Summary: We will not investigate this complaint about charging for adult social care. The Council followed the correct process to assess needs and ability to pay, explain about charging for care, and charge for care it arranged. It is unlikely an Ombudsman investigation would find evidence of fault or lead to a different outcome.

The complaint

1. Ms B says the Council is charging for care which it did not provide to her relative, Mr C. Ms B says the Council is sending invoices for care she thought the NHS was paying for. This is causing distress and uncertainty for the family.

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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))

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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. The Council is charging for care which it arranged following its assessment of the care Mr C needed. The Council’s records show it explained to Ms B about charging for care and sent a letter to Mr C, care of his wife, about financial assessment and how much he would pay. There is no fault in the Council asking for payment and sending invoices for care it has arranged and provided, and which it assessed Mr C needed and could pay toward. The Council has followed the correct process under the Care Act 2014 and its own policies.
6. However, the NHS was supposed to then assess whether it should be meeting Mr C’s needs under the Continuing Healthcare process. This assessment did not take place because of events with Mr C’s health. The Council has asked the NHS to assess Mr C now. If the NHS finds Mr C is eligible it may backdate funding for the period Ms B disputes. Meanwhile, there is no fault in the Council asking for payment for that period.

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Final decision

7. We will not investigate Ms B’s complaint because there is not enough evidence of fault by the Council. It is unlikely an Ombudsman investigation would achieve a different outcome.

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Investigator's decision on behalf of the Ombudsman