Summary: We will not investigate this complaint about the Council’s handling of adult social care charges because there is insufficient evidence of fault to justify our involvement.

The complaint

1. Ms X complained about the Council’s handling of adult social care charges for her relative, Ms Y, who was living in a care home until her death. Ms X says:
• Ms Y should not have been charged for her care home stay as she should have been receiving NHS Continuing Healthcare funding;
• The Council should not have allowed a third party to use Ms Y’s bank card to pay her care home fees.
• The Council was wrong to pursue Ms X for outstanding care costs after Ms Y died because Ms X is not legally responsible for Ms Y’s care costs.
2. Ms X said she felt harassed by the Council and the fear and anxiety this caused led to sleepless nights.

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The Ombudsman’s role and powers

3. 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.

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

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How I considered this complaint

4. I considered information provided by Ms X and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

What happened

6. Ms Y went into a care home in 2020. Initially, this was funded by the health body as part of COVID-19 arrangements. NHS Continuing Healthcare (NHS CHC) was refused later in 2020, but Funded Nursing Care (FNC) payments were agreed.
7. Ms Y’s contribution to her care costs were paid online until October 2021. In her complaint, Ms X said these were paid by a neighbour using Ms Y’s bank card. In its response, the Council said it could not know who was making the payments.
8. In March 2022, Ms X asked the Council to send information about her aunt’s care costs to her as she was applying to the Court of Protection to become a deputy for her relative.
9. Ms Y died in late 2022 and the Council contacted Ms X about the outstanding care costs. In her complaint Ms X said the Council should have contacted another relative, Mr Z, who was named as executor in Ms Y’s will. In its response, the Council said it did not know who was named as executor and would not have contacted Mr Z because it was aware he did not have mental capacity to act as executor and that Ms Y had a Lasting Power of Attorney for him. Further, Ms X had told it she was administering Ms Y’s estate.
10. Also in her complaint, Ms X said Ms Y was paying rent and household expenses at the same time as paying towards the care home costs between 2020 and early 2022. Although it said it had not been told this before, the Council reassessed the contribution Ms Y was required to pay to reflect those costs, which reduced the outstanding amount. It explained how it had calculated this.
11. The Council explained that, as the person administering Ms Y’s estate, it was Ms X’s responsibility to pay Ms Y’s creditors or to provide them with evidence there were no funds available after paying for Ms Y’s funeral.

My assessment

12. Ms X complained the Council should not have asked Ms Y to pay towards the cost of her care because it should have been funded by NHS CHC funding. The Council have provided evidence that NHS CHC funding was not agreed. If either of the care homes where Ms Y lived considered she met the criteria for that funding, they could have asked for a review or a reassessment.
13. Since Ms Y did not meet the criteria for health funding, the Council was entitled to ask her to pay an assessed contribution towards the cost of her adult social care. Ms X has not provided any evidence to indicate any fault in the way the Council calculated that contribution, which it has adjusted to reflect rent and housing-related costs Ms X told it about when she complained.
14. The Council is entitled to recover outstanding care costs from the estate of a person who has died and has explained why it is writing to Ms X about this.
15. We will not consider this complaint further because there is insufficient evidence of fault to justify our involvement.

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Final decision

16. We will not investigate Ms X’s complaint because there is insufficient evidence of fault to justify our involvement.

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Investigator's decision on behalf of the Ombudsman