Summary: We will not investigate Miss X’s complaint about the care fees paid by her mother Mrs X to the Care Provider being higher than its fee now agreed with the Council for the same placement. There is not enough evidence of fault by the Care Provider to warrant an investigation and investigation would not achieve a different outcome.

The complaint

1. Mrs X lives in a private care home and did so for several years as a self‑funder. Her daughter Miss X says Mrs X’s funds recently fell below the savings threshold of £23,250 and the local authority has now taken over the funding of Mrs X’s placement at the same home.
2. Miss X complains the Care Provider charged Mrs X at a much higher rate for the care placement than the Council is now paying.
3. Miss X says the fee difference shocked her and unsatisfactory answers from the Care Provider caused her frustration. Miss X says Mrs X has depleted her money, which upsets Miss X. Miss X feels Mrs X has been discriminated against as someone who saved for her future.
4. Miss X wants:
• all residents to pay the same fees, whether self-funding or not;
• the Care Provider to make families aware if there must be variations in the fees;
• self-funder fees to stop subsidising Council placements.

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The Ombudsman’s role and powers

5. 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)
6. 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 it is unlikely further investigation will lead to a different outcome. (Local Government Act 1974, sections 34B(8) and (9))

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How I considered this complaint

7. I considered information from Miss X, and the Ombudsman’s Assessment Code.

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My assessment

8. Miss X’s complaint is that Mrs X was charged more for her placement when compared with the fee now being paid for it by the Council. But the fee charged by the Care Provider when Mrs X was a self-funder formed part of the contract between her or her representatives and the Provider. They entered into that contract and agreed the Provider’s rate. There is not enough evidence of fault by the Care Provider in agreeing the care fee for Mrs X’s placement under the signed contract terms to warrant us investigating. We cannot go behind that contract now and say the agreed payment terms were fault by the Care Provider, so investigation would not achieve any different outcome.

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Final decision

9. We will not investigate Miss X’s complaint because:
• there is not enough evidence of fault by the Care Provider to warrant an investigation; and
• investigation would not achieve a different outcome.

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Investigator's decision on behalf of the Ombudsman