Summary: We will not investigate this complaint about an adult social care financial assessment. This is because there is insufficient evidence of fault.

The complaint

1. Mr X complained the Council has refused to include some daily living costs as Disability Related Expenditure (DRE) when calculating his relative, Mr Y’s, required contribution towards his care. He says this has caused distress and financial loss. He also complains of poor complaints handling. He wants the Council to review the financial assessment and include the disputed items as DRE.

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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))
3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)

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How I considered this complaint

4. I considered information provided by the complainant and the Council.
5. I considered the Ombudsman’s Assessment Code.
6. I considered the Care and Support Statutory Guidance.

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My assessment

7. Where a council is providing adult social care and support, it can charge the person for the service. The council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
8. Where a council has decided to charge for care, it must carry out a financial assessment to decide what the person can afford to pay.
9. Councils can take Disability Related Expenditure (DRE) into account when calculating how much someone should pay towards their care. There is no set list of what councils should accept as DRE, but the Care and Support Statutory Guidance sets out a list of examples of such expenditure. The guidance also says councils may also adopt a policy not to accept certain items as DRE, where there is a reasonable alternative at a lesser cost.
10. The Council’s policy says requests for DRE that are health-related and are the responsibility of or can be provided by the NHS are unlikely to be approved.
11. Mr X requested the Council allow for certain personal care items to be allowed as DRE for Mr Y. The Council considered the request but did not approve these, on the grounds they were health-related costs. It advised Mr X to approach the NHS to request funding for these.
12. The Council must have regard to the statutory guidance in its decision making but has discretion to decide what it will or will not allow as DRE. Although Mr X does not agree with the Council’s decision, there is no evidence of fault in how it considered his request. The decision is in line with its policy and one the Council is entitled to make. There is insufficient evidence of fault to warrant further investigation.
13. Mr X also complains about poor communication and delay responding to his complaint. We will not investigate this as it is not a good use of public resources to investigate complaints about complaint procedures, if we are unable to deal with the substantive issue.

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Final decision

14. We will not investigate Mr X’s complaint because there is insufficient evidence of fault.

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Investigator's decision on behalf of the Ombudsman