Summary: We will not investigate this complaint about the Council not meeting the complainant’s health needs because we are unlikely to find fault with the Council’s actions.

The complaint

1. Miss A complains that her health needs are not being properly met since her care transferred to North Lincolnshire Council (the Council). She says the Council should be working with health services to provide the care she needs. Miss A says the failings have left her with insufficient support to meet her health needs, causing her anxiety and putting her at risk of harm.

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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 or may decide not to continue with an investigation if we decide there is not enough evidence of fault to justify investigating, or we cannot achieve the outcome someone wants.

(Local Government Act 1974, section 24A(6))

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How I considered this complaint

3. I considered information provided by Miss A and the Council.
4. I considered the Ombudsman’s Assessment Code.
5. The complainant had an opportunity to comment on my draft decision before the final decision statement was completed.

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My assessment

6. Miss A previously had her mental health care provided by a combined health and social care enterprise service. After moving home, it transferred her care to the Council in 2018 because she was then resident in the Council’s area.
7. The Council completed a social care needs assessment and sent a Continuing Healthcare (CHC) checklist to the local Integrated Care Board (ICB - previously known as Clinical Commissioning Groups). The ICB declined CHC funding.
8. The Council continued to provide social care and when completed an annual review in 2022, it completed another CHC checklist because Miss A felt she had unmet health needs. The ICB declined CHC funding again because her health needs had not changed since its previous decision.
9. The Council’s responsibility on Miss A’s move into the area was to provide social care and support her to other services, including health care, where indicated. As noted above, the Council completed a CHC checklist on two occasions and has also provided advice to Miss A about seeking access to health services through her GP and local NHS mental health team. There has been no complaint about the social care provision from the Council.
10. The Council appears to have met its duties in providing social care to meet Miss A’s assessed needs. It has also supported her to try to access health services. If Miss A considers health organisations are not providing her with suitable support, she would need to complain to the relevant NHS organisation/s. There is no evidence of fault in how the Council considered Miss A's health needs in the context of it meeting her social care needs.

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Final decision

11. My view is we should not investigate this complaint. This is because we would be unlikely to find fault with the Council’s actions.

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Investigator's decision on behalf of the Ombudsman