Summary: We will not investigate this complaint about financial assessment for residential care fees. There is not enough evidence of fault by the Council. It reached its decision based on a financial assessment, which it reconsidered based on information from the complainant. There is no reason for the Ombudsman to question or criticise the Council’s decision, even though the complainant disagrees. It is unlikely we would add to the Councils investigation or reach a different outcome.

The complaint

1. Mr D says the Council has got the financial assessment wrong for his relative, Ms E. Mr D says this has caused him a lot of stress and had a financial impact on Ms E.

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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))

3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)

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How I considered this complaint

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

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My assessment

6. Ms E was arranging and paying privately for residential care in a care home. When a persons’ capital drops below the upper threshold (currently £23,250) they can ask their local authority to help with funding their care.
7. Mr D says the Council has got the calculation wrong as to when Ms E’s capital dropped below the threshold. The Council says it has reviewed the dates Ms E paid her care fees and this does not alter its calculation as to the date Ms E fell below the upper capital threshold and was eligible for support with her funding.
8. The Ombudsman is not an appeal body. We cannot challenge the Council’s decision unless there is fault in its decision making. In this case, I am satisfied the Council has investigated and taken the right steps in considering relevant information and evidence. I understand Mr D disagrees. However, this is not evidence of fault in the Council’s decision or the way it has investigated.

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Final decision

9. We will not investigate Mr D’s complaint because there is not enough evidence of fault by the Council. It reached its decision based on a financial assessment, and considered the information Mr D gave to challenge the assessment. Relevant professionals made the decision based on the evidence. It is unlikely we would add to the Council’s investigation or reach a different outcome.

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Investigator's decision on behalf of the Ombudsman