Summary: We will not investigate Mr X’s complaint about the increase in charges from his mother’s Care Provider for care costs. There is not enough evidence of fault to justify an investigation.

The complaint

1. Mr X complains about the increases in charges from his mother’s Care Provider for care costs. He says that he is unhappy with the Care Provider’s responses about this.

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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. (Local Government Act 1974, section 24A(6), as amended, section 34(B)).
3. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)

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How I considered this complaint

4. I considered information provided by Mr X and the Care Provider.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. The Ombudsman can consider a contract on ordinary reading and examine how it appears to the reasonable member of the public. The strict interpretation of a contract is for the courts. The Ombudsman cannot say what is a fair cost for care or stipulate how much a Care Provider can charge or increase its fees by.
7. The Care Quality Commission regulates care providers in England. Regulation 19 of the Care Quality Commission (Registration) Regulations 2009 is about fees. This requires providers to give people information about the terms and conditions of their care, treatment or support, including the expected costs and the requirement to pay for their care, treatment and support. Providers must notify people of any changes to their terms and conditions, including increases in fees and give them enough time to consider whether they wish to continue with the service.
8. Mr X says that he is unhappy with the increases in his mother’s care costs. I have reviewed two copies of the terms and conditions provided. Both copies (one from 2020 and another from 2022) confirm the Care Provider can increase prices annually.
9. Both terms and conditions also say the Care Provider can increase prices during the year, with 28 days’ notice being provided. I have reviewed letters addressed to Mr X’s mother dated 25 October 2023 and 20 November 2024 and both give advanced notice of a price increase.
10. There is insufficient evidence of fault regarding the Care Provider notifying Mr X of the increase in care costs. This is because in my view the Care Provider has acted under its contract. If Mr X believes there has been a breach of contract it would be reasonable for him to seek legal advice and pursue the matter in court.

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Final decision

11. We will not investigate Mr X’s complaint because there is insufficient evidence of fault which would warrant an investigation.

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Investigator's decision on behalf of the Ombudsman