Summary: We will not investigate this complaint about charging for adult social care because there is not enough evidence of fault by the Council.

The complaint

1. Mr D says Ms E should not have to pay for her adult social care support after hospital, because it should have been free for up to six weeks. Mr D wants the Council to cancel the invoice.

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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
• any fault has not caused significant enough injustice to the person who complained to justify our involvement, 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. Intermediate care is a free short-term service. The person will agree their goals and how to achieve them and care staff will help the person practice doing things on their own. The service is available for up to six weeks, for those assessed as needing it. The Council, and health professionals involved with Ms E’s discharge from hospital, did not assess that Ms E would benefit from this service due to her confusion and inability to do things for herself. The Ombudsman cannot question or criticise this decision which was based on a properly completed face to face assessment with Ms E.
7. The Council assessed Ms E’s care and support needs, with Mr D’s input, and decided she needed a package of care support at home.
8. Under the Care Act 2014, when the Council is responsible to meet a person’s adult social care needs, it must also assess what if anything they can pay toward that care support.
9. The Council told Mr D the care would be chargeable, and it would complete a financial assessment to decide what Ms E had to pay. Although the standard written information given to Mr D covered intermediate care, nobody ever said this was what Ms E was receiving. All the Council’s information to Mr D explained the care was chargeable. If Mr D was unsure, he could have asked the Council to clarify.
10. There is no fault in the Council charging for care it assessed Ms E needed and which she received. The Council told Mr D before the care started that it would be a chargeable service and sent him the financial assessment forms, and he did not query this. Although Mr D did not know the exact costs, he accepted the service on that basis. There is not a significant enough injustice caused by delayed billing to justify an Ombudsman investigation.
11. The Council did not answer Mr D’s query about why Ms E did not qualify for intermediate care. But we will not consider complaint handling as a standalone issue, and it does not cause a significant enough injustice to justify an investigation.

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Final decision

12. We will not investigate Mr D’s complaint because there is not enough evidence of fault in the Council charging for care. Not all care after hospital discharge is free for six weeks, only if assessed as eligible, which did not happen in Ms E’s case.

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Investigator's decision on behalf of the Ombudsman