The Ombudsman's final decision
Summary: We do not propose to investigate this complaint about the Council’s provision of information with regard to charging for residential care provision. This is because although there was fault by the Council, we do not consider it caused the injustice the complainant claims, and we cannot achieve his desired outcome.
The complaint
The complainant, who I refer to here as Mr H, says that the Council: Did not properly explain the top up fee that his mother agreed to when she entered residential care; Did not explain or discuss properly other options available; Overpaid the Care Provider, in error, for several years; and Refuses to investigate Mr H’s complaints about the quality of care his mother received at the Home.
The Ombudsman’s role and powers
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: any fault has not caused the claimed injustice to the person who complained, or we cannot achieve the outcome someone wants. (Local Government Act 1974, section 24A(6))
How I considered this complaint
I considered information provided by Mr H.
I considered the Ombudsman’s Assessment Code.
Mr H now has an opportunity to comment on my draft decision. I will consider his comments before making a final decision.
My assessment
When Mr H raised his complaint about the insufficient level of information provided by the Council, at the point where M entered residential care, the Council initially agreed that it could have explored other options more fully. It said that it had changed its procedures to ensure that better information was provided in future. Nonetheless, it did tell M and Mr H clearly there was a top up fee, which they agreed to, as M liked the setting and wanted to remain there. The council therefore rejected Mr H’s claim for £10,000 which he said would not have been spent if clearer information had been given.
The Council offered Mr H £250 as a time and trouble payment. He was not satisfied with this outcome and went back to the Council, expressing the view that as the Council had changed its procedures, it clearly acknowledged fault, which he felt had caused an unnecessary high level of payment.
The Council’s second response said that it had now realised that M had retained ownership of owned a property whilst in the Home and was actually a self-funder. The import of this information, is that rather than the Council paying care home fees with a top up from M, the real situation was that M’s estate was ultimately responsible for the entirety of any fee agreed with the Care Provider. Consequently, any explanation about top up fees and alternatives to them, would not have had any relevance.
The Council has apologised for providing insufficient and inaccurate information.
This is fault, but I do not consider it caused the injustice that Mr H claims. It is not possible to say that had the Council provided more information about other options M would have chosen a different Care Home, and I cannot achieve Mr H’s desired outcome of a £10,000 financial payment. The Council has repeated its offer of £250 as an apology for the time and trouble caused, and I regard this as acceptable.
With regard to the Council’s overpayment to the Care Provider, the situation has now been rectified and in any case, it did not cause M any injustice.
Finally, although Mr H has now raised concerns regarding the care M received at the Home, the Council points out that no concerns were raised at the time. I support the Council’s view that an investigation at this time would be unlikely to be effective or have a worthwhile outcome.
Final decision
Subject to any comments Mr H might make, my view is we should not investigate this complaint. This is because fault by the Council cannot be shown to have caused the claimed injustice, and we cannot achieve Mr H’s desired outcome.
Investigator's decision on behalf of the Ombudsman