Summary: We will not investigate this complaint about the Council’s refusal to repay the family for fees incurred for providing extra care when his mother had suspected COVID-19. There is not enough evidence of fault to justify investigating.

The complaint

1. Mr X complains for his mother, Mrs Y. He says the Council refuses to repay the family for the fees they incurred after arranging for extra care for Mrs Y when she suffered a suspected case of COVID 19.

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The Ombudsman’s role and powers

2. The Ombudsman investigates 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 may decide not to continue with an investigation if we decide there is not enough evidence of fault to justify investigating.

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

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How I considered this complaint

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

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My assessment

5. Mr X is asking the Council to pay him for extra care the family commissioned during April and May 2020. This was because his mother was unwell with suspected COVID 19, a chest infection and a urine infection and needed extra care.
6. The Government has published guidance on accessing emergency funding from the local authority to ensure people receiving direct payments receive the care and support they need. This says:

“During this time, we understand there may be additional and unanticipated costs to your care and support. There may be occasions where you therefore need to request additional funding in an emergency because you do not have enough money to cover these additional costs and receive the care and support you need. In these circumstances you should discuss this need with your LA or CCG immediately, who will consider this. Requests for additional emergency funding to prevent care breaking down will be prioritised, and LAs and CCGs should respond to any request as quickly as possible to ensure the care and support you need, is given.”

7. Mr X says he was not aware that extra funding was available. Therefore, they did not ask the Council until they discovered this was possible.
8. When the Council assessed Mrs Y, completed the care plan, and set up direct payments, it would have explained that she should contact the Council for a reassessment if her needs changed.
9. The Council completed a reassessment for Mrs Y in May 2020 and the family did not advise of any changes in Mrs Y’s needs. Nor were any extra needs mentioned when the signed review document was returned to the Council in June 2020 and the Council was not told the family had privately arranged extra care for Mrs Y.
10. I understand Mr X says he was not aware emergency funding was available and therefore had not asked for help when Mrs Y became ill. However, it was open for him to have made the Council aware that Mrs Y’s needs had changed. He did not. I see no fault in the Council’s decision not to repay Mr X retrospectively.

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Final decision

11. I will not investigate this complaint. This is because there is insufficient evidence of fault in the Council’s actions to warrant investigating.

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Investigator's decision on behalf of the Ombudsman