Summary: We will not investigate this complaint about the Council charging care fees for a period as there is insufficient evidence of fault to justify an investigation. We have upheld Mrs X’s complaint about the Council’s delay in responding to her emails about the charges. The Council has agreed to provide a proportionate remedy for the distress caused to Mrs X.

The complaint

1. Mrs X complained that the Council:

• Wrongly charged care home fees to Mrs Y for the period 9 January to 4 February 2025 despite the Integrated Care Board advising that Mrs Y would not be charged while waiting for a Decision Support Tool assessment. Mrs X says the Council is wrongly seeking recovery of care fees from Mrs Y’s estate.
• Delayed in responding to Mrs X’s emails about the charges which caused significant distress and uncertainty to her.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. 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)
3. 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))
4. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended).

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How I considered this complaint

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

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My assessment

7. Mrs Y moved into a care home following a period in hospital. Mrs Y’s care was initially funded by Discharge 2 Assess (D2A) funding. The Council commissioned Mrs Y's care from 9 January 2025 when the D2A funding ended.
8. On 4 February 2025, the Council and NHS carried out a decision support tool assessment (DST) for Mrs Y to determine if she was eligible for NHS continuing health care (CHC) funding. Mrs Y was not eligible for CHC funding.
9. The Council sent invoices to Mrs X for Mrs Y’s care fees between 9 January and 4 February 2025. Mrs X asked the Council to explain why it had charged Mrs Y for care fees during this period. Mrs X said the Integrated Care Board (ICB) told her Mrs Y would not be charged until it carried out the DST assessment. The Council did not explain the charges to Mrs X for approximately three months.
10. We will not investigate Mrs X’s complaint that the Council charged Mrs Y for her care fees between 9 January to 4 February 2025. A council is entitled to charge for care except where it is required to arrange care without charge. Mrs Y was not eligible for CHC funding so the Council was entitled to charge her from 9 January 2025 when the D2A funding ended. So, there is insufficient evidence of fault by the Council to justify an investigation.
11. We are mindful that the ICB may have advised Mrs X that Mrs Y would not have to pay any fees until the DST assessment was carried out. But this is not evidence of fault by the Council. As stated above, the Council was entitled to charge Mrs Y before the DST assessment was carried out as she was not eligible for CHC funding.
12. It is likely we would find fault if we were to investigate Mrs X’s complaint about the Council’s delay in responding to her emails about the charges. The Council took approximately three months to explain the charges to Mrs X. This delay will have caused significant distress to Mrs X. She had to repeatedly chased the Council for a response and she was not aware of the reasons for the charges for a prolonged period of time. The delays also occurred at a difficult time for Mrs X.
13. We therefore asked the Council to consider remedying the injustice caused to Mrs X by apologising and making a symbolic payment of £150 to acknowledge the distress caused. This remedy is in accordance with our guidance on remedies.

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Agreed Action

14. The Council agreed to send a written apology and make a symbolic payment of £150 to Mrs X to acknowledge the distress caused to her by the delay in explaining the care charges to her. The Council will take this action within one month of this final decision.

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Final decision

15. We will not investigate Mrs X’s complaint about the Council’s decision to charge Mrs Y for her care between 9 January and 4 February 2025. There is insufficient evidence of fault to justify an investigation. We have upheld Mrs X’s complaint about the Council’s delay in explaining the care charges to her because the Council has agreed to resolve the complaint early by providing a proportionate remedy.

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Investigator's decision on behalf of the Ombudsman