Summary: We will not investigate Mrs X’s complaint about the therapeutic support she received at a privately funded residential unit. That is because we have no jurisdiction to investigate her substantive complaint.

The complaint

1. Mrs X complained about the therapeutic support she received whilst she was resident at a privately funded rehabilitative unit (the Unit). She said she was mis-sold the service; did not receive the amount of physiotherapy support expected and could not use the main physiotherapy facilities.
2. Mrs X also complained the care staff delayed in responding to the call bell when she required assistance with using the toilet.
3. Mrs X said she had not made the progress she had anticipated and wanted a partial reimbursement of the fees paid to enable her to source further physiotherapy support.

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The Ombudsman’s role and powers

4. Part 3 and Part 3A of the Local Government Act 1974 give us our powers to investigate adult social care complaints. Part 3 is for complaints where local councils provide services themselves. It also applies where a council arranges or commissions care services from a provider, even if the council charges the person receiving the care. In these cases, we treat the provider’s actions as if they were council actions. Part 3A is for complaints about care bought directly from a care provider by the person who needs it or their representative, and includes care funded privately or with direct payments using a personal budget. (Part 3 and Part 3A Local Government Act 1974; section 25(6) & (7) of the Act)
5. 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 further investigation would not lead to a different outcome. (Local Government Act 1974, section 24A(6))

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How I considered this complaint

6. I considered information provided by the complainant and the Care Provider.
7. I considered the Ombudsman’s Assessment Code.

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My assessment

8. The Ombudsman can investigate complaints about privately funded care, where the actions complained of relate to social care as defined by the Health and Social Care Act 2008 (the Act). These are “all forms of personal care and other practical assistance provided for individuals who by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances, are in need of such care or other assistance.”
9. Mrs X’s substantive complaint is about the amount of physiotherapy she received and lack of access to the main physiotherapy facilities at the Unit. These services were not provided to meet a social care need as defined by the Act, therefore we have no jurisdiction to investigate.
10. Mrs X does require support with personal care and transfers. In the Unit’s response to Mrs X’s complaint about delays in answering the call bell, it identified three occasions where it had left Mrs X for over an hour. It apologised for this and said it had reminded staff about the need to respond promptly to call bells. Although Mrs X disagrees with the number of times the Unit delayed in responding to her, we will not investigate this complaint further. Any investigation by the Ombudsman is unlikely to lead to a different outcome and the Unit has apologised, therefore there is no outstanding injustice.

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Final decision

11. We will not investigate Mrs X’s complaint because the substantive issues are outside our jurisdiction.

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Investigator's decision on behalf of the Ombudsman