Summary: We will not investigate Mrs X’s complaint about the Council’s and NHS Trust’s decisions and communication about charges for a care placement after her mother, Mrs Y, was discharged from hospital. We found no indications of fault by the organisations with the decisions. The Trust did accept it could have given more notice on the day Mrs Y left hospital to a care home and it apologised for any distress. We are unlikely to achieve a different outcome by investigating.

The complaint

1. Mrs X complains about London Borough of Havering (the Council) and Barking, Havering and Redbridge University Hospitals NHS Trust (the Trust). She complains the Council charged her mother, Mrs Y, for her care after the Trust discharged her from hospital into a Care Home in August 2023. Mrs X says she was told the care would be free for up to four weeks. Mrs X also complains that the Trust only gave her 30 minutes notice before it discharged Mrs Y from hospital.
2. Mrs X says the unexpected charges on top of the worry about her mother’s health has caused her distress. She wants the Council to cancel the charges and for the organisations to provide better information to relatives about discharges from hospital.

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The Ombudsmen’s role and powers

3. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
4. 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 we would find fault, the injustice is not significant enough to justify our involvement, or it is unlikely we could add to any previous investigation by the bodies.
5. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something an organisation has done. (Local Government Act 1974, sections 26B and 34D, as amended, and Health Service Commissioners Act 1993, section 9(4).)

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How I considered this complaint

6. I considered evidence provided by Mrs X, the Council and the Trust, as well as relevant law, policy and guidance.
7. Mrs X had an opportunity to comment on my draft decision. I consider her comments before reaching my final decision.

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What I found

Brief background

8. Mrs Y went into hospital following a fall in August 2023. When she was medically ready to leave hospital, the Trust followed its discharge to assess pathway and moved Mrs Y to a Care Home placement for assessment of her longer term needs. Mrs X says staff told her the placement would be free for up to four weeks, however, the Council later invoiced Mrs Y for the time she was in the Care Home.
9. Mrs X complained to the Council then brought her complaint to the Ombudsmen in December 2023. At this point the Trust had not completed its complaints procedure so we closed our case. The Trust responded in November 2024, however Mrs X did not receive this. She followed this up with the Trust and it resent the response in August 2025. Mrs X then brought her complaint back to the Ombudsmen.

My assessment

10. The complaint concerns events that happened, and the complainant had awareness of, more than 12 months ago. This is therefore late. However, Mrs X did not receive the Trust’s response. She has explained she did not follow this up sooner because she has had health problems and other personal issues to deal with during this time. Having considered these issues, I am satisfied it would have been difficult for Mrs X to complain sooner and we have exercised discretion to consider her complaint.
11. Mrs X says that hospital staff told her Mrs Y’s Care Home accommodation would be free for up to four weeks when she left hospital. The Trust and the Council complaint responses said they explained the placement would be chargeable from day one.
12. The Council and the Trust follow a Discharge to Assess pathway. Under this pathway, patients ready to leave hospital but are not well enough to return to their own home (but do not have identified nursing needs), are discharged into a residential home. They will receive extra support and further assessment. The Council identify a suitable care home. This is chargeable from the day of discharge from hospital and subject to a financial assessment. If someone still has nursing needs, they will be discharged to a nursing home and will receive a financial contribution.
13. Mrs Y’s medical records show an Occupational Therapist (OT) assessed her when she was medically ready to leave hospital. This assessment did not identify Mrs Y had nursing needs. The records show the OT spoke to Mrs X about Mrs Y’s ability to manage at home and they agreed she needed extra support. The OT explained to Mrs X that Mrs Y did not have nursing needs and she should be discharged to a residential care home for further assessment. The OT also advised Mrs X this placement would be chargeable from day one. The records show Mrs X did not agree with the decision, but it was discussed and the OT repeated the information a few days later.
14. The Council’s records show it contacted Mrs X by telephone while Mrs Y was still in hospital. It provided “basic financial information” and “placement can be charged from date of discharge dependent on outcome of financial assessment.” The Council also sent financial information to Mrs X by post.
15. The Council emailed Mrs X shortly after Mrs Y’ left hospital. It confirmed the placement was chargeable from day one and that Mrs Y would be a self-funder as she had savings over the upper capital limit.
16. The records show the Trust and the Council independently explained to Mrs X that Mrs Y’s care home placement would be chargeable. This was in line with local policy. I have therefore not seen indications of fault by the Trust nor the Council about the decision to charge Mrs Y for her care home placement, or with the communication about this.
17. The Trust accepted there was little notice when Mrs Y moved to the care home and apologised it did not give more notice. The Trust’s complaint response explained Mrs Y’s discharge pathway was a “no choice” pathway and that when places become available, confirmation can happen the same day. It explained its usual process was to tell a patient’s next of kin about discharge arrangements earlier.
18. I recognise Mrs X was caused some distress by the short notice. However, the records show the Trust discussed Mrs Y’s hospital discharge plan with Mrs X in the days before this happened. The Trust said it would normally give more notice if possible, but it needed to move quickly when a place became available. The Trust acknowledged the distress this caused and apologised to Mrs X. I consider this is a proportionate outcome and we are unlikely to achieve more by investigating.

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Decision

19. We will not investigate this complaint. This is because there are no indications of fault by the Council or the Trust with the discharge pathway. We are also unlikely to achieve a different outcome to the complaint about the notice given before Mrs Y’s discharge from hospital.

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Investigator's decision on behalf of the Ombudsman