Summary: We will not investigate this complaint about adult social care fees for a care home placement, including top-up fees. It is unlikely the Ombudsman would find evidence of fault. The Council has given a thorough explanation which we cannot add to. It is unlikely an Ombudsman investigation would achieve a different outcome.

The complaint

1. Mr B says the Council increased the care providers fee before the annual increase but did not reduce the top-up he pays. Mr B says the Council has paid the care provider more than the agreement. Mr B says this is unfair for anyone paying a top-up for care fees. Mr B wants the Council to change the way it charges for residential care.

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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, or
• we cannot achieve the outcome someone wants, or
• there is no worthwhile outcome achievable by our investigation.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

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

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My assessment

5. Mr B’s relative lived in a care home and paid a weekly contribution towards her care based on a financial assessment of what she could pay. The Council paid the care home the remaining amount up to its framework agreed rate for care. Mr B agreed to pay a weekly top-up for this care home.
6. Mr B says when the Council increased its framework rate it was before the contractual annual increase of care fees. Mr B says the care home should not have been paid more than stated in the contract. Mr B believes when the Council increased what it would pay it should have reduced his top up payment.
7. The Council has explained when it increased its framework rate it is because of inflation, and the care home is entitled to that increased fee before any annual review of fees. This is in line with the Council’s framework agreement with the care provider. This does not impact on the agreed top-up fee or any contractual arrangements with Mr B or his relative.
8. There is no evidence to suggest the care home has been overpaid, or that there is any injustice to Mr B or his relative. They have continued to pay the amounts they agreed or the Council assessed the resident was able to pay.

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Final decision

9. We will not investigate Mr B’s complaint because there is not enough evidence of fault or injustice. We would not add to the Council’s investigation or reach a different outcome.

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Investigator's decision on behalf of the Ombudsman