Summary: The Ombudsman will not investigate Mr X’s complaint. The Ombudsman is unlikely to find fault with Buckinghamshire County Council’s decision to stop providing Mr X with a care package for his social care needs.

The complaint

1. Mr X says Buckinghamshire County Council (the Council) stopped his care package and direct payments which were meeting his social care and wellbeing needs. Therefore, the Council has not been meeting his social care and wellbeing needs since 1 June 2019. Mr X says this has led him to attempt suicide and his mental health has suffered. Mr X would like the Council to reinstate his direct payments and backdate them to 1 June 2019. He would also like compensation for the distress events have caused him and his wife.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. 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.
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I considered information Mr X provided in writing and by telephone. This includes documents by the organisations complained about. I have also written to Mr X with my draft decision and considered their comments.

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What I found

Key facts

5. The Council previously paid Mr X a direct payment to meet his social care needs. Mr X used that payment to attend a Jewish mental health service, sports events and for cultural activities.
6. In April 2019 the Local Government and Social Care Ombudsman and Parliamentary and Health Service Ombudsman’s (PHSO) joint working team completed its investigation into a previous complaint by Mr X. The Ombudsmen recommended the Council and Oxford Health NHS Foundation Trust (the Trust) complete a social care/continuing health care (CHC) assessment to understand Mr X’s needs.
7. In May 2019 Mr X accepted a managed personal health budget from the Trust after its CHC assessment found he had a primary health need. The Council also told Mr X because he had a primary health need it did not have a legal duty to provide a direct payment to him.
8. In response to Mr X’s complaint, the Trust (who provides the CHC service on behalf of a clinical commissioning group [CCG]) told Mr X he would not receive a direct payment on top of the personal health budget. The Trust’s personal health budget meets Mr X’s health and associated care needs. He has 63 hours support a week to use flexibly to manage his social care needs.
9. In July 2019, the Trust also told Mr X he could appeal any decision about CHC if his needs had changed.

Analysis

10. The Department of Health’s National Framework for NHS Continuing Healthcare and NHS‑funded Nursing Care (November 2012 (Revised)) (the National Framework) is the key guidance about Continuing Healthcare.
11. Paragraph 172 of the National Framework states: “Where a person qualifies for NHS Continuing Healthcare, the package to be provided is that which the CCG assesses is appropriate to meet all of the individual’s assessed health and associated care and support needs. The CCG has responsibility for ensuring this is the case, and determining what the appropriate care package should be. In doing so, the CCG should have due regard to the individual’s wishes and preferred outcomes. Although the CCG is not bound by the views of the local authority on what services the individual requires, any local authority assessment under the Care Act 2014 will be important in identifying the individual’s needs and in some cases the options for meeting them”.
12. I do not consider I am likely to find fault with the Council’s decision to stop Mr X’s care package and direct payments. Once the Trust said Mr X had a primary health need, it became responsible for meeting that primary health need, plus any associated social care needs. As the National Framework states above, during the care planning stage the Trust should consider the needs the Council identified in its assessments under the Care Act 2014.

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Final decision

13. I consider the Ombudsman should not investigate this complaint. I do not consider I am likely to find fault with the Council’s actions.

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Investigator's decision on behalf of the Ombudsman