Summary: We will not investigate Ms X’s complaint about the Council’s handling of her late mother’s care home fees because there is insufficient evidence of fault to justify our involvement.

The complaint

1. Ms X complained the Council transferred funds from her mother’s deferred payment account to her care home in 2021 without Ms X’s consent. Ms X says this was an illegal act.

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The Ombudsman’s role and powers

2. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
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:

• there is not enough evidence of fault to justify investigating, or
• any injustice is not significant enough to justify our involvement, 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

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

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My assessment

7. We usually expect people to complain to us within 12 months of the events complained about, unless there are good reasons for the delay. Ms X complained to us in December 2024 about events in 2021 and told us she had notice of the issue complained about by October 2023. On that basis, although the complaint was late, it was not significantly late, and I noted she was pursuing the Council to resolve the matter during 2024. Therefore, I decided there were good reasons to consider her complaint.

What happened

8. Mrs Y, who is Ms X’s mother moved to a care home. The Council assessed Mrs Y as needing to pay a contribution to the cost of her care. She also paid a top-up fee to the care home, because the care fees were more than the personal budget the Council had calculated for her care.
9. In 2021 the Council carried out a fresh financial assessment. Due to changes in Mrs Y’s financial circumstances, which meant she was assessed as having to pay the full cost of her care from 9 March 2020, the Council changed its payment method. It made a back-dated payment to the care home for the difference between the two payment methods for the period 9 March 2020 to 31 August 2021. It asked the care home to refund any overpayments from 9 March onwards and spoke to it to confirm it would do so. It wrote to Ms X to explain the change and also spoke to her about it in June and again in July 2021. Ms X confirmed the care home were arranging a refund. Ms X also asked about a deferred payment arrangement, which was subsequently set up.
10. In 2023, after Mrs Y died, Ms X raised concerns about the outstanding care fees. The Council investigated and identified the care home had not, in fact, refunded £10,203 that Mrs Y had paid to it directly for the period from 9 March 2020. This meant the care home had been paid that amount twice. The Council recovered that sum from the care home and credited it to Mrs Y’s deferred payment account. In its complaint response, it confirmed there had been no illegal transfer of assets to the care home and that, in any case, the overpayment had been recovered.
11. In response to my enquiries, the Council confirmed Mrs Y had not been charged any additional interest as a result of the overpayment to the care home, because this was calculated based on the full cost of care, less the assessed contribution.

My assessment

12. The Council changed its payment method in response to changes in Mrs Y’s circumstances in 2020 that it did not become aware of until the financial assessment in 2021. It wrote to Ms X about the change and also spoke to her. Ms X told it the care home was arranging to refund the overpayment and the care home confirmed it was doing so. We will not consider this complaint further because there is insufficient evidence of fault to justify our involvement.

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Final decision

13. We will not investigate this complaint because there is insufficient evidence of fault to justify our involvement.

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Investigator's decision on behalf of the Ombudsman