Summary: We will not investigate this complaint about a care home commissioned by the Council charging additional fees to Mrs X. This is because the complaint is late and there are no good reasons to exercise discretion to investigate it. We also will not investigate the complaint about the Council not informing Mrs X’s family that she may be able to apply for Continuing Health Care funding. This is because any fault by the Council would not have caused a significant enough injustice to justify an investigation.

The complaint

1. Ms Y complains that a care home charged additional fees to Mrs X between 2022 and 2024. Ms Y says that, as a result, Mrs X wrongly paid over £8000 in additional fees.
2. Ms Y also complains the Council failed to notify Mrs X and her family that she may be eligible for Continuing Health Care funding. Mrs X therefore missed the opportunity to reduce her care home fees.

Back to top

The Ombudsman’s role and powers

3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
4. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect 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 an investigation if we decide the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)

Back to top

How I considered this complaint

5. I considered information provided by Ms Y and the Council.
6. I considered the Ombudsman’s Assessment Code.

Back to top

My assessment

7. Mrs X lived in a care home and initially arranged and paid for her own placement. In 2022 the Council commissioned Mrs X’s placement. Ms Y said the care home asked Mrs X to pay another fee of £100 per week. This was in addition to the rate agreed by the Council with the care home when it arranged her placement. The care home charged the additional fee until Mrs X sadly passed away in 2024.
8. Ms Y made a complaint to the Council about the care home charging the additional fee in February 2025. She then made a complaint to the Ombudsman in May 2025.
9. We will not investigate this complaint as it is late. Ms Y said she and her family were not aware that the Council had commissioned Mrs X’s place until 2024. The Council’s response to Ms Y’s complaint shows the family were aware of the additional fee in 2022 and queried it with the Council at that time. So, I am satisfied Ms Y was aware of the complaint more than 12 months before making the complaint to us. The fact that Ms Y was unaware the Council had commissioned Mrs X’s placement would not have prevented her from making a complaint to us sooner. I therefore do not consider there are good reasons to exercise our discretion to investigate the complaint.
10. Ms Y also said the Council did not tell Mrs X and her family that she may be eligible for Continuing Health Care (CHC) funding. We will not investigate this complaint. This is because we could not say, on balance, that any fault would have caused Mrs X a significant enough injustice to justify an investigation of the complaint. We cannot know if Mrs X would have been eligible for CHC funding.

Back to top

Investigator's decision on behalf of the Ombudsman