Summary: We will not investigate Mrs X’s complaint about being charged for care which she believes should have been free as she was told it was reablement care. This is because there is insufficient evidence of fault.

The complaint

1. Mrs X complains about being charged for care which she believes should have been free as she was told it was reablement care.

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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 an investigation if we decide there is not enough evidence of fault to justify investigating. (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 and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. Mrs X was in hospital following a medical event. She says that she was told she would receive short term intensive therapy upon discharge which would be free of charge.
6. Councils must not charge for certain types of care and support, including reablement care. This can be provided free of charge for up to six weeks. However, reablement care is not guaranteed as this care will not always be appropriate.
7. The hospital care team referred Mrs X to the Council with a request for a package of care to support with personal care, meals, and medication. The package of care was for four calls a day. There is no reference to reablement care within the referral document or any reference that the care and support would be provided by the Council’s rapid response team. Services provided by the rapid response team is free.
8. The Council met with Mrs X and her family before discharge. During this meeting, it was recorded the details of the package of care was discussed, as well as the weekly cost of the care package being just under £300 a week. A discussion was also noted that Mrs X was anxious about the cost of care, but that Mrs X’s daughter had reassured Mrs X it would not be a problem.
9. It was also recorded that the officer had advised Mrs X and her family that because she owned a second property, the value of the property would be treated as capital and so Mrs X would be responsible for paying the full cost of her care package.
10. An investigation is not justified because we are not likely to find fault. This is because the evidence shows the Council had made Mrs X aware that the care package arranged for her would be chargeable and that she was responsible for the full cost of the care package. The Council also told Mrs X about the full cost of the care package before it started. There is no evidence the Council had advised Mrs X the care package would be free.
11. It appears it was the hospital team that may have told Mrs X the care package would be provided free of charge. It is open to Mrs X to raise a complaint with the relevant integrated care board and then make a complaint to the Parliamentary and Health Service Ombudsman.

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Final decision

12. We will not investigate Mrs X’s complaint because there is insufficient evidence of fault.

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Investigator's decision on behalf of the Ombudsman