Summary: We will not investigate this complaint about quality of a domiciliary care package and lack of clarity about how the care would be funded. We could not achieve a more meaningful outcome by investigating the matter now, and there is insufficient evidence of fault in the Council’s actions.

The complaint

1. Mrs X complained about the standard of care provided to her father (Mr Y) and a lack of clarity over funding. She said the family were told Mr Y was receiving free reablement care, but later found out this was not the case. Concerns about the care provider included issues with medication, Mr Y’s wife (Mrs Y) having to tell carers what tasks were required, poor record-keeping, and unsuitable timings of visits.
2. Mrs X said this caused a financial impact for the family, who received an invoice for £5,892, and significant distress. She said Mr Y’s needs were at times not met. She wanted the Council to waive some of Mr Y’s charges.

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The Ombudsman’s role and powers

3. 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, or
• we cannot achieve the outcome someone wants, or
• there is no worthwhile outcome achievable by our investigation.

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

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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.

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My assessment

Quality of care

6. Mrs X and Mrs Y complained to the Care Provider about several issues relating to Mr Y’s care at home. They asked it to refund 50% of Mr Y’s care fees.
7. The Care Provider accepted in its complaint response that there had been some issues with a lack of communication when carers were running late, information about how to access Mr Y’s care plans via an app, and in its complaint-handling. The Care Provider apologised for this and offered to refund the family the costs of 23 care calls that had been significantly later than expected. It explained changes it had made to its processes and staffing to avoid similar issues arising in future.
8. Any injustice resulting from poor-quality care would have been mostly to Mr Y, who has since died. When someone has died, it is not possible for us to remedy injustice such as distress or discomfort they may have experienced.
9. We would not normally recommend a refund to a person’s estate unless fault had caused a quantifiable financial injustice. There is not a quantifiable financial injustice in this case, because but for any fault we may find if we investigated,
   Mr Y would still have paid for his care.
10. If we investigated this complaint, we instead would likely decide any injustice resulting from fault, requiring a remedy, was some distress and inconvenience for Mrs Y. We may have recommended a symbolic financial remedy, in line with our Guidance on Remedies, which would not be dissimilar to the amount the Care Provider offered to refund. We could not therefore achieve a more meaningful outcome by investigating the matter further.

Communication about funding for care

11. Mrs X and Mrs Y complained to the Council about a lack of clarity regarding how
    Mr Y’s domiciliary care would be funded. They say they were given the impression Mr Y would receive four weeks’ free reablement care before any paid package would start. However, they then received an invoice which included charges for the first four weeks of care, which they asked the Council to waive.
12. If we investigated this complaint, it is unlikely we would find fault in the Council’s actions. The Council explained in its complaint response why Mr Y would not have been eligible for free reablement care, and that is a decision it was entitled to make. There is no substantive evidence that indicated the family were told Mr Y would receive reablement care. The Council provided information to the family about charging and financial assessments.
13. While Mrs X says she would not have been aware of the existence of reablement care were it not for her having been told Mr Y would receive it, we simply could not come to any sound conclusions about verbal conversations now. There is insufficient evidence of fault by the Council.

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Final decision

14. We will not investigate Mrs X’s complaint because we could not achieve a more meaningful outcome by doing so, and there is insufficient evidence of fault in the Council’s actions.

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Investigator's decision on behalf of the Ombudsman