Summary: We will not investigate this complaint about charging for adult social care. Although it is worrying for the complainant, there is not enough evidence of fault by the Council to justify an Ombudsman investigation.

The complaint

1. Ms B says the Council’s financial assessment for Ms C’s contribution to adult social care fees is wrong, because Ms C does not have enough money to pay.

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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
• 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 and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Ms C has lived in a residential care home for many years, Ms B is responsible to manage Ms C’s finances. When Ms C’s finances dropped below the upper capital threshold, currently £23,250, Ms B approached the Council for support with Ms C’s care.
7. The Council became responsible to meet Ms C’s adult social care needs. The Council then must complete a financial assessment to decide what, if anything, Ms C can pay toward her care support. The Council must review this each year or when circumstances change. The Council has done this, but Ms B has questioned the outcome because Ms C does not have enough money to pay her contribution.
8. The Council has explained to Ms B many times over the last few years that Ms C’s money must be spent on her care fees. But despite this, money has been taken from Ms C’s account to pay for other items or to gift to family members. The Council has asked Ms B for further information and evidence of this spending; it has decided these payments are a deprivation of Ms C’s capital. Under the relevant charging rules (law and guidance set by government) the Council treats Ms C as if she still has the money that has been taken from her account (notional capital). In short, the public purse will not pay for care which the person could pay for if they had not given money away.
9. The Council has also given Ms B advice on maximising Ms C’s income and drafted a letter for her to send to the pension credit service. However, it appears Ms C is not receiving what she is entitled to, which also affects her ability to pay her care fees. The Council has given Ms B consistent advice about this over the last few years.

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Final decision

10. We will not investigate Ms B’s complaint. I appreciate it is worrying for Ms B regarding how to pay the debt for care fees, but there is not enough evidence of fault by the Council to justify an Ombudsman investigation. The Council has properly completed a financial assessment in line with law and guidance and kept this under review. The Council has explained its decision about deprivation of assets and including notional capital in Ms C’s financial assessment. And the Council has given Ms B advice about how to maximise Ms C’s income.

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Investigator's decision on behalf of the Ombudsman