Summary: Ms X complained the Care Provider failed to deduct funded nursing care payments from the cost of her relative Ms Y’s care since 2019. The complaint is late as it was not made to us within 12 months of Ms X or Ms Y becoming aware of the issue. And there is no good reason for the lateness. So we ended the investigation.

The complaint

1. Ms X complained for Ms Y the Care Provider failed to deduct FNC (funding nursing care) payments from the cost of care between August 2019 and March 2024. She said this caused avoidable confusion, time and trouble and a financial loss.

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The Ombudsman’s role and powers

2. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
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 care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)
4. It is our decision whether to start, and when to end an investigation into something the law allows us to investigate. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended)

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How I considered this complaint

5. I considered evidence provided by Ms X as well as relevant law, policy and guidance.
6. Ms X and the Care Provider had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

7. Ms Y’s care home was run by a different provider when the contract was signed in 2019.
8. Ms X is Ms Y’s representative for financial affairs. Ms X complained to us in January 2025. Ms Y has signed a form of authority for the LGSCO which gives permission for Ms X to represent her. Ms X told us Ms Y had no cognitive impairments. In line with the principles of the Mental Capacity Act 2005, we have no reason to question Ms Y’s mental capacity around decision-making in relation to financial and complaint matters.
9. Ms X told us matters came to her attention in 2022 when she looked at the contract for Ms Y’s care and she then sought advice from a solicitor. Ms X said she tried to resolve the dispute with the Care Provider until it dealt with her concerns as a complaint in 2024.
10. There is a new contract in place from 2024 which says the Care Provider will deduct FNC payments from the overall fee. Ms X told us she had no issues with the 2024 contract.
11. Ms X provided a copy of the original 2019 contract. She has had this in her possession since 2019 and as Ms Y’s representative for financial affairs, she has been receiving and paying invoices for Ms Y’s care since 2019. Her date of awareness of the matters she is raising is therefore 2019, when the original contract was issued and when invoicing began. This complaint is late with no reason for the delay in complaining to us.
12. Even if we accept the later date of 2022 as Ms X’s date of awareness, the complaint is still late because Ms X did not complain to us until the start of 2025.

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Decision

13. We ended the investigation because Ms X’s complaint has not been made to us within 12 months of her becoming aware of it and there is no appropriate reason for the delay.

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Investigator's decision on behalf of the Ombudsman