Summary: We will not investigate Mrs X’s complaint about the Council’s refusal to refund her for the period her husband did not use the services of his care provider. This is because there is insufficient evidence of fault.

The complaint

1. Mrs X complains about the Council’s refusal to refund her for the period her husband did not use the services of his care provider.

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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’s husband, Mr X, receives care and support services. The Council completed a financial assessment to determine how much Mr X needed to contribute towards the cost of his care and support. The outcome of this assessment was that he needed to contribute over £5500 per year. The Council told Mr X of his assessed charges in 2022.
6. Mrs X says there were some dates where Mr X did not receive care and support services from the care provider. These dates had been agreed with the care provider.
7. At the end of the financial year, the Council completed a reconciliation on Mr X’s account to review whether any refund was due on the account. The Council provided information to Mrs X and her husband about this process and in what situations a refund would be due.
8. The information detailed that for a refund to be due, the support received must cost less than what the service user has been assessed as needing to contribute. Therefore, if the care and support cost more than the maximum Mr X needed to contribute, no refund was due.
9. The Council confirmed the care provider had not charged for the dates Mrs X had highlighted. This therefore reduced the overall cost of the care services provided by the care provider. This meant the cost of Mr X’s care services were less than anticipated. However, the Council noted the cost of care services provided amounted to over £6300.
10. Therefore, an investigation is not justified as we are not likely to find fault. This is because Mr X must pay his assessed contribution up to the maximum. As the actual cost of his care and support services amounted to more than his assessed maximum contribution, no refund is due.

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Final decision

11. 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