Summary: Mr W and Ms X complain about a Nursing Home unfairly charging their father, Mr Y, top-up fees after Wirral Metropolitan Borough Council and two NHS Trust’s jointly placed him on a ‘Discharge to Assess’ bed. We have decided to end our investigation. This is because the Council has agreed to provide a remedy which would resolve Mr W and Ms X’s complaint.

The complaint

1. Mr W and Ms X complain on behalf of their father, Mr Y. They complain about Wirral Council (the Council), Wirral University Teaching Hospital NHS Foundation Trust’s Integrated Discharge Team (IDT - a shared service with Wirral Community Health and Care NHS Foundation Trust) and Cheshire and Merseyside Integrated Care Board (the ICB).
2. The family say the Council and the IDT pressured the family to find a suitable Nursing Home to support their father on discharge to a Discharge to Assess bed in August 2021. The family also feel they should not have to pay the Nursing Home’s top-up fees until the Council and ICB assessed their father’s needs in November 2021.
3. The family would like the organisations to pay the top-up fees between August and November 2021. The organisations should carry out service improvements to avoid similar fault happening to others. The family also would like the organisations to apologise for the stress and time and trouble they suffered.

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The Ombudsmen’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. We can decide whether to start or discontinue an investigation into a complaint within our jurisdiction. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended)

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How I considered this complaint

5. I spoke to Mr W and considered information provided by him, Ms X and the organisations.
6. Mr W, Ms X and the Council had an opportunity to comment on my draft decision.

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What I found

7. Mr Y’s family were unhappy they had to pay a top-up charge to a Nursing Home in Wigan after the Council and IDT discharged Mr Y to a ‘Discharge to Assess’ (D2A) bed. D2A is a model for people who are medically fit to be discharged from acute hospitals into the community (either back home or to a 24‑hour bed-based setting). Health (for ICBs) or social care workers (for councils) then carry out assessments of those people in the community.
8. The Council paid Mr Y’s standard care fees for the Nursing Home in Wigan between August and November 2021. It also said the family needed to pay top-up fees to the Nursing Home.
9. In November 2021, the ICB assessed Mr Y’s needs and decided to fund part of his care, backdated to August.
10. In response to Mr W’s complaint, the Council said the family agreed the top‑up with the Nursing Home in Wigan. A Social Worker explained the top-up to the family, who confirmed they understood it. The Council said it offered alternative homes to the family with and without top-ups, but they decided to move Mr Y to a more expensive nursing home closer to them.
11. I agreed to investigate Mr W and Ms X’s complaint in February 2023. In response to my enquiries, the Council accepted it did not formally offer Mr Y’s family a placement in Wirral with or without a top-up charge. Because it did not do that, it agreed it should have paid the top-up charge at the Nursing Home in Wigan until the ICB conducted its assessment of Mr Y. The Council offered to repay the family the top-up fees they paid between August and November 2021. It also offered to send an apology letter and make a £200 payment to recognise the time and trouble Mr W suffered making his complaint.
12. The family accepted the Council’s offer which remedied their injustice.
13. I will end my investigation because the Council has agreed to provide an appropriate remedy which has resolved Mr W and Ms X’s complaint. I consider the Council’s offer is appropriate to remedy their claimed injustice.
14. I will not make any findings against the two Trusts or the ICB on this complaint. The Council was responsible for arranging the Nursing Home placement with the family on discharge from hospital. So, it was also responsible for remedying the claimed injustice. Therefore, I will not take further action on this complaint.

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Final decision

15. I have ended my investigation and uphold Mr W and Ms X’s complaint. The Council has agreed to take action which has resolved the outstanding issue and no further action by the Ombudsmen is needed.

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Investigator's decision on behalf of the Ombudsman