Summary: Mr X complained about the Council and ICB’s decision to charge a top-up fee for care home accommodation. He also complained about the quality of care provided to his mother by health and social care services and the care home. We will not investigate the charging complaint because there is not enough evidence of fault. We will not investigate the complaints about the care provided because the coroner will consider this as part of their inquest. Once the coroner’s inquest is complete, Mr X can ask us to look at this part of the complaint.

The complaint

1. Mr X complains about Stockport MBC (the Council), NHS Greater Manchester ICB (the ICB) and Borough Care Ltd (the Care Home). He complains about the arrangements after Mrs Y, his mother left hospital.
2. In particular Mr X complains about:
• Top-up charges for Mrs Y’s accommodation;
• Safeguarding and inadequate care at the Care Home; and
• Complaint handling by the Council.
3. Mr X says the faults caused Mrs Y and her family distress and jeopardised her safety and legal rights. He says Mrs Y should not have paid a top-up fee, so therefore there is also a financial injustice.
4. Mr X wants the Council to cancel the invoice for top-up fees and a safeguarding investigation to be reopened. He also wants the organisations to apologise.

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The Ombudsmen’s role and powers

5. 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).
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 we would find fault, or
• the injustice is not significant enough to justify our involvement, or
• there is another body better placed to consider this complaint.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

7. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start an investigation if they believe it would be reasonable to wait for the outcome of investigations or reviews by other organisations before considering a complaint. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

8. I considered evidence provided by Mr X and the organisations complained about as well as relevant law, policy and guidance.

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What I found

Brief background

9. Following a hospital admission, a change in Mrs Y’s needs meant she was going to move into a care home. Mrs Y was eligible for free aftercare (up to her personal budget). The Council provided Mrs Y and her family a list of suitable care homes it considered could meet Mrs Y’s needs.
10. Mrs Y’s choice of care home was over the personal budget, which meant this would need a top-up fee to be paid.
11. Mrs Y needed to be readmitted to hospital soon after she had moved into the Care Home.
12. Mr X complained to the Council on 17 October 2025 and the Council responded on 13 November.
13. Mrs Y died in late November 2025. In January 2026, the coroner opened an inquest into her death. The coroner set a final inquest hearing date for June 2026.

My assessment

14. The Council and the ICB funded Mrs Y’s care home placement under section 117 of the Mental Health Act. Under these arrangements a person has a personal budget for the accommodation. The Council is responsible for arranging the placement. It is required to provide a choice of accommodation and ensure at least one option is available and affordable within the person’s personal budget. However, a person must also be able to choose alternative options, including a more expensive setting, where the person is willing and able to pay the additional cost. This is called a ‘top-up’.
15. The Council provided Mrs Y with a list of available care home placements when she was getting ready to leave hospital. One of these placements was within budget, although others would have required a top-up to be paid. The Council explained this to Mrs Y and her family.
16. Mrs Y and her family did not consider the placement that was in budget was suitable because of issues with access to the bathroom and the Care Quality commission (CQC) rating.
17. Council’s do not rely solely on CQC ratings and have their own processes and checks to ensure placements are safe and can meet the needs of residents. If placements do not meet these standards, the Council would not commission them. If any of the facilities at the care home were a concern for Mrs Y or her family, this could have been considered. If the Council agreed this was unsuitable, it would have needed to identify an alternative placement within budget. However, the Council explained that at this point Mrs Y decided she preferred Shepley House and wanted to move there, even though she was aware this would be subject to a top-up.
18. The Council clarified that Mrs Y could understand and make this decision. Mr X has since questioned whether Mrs Y had the mental capacity, as this had been variable during her hospital admission.
19. The Mental Capacity Act 2005 (the MCA) applies to people who may lack mental capacity to make certain decisions. Under the MCA, individuals are presumed to have capacity unless there is proof to the contrary. Capacity is time and event specific.
20. The Council discussed this decision with Mrs Y and was satisfied she understood the decision she was making and that this would mean a top-up was payable. It was Mrs Y’s choice to move to the Care Home in the knowledge this would attract a top-up. I therefore consider we unlikely to find fault by the Council or the ICB about the decision to charge a top-up fee.
21. With regards to the Council’s complaint handling, I note Mr X chased the Council around two weeks after he complained. It accepted it had not acknowledged Mr X’s complaint and explained this was due to a misunderstanding. It had understood Council staff were arranging a meeting to resolve his concerns. The Council apologised and confirmed it would consider the complaint. The Council sent its response on 13 November.
22. The complaints procedure for health and adult social care complaints is set out in The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. This say organisations should acknowledge a complaint in 3 working days and investigate the complaint in a manner appropriate to resolve it speedily and efficiently. The Council’s own complaints procedure states it will try to respond to complaints within 20 working days.
23. Although the Council did not acknowledge the complaint until after Mr X followed this up, it explained the reasons for this and apologised. It also responded to the complaint within its target range. Therefore I do not consider the fault and injustice to be significant enough to warrant an Ombudsmen’s investigation into the Council’s complaint handling.
24. Mr X has also complained about safety concerns around Mrs Y’s hospital discharge, safeguarding investigations about Mrs Y’s care and the care while she was at the Care Home. The Coroner has confirmed they are undertaking an inquest into Mrs Y’s death. I consider this is likely to consider some or all of the issues raised about Mrs Y’s care and safety.
25. The Ombudsmen will therefore not continue to consider these complaints while the coroner’s investigation and SAR are open. This is because:
• the organisations could end up unnecessarily duplicating work;
• having to respond to more than one investigation at the same time could place an unreasonable burden on Council and Trust resources, affecting services to the public; and
• the outcomes of the coroner’s investigation may provide resolve the complaint, without the need for an investigation by the Ombudsmen.
26. Mr X can complain to us again if he has outstanding concerns once the coroner’s investigation is finished. We will then reconsider whether we can and should investigate his complaint.

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Decision

27. We will not investigate this complaint because there is insufficient evidence of fault with the decision to charge a top-up and no unremedied injustice from the Council’s complaint handling. We will not investigate Mr X’s complaints about Mrs Y’s care because it is reasonable to wait for the outcome of the coroner’s investigation. Mr X can resubmit this part of his complaint to the Ombudsmen if he has outstanding concerns after the conclusion the coroner’s investigation.

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Investigator's decision on behalf of the Ombudsman