Summary: We will not investigate this complaint about funding of adult social care. There is not enough evidence of fault to justify investigating and further investigation would not lead to a different outcome.

The complaint

1. Mr X complained the Council incorrectly charged him a third-party top-up fee when there was no option of an alternative placement. He said the top up agreement was signed under duress. Mr X said the Council incorrectly charged during a 12-week property disregard. He said this had a large impact on his family having to pay unlawful charges. He wanted the top-up charges to be waived, compensation and an apology.

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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
• further investigation would not lead to a different outcome

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

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How I considered this complaint

3. I considered information provided by Mr X and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. Mr X’s relative, Mr Y was discharged from hospital in September 2025 to a care home.
6. Mr X complained the Council incorrectly charged him a third-party top-up fee for Mr Y’s care during a 12-week property disregard period. Mr X said there was no suitable alternative care home available for Mr Y, and therefore the top-up fee should not have been charged.
7. In its complaint response, the Council said it had explored several alternative care homes that were suitable for Mr Y and could meet his cultural and care needs. The Council confirmed there was a placement available for Mr Y, but the family had expressed a preference for an alternative care home.
8. In its complaint response, the Council told Mr X the 12-week property disregard applied when someone moved into permanent residential care and owned a property that would normally be included in their financial assessment. The value of their main home is ignored for the first 12 weeks of their stay. As Mr Y owned a property, the value of the property was taken into account after the 12-week disregard ended in November 2025 and the Council were no longer involved in funding Mr Y’s care.
9. The Council said it would take religious and cultural needs into account when planning care, however it must also ensure that arrangements were suitable and affordable within the personal budget. The charges at the preferred care home were higher than Mr Y’s personal budget. Therefore, Mr X’s family were asked to sign a third-party top-up agreement to cover the additional charges.
10. In its complaint response, the Council confirmed that it had factored Mr Y’s cultural and religious needs into his care planning. It said it also considered Mr X’s family’s preferences and whilst the preference was acknowledged, it was not an integral part of Mr Y’s assessed eligible care needs. The Council said it had a statutory duty to balance individual wishes with the need to provide care that was suitable, affordable and sustainable for all residents.
11. We will not investigate this part of the complaint because there is not enough evidence of fault to justify investigating. The Council confirmed it had explored alternative care homes which would be suitable for Mr Y before pursuing a top-up arrangement for the family’s preferred care home. The Council explained how it had factored Mr Y’s cultural and religious needs into the care planning process.
12. Mr X also said the third-party top-up agreement was signed under duress because the Council only provided 2 hours to sign the agreement.
13. In its complaint response, the Council said it did not agree the the top-up agreement had been signed in duress. It told Mr X it had provided the family with information about third party top-ups several weeks before the agreement was signed. The Council said this provided Mr X’s family with the opportunity to consider their options. The Council told Mr X any sense of urgency in its correspondence about the top-up agreement was due to Mr Y’s imminent discharge from hospital.
14. We will not investigate this part of the complaint because there is not enough evidence of fault to justify investigating. The Council provided Mr X’s family with information about third party top-ups weeks before the agreement was signed.
15. Mr X also complained he was not present at Mr Y’s Continuing Healthcare (CHC) assessment. In its complaint response, the Council acknowledged there had been communication issues before the CHC assessment. It said it would raise this matter as a learning point with the team involved.
16. We will not investigate this part of the complaint because further investigation would not lead to a different outcome. The Council has taken steps to prevent the matter recurring.

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Final decision

17. We will not investigate Mr X’s complaint because there is not enough evidence of fault to justify investigating and further investigation would not lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman