Summary: We will not investigate this complaint about an adult social care package and the associated costs. There is not enough evidence of fault in how the Council assessed the care and support needs and decided the necessary care package. The complainant did not know the cost of the package until after it started. The complainant accepted the care knowing they might have to pay for it; the Council confirmed the cost three weeks later, so there is no significant injustice to justify an investigation. It is unlikely the Ombudsman would add to the Council’s investigation or reach a different outcome.

The complaint

1. Ms B says the costs for Mr C’s adult social care package are excessive because the package of care was greater than it needed to be. Ms B says they could not make an informed decision about these costs because the Council did not say before the package started how much it would cost. Ms B says the Council later told them they might buy cheaper directly with a provider. Ms B was shocked when she received the invoice. It has caused stress, impacted on health, and caused financial strain.

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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 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.

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

3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)

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How I considered this complaint

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

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My assessment

6. The Council’s duty under the Care Act 2014 is to assess the care and support needs of adults in its area who it knows may need support. If the Council assesses the person has eligible needs, then it must meet those needs. The Council must complete a financial assessment to decide if the person must pay any or all the care costs. There are no timescales set out for the completion of the care and support assessment or the financial assessment.
7. The Council completed the assessment of Mr C’s needs involving Mr C, his family, and relevant medical professionals involved in his care. Although Ms B says the care package was excessive, the Ombudsman cannot criticise the Council’s decision on how to meet Mr C’s needs as it followed a proper assessment process to reach its decision.
8. The Ombudsman expects, based on the wording of the statutory guidance supporting the Care Act, that councils complete financial assessments before care services start. This would enable people to know how much they must pay, if anything, before the care starts. However, in practice this rarely happens.
9. Councils have a duty to provide information about the charging arrangements for care and support. The Council told Ms B in writing before the care package started that care and support was chargeable and a financial assessment would decide how much Mr C would pay. The Council says it verbally told Ms B if Mr C had savings over the upper capital limit, then he would be responsible for the full costs of his care. So, although Ms B did not know the costs when the care package started, Ms B accepted the care package on that basis knowing Mr C may need to pay some or all the costs.
10. There was no excessive delay by the Council in completing the financial assessment, it completed it and wrote to Ms B with the outcome three weeks after the care package started. At this point the Council said Mr C may be able to buy his care cheaper by arranging it privately. Ms B says the Council should have told her this sooner. The Council would not have known Mr C was a self-funder until the outcome of the financial assessment. There is no specific requirement to tell Mr C this information sooner, so we do not find fault by the Council. The Council has apologised to Ms B for distress caused by its actions.

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Final decision

11. We will not investigate Ms B’s complaint because although she did not know the cost of care before it started, the family accepted the care package on that basis, knowing they may have to pay in full after the financial assessment was complete. Within three weeks the Council confirmed the position and sent an invoice. Mr C needed care and would always have had to pay for it, so there is not a significant enough injustice to justify an investigation. It is unlikely an Ombudsman investigation would add to the Council’s investigation, which gives a thorough explanation of what happened, or reach a different outcome.

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Investigator's decision on behalf of the Ombudsman