance. Once this happened, the credit amount was reduced to approximately £700. I have not found any evidence of fault in relation to the Council’s explanation provided to Mr X. That said, the Council has apologised to Mr X because the invoice showing the credit should not have been posted until the 2018 assessment had been reconciled against the 2023 reassessment. This was fault by the Council, but given a refund of £13,000 was not actually owed, I do not consider Mr X suffered a significant enough injustice to warrant investigation of the issue.
8. I recognise Mr X points to fault by the Council in its handling of his complaint. However, where we decide there is no basis to investigate the substantive issues being raised, we do not normally consider it to be a good use of public money to investigate complaints about the complaints process. As there is no evidence to suggest the Council’s adjusted invoice to Mr X is flawed, I do not consider it proportionate to investigate his concerns about a delay by the Council in responding to him. In addition, we are unable to achieve Mr X’s desired outcome to this complaint. We cannot recommend the Council refund him an amount when there is insufficient evidence to show the amount is actually owed.

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Final decision

9. We will not investigate this complaint. This is because the restriction I outline at paragraph three (above) applies.

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Investigator's decision on behalf of the Ombudsman