Summary: We will not investigate Mrs X’s complaint about Council’s proposal to move her mother, Mrs Y, to another residential care home placement. It is unlikely we would find enough evidence of fault with the Council’s actions to warrant us investigating further. Other bodies are also better placed to make decisions about whether Mrs Y needs nursing care and what action is in her best interests.

The complaint

1. Mrs X complains about the Council’s proposal to move her mother, Mrs Y, to another residential care home placement. Mrs X believes the Council’s alternative to charge a top-up fee of £600 a week so Mrs Y can remain at her placement is unreasonable. Mrs X believes the Council is making decisions about her mother’s placement solely on costs rather than what is in her best interests. She does not agree it is fair to charge Mrs Y a substantial weekly top-up fee to remain at a residential placement that best meets her needs.

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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 cannot achieve the outcome someone wants, or
• there is another body better placed to consider this complaint, or
• there is no worthwhile outcome achievable by our investigation. (Local Government Act 1974, section 24A(6), as amended, section 34(B))

3. We may investigate a complaint on behalf of someone who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable. (Local Government Act 1974, section 26A(2), as amended)

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How I considered this complaint

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

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My assessment

5. The Council has responded to the parts of Mrs X’s complaints summarised in paragraph 1 above. It believes Mrs Y does not need the high-level complex nursing care her current residential placement provides and considers her low-level dementia needs could be met elsewhere. The Council has offered to allow Mrs Y to remain at her current placement if she or her representative(s) pay a top-up fee of £600 per week. At the time of Mrs X’s complaint to us, the Council confirmed it would be completing a best interests assessment for Mrs Y to determine whether a move to another care home would be appropriate. The Council also advised Mrs X it would involve her in this assessment as Mrs Y’s attorney.
6. If there is a disagreement about whether a decision is in someone’s best interests, the person affected or their representative can go to the Court of Protection to settle the disagreement. We have no jurisdiction to intervene in such decisions. Because of this it would not be appropriate for us to investigate this part of Mrs X’s complaint.
7. Mrs X believes her mother needs nursing care and the Council disagrees. I understand Mrs X has asked the NHS directly for a Continuing Healthcare (CHC) assessment to decide whether Mrs Y has nursing needs which the NHS should fund. Mrs X would then have the right to challenge the result of the CHC assessment with the NHS. We have no powers to investigate or intervene in any decisions made by the NHS.

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Final decision

8. We will not investigate Mrs X’s complaint because there are other agencies better placed to consider her concerns about what is in her mother’s best interests and her needs.

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Investigator's decision on behalf of the Ombudsman