Summary: We will not investigate Ms X’s complaint that the Council told her that her father’s care would be free. There is not enough evidence of fault to justify an investigation.

The complaint

1. Ms X complains that the Council told the family that her father, Mr Z’s, care would be free after his Continuing Health Care (CHC) payments ended. She says the Council did not advise them correctly for around three months.
2. Ms X says that because she was told Mr Z’s care would be free, she did not appeal the ending of the CHC payments.
3. She wants the fees for the period when they thought his care would be free to be waived.

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The Ombudsman’s role and powers

4. 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))

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How I considered this complaint

5. I considered information provided by the complainant.
6. I considered the Ombudsman’s Assessment Code.

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My assessment

7. Mr Z, who is in a care home, used to receive CHC payments. This meant all his health and social care costs were paid for by the NHS.
8. In June 2024 the NHS assessed Mr Z and decided to end his CHC payments. It informed the Council in July.
9. The same month, the Council emailed Ms X and provided her with details of potential residential care costs.
10. Ms X disputes this and says the Council did not inform the family until October. She therefore wants it to waive Mr Z’s fees for the three month’s from July when Mr Z’s CHC payments ended to October 2024.
11. The Council has provided evidence that it emailed the family at the beginning of July with details of paying for residential care. Therefore, there is not enough evidence of fault to investigate.
12. But even if we had found fault, we would not recommend the Council waive the fees for that period. Mr Z received the care and so it is appropriate that he should contribute the amount his financial assessment says he can afford.
13. Ms X says if she had known earlier that Mr X would have to pay for his care, she would have appealed the CHC decision. Appeals should be made within 6 months, although it is possible to make a late appeal if there are good grounds. Therefore, putting aside the disagreement over when precisely the family was informed of potential care fees, she would still have been in time to appeal.

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Final decision

14. We will not investigate Ms X’s complaint because there is not enough evidence of fault to justify an investigation.

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Investigator's decision on behalf of the Ombudsman