Summary: We will not investigate this complaint about financial assessment for contribution toward adult social care costs. The Council has followed the correct law, guidance and policy to make its decision. So, it is unlikely we would find evidence of fault, even though the complainant disagrees with the Council’s decision. An investigation is unlikely to add to the Council’s investigation or reach a different outcome.

The complaint

1. Ms B said the Council failed to properly complete the financial assessment for Mr C. Ms B said Mr C cannot afford the contribution to his adult social care. This is stressful and Mr C is reducing his care support because of cost. Ms B wants the Council to reconsider.

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The Ombudsman’s role and powers

2. 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) and 34C(2), as amended)

3. We have accepted Ms B as a suitable representative for Mr C.
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, 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))

5. 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

6. I considered information provided by the complainant and the Council.
7. I considered the Ombudsman’s Assessment Code.

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My assessment

8. When the Council arranges adult social care, it must each year complete a financial assessment to decide what, if anything, the person must pay toward their care. Central government set the rules of how the Council must complete the financial assessment and the Council will also have its own policy.
9. The financial assessment will also consider any disability related expenditure. This is extra, necessary costs incurred because of a disability or illness, not covered by the NHS or social services. For example, higher than average heating costs. You will need to evidence your spending for the Council to consider allowing the cost.
10. You can appeal against the Council’s decision if you feel it is not correct. The Council then reviews the financial assessment and confirms the outcome.
11. The Ombudsman is not an appeal body. We cannot challenge the Council’s decision unless there is fault in its decision making. In this case, I am satisfied the Council has considered the relevant law, guidance and policy when completing Mr C’s financial assessment for contribution toward his adult social care costs.
12. The Council has considered items Mr C sought as disability related expenditure and explained its reasons why it will or will not allow them. I understand Ms B disagrees and is concerned by Mr C’s financial situation. However, this is not evidence of fault in the Council’s decision or the way it has investigated

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Final decision

13. We will not investigate Ms B’s complaint because there is not enough evidence of fault by the Council. It followed the correct process to make its decision, and to consider it at appeal. We cannot question or criticise the decision even though Ms B disagrees with it.

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Investigator's decision on behalf of the Ombudsman