Summary: We will not investigate this complaint about matters that occurred at a care home. This is because, the substantive matter; the outcome of a Funded Nursing Care Assessment is an NHS responsibility. Therefore, another body is better placed to investigate the matter.

The complaint

1. Mrs X complained on behalf of her grandmother, Mrs Y about matters that occurred at her care home. She said:
• The Funded Nursing Care (FNC) assessment carried out for Mrs Y was inaccurate.
• The home did not gain consent to undertake the assessment.
• The care home increased Mrs Y’s fees even though she was not eligible for FNC.
• There were safeguarding issues relating to Mrs Y wearing other residents’ glasses and obtaining unexplained injuries.
2. Mrs X said the situation has caused her and her family stress and upset.
3. Mrs X wants the care home to improve its communication methods, management and leadership. She also believes the care home should investigate its registered nurses’ experience.

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The Ombudsman’s role and powers

4. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)

We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe there is another body better placed to consider this complaint. (Local Government Act 1974, sections 34B(8) and (9))

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How I considered this complaint

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

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My assessment

7. The NHS is responsible for meeting the cost of care provided by registered nurses to residents in all types of care homes. Council funded and self-funding residents who need to move into care homes with nursing should have a comprehensive assessment to identify any nursing needs, including the possible need for NHS-funded continuing healthcare (CHC) or for NHS-funded nursing care (FNC).
8. A registered nurse carried out a FNC assessment of Mrs Y. The NHS not the care home is responsible for the assessment. The Parliamentary and Health Care Ombudsman (PHSO) investigates complaints made about NHS services. Therefore, I will not investigate this matter.
9. I will not investigate the other issues raised by Mrs X as the substantive issue is out of our jurisdiction.

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Final decision

10. We will not investigate Mrs X’s complaint because another body is better placed to investigate the matter.

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Investigator's decision on behalf of the Ombudsman