Summary: We will not investigate this complaint about the Council allowing a resident’s arrears to accrue to £52000 before agreeing to step in and fund the placement, and for only agreeing to fund the placement at the Council’s rate. This is because there is insufficient evidence of fault.

The complaint

1. Miss X complains the Council allowed a resident’s arrears to accrue to £52000 before it agreed to step in and fund the care placement. She also complains the Council only agreed to fund the resident’s placement at the Council’s rate, instead of the private rate.

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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 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 complainant.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. The Council explained to Miss X that it only agreed to fund the resident from November 2022 onwards, under a deferred payment scheme. The Council said the resident was responsible for paying any fees prior to this date as the resident would have agreed a private agreement/contract for services. The Council told Miss X the care home needed to pursue the resident and/or their representatives for the outstanding debt.
6. An investigation is not justified as we are not likely to find fault. This is because the resident entered a private arrangement with the care home and the Council has no responsibility to pay for the debt accrued by the resident prior to the date it agreed to provide funding under a deferred payment scheme.
7. The deferred payment scheme was designed to help residents in care homes who have been assessed as having to pay the full cost of their residential care due to ownership of property/land and have savings of less than £23250. In these cases, residents are often unable to make payments for their care in full as their capital is tied up in their property/land. Councils will only fund up the cost needed to meet the person’s needs. This means if there is a care home that can provide a placement that meets the resident’s needs at a particular cost, this will be the amount the Council will fund. If an individual wants a more expensive placement, they will need to agree a third party top up.
8. Therefore, we are not likely to find fault with the Council for only agreeing to fund the resident’s placement at the Council’s rate as it is likely there were placements available that could meet the resident’s need at that rate.

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Final decision

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

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Investigator's decision on behalf of the Ombudsman