Summary: We will not investigate this complaint about adult social care charges. The Council assessed the person needed residential care, which they received, and which the Council assessed the person could pay for. An Ombudsman investigation would be unlikely to reach a different outcome or achieve the outcome the complainant wants of a refund of care charges.

The complaint

1. Mr D says the Council placed Ms E in a care home without consulting family or next of kin. The Council demanded payment of the care fees after Ms E’s death but have not provided supporting evidence. Mr D wants the Council to refund the care fees and discipline a member of staff for rude correspondence.

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The Ombudsman’s role and powers

2. We may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

3. Mr D is an executor of Ms E’s estate, so is a personal representative and suitable to raise the complaint.
4. 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:

• any fault has not caused significant enough injustice to the person who complained to justify our involvement, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome, or
• we cannot achieve the outcome someone wants, or
• there is no worthwhile outcome achievable by our investigation.

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

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How I considered this complaint

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

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My assessment

7. Councils have a duty under the Care Act 2014 to assess the needs of adults in its area who may need care and support. Where a council decides it must meet a person’s social care needs it must assess what, if anything, the person must pay toward that care support.
8. The Council assessed Ms E needed residential care and placed her in a care home. Following a best interest decision process under the Mental Capacity Act because Ms E could not make her own decisions about her care. The Council assessed Ms E could pay the full cost. The Council was in correspondence with a firm of solicitors acting for Ms E in her lifetime, but the care charges were not paid. After Ms E died the Council contacted the executors of her estate about the debt.
9. Mr D says the Council did not involve Ms E’s family when it decided she should move to residential care. The Ombudsman could not say the outcome would be any different. The Council assessed Ms E needed residential care to meet her needs, and it is not disputed that she received that care and is responsible to pay for the care she received.
10. Mr D says the Council did not explore NHS funding. If Mr D thinks Ms E might have been eligible, he can make a retrospective application to the NHS for Continuing Healthcare funding.
11. We do not investigate all complaints we receive. In deciding whether to investigate we need to consider various tests. These include the alleged injustice to the person complaining. We only investigate the most serious complaints.
12. Mr D says the Council has not dealt with the executors in a fair manner. I do not consider that causes significant enough injustice to justify an Ombudsman investigation. The role of the executors is to deal with creditors, which will involve some time and trouble finding out facts of the debt.
13. The Council accepted one of its letters to Mr D was not appropriate in tone and has spoken with the relevant staff member.
14. We cannot achieve the outcomes Mr D wants. We have no powers to recommend disciplinary actions against individual staff members, this is a matter between employer and employee. It is unlikely we would recommend a refund of the care charges. It is accepted Ms E received the care and the Council’s financial assessment confirmed what she could pay.

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Final decision

15. We will not investigate Mr D’s complaint because further investigation would not lead to a different outcome. We cannot recommend the Council waive care charges which was needed and received, and the person was assessed as able to pay.

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Investigator's decision on behalf of the Ombudsman