Summary: We will not investigate this complaint about a period of intermediate care and a subsequent invoice. There is insufficient evidence of fault to justify us investigating the matter.

The complaint

1. Mrs X complained the Council revoked an agreement her father (Mr Y) would receive three weeks’ free care after moving from hospital into a care home. She complained the Care Provider then overcharged Mr Y, and said the Council failed to investigate the matter properly. Mrs X said the matter caused further distress to her grieving family. She wanted the Council to acknowledge Mr Y was misled and the invoice is disproportionate and incorrect, and waive the charges.

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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 impact 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 or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained.

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

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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.

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My assessment

5. Mr Y moved into a care home on a short-term basis after being discharged from hospital. This was under the Council’s ‘Time to Think’ pathway, which is intermediate care.
6. After a week in the care home, Mr Y decided he wanted to stay as a long-term resident. The Council advised him and Mrs X this would mean the Time to Think funding would come to an end.
7. Mrs X was not happy with this, and when she received an invoice some weeks later, after Mr Y had died, she complained to the Council and then to us.
8. Intermediate care is a programme of care provided for a limited period of time to assist a person to maintain or regain the ability to live independently. Intermediate care is free of charge for up to six weeks, but may end sooner if the person no longer needs it. (Care and Support Statutory Guidance, sections 2.14, 2.61)
9. The Council’s decision Mr X would no longer be entitled to intermediate care once he decided he could not return home is in line with the guidance, and is not fault. At this point, Mr X became a permanent resident at the care home, which meant he was required to pay for his care.
10. The Council provided Mrs X a breakdown of how Mr Y’s charges were calculated. The Care Provider had issued an invoice stating the amount was for ten days, however the chargeable period was instead 12 days. I have checked the Council’s figures, and there is insufficient evidence of fault in this respect. The amount is consistent with 12 days’ charges.
11. Mrs X says the Council misled Mr Y as it said he would receive three weeks’ care free of charge. It is not proportionate for us to consider this further. This is because, even if we decided the Council did not communicate clearly, this did not cause Mr Y injustice. It is likely Mr Y would have decided to move into the care home in any event, because he did not feel able to manage at home. After one week of care, he was satisfied he required long-term care. Mr Y would have been required to pay for his care from that point in any event.
12. It does not therefore follow that a waiver of fees would be appropriate in response to any fault in the clarity of the Council’s initial communication. It is not proportionate to investigate this matter further.

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Final decision

13. We will not investigate Mrs X’s complaint because there is insufficient evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman